Abstract
One purpose of this study was to understand whether the Music and Memory (M&M) program, designed to help residents with dementia, could be implemented as a Quality Assurance Performance Improvement (QAPI) process and whether a tailored QAPI tool would improve implementation and sustainability in nursing homes (NHs). There are 5.4 million Americans with dementia; 70% reside in NHs and a significant number are reported to have behavioral and psychiatric symptoms, many of whom have been treated with antipsychotics. M&M is a program that provides an alternate to antipsychotics through personalized music that can be implemented in NHs as a quality improvement project. Research has shown that NHs have been challenged in implementing and sustaining quality improvement. This was a quasi-experimental study with NHs randomized to intervention and control groups. All NHs received M&M equipment – a computer, iPods, earphones. Both the control and intervention groups were provided QAPI at a Glance, a publicly available document; the intervention group also received a tailored QAPI tool. Of the NHs submitting data, 74% of NHs were planning, in progress, or fully using a QAPI approach at the end of 12 months. Of the intervention group (n=26), 50–75% reported they were in progress or fully using the tailored QAPI tool. Over 40% reported the tool to be somewhat helpful and 37–42% reported the tool mostly to extremely helpful. Early findings from this study suggest that most NHs take a QAPI approach to implementing M&M and that a tailored QAPI implementation guide may be helpful.