ANNOUNCEMENT: THRIVE Research Results, Coming Soon!

By / Posted on October 14th, 2015

Thrive2The buzz is about to begin !!  The THRIVE research team, which collected information in and about Green House homes and other nursing homes, completed its efforts.

Presentations of the results have been made at meetings of The Green House Project, the Pioneer Network, Advancing Excellence, LeadingAge, the Society for Post-Acute and Long-Term Care Medicine, the American Society on Aging, Academy Health, the Gerontological Society of America, and others.

In a few months, the THRIVE results will be published in Health Services Research, one of the top journals that impacts health practice and policy.  So, to repeat:  the “buzz” is about to begin!  2

Publication is expected to generate great interest and discussion among policy makers, providers, investors, and other stakeholders — promoting what works best about Green House homes and informing new practices. Green House webinars will be offered to provide updates along the way. Hold on for the ride!  MORE TO FOLLOW!


CARE: Dedicated to Improving How We Age

By / Posted on May 7th, 2015

The University of Wisconsin-Madison School of Nursing created the Center for Aging Research and Education (CARE) in response to the rapidly expanding care needs of our aging population. The center works toward transformation by using “…nursing leadership, discovery, education, and practice…” to support happiness, health and security for all older adults.

In a recent online post by the CARE team entitled, “What Makes a Green House Home? How You Decide Matters,” the author considers the persistence and commitment necessary to take the philosophical tenets of culture change and put them into practice.

The post describes how UW-Madison School of Nursing Associate Dean Barb Bowers, PhD, RN, FAAN and research manager Kim Nolet, MS have conducted research that analyzes the “lived experience” that the Green House model now has after more than 10 years as the pinnacle of culture change.

“By interviewing 166 staff members at 11 Green House homes, Bowers and Nolet identified patterns of problem solving as important to the erosion or reinforcement of the Green House model over time.”

The researchers found that along with the architecture of the Green House home, it is collaboration across the organization and between nurses and Shahbazim that allows the significant benefits of this model to be realized.

Both Bowers and Nolet are a part of The Research Initiative Valuing Eldercare (THRIVE). Interested in learning more about the THRIVE initiative? Take a look at this recent blog post which discusses the importance of the soon to be published THRIVE research results.

 

 

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Data Collection for THRIVE Projects is Now Complete

By / Posted on October 31st, 2014

The Green House Project has partnered with the Robert Wood Johnson Foundation’s THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes. Each quarter, a member of the THRIVE team will contribute a blog post to the Green House Project website.

Data collection for the THRIVE projects is now complete, and the research team is analyzing the results.  The THRIVE team will share research findings in upcoming articles in a special issue of the journal Health Services Research, and through conference and webinar presentations and blog posts.  In 2014, conference presentations will include those at annual meetings of LeadingAge (October), and the Gerontological Society of America, and the Green House (both in November).  This blog post is part of our series devoted to explaining research terms so that non-researchers can better understand these articles, presentations, and posts.  This post focuses on quantitative research – research based in numbers – and explains the important topic of “significance.”

Quantitative research findings are often discussed in terms of their statistical significance.  What does it mean to say a finding is significant?

Let’s consider an example.   A researcher thinks that there may be more female than male elders living in Green House homes.  This hunch is called a hypothesis.  The researcher visits all the Green House homes in the state, tallies the numbers of females (85) and males (15) and performs a statistical test to compare males and females.  The statistical test will result in a p-value (probability value) expressing whether the difference is large enough to indicate that it isn’t just by chance.

 

To better understand what it means to have a “large enough” difference, think of it this way:  if the number of females was 52, and the number of males was 48, the difference between these numbers is pretty small, and it’s not likely statistically significant.  The question is, is the difference between 85 and 15 large enough to suggest that there are statistically more females than males living in Green House homes?  A difference of 85 to 15 is probably large enough to not be by chance (i.e., it is statistically significant), whereas a difference of 52 to 48 is so small that it quite likely occurred by chance.

It’s also important to realize that findings that are statistically significant may not be clinically significant.  Clinical significance means that the information is important for clinical care.  In terms of care, does it matter that there are more females than males residing in Green House homes?  It does matter, for example, if women tend to be more depressed than men, or to have more family members.  However, if there are no clinical implications related to the difference, than they are statistically, but not clinically, significant.

