Reimagining Nursing Home Care
To address the structural issues that nursing homes face, we develop, test, and disseminate a set of simple adaptations of existing care processes. Our goal is to to reorganize nursing home care around wellbeing and quality of life through processes that strengthen the communication and interdisciplinary functioning of nursing home care teams.
Nursing homes are challenged with caring for some of the most vulnerable patients in the health care system. They are working to provide quality medical care while creating a home-like environment and often fall short at both.
Currently, care in many nursing homes is designed and organized around discipline-specific tasks, such as personal care, feeding, and activities. However, our research has shown that care centered instead around patient wellbeing leads to improved clinical outcomes, and can enhance the quality of life of nursing home residents. Our research has also shown that these same interventions can increase job satisfaction and retention of nursing home staff.
To address this gap, we set out to develop a wellbeing framework that will offer a structured approach to integrate what matters most to patients into systems of care.
Through an analysis of existing frameworks for wellbeing, the team identified four core principles of wellbeing, which we refer to as the PASS framework, that form the basis of our tools:
meaning in one’s life, activities, relationships
the ability to make decisions about one’s day and one’s care; the right to dignity and the expression of one’s individual identity
relationships that are reciprocal in nature
the feeling of safety and being free from harm
We then developed a set of tools to be used at key points during a nursing home’s workflow, including patient admission, quarterly care planning, weekly troubleshooting meetings, and daily huddles.
The tools offer structured guides for each of these meeting points that encourage all members of the team to contribute, and ensure that each of the four principles of wellbeing are central to the conversation and residents’ care. By elevating all staff voices and creating opportunities to discuss wellbeing, the culture of care can begin to shift towards one that fully supports the wellbeing of each resident.
The team will partner with 15 nursing homes to begin testing the tools.