The effect of using high facilitation when implementing the Gold Standards Framework in Care Homes programme: a...

Area of Science:

• Gerontology
• Healthcare Management
• Palliative Care

Background:

• Quality end-of-life care is a national priority.
• The Gold Standards Framework for Care Homes (GSFCH) is a UK initiative to improve end-of-life care in care homes.
• Lack of national guidelines for GSFCH facilitators leads to variable implementation.

Purpose of the Study:

• To evaluate if action learning with high facilitation improves end-of-life care in nursing homes.
• To assess the impact on the proportion of hospital deaths among residents.
• To determine if GSFCH implementation enhances care home staff's facilitation skills.

Main Methods:

• A cluster randomised controlled trial involving 38 nursing homes.
• Intervention groups received high facilitation, with some also participating in action learning sets.
• A control group received standard GSFCH facilitation.

Main Results:

• Nursing homes with high facilitation and action learning showed a non-significant increase in in-house resident deaths.
• A significant association was found between the level of facilitation and achieving GSFCH accreditation.
• All outcome measures demonstrated year-on-year improvement across groups.

Conclusions:

• Variable facilitation without national guidelines risks inconsistent GSFCH implementation.
• Active engagement of nurse managers is crucial for successful GSFCH implementation.
• Standardized national guidelines are needed to ensure consistent quality of end-of-life care facilitation.