Agile Methodology Effectively Delivers Person-Centered Care in NHs

The implementation of Agile methodology processes helped nursing home (NH) staff to properly accommodate residents’ preferences during quarantines including individualized approaches for meeting preferences related to social contact, comfort, and belonging, according to study findings published in the Journal of the American Medical Directors Association (JAMDA).

Agile implementation “involves 8 interconnected steps that allow for the uniqueness of each health care delivery system and recognizes that variation in clinical decisions, translation into patient care, and patient responses will influence the impact of a solution.”

The 8 steps, according to another article published in JAMDA are as follows:

1. Identify opportunities
2. Identify evidence-based health care services
3. Develop evaluation and termination plans
4. Assemble a team to develop a minimally viable service
5. Perform implementation sprints
6. Monitor implementation performance
7. Monitor whole system performance
8. Develop a minimally standardized operating procedure.

“We first determined if care plans reflected each resident’s important preferences, developed a method for tracking whether residents attended activities that matched their preferences, and determined if residents were satisfied that their preferences were being met,” wrote study authors.

When COVID-19 limited visitors and impacted staff workflow the agile processes set in place had positive effects.

“The ready availability of preference-based reporting was critical to quickly informing new staff on how to meet residents’ most important preferences,” reported researchers. “Based on lessons learned, we describe a developmental approach that other providers can consider for adoption.”

While Agile methodology is not typical for NHs, study authors concluded there is a need for provider training in Agile methodologies to support iterative improvements, additional research around workflow processes, and the need for policies that reimburse providers for their efforts.

Reference:

1. Abbot KM, Hulshult A, Eshraghi K, et al. Applying Agile methodology to reengineer the delivery of person-centered care in a nursing home: a case study. J Am Med Dir Assoc. Published online June 14, 2022. doi:10.1016/j.jamda.2022.05.012
2. Solid C, Nazir A. Agile implementation. 2019.;20(7):795-797. J Am Med Dir Assoc. doi:10.1016/j.jamda.2019.05.017