(1) Direct observation of
(a) Residents’ daily life (b) Residents’ medical care (c) Treatment team meetings (d) Staffa meetings (e) Tesident committee meetings
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(a) Structured, facility-generated observation tool to capture residents’ lived, longitudinal (if possible) experience or brief notes from multiple, timed, unobtrusive observation of residents (again, longitudinal may be preferred) (b) Notes from unobtrusive, respectful shadowing of clinical staff during residents’ medical care (c) Notes from silent observation of treatment team meetings by non-participating observer (d) Notes from silent observation of staff meetings by non-participating observer (e) Notes from silent observation of resident committee meetings by non-participating observer
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(2) Interviews
(a) With residents (b) With staffa (c) With family
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(a), (b), and (c): pre-formulated list of non-leading interview questions (open-ended or a mix of open- and
closed-ended) with interviews conducted by someone not directly involved in resident's care or staff
member's performance evaluation |
(3) Focus groups
(a) With residents (b) With staffa (c) With family
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(a), (b), and (c): pre-formulated list of non-leading focus group questions (open-ended or a mix of open- and
closed-ended) with focus groups conducted by someone experienced in listening and group facilitation who
is not directly involved in residents’ care or staff members’ performance evaluations |
(4) Surveys
(a) Of residents/family (b) Of staffa
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(a) and (b): survey tool with non-leading questions (closed- and/or open-ended) with responses collected by
anonymous method (e.g., no name on survey, deposit in sealed drop box in common area; Web-based) |
(5) Review of documents relating to
(a) Treatment team meetings (b) Notes in residents’ charts about specific issues (c) Records of residents’ use of time (d) Facility organizational structure and processes (e) Staffa meetings (f) Resident committee meetings (g) Quality and safety concerns (h) Staff training
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(a) Brief notes taken on standardized template, from review of treatment team meeting notes from pre-identified time period, with focus on particular topic of interest (e.g., evidence of resident/family member participation and team's follow-through on resident/family member requests) (b) Brief notes taken on standardized template, from review of pre-identified, specific areas of resident chart for pre-identified time period, with focus on particular topic of interest (c) Standardized template used to record information (e.g., numbers or words) about residents’ meaningful use of time from relevant document sources for pre-identified time period; template should have space to note lack of documentation (d) Standardized template used to record information from facility records; template should have space to note lack of documentation (e) and (f): brief notes taken on standardized template from review of documents pertaining to these meetings for pre-identified time period, with focus on particular topic of interest (g) Standardized template used to collect data consistently and longitudinally from relevant documents on implementation of culture change and incidence of established quality indicators or other safety concerns; ideally, baseline period should be established for incidence rates prior to new culture change intervention initiation (h) Standardized template used to record information about type, quantity, frequency, duration, attendance, availability, quality, etc. of staff trainings on particular topic of interest
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