Redesign of Health Services: Pilgrim Place

1. Redesign of Health Services: Pilgrim Place MPA 504 and ►Dr. S. M. Emerson JUNE 16, 2012

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

3. Research Questions • How to assess the quality of life in neighborhoods? • How to compare perceptions of elders (residents) and staff? Tyee Research Agenda

4. Scope of Research Develop survey instrument. Conduct baseline measurement. Periodic follow-up measurements. Analyze survey data. Kevin M

5. Limits to Scope NOT applicable for medical or ADL assessment NOT a substitute for supervision or other research method. Kevin M.

6. Research Process • Consultation • Survey of literature • Pre-test of instrument and Informed Consent • Analysis of instrument Kevin D. Steps Taken

7. Research Process • Consultation • Survey of literature • Pre-test of instrument and Informed Consent Form (ICF) • Analysis of Instrument Kevin D Steps Taken

8. Analysis Measures Validity Reliability Robustness Criticality Duplicates Diana

9. Analysis by Topic _ Diana

10. Services Robust but: • Amend question 2 to serve as outcome questions • Delete question 2 for more concise instrument Bathing and Dressing (Questions 1 – 4 & 2.1 – 2.2) Keiry

11. Services • 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 Food (Questions 5 – 7 & 2.4 – 2.8)

12. Services • Delete two questions: “Satisfaction with staff assistance using restroom” • Neither robust nor reliable • “Feeling of safety when alone in the halls” • Zero variance Mobility (Questions 8 – 10, 2.3, 2.15, 2.25, 2.31, 2.32) • Kevin D.

13. Environment • Questions since robust and reliable. • Diana Living Areas (Questions 11 – 16, 2.24, & 2.26 – 2.30)

14. Environment • Looked at four variables • All questions robust and reliable. • Kevin M Noise (Questions 17 and 2.17)

15. Activities • 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 John B (Questions 18 – 20, 2.9 – 2.11, 2.20, 2.22, & 2.23 ii)

16. Well being and respect (Questions 21 – 23, 2.12, 2.14 – 2.16a, 2.18, 2.19, 2.23 i, 2.33, 2.34) • 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

17. 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

18. Open Ended and Tri City • Few additional remarks • One open ended question for “other positive or negative comments”. • Parker • Delete Tri-City questions

19. Management Concerns • Balancing Question Utility in Context of Regulations • Marginal utility in measuring quality of life. • Parker

20. Conclusions Revisions to survey instrument Recommendations to survey process Keiry

21. Recommendations – Cal Poly Based on class analysis Modify survey instruments Modify staff survey process Summer 2012 – Survey staff Fall 2012 – Survey residents John B.

22. Recommendations – Pilgrim Place Delete regulatory and marginal QOL questions Add questions to Staff survey Separate Tri-City Wellbeing survey Conduct HSC survey on rotating basis John B.

23. Questions ? _Tyee

24. Thank you Dr. Emerson