Tri-focal Model of Care Implementation: Perspectives of Residents and Family

Alison Hutchinson; Helen Rawson; Beverly O'Connell; Helen Walker; Tracey Bucknall; Helen Forbes; Joan Ostaszkiewicz; Cherene Ockerby

doi:10.1111/jnu.12269

Tri-focal Model of Care Implementation: Perspectives of Residents and Family

J Nurs Scholarsh. 2017 Jan;49(1):33-43. doi: 10.1111/jnu.12269. Epub 2016 Nov 21.

Authors

Alison Hutchinson¹, Helen Rawson², Beverly O'Connell³, Helen Walker⁴, Tracey Bucknall⁵, Helen Forbes⁶, Joan Ostaszkiewicz⁷, Cherene Ockerby⁸

Affiliations

¹ Lambda Pi-at-Large, Professor of Nursing, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery; Chair in Nursing, Centre for Nursing Research - Deakin University & Monash Health Partnership, Melbourne, Australia.
² Research Fellow, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Centre for Nursing Research - Deakin University & Monash Health Partnership, Melbourne, Australia.
³ Dean and Professor, College of Nursing, Rady, Faculty of Health Sciences; University of Manitoba, Canada and Honorary Professor, Deakin University, Melbourne, Australia.
⁴ Research Manager, Centre for Research in Assessment and Digital Learning, Portfolio of the Deputy Vice-Chancellor, Deakin University, Melbourne, Australia.
⁵ Xi Omicron, Associate Head of School (Research), Professor of Nursing, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery; Foundational Chair of Nursing, Alfred Health, Melbourne, Australia.
⁶ Associate Head of School (Teaching & Learning), Associate Professor of Nursing, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Melbourne, Australia.
⁷ Research Fellow, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research School of Nursing and Midwifery, Melbourne, Australia.
⁸ Research Assistant, Centre for Nursing Research - Deakin University & Monash Health Partnership, Melbourne, Australia.

Abstract

Purpose: To explore residents' and family members' perceptions of partnership-centered long-term care (LTC) associated with implementation of the Tri-focal Model of Care. The Model promotes partnership-centered care, evidence-based practice, and a positive environment. Its implementation is supported by a specifically designed education program.

Methods: The Model was implemented over approximately 12 months in seven LTC facilities in Victoria, Australia. A qualitative exploratory-descriptive approach was used. Data were collected using individual and focus group interviews with residents and family members prior to and following implementation of the Model. Data were analyzed thematically.

Findings: Prior to implementation of the Model, residents described experiencing a sense of disempowerment, and emphasized the importance of communication, engagement, and being a partner in the staff-resident care relationship. Following implementation, residents reported experiencing improved partnership approaches to care, although there were factors that impacted on having a good experience. Family members described a desire to remain involved in the resident's life by establishing good communication and rapport with staff. They acknowledged this was important for partnership-centered care. Following implementation, they described experiencing a partnership with staff, giving them confidence to assist staff and be included in decisions about the resident.

Conclusions: The Tri-focal Model of Care can enable residents, family members, and staff to be partners in resident care in LTC settings.

Clinical relevance: With an ageing population, an increasing demand for complex, individualized LTC exists. Delivery of high-quality LTC requires a strategy to implement a partnership-centered approach, involving residents, family members, and staff.

Keywords: Aged care; long-term care; model of care; nursing; person-centered care; qualitative; residential aged care facility.

MeSH terms

Attitude to Health*
Family / psychology*
Focus Groups
Humans
Long-Term Care
Models, Organizational*
Qualitative Research
Residential Facilities / organization & administration*
Victoria