Physicians' Views on Advance Care Planning and End-of-Life Care Conversations.

Objectives: To evaluate physicians' views on advance care planning, goals of care, and end-of-life conversations.

Design: Random sample telephone survey.

Setting: United States.

Report on milestones for care and support under the U.S. National Plan to Address Alzheimer's Disease.

Introduction: Under the U.S. national Alzheimer's plan, the National Institutes of Health identified milestones required to meet the plan's biomedical research goal (Goal 1).

The preferences for everyday living inventory: scale development and description of psychosocial preferences responses in community-dwelling elders.

Purpose Of The Study: Assessing preferences for daily life is the foundation for person-centered care delivery. This study tested a new measure, the Preferences for Everyday Living Inventory (PELI), with a large sample of community-dwelling older adults. We sought to evaluate the tool's convergent and divergent validity, identify the most commonly held preferences within the sample, and explore relationships between gender and race and strength of preferences.

Reducing perceived barriers to nursing homes data entry in the advancing excellence campaign: the role of LANEs (Local Area Networks for Excellence).

Purpose: Advancing Excellence (AE) is a coalition-based campaign concerned with how society cares for its elderly and disabled citizens. The purpose of this project was to work with a small group of volunteer nursing homes and with local quality improvement networks called LANEs (Local Area Networks for Excellence) in 6 states in a learning collaborative. The purpose of the collaborative was to determine effective ways for LANEs to address and mitigate perceived barriers to nursing home data entry in the national Advancing Excellence campaign and to test methods by which local quality improvement networks could support nursing homes as they enter data on the AE Web site.

Factors associated with perceived effectiveness of local long-term care ombudsman programs in New York and California.

Objective: Long-term care (LTC) ombudsman advocate for the health, safety, welfare, and rights of residents in LTC facilities. This article examines factors associated with self-rated effectiveness of local LTC Ombudsman Programs (LTCOPs) in California and New York across the five statutorily mandated activities under the Older Americans Act: complaint investigation, resident/family education, community education, monitoring laws, and policy advocacy.

Method: Data were collected from telephone interviews with coordinators of local LTCOPs in California and New York and from the National Ombudsman Reporting System.

Translating research into practice: transitional care for older adults.

Rationale: Over the last decade, in order to close the safety and health care quality chasm, there has been a growing imperative to translate evidence-based research into practice.

Aims And Objectives: This study examines the major facilitators and barriers of implementing in a large US insurance organization - Aetna Corporation - an evidence-based model of care, the Transitional Care Model, which has been rigorously tested over the past twenty years by a multidisciplinary team at the University of Pennsylvania.

Methods: Semi-structured interviews of 19 project leaders, case managers, and transitional care nurses were conducted during two phases of translation - start-up and roll out.

Person-centered care for nursing home residents: the culture-change movement.

The "culture change" movement represents a fundamental shift in thinking about nursing homes. Facilities are viewed not as health care institutions, but as person-centered homes offering long-term care services. Culture-change principles and practices have been shaped by shared concerns among consumers, policy makers, and providers regarding the value and quality of care offered in traditional nursing homes.

Where should Momma go? Current nursing home performance measurement strategies and a less ambitious approach.

Background: Nursing home performance measurement systems are practically ubiquitous. The vast majority of these systems aspire to rank order all nursing homes based on quantitative measures of quality. However, the ability of such systems to identify homes differing in quality is hampered by the multidimensional nature of nursing homes and their residents.

Continuous quality improvement as an innovation: which nursing facilities adopt it?

Purpose: We identify environmental and organizational predictors that best discriminate between formal continuous quality improvement (CQI) adopters and nonadopters in nursing homes (NHs) and create a diagnostic profile for facility administrators and policy makers to promote CQI.

Design And Methods: We performed a cross-sectional survey of licensed NH administrators in New Jersey in 1999, using The Nursing Care Quality Improvement Survey ( Zinn, Weech, & Brannon, 1998) and The New Jersey NH Profiles Chart. We also performed a discriminant analysis.

Translating research into practice: speeding the adoption of innovative health care programs.

For this study, the authors conducted case studies of four varied clinical programs to learn key factors influencing the diffusion and adoption of evidence-based innovations in health care. They found that the success and speed of the adoption/diffusion process depend on: the roles of senior management and clinical leadership; the generation of credible supportive data; an infrastructure dedicated to translating the innovation from research into practice; the extent to which changes in organizational culture are required; and the amount of coordination needed across departments or disciplines. The translation process also depends on the characteristics and resources of the adopting organization, and on the degree to which people believe that the innovation responds to immediate and significant pressures in their environment.