Tri-focal Model of Care Implementation: Perspectives of Residents and Family.
Alison Hutchinson, Helen Rawson, Beverly O'Connell and 5 others
PMID 27871120WHAT IT FOUND
Residents and families described long-term care as often excluding them from choices and decisions.
After staff were taught a partnership model, they reported more listening and choice, but still wanted staff to know their lives and have enough time.
Key findings
01Before implementation, residents said care was often decided for them, while families felt excluded and wanted to advocate and retain control.
02After implementation, residents said their preferences were being considered and families reported more open, approachable communication with staff.
03Even after implementation, residents highlighted staff lack of knowledge about life history and perceived staff shortages, while families emphasised the need to be involved in care decisions.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The study interviewed a small number of residents and family members, and most follow-up participants were different from baseline because many baseline residents had died. Participants were cognitively unimpaired residents able to communicate in English, so views of residents with dementia or communication needs were not captured. Facilities were selected because managers were interested in the model, so results may not apply to facilities without motivation. There was no control group, and 12 months passed between interviews, so perceived changes may not be attributable to the model. Family members of deceased residents were not contacted for follow-up. Baseline interviews may have influenced later responses, although the authors note the long interval made this unlikely.
The easy way to misread this
Do not conclude the education program caused better care or improved outcomes. This is a qualitative study of perceptions after implementation, with small, mostly unmatched samples and no control group, so changes may reflect time, participant selection, or interview effects.