How stories can contribute towards quality improvement in long-term care

It is important to evaluate how residents, their significant others and professional caregivers experience life in a nursing home in order to improve quality of care based on their needs and wishes. Narratives are a promising method to assess this experienced quality of care as they enable a rich understanding, reflection and learning. In the Netherlands, narratives are becoming a more substantial element within the quality improvement cycle of nursing homes. The added value of using narrative methods is that they provide space to share experiences, identify dilemmas in care provision, and provide rich information for quality improvements. The use of narratives in practice, however, can also be challenging as this requires effective guidance on how to learn from this data, incorporation of the narrative method in the organizational structure, and national recognition that narrative data can also be used for accountability. In this article, five Dutch research institutes reflect on the importance, value and challenges of using narratives in nursing homes.</p

Experienced Quality of Post-Acute and Long-Term Care From the Care Recipient's Perspective-A Conceptual Framework

This article aims to conceptualize experienced quality of post-acute and long-term care for older people as perceived by care recipients. An iterative literature review and consultations with stakeholders led to the development of the INDividually Experienced QUAlity of Long-term care (INDEXQUAL) framework. INDEXQUAL presents the process of an individual care experience consisting of a pre (expectations), during (experiences), and post (assessment) phase. Expectations are formed prior to an experience by personal needs, past experiences, and word-of-mouth. An experience follows, which consists of interactions between the players in the caring relationships. Lastly, this experience is assessed by addressing what happened and how it happened (perceived care services), how this influenced the care recipient's health status (perceived care outcomes), and how this made the care recipient feel (satisfaction). INDEXQUAL can serve as a framework to select or develop methods to assess experienced quality of long-term care. It can provide a framework for quality monitoring, improvement, and transparency. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine

Oral Histories and Story Telling – Methods Matter: Series 2, Episode 1

In expert corner for this episode is Dr Kahryn Hughes, from the University of Leeds. Dr Hughes is Director of the Timescapes Archive, Editor in Chief of Sociological Research Online, Convenor of the MA Qualitative Research Methods and a Senior Fellow for NCRM. In researcher ranch is Dr Katya Sion, Postdoctoral Researcher in Living-Lab in Ageing and Long-Term Care at Maastricht University. Dr Sion’s research is focused on quality of residential elderly care from the resident’s perspective and how to assess this. Her current postdoc position is aimed at the national valorisation of the narrative method of connecting conversations, which was developed during her PhD. Methods Matter – from Dementia Researcher and the National Centre for Research Methods – is a podcast for people who don't know much about methods, those who do and those who just want to find news and clever ways to use them in their research. In this second series, Clinical Research Fellow Dr Donncha Mullin from the University of Edinburgh brings together leading experts in research methodology, and the dementia researchers that use them, to provide a fun introduction to five qualitive research methods in a safe space where there are no such things as dumb questions. In this season, the podcast covers oral histories and story telling, grounded theory, visual and creative methods, focus groups and surveys and questionnaires

A multi-stakeholder perspective on quality of care among residents, family members and nursing staff in nursing homes:A Balanced Centricity approach

The objective of this study was to use a Balanced Centricity (BC) approach to describe how personal values related to experienced quality of care are defined for residents, family and nursing staff in nursing homes. Capturing the values from a multi-stakeholder perspective, a qualitative approach was conducted in which the stakeholders’ (e.g., residents, family members of residents and nursing staff; a triad) experiences, opinions and values were explored. Participants were recruited from ten nursing homes within the Living Lab in Ageing & Long-Term Care Limburg, the Netherlands. The audio recording of every interview was transcribed verbatim. The analysis made use of an inductive and deductive approach. In total, 12 individuals were interviewed in 4 triads. Three main values were identified throughout the triads: greater focus on wellbeing, feelings of autonomy and family matters. All stakeholders mentioned the need for a greater focus on well-being in which more one-on-one time (i.e., between one resident and a staff member) is possible. However, discrepancies in the values between these three stakeholders are also present in topics such as autonomy and the role of family visits. This study underscores that, although several values are aligned between these stakeholders, other values display discordance. Especially in a setting as complex as nursing homes, a BC approach might be considered in which not only the values and needs of residents, but also those of their family members and nursing staff are taken into consideration. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Text mining in long-term care:Exploring the usefulness of artificial intelligence in a nursing home setting

