mpa 504 and ►dr. s. m. emerson june 16, 2012. hypothesis person-centered care improves quality of...

Redesign of Health Services: Pilgrim

Place MPA 504 and ►Dr. S. M. Emerson

JUNE 16, 2012

Hypothesis

Person-centered care improves quality of life and medical outcomes.

Tyee

Research Questions

Tyee Research Agenda

How to assess the quality of life in neighborhoods?

How to compare perceptions of elders (residents) and staff?

Scope of Research

Develop survey instrument.Conduct baseline measurement.Periodic follow-up measurements.Analyze survey data.

Kevin M

Limits to Scope

NOT applicable for medical or ADL assessment

NOT a substitute for supervision or other research method.

Kevin M.

Research Process

Kevin D. Steps Taken

Consultation

Survey of literature

Pre-test of instrument and Informed Consent

Analysis of instrument

Research Process

Kevin D Steps Taken

Consultation

Survey of literature

Pre-test of instrument and Informed Consent Form (ICF)

Analysis of Instrument

Analysis Measures

ValidityReliabilityRobustnessCriticalityDuplicates

Diana

Analysis by Topic _ Diana

Services Bathing and Dressing(Questions 1 – 4 & 2.1 – 2.2) Keiry

Robust but:

Amend question 2 to serve as outcome questions

Delete question 2 for

more concise instrument

Services Food(Questions 5 – 7 & 2.4 – 2.8)

Keiry

All variables are robust with the exception of staff_food

This variable measures how polite/friendly staff are when serving food

Recommend deleting question 6

Low variability Weak reliability

Services Mobility(Questions 8 – 10, 2.3, 2.15, 2.25, 2.31, 2.32)

Delete two questions: “Satisfaction with staff

assistance using restroom”◦ Neither robust nor reliable

“Feeling of safety when alone in the halls”◦ Zero variance

Kevin D.

EnvironmentLiving Areas(Questions 11 – 16, 2.24, & 2.26 – 2.30)

Questions since robust and reliable.

Diana

EnvironmentNoise(Questions 17 and 2.17)

Looked at four variables

All questions robust and reliable.

Kevin M

Activities (Questions 18 – 20, 2.9 – 2.11, 2.20, 2.22, & 2.23 ii)

John B

All variables prove robust with the exception of “activities by oneself" and “confidence of abilities”

Quality of Life: Still measured by the variation in both items.

Recommend retaining all variables to provide a comprehensive instrument

Well being and respect

Erika

We looked at 13 variables with regards to respect

Strongest variables were:◦ Encouraging elders to

chat◦ Time to get elder’s

directions◦ Listening to what elder is

saying

Highly Reliable

(Questions 21 – 23, 2.12, 2.14 – 2.16a, 2.18, 2.19, 2.23 i, 2.33, 2.34)

Well being and respect

Erika

Weakest variable was access to friends because it lacked variability

Frequency to mental health was also weak but will retain because may serve unique need.

Challenges with survey questions

Open Ended and Tri City Few additional

remarks

One open ended question for “other positive or negative comments”.

Parker

Delete Tri-City questions

Management Concerns

Balancing Question Utility in Context of Regulations

Marginal utility in measuring quality of life.

Parker

Conclusions

Revisions to survey instrumentRecommendations to survey processKeiry

Recommendations – Cal Poly

Based on class analysis

Modify survey instrumentsModify staff survey processSummer 2012 – Survey staffFall 2012 – Survey residents

John B.

Recommendations – Pilgrim Place

Delete regulatory and marginal QOL questionsAdd questions to Staff surveySeparate Tri-City Wellbeing surveyConduct HSC survey on rotating basis

John B.

Questions ? _Tyee

Dr. Emerson

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Thank you