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Published in: BMC Geriatrics 1/2013

Open Access 01-12-2013 | Research article

Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention

Authors: Kimberly D Fraser, Hannah M O’Rourke, Melba Andrea B Baylon, Anne-Marie Boström, Anne E Sales

Published in: BMC Geriatrics | Issue 1/2013

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Abstract

Background

Audit with feedback is a moderately effective approach for improving professional practice in other health care settings. Although unregulated caregivers give the majority of direct care in long-term care settings, little is known about how they understand and perceive feedback reports because unregulated providers have not been directly targeted to receive audit with feedback in quality improvement interventions in long-term care. The purpose of this paper is to describe unregulated care providers’ perceptions of usefulness of a feedback report in four Canadian long-term care facilities.

Methods

We delivered monthly feedback reports to unregulated care providers for 13 months in 2009–2010. The feedback reports described a unit’s performance in relation to falls, depression, and pain as compared to eight other units in the study. Follow-up surveys captured participant perceptions of the feedback report. We conducted descriptive analyses of the variables related to participant perceptions and multivariable logistic regression to assess the association between perceived usefulness of the feedback report and a set of independent variables.

Results

The vast majority (80%) of unregulated care providers (n = 171) who responded said they understood the reports. Those who discussed the report with others and were interested in other forms of data were more likely to find the feedback report useful for making changes in resident care.

