The Quality Improvement Program for Missouri's Long - Term Care Facilities (QIPMO) is committed to Missouri's Elderly.
The "Aging-in-place" model allows older adults to receive health care in their preferred place of living, eliminating the need for a more restricted living space, such as a nursing home.
TigerPlace is a specially designed elder housing project initiated by the MU Sinclair School of Nursing, working to provide elders a better quality of life.
TigerPlace (named after the University of Missouri mascot, the tiger) is a specially designed elder housing project that was initiated by the MU Sinclair School of Nursing (SON) and designed by MU faculty working with the Americare Corporation of Sikeston, Missouri.
TigerPlace is built to nursing home standards, but not the typical configuration. The building has 32 private apartments with fully accessible bathrooms, kitchens, and screened porches. Private garages and a private dining room for special family occasions are available, as are beautiful common spaces such as a large living room, dining room, meeting room, library, sports bar, and beauty shop. Included in this list of amenities that surpasses the typical list of long term care options are TigerPlace Pet Initiative (TiPPI) Veterinary Medicine Clinic, TigerCare Wellness Center, and TigerCize Exercise and Spa area.
A major goal for MU is to design and implement exciting research, education, and practice opportunities at TigerPlace while integrating TigerPlace into the MU campus and the Columbia community. From the resident’s point of view, on-going assessment, early illness recognition, health promotion activities, and a well-designed housing environment will help older people stay healthier and active longer, avoid expensive and debilitating hospitalizations, and for most residents, avoid relocation to a nursing home. The links with MU are important as seniors become involved in the student learning projects and take advantage of classes and cultural activities of their interest at MU.
In the area below you will find a list of recently added TigerPlace research articles.
Background: Effectiveness of clinical information systems to improve nursing and patient outcomes depends on human factors including system usability, organizational workflow, and user satisfaction.
Objective: The specific aim of this research is to examine to what extent residents, family members, and clinicians find a sensor data interface used to monitor elder activity levels usable and useful in an independent living setting.
Methods: Three independent expert reviewers conducted an initial heuristic evaluation. Subsequently, 20 end users: 5 residents, 5 family members, 5 registered nurses, and 5 physicians participated in evaluation. During the evaluation each participant was asked to complete three scenarios taken from three residents. Morae recorder software was used to capture data during the user interactions.
Results: The heuristic evaluation resulted in 26 recommendations for interface improvement; these were classified under the headings content, aesthetic appeal, navigation, and architecture which were derived from heuristic results. Total time for elderly residents to complete scenarios was much greater than other users. Family members spent more time than clinicians, but less time than residents to
complete scenarios. Elder residents and family members had difficulty interpreting clinical data and graphs, experienced information overload, and did not understand terminology. All users found the sensor data interface useful for identifying changing resident activities.
Discussion: Older adult users have special needs that should be addressed when designing clinical interfaces for them, especially information as important as health information. Evaluating human factors during user interactions with clinical information systems should be a requirement before implementation.
The paper describes the evolution of an early illness warning system used by an interdisciplinary team composed of clinicians and engineers in an independent living facility called TigerPlace. The early illness warning system consists of algorithms which analyze resident activity patterns obtained from sensors embedded in residents’ apartments. The engineers designed an automated reasoning system to generate clinically relevant alerts which are sent to clinicians when significant changes occur in the sensor data, for example declining activity levels. During January 2010 through July 2010 clinicians and engineers conducted weekly iterative review cycles of the early illness warning system to discuss concerns about the functionality of the warning system, to recommend solutions for the concerns, and to evaluate the implementation of the solutions. A total of 45 concerns were reviewed during this period. Iterative reviews resulted in greater efficiencies and satisfaction for clinician users who were monitoring elder activity patterns.
Key Words: Human Factors, Information Technology, Patient Safety, Patient Care, Gerontology
As in acute care, use of health information technology in long-term care holds promise for increased efficiency, better accuracy, reduced costs, and improved outcomes. A comprehensive electronic health record (EHR), which encompasses all health care measures that clinicians want to use-both standard health care assessments and those acquired through emerging technology-is the key to improved, efficient clinical decision making. New technologies using sensors to passively monitor older adults at home are being developed and are commercially available. However, integrating the clinical information systems with passive monitoring data so that clinical decision making is enhanced and patient records are complete is challenging. Researchers at the University of Missouri (MU) are developing a comprehensive EHR to: (a) enhance nursing care coordination at TigerPlace, independent senior housing that helps residents age in place; (b) integrate clinical data and data from new technology; and (c) advance technology and clinical research.
Technology offers potential solutions to the pending crisis of health care for older adults while health care workers are in short supply. Technology can enable remote monitoring of individuals and early detection of potential problems, so that early interventions can help older adults remain as healthy and independent as possible. Research is underway with passive monitoring technology in senior housing that is finding patterns in the data that can enhance nurse care coordination through early illness detection. With early detection, interventions can be more effective and reduce hospitalization and other health care expenses. Case studies are presented and implications are discussed.
This article provides results of an expert review of data displays for a sensor system used to monitor functional abilities in older adults. The research took place at TigerPlace, an assisted living facility where the sensor system is currently being evaluated. A checklist of 16 heuristic criteria was used to evaluate the sensor data displays, with consideration to the users of the system: residents, their families, and health care providers. Results of this expert review indicate that flexibility and efficiency of use, help, and documentation, navigation, and skills were not well-developed in the sensor data displays. Conversely, sensor data displays were rated highly for their aesthetic value and the ample visual contrast on the main display components. Through the use of a sensor system, new ways of detecting functional decline in elderly residents of assisted living facilities can be accomplished.
The objective of this study was to explore the role of videophone technology in enhancing the distant caregiving experience of and communication between residents of a long-term care facility and their family members. Ten participants – 4 residents of an independent retirement facility and 6 family members – were recruited. A videophone was installed in each resident’s apartment, and another was mailed to the remote family member. Participants were asked to conduct a video-call at least once per week for 3 months. Exit interviews assessed general impressions of videophone communication, the relationship between residents and family members, stress, burden, and isolation. Participants were enthusiastic and emphasized a sense of closeness, the inclusion of the resident in family interactions, and reduced feelings of guilt and isolation as key benefits. New models of care are needed to challenge the existing paradigm, which often excludes distant caregivers from the care process. Technology can facilitate this process by bridging geographic distance.