Evidence map›Paper›PMID 34979138›Full record

ArticleJournal of the American Medical Directors Association2022

Implementing Large-Scale Data-Driven Quality Improvement in Assisted Living.

Edmond Ramly, Reid Parks, Theresa Fishler, James H Ford, David Zimmerman, Susan Nordman-Oliveira

Abstract read
In one paragraph

Article in Journal of the American Medical Directors Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Edmond RamlyDepartment of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA. Electronic address: ramly@wisc.edu.
Reid ParksDepartment of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Theresa FishlerDepartment of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
James H FordSchool of Pharmacy - Social and Administrative Sciences Division, University of Wisconsin-Madison, Madison, WI, USA.
David ZimmermanDepartment of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA.
Susan Nordman-OliveiraDepartment of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.

Funding

Institutional Clinical and Translational Science AwardUL1TR000427 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI DREZNER, MARC KENNETH · 2012 to 2016
$32.2M
NCATS NIH HHS UL1 TR000427
6 · The paper itself

Abstract

objectivesDevelop and evaluate the implementation of a proposed model for large-scale data-driven quality improvement in assisted living.

designWe conducted a mixed-methods evaluation of the implementation of a large-scale data-driven quality improvement collaborative of Wisconsin assisted living communities (ALCs). SETTING AND

participantsThe model has been voluntarily implemented by 810 Wisconsin-licensed ALCs serving >20,000 residents.

methodsThe model was codesigned iteratively 2009-2012 by a public-private multistakeholder advisory group. Using system usage statistics and project records, we evaluated implementation outcomes: appropriateness, acceptability, adoption, feasibility, fidelity, penetration, and sustainability.

resultsImplementation for ≥1 quarter was feasible for 92% of the 810 ALCs that enrolled. The model has been deemed appropriate and acceptable by public-private stakeholders representing residents, providers, regulators, and payers, and appropriateness for ALCs serving different populations has been iteratively improved through targeted workgroups. The model is currently adopted in Wisconsin by 31% of the 1573 ALCs in provider associations. Among adopters, 88% on average implemented the model with fidelity to key membership rules per quarter. The model achieved demographic and institutional penetration by currently reaching 24% of Wisconsin ALC residents and by leveraging initial grant funding to become integrated in Wisconsin's annual Medicaid budget and being central to Wisconsin's incentive program to managed care organizations. Model implementation for 8 years has been sustained by member enrollment for nearly 4 years on average, with 71% of members enrolled >2 years and sustained early adopters representing 37% that have been enrolled >5 years. CONCLUSIONS AND IMPLICATIONS: This is the first implementation study of large-scale data-driven quality improvement in assisted living, despite its demonstrated value in other health care sectors. The article proposes a model with core components and implementation strategies drawing on a decade-long public-private collaboration. The implementation study findings establish a promising path and future directions for wider implementation.

Indexed as

MedicaidQuality ImprovementHumansWisconsinAssisted livingimplementationquality improvement

Identifiers

PMID34979138
PMCPMC12825321

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.