Pennybyrn Case Study Site Orientation

Orientation Manual Case Study Sites

Designation of Excellence in PersonCentered Long-Term Care June 2022 Project Year Two

Table of Contents Welcome Letter ................................................................................... 3

Meet the Project Team ....................................................................... 4 Designation of Excellence Project Trajectory ................................... 6 Project Activities .................................................................................. 7 Project Milestones ............................................................................... 8 Project Current Status Report ............................................................ 10 GSA Poster ........................................................................................... 12 Mapping the Evidence ........................................................................ 14

Person-Centered Care Domains ........................................................ 16 Designation Process ............................................................................ 18 Designation Manual Concept ............................................................. 20 Designation Scoring ............................................................................ 24 Case Study Site Expectations ............................................................. 26 Project Links and Zoom Links ............................................................ 28

2

June 2022

Dear Pennybyrn Community ~ Thank you for your willingness to partner with the Designation of Excellence (DoE) project team to field test some of the DoE manual contents and provide feedback so we can achieve the goal of offering a practical, accessible, and affordable process for achieving the Designation.

We understand that your participation at this stage of the project requires a commitment of time and resources, all of which are still in short supply for long-term care providers across the country.

We hope you and your internal project team can review the contents of this manual before our orientation meeting presently scheduled for June 8th at 10:00 a.m. At that meeting, we will review this material, address your questions, and establish a meeting schedule for the months ahead.

The national project team is still very busy collecting data, analyzing the data we already have, and building modules to field test with you and with other case study sites that will come on board over the course of this coming year.

We will shortly forward a full agenda for our upcoming meeting, but in the interim, thank you again for your willingness to lend your expertise to this important project! It has the potential to generate broad policy and practice discourse to improve person-centered care delivery for both recipients and deliverers of care.

Thank you again and welcome!

The Designation of Excellence Project Team

Meet the Project Team Click on this link to be directed to the project team bios

Funder The Mayer Rothschild Foundation

Paul Nebenzahl, Executive Director

4

Principal investigators

Jennifer Crittenden, PhD, MSW

Lenard Kaye, PhD, DSW

Angela Hunt, MS, RPT

Team members

Top Row: Mary Lou Ciolfi, JD, MS

David Wihry, MPA

Tracy Ericson, BS

Bottom Row: Melanie Marchman

Katrina St. Jeor

Tyler DuBois

Consultants

Liam O’Brien, PhD

Kathryn Callnan, RN

5

Judith Josiah-Martin, PhD

Designation Trajectory

Launch

Practical

We are here

Concrete

Conceptual The DoE Project has moved from the abstract through to the conceptual to the concrete and now we are relying on our case study partners to help us build a Designation that has practical utility and benefit – to residents and to operations so it is ready to launch in 2023.

Abstract

6

Project Activities

7

Project Milestones 2021-2022 1

Literature Review, Metrics, & Mapping

Message Board & Resident Survey

2

3

Key Informant Interviews

DoE Framework Concept

Staff, Family, Resident Focus Groups

6

7

4

5

DoE Module Template

Case Study Site Partnerships

8

Key Informant Interviews Steering Committee Members Expert Panelists Message Board Activity Sites 9

Current Project Status Report (January 2021 - May 2022) Aim 1: Identify and synthesize the priority components of person-centered care (PCC) based on a variety of research, resident, expert and staff perspectives.

In our first year, we looked at what other researchers have done before us and made a set of categories to guide our project. As we continue working on the project, our nine categories (Personhood, Physical Environment, Family Engagement, Resident Care, Staff Empowerment,

Shared Leadership, Food and Dining, Enrichment and Socialization, and Quality Improvement) will be further refined based on what we learn from stakeholders. We have developed a Designation framework that allows us to look at each domain separately and see the bigger picture at the same time. We are combining the current research with the data collected from

stakeholders and creating something residents, family members, staff and leaders can use to guide service improvement.

Aim 2: Develop a framework for a person-centered care Designation of Excellence tool that will ultimately be deemed practical and attractive industry-wide across a variety of settings and contexts in long-term care and provide consumer transparency.

We have a proposed process for applying for the Designation, and we will keep updating it as we work on the project. We have created a test module for the personhood domain. We have also created a proposed scoring framework so that LTC communities applying for the Designation can demonstrate why they think they meet a particular ranking. Each domain module will contain links to outside help communities can use to improve their care and services. Case study sites will help us refine each module and update the scoring content and process.

