Perceptions of staff quality improvement training needs among Veterans Affairs nursing home leadership

Abstract

This study seeks to describe clinical leadership’s perceptions of staff understanding of the minimum data set (MDS) quality indicators (QIs) and ways to improve staff understanding of this system, as well as specific perceived training needs among Department of Veterans Affairs (VA) nursing home care unit (NHCU) clinical leadership. This cross-sectional online survey using structured (quantitative) and open-ended (qualitative) items took place in 97 VA NHCUs nationwide. A total of 289 leadership staff including directors of nursing, medical directors, MDS coordinators participated. Qualitative analysis yielded several themes regarding why staff do/do not understand MDS QIs, and strategies to improve staff understanding included involvement, staffing/staff roles, education/training, mechanics, big picture. Regarding how to improve understanding, respondents recommended education/training, involvement, reinforcement and others. Of specific training strategies/needs, the most frequently identified were using the MDS as a clinical assessment tool. Quantitative analyses were not significant. These results highlight the range of causes identified by managers for frontline staff’s understanding (or lack thereof) of the QIs, and their preference for ways to improve staff understanding of what the MDS means. Understanding and applying these strategies may help improve staff’s use of the MDS QIs in VA and non-VA skilled nursing facilities.