Testing the Implementation of Function-focused Care in Assisted Living Settings

Objectives: The purpose of this study was to evaluate the Function-Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT) intervention. Design: FFC-AL-EIT was a randomized controlled pragmatic trial including 85 sites and 794 residents. Intervention: FFC-AL-EIT was implemented by a Research Nurse Facilitator working with a facility champion and stakeholder team for 12 months to increase function and physical activity among residents. FFC-AL-EIT included (Step I) Environment and Policy Assessments; (Step II) Education; (Step III) Establishing Resident Function-Focused Care Service Plans; and ( Step IV) Mentoring and Motivating. Setting and Participants: The age of participants was 89.48 years [standard deviation (SD) = 7.43], and the majority were female (n = 561; 71%) and white (n = 771; 97%). Methods: Resident measures, obtained at baseline, 4, and 12 months, included function, physical activity, and performance of function-focused care. Setting outcomes, obtained at baseline and 12 months, included environment and policy assessments and service plans. Results: Reach was based on 85 of 90 sites that volunteered (94%) participating. Effectiveness was based on less decline in function (P < .001), more function-focused care (P = .012) and better environment (P = .032) and policy (P = .003) support for function-focused care in treatment sites. Adoption was supported with 10.00 (SD = 2.00) monthly meetings held, 77% of settings engaged in study activities as or more than expected, and direct care workers providing function-focused care (63% to 68% at 4 months and 90% at 12 months). The intervention was implemented as intended, and education was received based on a mean knowledge test score of 88% correct. Evidence of maintenance from 12 to 18 months was noted in treatment site environments (P = .35) and policies continuing to support function-focused care (P = .28)]. Conclusions and Implications: The Evidence Integration Triangle is an effective implementation approach for assisted living. Future work should continue to consider innovative approaches for measuring RE-AIM outcomes. (C) 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Automated summary

The Function-Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT) intervention successfully increased function and physical activity among residents, with improved environment and policy support. The study showed that the intervention was effectively implemented, providing insights for future assisted living care practices.