The implementation of the narrative assessment method ‘Connecting Conversations’

Abstract

Objective:Connecting Conversations is a narrative method that assesses experienced quality of care in nursing homes from the resident’s perspective. This study aimed to identify facilitators and barriers in implementing Connecting Conversations.Methods:In 2022, Connecting Conversations was actively implemented in a nursing home organization where the organization was in the lead. A process evaluation was performed focused on completeness (to what extent did the planned wards complete participation?), value and burden (how did respondents, care teams, ward managers and interviewers experience Connecting Conversations?), and usability of the findings (to what extent was the narrative data used for quality improvement initiatives?). Data were collected with interviews, focus groups and structured observations.Results:In 2022, 6 internal interviewers followed the Connecting Conversations’ interviewer training and performed 42 conversations (13 residents, 14 family, 15 caregivers) in 4 nursing homes on 5 wards within the care organization.Findings show that vision & leadership, flexibility in performing the conversations, and clear instructions for respondents and participating wards are necessary for successful implementation. Identified barriers for implementation into the quality management cycle were the continuation of existing quality assessments, lack of resources and the administrational burden linked to research, such as randomization of participants and retrieving informed consent. In addition, it was identified as crucial to provide participating care teams ownership regarding how to use the data for learning and improvement initiatives. This process needs guidance from for example an internal facilitator.Conclusion:Stories from multiple perspectives provide valuable information for quality improvement initiatives. Yet, in order to implement Connecting Conversations successfully organizational support is indispensable