Using the IHI-Model for Improvement and a brief encounter education format to implement best practices in long term care settings

Objectives: Using principles of adult education and the IHI-Model for Improvement, to facilitate nurse-led improvement teams testing and adapting evidenced based clinical guidelines in their long term care settings and measuring the effects on resident care in quality improvement projects. Methods: Three long term care facilities in DC participated in IHI-style nine month Collaboratives over the course of three years. Long Term Care staff on nurse led teams were taught the plan-do-study-act method for improving quality care at the bedside. Each team chose a problem to work on and changes were tested. Teams kept track of the effectiveness of using the best practices by monitoring resident outcomes. In addition to participating in the quality improvement collaborative, staff at each facility participated in a unique brief encounter education programs that consisted of focused 20-minute-one-objective learning session. Results: Evaluations of the brief encounter education program indicate the majority of respondents were in favor of the teaching strategies, found the sessions helpful and were satisfied with the program content. The quality improvement projects yielded varying degrees of improvement in falls, pressure ulcer rates, pain reduction and bowel and bladder training using evidence based practice guidelines and tools. Conclusions: The education format improved the day to day work of staff, and offered a solution to educating long term care staff. The IHI Model can be used in long term care with nurse team leaders and offers opportunities for improving patient care and team work by incorporating best practice guidelines.