Timeline Review We are on track with our goals for most of this project and we are bringing our data collection and analysis goals with us into Year Two. We are still recruiting for the Resident Survey since the pandemic has strained long-term care providers in myriad ways including considerable reduction in available labor. We keep track of our progress with a graphic for each year posted on the website and reviewed our Year One timeline at stakeholder meetings last year. It provided an easy visual that all project participants could use. Currently, we are reviewing policy research, developing our DoE framework, reviewing that framework with case study sites, and continuing to get helpful direction from the Steering Committee and the Expert Panels we consult.

Data Collection Activities Message Board Activity We were able to use the message boards to get information from 24 organizations and 247 people. The activity online has been organized, compiled, and we are using a program called

10

Quirkos to analyze the information. A key finding in our data is that in all domains of the message board inquiry, residents overwhelmingly expressed the importance of being known and listened to by the staff. This confirms what we learned from the literature and provides a key area for further conversation in the upcoming resident focus groups.

Key Informant Interviews We talked to 14 LTC leaders, called “key informants” across our case study sites and obtained data about the successes and challenges of the PCC being delivered to residents every day. The key informant interviews are transcribed and are currently being analyzed using qualitative data software. Overall early impressions are that LTC communities are uniformly aware of and dedicated to using PCC principles to guide their resident services, staff training, family engagement, and operational strategic planning. They also recognize many barriers including recent pandemic restrictions, short labor supply, lack of funding for physical plant upgrades, and collecting and analyzing data on various aspects of PCC.

Focus Groups All 35 staff participating in the focus groups at The Cedars were thoughtful, engaged, and candid in their responses. Staff were spread across departments with a concentration in nursing. The project team is currently analyzing the data and early impressions are that frontline staff are dedicated and authentic in their effort to get to know residents, whether they have formal training in PCC. Communication challenges, physical plant constraints, and staff shortages and stress appear to be the primary barriers to improving PCC delivery. Family focus groups are completed, and we will be analyzing those data this summer, along with resident focus groups and interviews, which are now complete.

Resident Survey A total of 92 resident surveys have been collected to-date from residents at The Cedars in the field pilot and from a couple of LTC sites around the country. Resident survey distribution in other settings has been considerably hampered by the ongoing pandemic and associated labor shortage in LTC across the country. In light of these challenges, the project team has considered an alternative approach using the services of an independent contractor, paid by the project staff member, to manage survey distribution to approximately 400 residents around the country.

National Survey of Older People Living Independently The national survey of independent living older adults has been deployed and will remain open until June 12th. Thus far, we have received over 700 responses from older people all over the country. After June 12th, the quantitative data will be analyzed by our project statistician and the results integrated into the Designation concept.

Committee Engagement Activities The project’s national Steering Committee or residents and family members and our national Expert Panel meet monthly and are providing project direction and input. The Expert Panel has three subcommittees to focus specific attention on DEI, policy, and implementation of the Designation.

11

GSA Poster Presentation November 2021

12

13

Evidence Mapping The extensive scoping literature review with evidence mapping as conducted in Year One. Each PCC domain evidence was mapped according to whether the study was conceptual, operational, or had resident, family, or staff impact.

A sample map of the Personhood domain is featured here.

We will use a version of these maps in the manual based on input from case study site feedback about what might be most helpful to get a sense of the scientific literature on person-

centered long-term care.

14

15

The Primary Domains of Person-Centered Long-Term Care

Resident Care, Choice, & Engagement

Physical Environment

Food & Dining

Personhood Enrichment & Socialization

Family Engagement

Staff Empowerment

In each domain: Quality Improvement

Diversity, Equity, Inclusion

16

The Primary Domains of Person-Centered Long-Term Care Other domain topics: Shared Leadership End-of-Life Care and Considerations Pandemic Considerations Measuring Person-Centered Care

17

The Designation Process

18

19

DoE Manual Concept The project team is developing one Designation application “module” that we can use as a pilot template during the development process. Our case study partnership will allow us to co-create the module with input from your team.

20

21

Module One – Proposed Table of Contents

22

23

24

25

26

Thank you!!

27

Thank you for your participation!

Please note links below to project website and team members

Zoom link DoE Project website UMaine Center on Aging

The Cedars The Mayer-Rothschild Foundation

28