The Influence of Nursing Home Context on Implementation: Early Findings

Chair(s)

• 

  Carole Estabrooks, CM, PhD, RN, FRSC, FCAHS, FAAN, FCAN

  Professor
  College of Health Sciences
  University of Alberta
  Edmonton, Alberta, Canada

  Slides

Co-Chair(s)

• 

  Anna Beeber, PhD, RN, FAAN (she/her/hers)

  Associate Professor
  School of Nursing
  Johns Hopkins University
  Baltimore, Maryland, United States

Discussant(s)

• 

  Amy Vogelsmeier, PhD, RN, FAAN

  Associate Professor
  Sinclair School of Nursing
  University of Missouri
  Columbia, Missouri, United States

Individual Symposium Abstract First Author(s)

• WB

  Whitney Berta, PhD, MBA, BSc

  Professor
  Institute of Health Policy, Management & Evaluation
  University of Toronto
  Toronto, Ontario, Canada
• 

  Jing Wang, PhD

  assistant professor
  School of Nursing
  University of North Carolina at Chapel Hill
  Chapel Hill, North Carolina, United States
• 

  Janelle Perez, PhD (she/her/hers)

  Postdoctoral Fellow
  School of Nursing
  University of North Carolina Chapel Hill
  Chapel Hill, North Carolina, United States
• 

  Yinfei Duan, PhD

  Postdoctoral fellow
  Faculty of Nursing
  University of Alberta
  Edmonton, Alberta, Canada
• AI

  Alba Iaconi, PhD

  Postdoctoral fellow
  TREC, Faculty of Nursing - College of Health Sciences
  University of Alberta
  Edmonton, Alberta, Canada

Evidence suggests that organizational context, including context of care in nursing homes (NHs) is associated with implementation and improvement success and that optimized context contributes to improved resident and staff outcomes. However, evidence on mechanisms of these influences is scarce. The longitudinal Translating Research in Elder Care program (2007 to present) is our data source. This symposium reports findings of a secondary analysis of longitudinal organizational structural and contextual, staff worklife, and resident care quality data collected in nursing homes from 2007-2021, in a cohort of 94 Canadian nursing homes. Our data include continuously collected administrative data (RAI-MDS 2.0), 5 waves of primary surveys from multiple care providers in NHs (15,000 cases to date), extensive qualitative case study data, and data from two large scale pragmatic trials. The TREC program was framed originally and continues to be, using the Promoting Action on Research Implementation in Health Services (PARiHS) framework. Each of our 5 papers will report on a critical aspect of the findings. The symposium will conclude with a discussion of implications of these findings of phase one and a description of phase two and how it is shaped by our interactions with expert panels (context and implementation experts, policymakers, NH managers, paid care providers, and residents and families). Early implications of this work for future research in nursing homes and for practice and policy will be mentioned.

Presentations:

• 8:00 AM – 9:30 AM ET

  Developmental Advances of the PARiHS Framework Over the Last Decade: A Critical Interpretive Synthesis
  

  Individual Symposium Abstract First Author: Whitney Berta, PhD, MBA, BSc – University of Toronto
• 8:00 AM – 9:30 AM ET

  Understanding Leadership in Nursing Home Context Through Adaptive Leadership Framework for Chronic Illness
  

  Individual Symposium Abstract First Author: Jing Wang, PhD – University of North Carolina at Chapel Hill
• 8:00 AM – 9:30 AM ET

  Context and Trust: Direct Care Worker Relationships, Care Practices, Facilitation, and Implementation of Innovations
  

  Individual Symposium Abstract First Author: Janelle Perez, PhD (she/her/hers) – University of North Carolina Chapel Hill
• 8:00 AM – 9:30 AM ET

  Organizational Context and Quality Indicators in Nursing Homes: A Microsystem Look
  

  Individual Symposium Abstract First Author: Yinfei Duan, PhD – University of Alberta
• 8:00 AM – 9:30 AM ET

  Organizational Context's Effect on Care Aides' Psychological Empowerment in Western Canada
  

  Individual Symposium Abstract First Author: Alba Iaconi, PhD – University of Alberta