Conclusions

This work suggests that unregulated care providers can understand and feel positively about using audit with feedback reports to make changes to resident care. Further research should explore ways to promote fuller engagement of unregulated care providers in decision-making to improve quality of care in long-term care settings.
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Literature
1.
go back to reference Berta W, Laporte A, Zarnett D, Valdmanis V, Anderson G: A pan-Canadian perspective on institutional long-term care. Health Policy. 2006, 79: 179-194.CrossRef Berta W, Laporte A, Zarnett D, Valdmanis V, Anderson G: A pan-Canadian perspective on institutional long-term care. Health Policy. 2006, 79: 179-194.CrossRef
2.
go back to reference Rantz MJ, Hicks L, Grando V, Petroski GF, Madsen RW, Mehr DR, Conn V, Zwygart-Staffacher M, Scott J, Flesner M, Bostick J, Porter R, Maas M: Nursing home quality, cost, staffing, and staff mix. Gerontologist. 2004, 44: 24-38. 10.1093/geront/44.1.24.CrossRefPubMed Rantz MJ, Hicks L, Grando V, Petroski GF, Madsen RW, Mehr DR, Conn V, Zwygart-Staffacher M, Scott J, Flesner M, Bostick J, Porter R, Maas M: Nursing home quality, cost, staffing, and staff mix. Gerontologist. 2004, 44: 24-38. 10.1093/geront/44.1.24.CrossRefPubMed
5.
go back to reference Cohen-Mansfield J, Jensen B: Physicians’ perceptions of care in the nursing home and of strategies for improvement in a survey on treatment of behavior problems. J Am Med Dir Assoc. 2008, 9: 633-640. 10.1016/j.jamda.2008.02.012.CrossRefPubMed Cohen-Mansfield J, Jensen B: Physicians’ perceptions of care in the nursing home and of strategies for improvement in a survey on treatment of behavior problems. J Am Med Dir Assoc. 2008, 9: 633-640. 10.1016/j.jamda.2008.02.012.CrossRefPubMed
6.
go back to reference Jamtvedt G, Young JM, Kristoffersen DT, O’Brien MA, Oxman AD: Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2006, 2: CD000259-PubMed Jamtvedt G, Young JM, Kristoffersen DT, O’Brien MA, Oxman AD: Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2006, 2: CD000259-PubMed
7.
go back to reference Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, O’Brien MA, Johansen M, Grimshaw J, Oxman AD: Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012, 6: CD000259-PubMed Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, O’Brien MA, Johansen M, Grimshaw J, Oxman AD: Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012, 6: CD000259-PubMed
13.
14.
go back to reference Caspar S, O’Rourke N: The influence of care provider access to structural empowerment on individualized care in long-term-care facilities. J Gerontol B Psychol Sci Soc Sci. 2008, 63: S255-S265. 10.1093/geronb/63.4.S255.CrossRefPubMed Caspar S, O’Rourke N: The influence of care provider access to structural empowerment on individualized care in long-term-care facilities. J Gerontol B Psychol Sci Soc Sci. 2008, 63: S255-S265. 10.1093/geronb/63.4.S255.CrossRefPubMed
16.
go back to reference Blair CE, Glaister JA: Making the most of nursing homes’ number one resource. Health Care Manage Rev. 2005, 30: 110-115. 10.1097/00004010-200504000-00005.CrossRefPubMed Blair CE, Glaister JA: Making the most of nursing homes’ number one resource. Health Care Manage Rev. 2005, 30: 110-115. 10.1097/00004010-200504000-00005.CrossRefPubMed
17.
go back to reference McGilton KS, Hall LM, Wodchis WP, Petroz U: Supervisory support, job stress, and job satisfaction among long-term care nursing staff. J Nurs Adm. 2007, 37: 366-372. 10.1097/01.NNA.0000285115.60689.4b.CrossRefPubMed McGilton KS, Hall LM, Wodchis WP, Petroz U: Supervisory support, job stress, and job satisfaction among long-term care nursing staff. J Nurs Adm. 2007, 37: 366-372. 10.1097/01.NNA.0000285115.60689.4b.CrossRefPubMed
18.
go back to reference Cruttenden KE: Long-term care planning study: strengths and learning needs of nursing staff. Can J Aging. 2006, 25: 347-361. 10.1353/cja.2007.0016.CrossRefPubMed Cruttenden KE: Long-term care planning study: strengths and learning needs of nursing staff. Can J Aging. 2006, 25: 347-361. 10.1353/cja.2007.0016.CrossRefPubMed
21.