The bottom line is that it’s important to carefully consider the meaning of all findings, and use your knowledge and judgment to interpret when differences matter and when they don’t.

Stay tuned for the next THRIVE blog post.  In the meantime, if you have questions about this post, or suggestions for future ones, please let us know.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).


Reducing Readmissions and Healthcare Costs: The Green House Solution

By / Posted on July 18th, 2014

In a recent issue of McKnight’s, I saw this headline – “Reducing readmissions should be No. 1 priority for reducing healthcare costs, quality experts say.”    That was a key conclusion of a recent online poll from 300 members of the American Society for Quality (ASQ) , which describes itself as the “largest network of quality resources and experts in the world” and includes prominent long-term care quality consultants.

It doesn’t take a quality expert to realize that reducing preventable readmissions is a great way to reduce healthcare costs.  By definition, “preventable” means wasted money.  In addition to saving money, reducing readmissions improves the quality of life for Elders, by minimizing the stress and disruption hospital admission causes.

Another article in McKnights from a couple of months ago suggests that pressure ulcer stats are the most reliable indicator of the likely readmission rate from a particular nursing home.  Based on an analysis of data from 4,000 hospitals, HSR: Health Services Research found that pressure ulcer prevalence in particular predicts whether a nursing home will readmit residents.

Can Green House homes help reduce readmissions?  The answer is a resounding “yes!”  In preliminary research (a complete study will be available later this year from the THRIVE research team), traditional nursing homes had readmission rates that were 7 points higher than Green House homes.  A related study found that the incidence of pressure ulcers in Green House homes was “significantly lower” than the incidence in traditional homes.

The bottom line?  The THRIVE research team concluded that the “overall difference in total Medicare and Medicaid costs per resident over 12 months (sum of hospitalization and daily care costs (RUG costs)) ranged from approximately $1,300 to $2,300 less for residents in Green House vs. traditional nursing homes” depending on RUG rates in the state.


THRIVE: Understanding the Language of Research

By / Posted on June 30th, 2014

The Green House Project has partnered with the Robert Wood Johnson Foundation’s THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes. Each quarter, a member of the THRIVE team will contribute a blog post to the Green House Project website.

As the THRIVE research projects head toward completion later this year, our research team has developed plans to share our research findings.  In addition to publishing articles in a special issue of the journal, Health Services Research, we also will share findings through conference and webinar presentations and blog posts.

Because some commonly used research terms may sound like jibberish to non-researchers (after all, who really knows what a p-value is?), we will devote our next few blog posts to explaining a few terms that will help non-researchers better understand the THRIVE articles, presentations, and posts.  We’ll start by reviewing Quantitative and Qualitative research designs.

When people think of research, they’re usually thinking of a Quantitative research design, which essentially measures and compares things.  Quantitative research asks questions like “How many residents in one nursing home have falls compared to residents in another?” or “Does providing one type of care work better than providing a different type of care?”  A quantitative research design allows a researcher to establish “how much”, whether one thing is related to another (such as whether falls are less frequent when certain care is provided), and also – depending on the details of the design – to establish cause and effect.  The data collected are usually in numerical form, and findings are expressed in terms including percents, means, and p-values (to answer the earlier question, a p-value denotes whether or not a number is or isn’t significantly ‘different’ from another…..we’ll come back to this in a future blog post).

Qualitative research designs essentially answer “how” and “why”.  Qualitative research asks questions such as “Why are so many falls occurring?” or “What conditions are necessary for a nursing home to provide a certain type of care?”  A qualitative research design permits a researcher to better understand events and the circumstances under which they occur and vary.  The information gathered in these types of studies are usually textual, and include the researchers notes and observations, as well as in-depth interviews and quotes from people who have knowledge of the event being studied.  This information is analyzed by looking for common themes across all of the information collected and reporting these findings – often contextualized using exemplative quotes.

The THRIVE team is using both quantitative and qualitative methods in their research, which is considered mixed-methods.  This is the best of both worlds, and is allowing us to answer questions such as:

Quantitative:    What was the annual turnover rate for shahbazim over the past two years?
Was this turnover rate statistically different (higher or lower) than that found
among CNAs in other nursing homes?

