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

Area of Science:

• Gerontology
• Healthcare Implementation Science
• Evidence-Based Practice

Background:

• Assisted living facilities face challenges in maintaining resident function and physical activity.
• Implementing evidence-based interventions requires structured approaches to ensure effectiveness.
• The Evidence Integration Triangle provides a framework for integrating research into practice.

Purpose of the Study:

• To evaluate the effectiveness of the Function-Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT) intervention.
• To assess the impact of FFC-AL-EIT on resident function, physical activity, and the care environment in assisted living settings.

Main Methods:

• A randomized controlled pragmatic trial involving 85 assisted living sites and 794 residents.
• The FFC-AL-EIT intervention was implemented over 12 months by a Research Nurse Facilitator, focusing on environment, policy, education, service plans, and mentoring.
• Measures included resident function, physical activity, and performance of function-focused care, alongside setting-level environment and policy assessments.

Main Results:

• The FFC-AL-EIT intervention led to less decline in resident function (P < .001) and increased function-focused care (P = .012).
• Treatment sites showed improved environment (P = .032) and policy support (P = .003) for function-focused care.
• High adoption rates were observed, with 90% of direct care workers providing function-focused care by 12 months, and sustained support in environments and policies.

Conclusions:

• The Evidence Integration Triangle is an effective implementation strategy for improving function-focused care in assisted living.
• The FFC-AL-EIT intervention demonstrates significant benefits for resident function and the care setting.
• Future research should explore innovative methods for measuring implementation outcomes (RE-AIM).