Abstract
State Support for Long-Term Care Facilities in Massachusetts During the COVID-19 Pandemic: A Qualitative Evaluation
APHA 2022 Annual Meeting and Expo
Background: From April 2020 to July 2021, the Massachusetts Department of Public Health (DPH) administered the COVID-19 Outreach Project, in which 22,209 phone calls were made to long-term care facilities (LTCF) to collect real-time data about COVID-19 outbreaks, offer guidance, and connect facilities to resources such as supplementary staffing and the state PPE stockpile. We then evaluated the program to assess impact and identify lessons learned.
Methods: In the fall of 2021, we conducted 37 in-depth semi-structured interviews with 15 DPH and 22 LTCF staff members who participated in the COVID-19 Outreach Project. Interviews were completed via phone or videoconferencing, lasting 30 minutes on average. Interviews were analyzed using deductive and inductive thematic analysis. Resource utilization was also analyzed to assess program impact and to inform stratified sampling of LTCF participants.
Results: Three themes emerged from the interviews: Program Processes, Service Utilization, and Quality of Support and Connections. Strengths and weaknesses were identified for each theme. Most interviewees found the program to be a source of informational and emotional support for LTCF staff. LTCFs expressed areas of improvement in the communication of expectations and streamlining data collection efforts across regulatory entities. Most interviewees expressed feeling overwhelmed and emotionally drained.
Conclusions: The program was effective in achieving its aims of collecting accurate outbreak data, providing guidance, and connecting facilities to resources. This program strengthened trust between LTCFs and DPH, facilitating better outcomes for pandemic response. Future work should prioritize collaborative approaches over punitive, and provide mental health resources for both program staff and LTCF staff.