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Improving Nursing Home Care through Feedback On PerfoRMance Data (INFORM): Protocol for a cluster-randomized trial

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Improving Nursing Home Care through Feedback On PerfoRMance Data (INFORM): Protocol for a cluster-randomized trial
Published in
Trials, January 2017
DOI 10.1186/s13063-016-1748-8
Pubmed ID

Matthias Hoben, Peter G. Norton, Liane R. Ginsburg, Ruth A. Anderson, Greta G. Cummings, Holly J. Lanham, Janet E. Squires, Deanne Taylor, Adrian S. Wagg, Carole A. Estabrooks


Audit and feedback is effective in improving the quality of care. However, methods and results of international studies are heterogeneous, and studies have been criticized for a lack of systematic use of theory. In TREC (Translating Research in Elder Care), a longitudinal health services research program, we collect comprehensive data from care providers and residents in Canadian nursing homes to improve quality of care and life of residents, and quality of worklife of caregivers. The study aims are to a) systematically feed back TREC research data to nursing home care units, and b) compare the effectiveness of three different theory-based feedback strategies in improving performance within care units. INFORM (Improving Nursing Home Care through Feedback On PerfoRMance Data) is a 3.5-year pragmatic, three-arm, parallel, cluster-randomized trial. We will randomize 67 Western Canadian nursing homes with 203 care units to the three study arms, a standard feedback strategy and two assisted and goal-directed feedback strategies. Interventions will target care unit managerial teams. They are based on theory and evidence related to audit and feedback, goal setting, complex adaptive systems, and empirical work on feeding back research results. The primary outcome is the increased number of formal interactions (e.g., resident rounds or family conferences) involving care aides - non-registered caregivers providing up to 80% of direct care. Secondary outcomes are a) other modifiable features of care unit context (improved feedback, social capital, slack time) b) care aides' quality of worklife (improved psychological empowerment, job satisfaction), c) more use of best practices, and d) resident outcomes based on the Resident Assessment Instrument - Minimum Data Set 2.0. Outcomes will be assessed at baseline, immediately after the 12-month intervention period, and 18 months post intervention. INFORM is the first study to systematically assess the effectiveness of different strategies to feed back research data to nursing home care units in order to improve their performance. Results of this study will enable development of a practical, sustainable, effective, and cost-effective feedback strategy for routine use by managers, policy makers and researchers. The results may also be generalizable to care settings other than nursing homes. ClinicalTrials.gov Identifier: NCT02695836 . Date of registration: 24 February 2016.

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The data shown below were compiled from readership statistics for 173 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 173 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 27 16%
Student > Bachelor 23 13%
Student > Ph. D. Student 14 8%
Researcher 13 8%
Student > Doctoral Student 10 6%
Other 35 20%
Unknown 51 29%
Readers by discipline Count As %
Nursing and Health Professions 42 24%
Medicine and Dentistry 28 16%
Psychology 12 7%
Social Sciences 11 6%
Economics, Econometrics and Finance 4 2%
Other 22 13%
Unknown 54 31%