Grant: Doctoral: Vanier Canada Graduate Scholarships

The care that older adults receive in nursing homes has been a serious concern for many reasons. One reason is that, until relatively recently, there was no standard for assessing nursing home residents and documenting the care that they receive. In many nursing homes, only minimal records were kept of the care given to residents. One major initiative to improve resident care has been to standardize approaches to assessing nursing home residents. In Canada, a single assessment tool is mandatory in most jurisdictions, called the Resident Assessment Instrument, or RAI version 2.0. The RAI 2.0 instrument collects information on the resident, allowing providers to develop comprehensive plans to provide care. RAI 2.0 data is also used to compare care across nursing homes by combining RAI 2.0 information for all residents within a unit or facility to construct 25 quality indicators. Quality indicators provide information on certain resident health characteristics that can be affected by the quality of care provided by that facility. For example, one RAI 2.0 quality indicator is the proportion of residents in a facility with pain. Past research has shown that presenting a long list of quality indicator scores to care providers does not always change the quality of care. The reason for this is partly because the large number of quality indicators makes it difficult to decide which quality area to focus on and invest resources into. I propose to address this problem by developing statistical quality indicator models that show which indicators influence each other and by how much. My work will illustrate which indicators may have the greatest influence on the quality of life of nursing home residents. It will also assist decision-makers such as unit managers to determine priorities among indicators. My research will contribute to our understanding of how the information from RAI 2.0 can be used to improve the care that nursing home residents receive.