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AHCA Quality Symposium San Antonio, TX February 18, 2011

The Development of Person-Centered Care Criteria and Measurement Tools: Process and Content of a Multidisciplinary Enterprise. AHCA Quality Symposium San Antonio, TX February 18, 2011. Michael Lepore, PhD Director of Quality, Research, & Evaluation Planetree mlepore@planetree.org &

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AHCA Quality Symposium San Antonio, TX February 18, 2011

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  1. The Development of Person-Centered Care Criteria and Measurement Tools: Process and Content of a Multidisciplinary Enterprise AHCA Quality Symposium San Antonio, TX February 18, 2011

  2. Michael Lepore, PhD Director of Quality, Research, & Evaluation Planetree mlepore@planetree.org & Investigator in Community Health Brown University michael_lepore@brown.edu

  3. Collaborators

  4. Research Support • The Commonwealth Fund • Developing Systems to Support Person-Centered Care: Optimizing Planetree’s Continuing Care Designation Criteria and Measurement Strategies

  5. A note on language For the purpose of this presentation, the terms person-centered careand person-centerednessare used, though other terms also are recognized (patient-centered, resident-centered, family-centered, relationship-centered, etc.)

  6. Outline • Person-centered care (PCC) criteria and measures • Why develop PCC criteria and measures? • How were PCC criteria and measures developed? • What are the PCC criteria and measures? • How can we use the PCC criteria and measures?

  7. Why develop PCC criteria and measures?

  8. Why develop PCC criteria and measures? • The Institute of Medicine identified PCC as a healthcare priority • What is person-centered care? • “health care that establishes a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients wants, needs, and preferences and that patients have the education and support they require to make decisions and participate in their own care.” (IOM, 2001, Envisioning a National Healthcare Quality Agenda)

  9. Why develop PCC criteria and measures? • PCC is a complex concept requiring multiple dimensions of culture change MJ Koren (2010). Person-Centered Care For Nursing Home Residents: The Culture-Change Movement. Health Affairs, 29: 312-317

  10. Why develop PCC criteria and measures? • Benchmark performance internally / longitudinally • Benchmark performance externally / in comparison to competitors • Understand relationship between PCC and other factors (e.g., financial, regulatory performance)

  11. Why develop PCC criteria and measures? • Long-term care executives call for new measures • “I think measurement is key. We have to develop new measurements if we want new outcomes. And people pay attention to what we’re measuring, and many of the current measurements are still good, but we need additional measurements.” • Long-Term Care Improvement Guide (available for free download at www.planetree.org)

  12. How were PCC criteria and measures developed?

  13. How were PCC criteria developed?

  14. Multi-Method Evaluation Protocol

  15. How were PCC measures developed?

  16. What are the PCC criteria and measures?

  17. What are the PCC criteria? Eleven core Components each with specific criteria

  18. Planetree Components of Person-Centered Care Component I. Structures & Functions Necessary for Implementation, Development & Maintenance of Resident-Centered Concepts & Practices Component V. Nutrition Program Component VI. Healing Environment: Architecture & Design Component VII. Arts Program / Meaningful Activities / Entertainment Component VIII. Spirituality & Diversity Component II. Human Interactions / Independence Dignity & Choice Component IX. Integrative Therapies / Paths to Well-Being Component III. Resident Choice & Responsibility Component X. Healthy Communities / Enhancement of Life's Journey Component IV. Family Involvement Component XI. Measurement

  19. What are the PCC criteria?

  20. What are the PCC criteria?

  21. What are the PCC criteria?

  22. What are the PCC criteria?

  23. What are the PCC criteria?

  24. What are the PCC measures? • Quality Profile (QP) includes quantitative metrics for evaluating an organization’s performance with regard to important elements of PCC as identified in the literature and from providers • QP to be completed on last Friday of month

  25. What are the PCC measures? • The measures, like the criteria, are designed to teach and to motivate, not merely to avoid lapses in quality • They beckon affiliates to rise up to the challenge and to reach for excellence • Some measures relate to specific criteria, and some are more global (e.g., relating to org. health)

  26. Additional PCC measures • Measures broadly related to PCC, but not tied to specific criteria

  27. Summary • Person-centered care criteria established through review of literature and provider experiences and views • Multi-method system for evaluating person-centered care established • Quantitative instrument for measuring person-centered care established

  28. Next Steps • Identify sites to formally pilot measures • Provide sites data collection measurement guides (e.g., worksheets for measures) • Provide sites mentoring in data use • Test measurement instrument • Validity, Reliability, Harmonization/Transportability

  29. For guidance in achieving person-centered care, the Long Term Care Improvement Guide is available for free download at http://www.planetree.org Questions: mlepore@planetree.org

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