Practice Change Interventions in Long-Term Care Facilities: What Works, and Why?

Caspar, S., Cooke, H. A., Phinney, A., & Ratner, P. A. (2016). Practice change interventions in long-term care facilities: What works, and why? Canadian Journal on Aging35(3), 372–384.

Over the past three decades, there has been a notable increase in studies of practice change interventions in long-term care (LTC) settings. This review addresses the following questions: What practice change intervention characteristics work? And, in what circumstances do they work and why?

We searched electronic databases and published literature for empirical studies of practice change interventions that (a) were conducted in LTC settings, (b) involved formal care staff members, and (c) reported a formal evaluation. Ninety-four articles met the inclusion criteria.

Key Findings:
1) Interventions that included only predisposing factors were least likely to be effective.
2) Interventions that included reinforcing factors were most likely to produce sustained outcomes.
3) We concluded that interventions aimed at practice change in LTC settings should include feasible and effective enabling and reinforcing factors.

These findings support the development of the Feasible and Sustainable Culture Change Initiative (FASCCI) model.