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Staff engagement for practice change in long-term care: evaluating the Feasible and Sustainable Culture Change Initiative (FASCCI) model

Caspar, Sienna, Berg, Kelsey, Slaughter, Susan, Keller, Heather and Kellett, Peter (2019) Staff engagement for practice change in long-term care: evaluating the Feasible and Sustainable Culture Change Initiative (FASCCI) model. Journal of Long-Term Care, 2020. 30 - 41. ISSN 2516-9122

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Identification Number: 10.31389/jltc.25

Abstract

Context: Interventions aimed at increasing the provision of person-centred care in long-term care (LTC) homes, that do not address contextual and system issues, most often fail. Promoting positive change in LTC homes requires requires a multilevel, systems approach. Objectives: Evaluate the effectiveness of the Feasible and Sustainable Culture Change Initiative (FASCCI) model for improving the provision of person-centred mealtime practices in a LTC home. Methods: A single-group, time series design was used to assess the impact of the FASCCI model for change on outcome measures across four time periods (pre-intervention, 2-month, 4-month and 6-month follow-up). Differences in scores from baseline were assessed utilizing Wilcoxon signed-rank tests. Interviews (n = 21) were also conducted to examine treatment fidelity and to ascertain the study participants’ perceptions of the process for making improvements using the FASCCI model. Findings: We observed increases in care staff’s capacity to consistently provide relational and person-centred care during mealtimes. Mealtime environment scores started increasing immediately following the intervention, with statistically significant improvements in all mealtime environment scales by six-months, including: the physical environment (W = 55.00, p = 0.008); social environment (W = 55.00, p = 0.008); relationship-centred care (W = 45.00, p = 0.014); and overall quality of dining environment (W = 55.00, p = 0.010). Analysis of data from qualitative interviews demonstrated that use of the FASCCI model resulted in improved team leadership, communication, and collaborative decision-making. Limitations: Generalizability is limited due to the small sample size and use of convenience sampling methods. Implications: Outcomes indicate that the FASCCI model seems promising in its ability to improve PCC mealtime practices in LTC homes and is worthy of a larger scale study. The results further demonstrate the value of supportive team environments in quality dementia care.

Item Type: Article
Official URL: https://journal.ilpnetwork.org/
Additional Information: © 2020 The Authors
Divisions: LSE
Subjects: R Medicine > RA Public aspects of medicine
H Social Sciences > HD Industries. Land use. Labor
Date Deposited: 24 Aug 2020 14:03
Last Modified: 20 Sep 2020 23:25
URI: http://eprints.lse.ac.uk/id/eprint/106227

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