Qualitative:      What was the role of the Director of Nursing in the Green House homes?
How might variations in this role relate to shahbazim turnover?

Stay tuned for the next THRIVE blog post.  In the meantime, if you have questions about this post, or suggestions for future ones, please let us know.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).


Early Research Findings from THRIVE

By / Posted on March 26th, 2014

The Green House Project has partnered with the Robert Wood Johnson Foundation’s THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes. Each quarter, a member of the THRIVE team will contribute a blog post to the Green House Project website.

Early findings from the THRIVE research collaborative were published in The February 2014 Gerontologist supplement, Transforming Nursing Home Culture: Evidence for Practice and Policy, a themed issue providing evidence to inform practice and policy related to culture change.  The full articles can be accessed at http://gerontologist.oxfordjournals.org/content/54/Suppl_1.toc and are summarized here.

A paper entitled “A “Recipe” for Culture Change? Findings from the THRIVE Survey of culture change Adopters” provided information from a survey that assessed which components of culture change – and in what combinations – have been adopted by nursing homes.  The survey was completed by 164 nursing homes that had already adopted culture change.  Results showed that adopted components of culture change varied across the type of nursing home model (i.e., small house, household, traditional unit).  As one example, respondents from small houses reported a significantly higher rate of direct care workers preparing meals (79%), but these were some of the least adopted practices for other adopters (22% of households and 13% of traditional units).  Results also showed that some traditional environments have been able to implement certain culture change components without large capital investments.  For instance, respondents reported similar rates of practices related to educational support and quality improvement regardless the nursing home model.  Taken together, these findings suggest that although practices do vary by model, some components of culture change are attainable for homes that have fewer resources to invest in large-scale renovations or reorganization.

A paper entitled “Who are the Innovators? Nursing Homes Implementing Culture Change” focused on the organizational factors associated with culture change implementation.  Using a sophisticated analytic process, information from 16,835 nursing homes was used to determine which resident, facility, and state characteristics related to a nursing home later being identified by experts as having implemented culture change.   These characteristics included being nonprofit, larger in size, and with fewer Medicaid and Medicare residents. Implementers also had better baseline quality with fewer health-related survey deficiencies and greater licensed practical nurse and nurse aide staffing. These findings suggest that nursing homes are in a better position to implement culture change if they start out with more resources and fewer challenges.   In a related article entitled “Culture Change and Nursing Home Quality of Care”, analyses examined how culture change implementation related to later nursing home quality.  This study found that nursing homes identified as culture change adopters later had fewer health-related survey deficiencies, but there was no improvement in the MDS-based metrics of quality.  These finding may suggest that culture change improves nursing home processes of care, and/or that surveyors recognized the homes’ culture change efforts in their ratings.  The lack of impact on MDS outcomes may suggest that either the early focus of such efforts has not been on clinical outcomes, or that because nursing homes adopting culture change already had better outcomes, there was less room for improvement.

Finally, a paper entitled “Developing the Green House Nursing Care Team: Variations on Development and Implementation” explored the roles of the nurse and the Shahbazim in the Green House model, focusing on how variations in the nursing team related to clinical care practices. Data were collected through observations and interviews with nurses, Shahbazim, Guides, and Directors of Nursing, and found that implementation of the nursing role within the Green House model varied both within and across sites.  Four nursing model types were identified: Traditional (nurse manages both care and non-care activities); Parallel (nurse manages care, Shahbaz manage non-care activities); Integrated (nurse and Shahbaz collaboratively manage care and non-care activities); and Visitor (Shahbaz manage care and non-care activities, with input from nurse as requested).  Care processes, Shahbaz skill development, and worker stress varied across each model, and although the Integrated model presents considerable challenges in terms of clarifying boundaries, it seemed to offer the greatest benefits in the areas addressed in this study.  

The THRIVE team will be expanding upon these and other findings in 2014, and will be sharing those with you and others via conference presentations, webinars, blog posts, and more journal articles.  As always, we invite your feedback about the best ways to keep you informed of the latest findings.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).

