Advancing Excellence: Person-centered Care Goal
Polisher Research Institute researchers have been working extensively on the topic of person-centered, preference-based care to develop better ways to measure the preferences for everyday living of frail seniors (see latest publications).
We view accurate knowledge about an individual’s preferences as the cornerstone of Person Centered Care (PCC). PCC is a multidimensional construct with many components. However, all the components build on knowing how an individual likes to live their everyday life.
Advancing Excellence (AE) is rolling out a new goal, which has significant implications in improving resident quality of life in the nursing home setting. The Person Centered Care (PCC) Goal falls squarely in the culture change realm and offers the long-term care industry an opportunity to measure and compare progress in delivering person centered care as they move forward in their culture change journey.
The PRI team is honored to be a part of the AE Workgroup that developed the Person Centered Care quality indicator. For more information about AE and the PCC tool, please to go to the AE website or view the May 2 AE Person Centered Care Tool Webinar.
The measurement of Preference Congruence, one of the AE PCC goal indicators, provides nursing homes with a tangible way to measure and improve this person centered care concept which is so strongly tied to the culture change movement. Preference Congruence is the degree to which nursing homes are able to fulfill basic care and recreational leisure pursuits most preferred by their residents.
The Preference Congruence quality measure builds on the existing structure of the Preferences for Customary Routine and Activities in Section F of the MDS 3.0 and then enhances the interview with a satisfaction component-“How well do you feel this preference has been satisfied in the last week?”
The Preference Congruence tool uses an Excel workbook to assist nursing home professionals with individual resident care planning, programming improvements at household levels and produce an aggregate measure of a nursing home’s level of preference fulfillment. The Advancing Excellence website allows participating facilities to upload and trend their aggregate results and compare them to state and national averages.
In addition to the Preference Congruence measure, the tool will also guide facilities in several ways to measure and bring the resident to the center of the care planning and care conference process. Three additional measures will calculate the degree to which key participants attend the care conference: 1) residents, 2) family or friends of resident and 3) direct care staff members. This robust goal and tool will also include suggestions for optimizing the care planning teams and processes.
Words of Wisdom from Nursing Home Communities Who Piloted the AE PCC Tool
Gwen Smith BS, Social Services Coordinator at participating pilot home Wesbury United Methodist Retirement Community in Meadville, PA had this to say about their experience using the PCC tool:
“This tool helps us update preferences as a person improves/declines to what is important at that time in their lives. It has made us “more aware” that preferences change, sometimes daily. Residents/families/staff are sharing/communicating more information since we are stressing the goal of Person Centered Care. It gives us the opportunity to give each person a voice in or “control” of their daily care, when often their own health issues are out of their control. Wesbury is now collaborating with our local TCU sharing information on residents’ preferences prior to admission to make the transition to our facility less stressful and it has made residents feel we “already know them”.
Brad Norris, Director of Therapeutic Recreation at Homewood at Martinsburg
On using the tool to assist with a facilities compliance with QAPI guidelines as a specific Performance Improvement Program (PIP):
“Incorporated into the CQI process the tool serves as a vehicle through which determinations can be made about qualitative measures of the “Person Centered” approach to care and how “well” a facility is doing from the Resident’s point of view. Too often these determinations aren’t made at all or, in cases where they are made they’re more of an anecdotal measure from the point of view of the staff.”
On using the tool to provide direct feedback on what community is doing well and what can be an opportunity for improvement:
“The tool takes the anecdotal slant out of the equation when determining the degree to which a facility has infused “Person Centered Care” into their approaches and places the measurements squarely in the scientific arena. The tool not only gives us the opportunity to benchmark internally but also establishes a baseline against which we can compare the perceptions of our Residents against the perceptions of Residents from other facilities in terms of the “person centeredness” of the care we deliver."
Michelle Morton(Administrator) & Jessica Buttil (Activities Coordinator) at The Hill at Whitemarsh
On using the tool to increase staff/resident communication:
“Traditionally our C.N.A.s are not involved in identifying resident preferences and preferences were not always relayed to them. Our C.N.A.s did get involved in this interview process by asking bout preferences. The C.N.A.s said they liked getting to know resident preferences before providing care and found it helpful. We had a lot of positive feedback from the C.N.A.s."
On using the tool as a conversation starter:
“We found the interview process to be a conversation starter in developing a more person-centered approach to care. Our residents reported feeling validated by being asked questions about their preferences. They were comforted by the interview because they felt they were heard and were able to make choices. In addition, we used the interview to ask additional questions about the residents’ preferences such as “what else is important to you?”
The Person Centered Care Toolkit consists of a portfolio of documents designed to facilitate its ease of use. Please download the following documents to begin using the toolkit in your community!
Download the AE PCC Excel Tool here and here
The AE Person Centered Care Instructions on how to use the Excel tool
Preference Congruence Interview Form and Instruction Aid for Interviewers
The PCC implementation guide and Detailed preference interview
Top 10 pilot tips and Why I should use the PCC tool