OBJECTIVES: In nursing homes, narrative data are collected to evaluate quality of care as perceived by residents or their family members. This results in a large amount of textual data. However, as the volume of data increases, it becomes beyond the capability of humans to analyze it. This study aims to explore the usefulness of text mining approaches regarding narrative data gathered in a nursing home setting. DESIGN: Exploratory study showing a variety of text mining approaches. SETTING AND PARTICIPANTS: Data has been collected as part of the project 'Connecting Conversations': assessing experienced quality of care by conducting individual interviews with residents of nursing homes (n = 39), family members (n = 37) and care professionals (n = 49). METHODS: Several pre-processing steps were applied. A variety of text mining analyses were conducted: individual word frequencies, bigram frequencies, a correlation analysis and a sentiment analysis. A survey was conducted to establish a sentiment analysis model tailored to text collected in long-term care for older adults. RESULTS: Residents, family members and care professionals uttered respectively 285, 362 and 549 words per interview. Word frequency analysis showed that words that occurred most frequently in the interviews are often positive. Despite some differences in word usage, correlation analysis displayed that similar words are used by all three groups to describe quality of care. Most interviews displayed a neutral sentiment. Care professionals expressed a more diverse sentiment compared to residents and family members. A topic clustering analysis showed a total of 12 topics including 'relations' and 'care environment'. CONCLUSIONS AND IMPLICATIONS: This study demonstrates the usefulness of text mining to extend our knowledge regarding quality of care in a nursing home setting. With the rise of textual (narrative) data, text mining can lead to valuable new insights for long-term care for older adults

Ruimte voor Zorg meet ervaren kwaliteit in verpleeghuizen door verhalen te verbinden

Relaties en interacties tussen bewoners, families en zorgverleners bepalen voor een groot deel hoe kwaliteit van zorg wordt ervaren in verpleeghuizen. Het is belangrijk om inzicht te krijgen in hoe bewoners de kwaliteit van de verpleeghuiszorg ervaren, om zo de kwaliteit te kunnen verbeteren gebaseerd op wat belangrijk is voor hen. Dit vereist een andere manier van kwaliteit meten. De narratieve methode ‘Ruimte voor Zorg’ meet ervaren kwaliteit door apart het waarderende gesprek aan te gaan met de bewoner, een familielid van die bewoner en een betrokken zorgverlener. Vanuit die driehoek wordt inzicht verkregen in hoe verpleeghuiszorg wordt ervaren

Ruimte voor Zorg meet ervaren kwaliteit in verpleeghuizen door verhalen te verbinden

Relaties en interacties tussen bewoners, families en zorgverleners bepalen voor een groot deel hoe kwaliteit van zorg wordt ervaren in verpleeghuizen. Het is belangrijk om inzicht te krijgen in hoe bewoners de kwaliteit van de verpleeghuiszorg ervaren, om zo de kwaliteit te kunnen verbeteren gebaseerd op wat belangrijk is voor hen. Dit vereist een andere manier van kwaliteit meten. De narratieve methode ‘Ruimte voor Zorg’ meet ervaren kwaliteit door apart het waarderende gesprek aan te gaan met de bewoner, een familielid van die bewoner en een betrokken zorgverlener. Vanuit die driehoek wordt inzicht verkregen in hoe verpleeghuiszorg wordt ervaren

The Validity of Connecting Conversations:A Narrative Method to Assess Experienced Quality of Care in Nursing Homes from the Resident's Perspective

It is important to assess experienced quality of care in nursing homes, as this portrays what is important to residents and helps identify what quality improvements should focus on. Connecting Conversations is a narrative method that assesses experienced quality of care from the resident's perspective in nursing homes by having separate conversations with residents, family, and professional caregivers (triads) within a learning network. This study assessed the validity of performing the narrative method, Connecting Conversations. Trained nursing home staff (interviewers) performed the conversations in another nursing home than where they were employed. In total, 149 conversations were performed in 10 nursing homes. Findings show that experts deemed the narrative assessment method appropriate and complete to assess experienced quality of care (face validity). The questions asked appeared to capture the full construct of experienced quality of care (content validity). Additionally, there was a range in how positive conversations were and first results indicated that a nursing home scoring higher on satisfaction had more positive conversations (construct validity). More data are needed to perform additional construct validity analyses. In conclusion, Connecting Conversations shows promising results for its use as a valid narrative method to assess experienced quality of care