Abstract
The purpose of this study was to document the existing environmental, organizational, and operational patterns of PEAK 2.0 participating homes at early stages of adoption and the patterns of sustained adopters to determine whether there were notable or distinguishing features that were different between these two groups. Using a case-study approach, a qualitative mixed-methods research design was employed. The patterns of staffing structures and patterns of spatial layout are used to understand the environmental affordances provided to residents and staff of these settings. The theory of environmental affordances has been applied here as a perceptual framework for understanding how person-centered care (PCC) behaviors can be enacted within a space. Environmental assessments revealed that advanced adopters had patterns of building use that were notably different from those of early adopters. Advanced adopters designated more staff to a single area; early adopters expected staff to cover multiple areas on each shift. Additionally, advanced adopters created more environmental affordances for residents and staff through the types of space allocations and features present. Results demonstrated that if considered holistically and strategically, impactful changes to institutionally shaped buildings can be made to accomplish and sustain PCC goals.
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