 


THRIVE (The Research Initiative Valuing Eldercare) Update on Green House Homes

By / Posted on January 27th, 2014

The Green House Project has partnered with the Robert Wood Johnson Foundation’s THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes. Each quarter, a member of the THRIVE team will contribute a blog post to the Green House Project website.
The THRIVE research team is committed to the timely dissemination of findings relevant to The Green House Project homes and stakeholders.  Members of the THRIVE team recently presented preliminary research findings at the 2013 Green House meeting and in a January 2014 webinar.  Highlights from these presentations include:

David Grabowski (Harvard Medical School) debunked several common myths about The Green House model.  Using administrative data, David’s presentation showed that although higher resource nursing homes are more likely to adopt the Green House model than are lower resource nursing homes, these lower resource homes can be successful adopters with adequate vision and internal and external support.  His data also looked at culture change more generally, and found that culture change homes perform better on survey inspections — in fact, they lowered their health-related survey deficiencies by almost 15%!  David’s findings appear in the February issue of The Gerontologist journal:

Culture Change and Nursing Home Quality of Care

Who Are the Innovators?  Nursing Homes Implementing Culture Change

Lauren Cohen (University of North Carolina at Chapel Hill) presented data comparing the characteristics of Green House, higher culture change, and lower culture change nursing homes.  Interviews with guides and administrators found that a greater proportion of Green House homes offer resident choice in bedtime and get-up time, but not in bath time.  Lauren noted that previous research has shown that the desire for choice is not universal, and that predictability may be most important.  Her data also showed that Green House homes were less likely than culture change nursing homes to offer prescheduled daily activities, but were more likely to empower caregivers to lead activities.  So, it remains essential that empowered caregivers offer activities and encourage participation.

Kim Nolet (University of Wisconsin – Madison) reviewed the variations in how the Green House model is being implemented across homes, and discussed the implications of this variation.  Kim described variations in several Green House elements, including the role of the Shahbazim and the use of the den.  Her presentation suggested that model variations occur due to the challenges presented by critical events, organizational changes, daily routines, and subtle evolution in how things are done in Green Houses.  These challenges lead to problem-solving that sometimes results in reinforcement of the model and its core values, and other times in practices that are inconsistent with the core values of the model.

The THRIVE team will be expanding upon these and other findings in 2014.  We have planned conference presentations, webinars, blog posts, and journal articles to communicate our findings to you and others, and invite your feedback about the best ways to keep you informed of the latest findings.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).


THRIVE: The Research Initiative Valuing Eldercare

By / Posted on June 17th, 2013

 

 

 

The Green House Project has partnered with the Robert Wood Johnson Foundation’s THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes. Each month, a member of the THRIVE team will contribute a blog post to the Green House Project website.

Why is the Minimum Data Set so Important for Research?
The Minimum Data Set (MDS) – nothing very “minimum” about it! – was developed to monitor and improve the quality of care in nursing homes. Nursing home staff use it to develop resident care plans, and the information is used more widely to develop quality measures and resource utilization group case-mix reports. Indeed, the MDS is the source of the quality information on the Federal Nursing Home Compare website (www.medicare.gov/nhcompare).

What many nursing home staff don’t realize is that MDS information is tremendously useful for research. After all, it’s not often that a mandate exists to report on the status of over 400 data elements for roughly 1.5 million people across 16,000 settings on a regular basis, is it? Beyond purposes of oversight, this information provides a tremendously rich data set to understand the needs of older adults who receive nursing home care, as well as how their needs change over time, and differences in the care they receive across different homes and regions of the country.

Of course, some information in the MDS is more useful for research than other information. A number of items create “standardized” scales, such as those that compose the Brief Interview for Mental Status (BIMS), or the depression scale from the Patient Health Questionnaire (PHQ-9). Before being included in the MDS, these scales were tested to assure they are of research quality in terms of how reliably and validly they actually document mental status and depression. Other scales have since been created from the MDS items, such as one summarizing resident function, and tested for research-quality.

Hundreds of research studies have been conducted with MDS information; in fact, a literature search found almost 800 such studies! The focus of recent research relates to differences in incontinence by race, the relationship of fracture risk to antipsychotic medication use, and the relationship between resident pain and behaviors; clearly, research such as this and others is helpful to inform practice and policy.