go back to reference Glouberman S, Richards J, El Bestawi M, Seidman-Carlson R, Teperman L: Reconnecting to care: a nursing initiative at the Baycrest Geriatric Health System. Nurs Leadersh. 2007, 20: 39-49.CrossRef Glouberman S, Richards J, El Bestawi M, Seidman-Carlson R, Teperman L: Reconnecting to care: a nursing initiative at the Baycrest Geriatric Health System. Nurs Leadersh. 2007, 20: 39-49.CrossRef
22.
go back to reference Mechanic D, Reinhard SC: Contributions of nurses to health policy: challenges and opportunities. Nurs Health Policy Rev. 2002, 1: 7-15. Mechanic D, Reinhard SC: Contributions of nurses to health policy: challenges and opportunities. Nurs Health Policy Rev. 2002, 1: 7-15.
23.
go back to reference McGillis Hall L, McGilton KS, Krejci J, Pringle D, Johnston E, Fairley L, Brown M: Enhancing the quality of supportive supervisory behavior in long-term care facilities. J Nurs Adm. 2005, 35: 181-187.PubMed McGillis Hall L, McGilton KS, Krejci J, Pringle D, Johnston E, Fairley L, Brown M: Enhancing the quality of supportive supervisory behavior in long-term care facilities. J Nurs Adm. 2005, 35: 181-187.PubMed
24.
go back to reference Kane RA: Ethics and the frontline care worker: mapping the subject. Generations. 1994, 18: 71-74.PubMed Kane RA: Ethics and the frontline care worker: mapping the subject. Generations. 1994, 18: 71-74.PubMed
25.
go back to reference Kalisch BJ, Curley M, Stefanov S: An intervention to enhance nursing staff teamwork and engagement. J Nurs Adm. 2007, 37: 77-84. 10.1097/00005110-200702000-00010.CrossRefPubMed Kalisch BJ, Curley M, Stefanov S: An intervention to enhance nursing staff teamwork and engagement. J Nurs Adm. 2007, 37: 77-84. 10.1097/00005110-200702000-00010.CrossRefPubMed
26.
go back to reference Yeatts DE, Cready C, Ray B, DeWitt A, Queen C: Self-managed work teams in nursing homes: implementing and empowering nurse aide teams. Gerontologist. 2004, 44: 256-261. 10.1093/geront/44.2.256.CrossRefPubMed Yeatts DE, Cready C, Ray B, DeWitt A, Queen C: Self-managed work teams in nursing homes: implementing and empowering nurse aide teams. Gerontologist. 2004, 44: 256-261. 10.1093/geront/44.2.256.CrossRefPubMed
27.
go back to reference Bishop CE, Squillace MR, Meagher J, Anderson WL, Wiener JM: Nursing home work practices and nursing assistants’ job satisfaction. Gerontologist. 2009, 49: 611-622. 10.1093/geront/gnp040.CrossRefPubMed Bishop CE, Squillace MR, Meagher J, Anderson WL, Wiener JM: Nursing home work practices and nursing assistants’ job satisfaction. Gerontologist. 2009, 49: 611-622. 10.1093/geront/gnp040.CrossRefPubMed
28.
go back to reference Zweig S, Lawhorne L: Improving the quality of nurse assistants in nursing homes: report of an attending physician survey and an AMDA symposium. J Am Med Dir Assoc. 2001, 2: 141-145. 10.1016/S1525-8610(04)70188-7.CrossRefPubMed Zweig S, Lawhorne L: Improving the quality of nurse assistants in nursing homes: report of an attending physician survey and an AMDA symposium. J Am Med Dir Assoc. 2001, 2: 141-145. 10.1016/S1525-8610(04)70188-7.CrossRefPubMed
29.
go back to reference Vogelsmeier A, Scott-Cawiezell J: Achieving quality improvement in the nursing home: influence of nursing leadership on communication and teamwork. J Nurs Care Qual. 2011, 26: 236-242. 10.1097/NCQ.0b013e31820e15c0.CrossRefPubMed Vogelsmeier A, Scott-Cawiezell J: Achieving quality improvement in the nursing home: influence of nursing leadership on communication and teamwork. J Nurs Care Qual. 2011, 26: 236-242. 10.1097/NCQ.0b013e31820e15c0.CrossRefPubMed
30.
go back to reference Kirchner JE, Parker LE, Bonner LM, Fickel JJ, Yano EM, Ritchie MJ: Roles of managers, frontline staff and local champions, in implementing quality improvement: stakeholders’ perspectives. J Eval Clin Pract. 2012, 18: 63-69. 10.1111/j.1365-2753.2010.01518.x.CrossRefPubMed Kirchner JE, Parker LE, Bonner LM, Fickel JJ, Yano EM, Ritchie MJ: Roles of managers, frontline staff and local champions, in implementing quality improvement: stakeholders’ perspectives. J Eval Clin Pract. 2012, 18: 63-69. 10.1111/j.1365-2753.2010.01518.x.CrossRefPubMed
31.
go back to reference Horn SD, Sharkey SS, Hudak S, Gassaway J, James R, Spector W: Pressure ulcer prevention in long-term-care facilities: a pilot study implementing standardized nurse aide documentation and feedback reports. Adv Skin Wound Care. 2010, 23: 120-131. 10.1097/01.ASW.0000363516.47512.67.CrossRefPubMed Horn SD, Sharkey SS, Hudak S, Gassaway J, James R, Spector W: Pressure ulcer prevention in long-term-care facilities: a pilot study implementing standardized nurse aide documentation and feedback reports. Adv Skin Wound Care. 2010, 23: 120-131. 10.1097/01.ASW.0000363516.47512.67.CrossRefPubMed
