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Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design.

Publication ,  Journal Article
Chisholm, L; Hanson, LC; Zimmerman, S; McConnell, E; Rosemond, C; Weiner, BJ
Published in: Journal of the American Medical Directors Association
July 2022

Nursing homes (NHs) provide care to residents with serious illness and related complex health care needs. As such, discussions about end-of-life care between NH staff and residents and families are necessary to ensure residents receive care consistent with their goals. Interventions such as video decision aids have been developed to promote discussions and improve advance care planning, but few studies have examined how NH characteristics may relate to the implementation of these interventions; such information might lead toward more use of successful interventions. The purpose of this study is to understand NH characteristics that are associated with the implementation of the Goals of Care (GOC) intervention, which combined a video decision aid with a structured discussion to guide decision-making in advanced dementia.A multiple case study.Staff surveys were conducted to examine factors related to implementation effectiveness in 11 NHs in North Carolina that participated in the GOC trial.Questions measured the dependent variable of implementation effectiveness: the consistency and quality of use of the GOC intervention. NH organizational characteristics were measured using publicly available data and an administrator survey. The analysis consisted of pattern matching logic.High management support aligned with implementation effectiveness within NHs. In addition, the within case pattern analysis indicated additional characteristics related to implementation effectiveness. Facility size, Medicare beds, residents' racial composition, and star rating were related to implementation effectiveness across 6 of the 11 NHs. NH financial resources, such as size and number of Medicare beds, may be important factors for successful implementation.NHs seeking to implement advance care planning interventions should focus on within and across NH differences, such as adequate management and financial support prior to implementation to increase the likelihood of implementation effectiveness.

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Published In

Journal of the American Medical Directors Association

DOI

EISSN

1538-9375

ISSN

1525-8610

Publication Date

July 2022

Volume

23

Issue

7

Start / End Page

1215 / 1220

Related Subject Headings

  • United States
  • Terminal Care
  • Nursing Homes
  • Medicare
  • Humans
  • Geriatrics
  • Communication
  • Aged
  • Advance Care Planning
  • 4206 Public health
 

Citation

APA
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Chisholm, L., Hanson, L. C., Zimmerman, S., McConnell, E., Rosemond, C., & Weiner, B. J. (2022). Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design. Journal of the American Medical Directors Association, 23(7), 1215–1220. https://doi.org/10.1016/j.jamda.2021.07.038
Chisholm, Latarsha, Laura C. Hanson, Sheryl Zimmerman, Eleanor McConnell, Cherie Rosemond, and Bryan J. Weiner. “Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design.Journal of the American Medical Directors Association 23, no. 7 (July 2022): 1215–20. https://doi.org/10.1016/j.jamda.2021.07.038.
Chisholm L, Hanson LC, Zimmerman S, McConnell E, Rosemond C, Weiner BJ. Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design. Journal of the American Medical Directors Association. 2022 Jul;23(7):1215–20.
Chisholm, Latarsha, et al. “Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design.Journal of the American Medical Directors Association, vol. 23, no. 7, July 2022, pp. 1215–20. Epmc, doi:10.1016/j.jamda.2021.07.038.
Chisholm L, Hanson LC, Zimmerman S, McConnell E, Rosemond C, Weiner BJ. Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design. Journal of the American Medical Directors Association. 2022 Jul;23(7):1215–1220.
Journal cover image

Published In

Journal of the American Medical Directors Association

DOI

EISSN

1538-9375

ISSN

1525-8610

Publication Date

July 2022

Volume

23

Issue

7

Start / End Page

1215 / 1220

Related Subject Headings

  • United States
  • Terminal Care
  • Nursing Homes
  • Medicare
  • Humans
  • Geriatrics
  • Communication
  • Aged
  • Advance Care Planning
  • 4206 Public health