The THRIVE team will be using MDS information in multiple ways. It will be used to inform the quality of care for residents, how it varies across participating sites, and how it changes over time. This information also will allow us to “control” for resident differences so we can better understand similarities and differences in care provision that are not related to differences in the resident population. In this way, the MDS is a powerful tool to help us all understand and predict the care needs of the people served in nursing homes.
Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).


Is There a Recipe for Culture Change?

By / Posted on January 7th, 2013

Is there a recipe for culture change? The Green House ‘recipe’ for culture change uses many ingredients. These include specific environmental features, like an open kitchen and private bathrooms, and also re-conceptualized staff (or Shahbazim) roles. Other nursing homes that have embraced culture change have a different recipe. Some, for example, have retrofitted, remodeled households, while others have more traditional environments; some utilize universal workers, but others do not. If culture change can appear unique on so many levels, what is it about the philosophy that really makes a difference? Are there any key ingredients for culture change? To better understand these questions, the THRIVE research team surveyed culture change adopters to learn more about their practices and environments.
What do most adopters report? These adopters most often reported certain relationship-based practices such as the use of staff consistent assignment or family member participation in care conferences. They also reported similar components of work organization and decentralized decision-making such as non-activity staff helping to choose activities and the ability of staff to fulfill requests without prior approval from an administrator. Adopters also reported similar mixtures of ingredients to enhance resident choice including dining in the small house or household to support choice in mealtime.
Are there differences in the culture change components that adopters report? Yes. There were distinct differences in the recipes of small houses, households and more traditional environments.  For example, small house models were more likely to report that direct care staff schedule themselves and choose care assignments, but these were some of the least adopted practices for other adopters. Small houses are also more likely to have CNAs attend care conferences and less likely to use overhead pagers or med carts than other adopters. Meal preparation varied for all three models. For example, small houses were more likely to prepare food in a kitchen in the home while households were more likely to use steam tables with food prepared in a centralized kitchen.
The THRIVE research team is in the process of studying the survey results to better describe the recipes of culture change adopters. As pay-for-performance and policy programs are developed to incentivize culture change, understanding the core ingredients in implementation can promote a recipe for change that is attainable for a broad range of providers.
The Green House Project has partnered with the Robert Wood Johnson Foundation’s
THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood
Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes.  Each month, a member of the THRIVE team will contribute a blog post to the Green House Project website.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).


Thrive Research: Culture Change Sustainability in the Green House Model

By / Posted on April 4th, 2012

The Green House Project has partnered with the Robert Wood Johnson Foundation’s THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care.  Supported by the Robert Wood Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes.  Each month, a member of the THRIVE team will contribute a blog post to the Green House Project website.

 

One of the broad concepts that long term care researchers, practitioners, and consumers are interested in is culture change. It’s hard to find a long-term care setting that doesn’t claim to be engaged in culture change in some way.  Many see it as a shift from the traditional institutional “one-size fits all” model of providing care to one that focuses on “person centered” care.  But are people walking the walk, or just talking the talk?  What extent of change is necessary to really change the culture?

The Green House is one model of culture change that uses a comprehensive approach to culture change, including creation of specific environmental features, alteration of traditional care practices, and re-organization of staff roles.  Alternately, some nursing homes have changed by adopting a single practice, such as consistent assignment of staff, or resident choice about what time to awake  in the morning. Some have changed the environment to offer private rooms, more intimate dining rooms, or more private lounge spaces.  Also, environmental changes using a “hotel amenity” approach are becoming particularly common to attract people who need short-stay rehabilitation.

Does any or all of this equal “culture change”? Can smaller changes achieve the same outcomes as more extensive changes? Are there specific practices or environmental changes that are necessary to achieve certain outcomes?  When are changes sufficient to suggest that culture change has occurred?  Is all culture change equal? 

Research suggests that change in an organization occurs only when a new way of doing things is generally accepted throughout an organization, and when policies, procedures, and routine practices are aligned with the new way of operating.  So, when implementing culture change, it’s important to ask:

1)     Do we generally agree about what is important?

2)     Are we all moving in the same direction, toward what we believe is important?

3)     Do our policies and procedures support this new way of operating or are they at odds with where we say we’re going to do?

The THRIVE research team will be exploring some of these questions with culture change organizations, many of which are Green House homes, and strives to understand how culture change is achieved and sustained within these organizations.