32.
go back to reference Bonner A, MacCulloch P, Gardner T, Chase CW: A student-led demonstration project on fall prevention in a long-term care facility. Geriatr Nurs. 2007, 28: 312-318. 10.1016/j.gerinurse.2007.04.014.CrossRefPubMed Bonner A, MacCulloch P, Gardner T, Chase CW: A student-led demonstration project on fall prevention in a long-term care facility. Geriatr Nurs. 2007, 28: 312-318. 10.1016/j.gerinurse.2007.04.014.CrossRefPubMed
33.
34.
go back to reference Gardner B, Whittington C, McAteer J, Eccles MP, Michie S: Using theory to synthesise evidence from behaviour change interventions: the example of audit and feedback. Soc Sci Med. 2010, 70: 1618-1625. 10.1016/j.socscimed.2010.01.039.CrossRefPubMed Gardner B, Whittington C, McAteer J, Eccles MP, Michie S: Using theory to synthesise evidence from behaviour change interventions: the example of audit and feedback. Soc Sci Med. 2010, 70: 1618-1625. 10.1016/j.socscimed.2010.01.039.CrossRefPubMed
35.
go back to reference Rantz MJ, Popejoy L, Petroski GF, Madsen RW, Mehr DR, Zwygart-Stauffacher M, Hickes LL, Grando V, Wipke-Tevis DD, Bostick J, Porter R, Conn VS, Maas M: Randomized clinical trial of a quality improvement intervention in nursing homes. Gerontologist. 2001, 41: 525-538. 10.1093/geront/41.4.525.CrossRefPubMed Rantz MJ, Popejoy L, Petroski GF, Madsen RW, Mehr DR, Zwygart-Stauffacher M, Hickes LL, Grando V, Wipke-Tevis DD, Bostick J, Porter R, Conn VS, Maas M: Randomized clinical trial of a quality improvement intervention in nursing homes. Gerontologist. 2001, 41: 525-538. 10.1093/geront/41.4.525.CrossRefPubMed
36.
go back to reference Morris JN, Hawes C, Fries BE, Phillips CD, Mor V, Katz S, Murphy K, Drugovich ML, Friedlob AS: Designing the national resident assessment instrument for nursing homes. Gerontologist. 1990, 30: 293-307. 10.1093/geront/30.3.293.CrossRefPubMed Morris JN, Hawes C, Fries BE, Phillips CD, Mor V, Katz S, Murphy K, Drugovich ML, Friedlob AS: Designing the national resident assessment instrument for nursing homes. Gerontologist. 1990, 30: 293-307. 10.1093/geront/30.3.293.CrossRefPubMed
38.
go back to reference Sales AE, Schalm C: Data for improvement and clinical excellence: protocol for an audit with feedback intervention in long term care. Implement Sci. 2010, 5: 74-10.1186/1748-5908-5-74.CrossRefPubMedPubMedCentral Sales AE, Schalm C: Data for improvement and clinical excellence: protocol for an audit with feedback intervention in long term care. Implement Sci. 2010, 5: 74-10.1186/1748-5908-5-74.CrossRefPubMedPubMedCentral
39.
go back to reference Brannon SD, Kemper P, Heier-Leitzell B, Stott A: Reinventing management practices in long-term care: how cultural evolution can affect workforce recruitment and retention. Generations. 2010, 34: 68-74. Brannon SD, Kemper P, Heier-Leitzell B, Stott A: Reinventing management practices in long-term care: how cultural evolution can affect workforce recruitment and retention. Generations. 2010, 34: 68-74.
40.
go back to reference Kuo HT, Yin TJ, Li IC: Relationship between organizational empowerment and job satisfaction perceived by nursing assistants at long-term care facilities. J Clin Nurs. 2008, 17: 3059-3066. 10.1111/j.1365-2702.2007.02072.x.CrossRefPubMed Kuo HT, Yin TJ, Li IC: Relationship between organizational empowerment and job satisfaction perceived by nursing assistants at long-term care facilities. J Clin Nurs. 2008, 17: 3059-3066. 10.1111/j.1365-2702.2007.02072.x.CrossRefPubMed
41.
go back to reference Mechanic D: Sources of power of lower participants in complex organizations. Adm Sci Q. 1962, 7: 349-364. 10.2307/2390947.CrossRef Mechanic D: Sources of power of lower participants in complex organizations. Adm Sci Q. 1962, 7: 349-364. 10.2307/2390947.CrossRef
Metadata
Title
Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention
Authors
Kimberly D Fraser
Hannah M O’Rourke
Melba Andrea B Baylon
Anne-Marie Boström
Anne E Sales
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2013
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/1471-2318-13-15

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