 

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).


Thrive Research: Guidelines for Reducing Risk Levels

By / Posted on February 24th, 2012

There are different types of research, and some are riskier than others.  Take the study of new medications, for example.  While a medication is tested for safety before people are asked to participate in a study to see how well it works, there might still be unknown risks to taking it and it’s not certain that the medication will be effective.  Some other types of research are very low risk, including studies that learn new things by watching people and asking them about care practices – both of which describe the THRIVE study that is learning about Green House homes and different models of nursing home care. 

To keep risks as small as possible, all research studies must follow guidelines.  Even low risk studies where researchers are simply watching people and asking questions must follow guidelines.  To make sure that researchers follow the guidelines, every study must first be reviewed and approved by an Institutional Review Board (or IRB), sometimes referred to as an ethics committee. 

A few of the rules that must be followed include:

 

  • Respect for people participating in studies.  This means that people must be volunteers and not feel coerced, and must consent (often in writing) to participating.  There are special rules to protect people who have trouble making their own decisions (such as children or people with advanced dementia).  Respect for people participating in studies also includes protecting confidentiality.  For example, researchers aren’t allowed to tell anyone the identity of who participated in a study. 
  • Beneficence.  This fancy word means that there must be a possibility that the research will benefit society, and that it will not harm society or the people participating.  When there are risks to taking part in research, the potential benefits must outweigh the risks.  A good example of beneficence is when a new drug might have some risks and side effects, but might also have the potential to cure cancer, so might be worth the risk.
  • Justice.  Research should benefit as many people as possible.  This means that unless there is a good reason why some people can’t or shouldn’t be in a research study (such as a study about pregnancy which might justifiably exclude men), everyone should have the right to participate in, and possibly benefit from, research.

All research conducted by the THRIVE collaborative has been reviewed and approved by an IRB.  Approval for THRIVE has been pretty easy, as THRIVE is a low risk study. THRIVE is collecting information to learn about existing components of care and resident status, to understand specifically which types of care are better care. We expect to learn ways to improve care, which will benefit all of us.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).

The THRIVE research studies are funded by the Robert Wood Johnson Foundation.


THRIVE Research – What does this mean for Green House Homes?

By / Posted on January 26th, 2012

THRIVE Research – What does this mean for Green House Homes?

 

You’ve probably heard about the THRIVE  research studies aimed at learning more about how the Green House model works and how it differs from other models of care.   You might be curious what this means for the Green House projects over the next few years.

 

Many of the Green House projects will be getting calls over the next year to discuss participation. Research team members from Pioneer Network, University of Wisconsin-Madison, University of North Carolina, and Health Management Strategies will be contacting several projects to ask them to participate in one or more parts of the study.

 

Here are some terms you might hear or see:

 

Questionnaires: These are paper or electronic surveys staff complete on a topic.

 

Site Visit: Several Green House projects will be asked to host a visit by a small team of friendly researchers (usually 2-4 people).  The purpose of the visit is to collect information on what life is like in the Green House homes for shabhazim and elders and how care is provided.

 

Interviews: Interviews are one way researchers get to know details about how things work in the Green House homes. Interviewees will be asked questions that allow them to tell stories and share their experiences.

 

What is a site visit like? 

Enjoyable !  A site visit from the research team is not like a visit from state regulators, in that the intent is to learn and not to evaluate.  It’s a time for researchers to learn about what life and care is like in a Green House, and for Green House staff, shabhazim, and elders to have the opportunity to contribute to what is being learned.  

 

Lori Kinney, Green House Guide at Lebanon Valley Brethren Home, has experienced a few site visits from research teams. “The research team’s communication was great, whether it was through emails or phone conversations. The visits went well… Since we, staff and elders, were prepared for the visits from the research team, things moved along swiftly and elders always appreciate visits from ‘new’ people that enjoy listening and talking with them.”

 

The researchers understand that the Green Houses are the elders’ homes and intend to minimize disruption as much as possible. The researchers are flexible and know things can “pop up” that make it difficult for staff to attend to the research needs during the visit. Elder’s needs are always the top priority.

 

The research team looks forward to working with the Green House homes! Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).

 

 The THRIVE research studies are funded by the Robert Wood Johnson Foundation.