(P41) Life Storytelling To Improve Person-Centered Care in Long-Term Care

Objective/Aim: To assess whether introducing patient life stories at one skilled nursing facility (SNF) can improve person-centered care by increasing knowledge about patients’ personal histories and improving patient/family-provider relationships.

Background: SNFs face high staff turnover, posing challenges for care continuity and person-centered care. Person-centered care interventions can improve satisfaction among patients, families and staff.

Quality Improvement

Methods: Long-term patients at a 77-bed SNF were invited to participate in a 45 minute life story interview with a volunteer; 30 patients have participated thus far. Volunteers obtained patient and family informed consent and used a structured questionnaire about life history, social support and legacy. Recorded interviews were sent to a professional writer at the study partner company, who wrote stories and shared with SNF clinical staff (e.g. nurses, certified nursing assistants, therapy staff, dietician). Surveys were completed at baseline (17 patients and 24 staff) and 3-6 months after story collection (15 patients, 11 staff, 9 family members). Surveys assessed satisfaction (e.g. job satisfaction, satisfaction with care), patient/family-staff relationships, and perceptions of care quality and improvements. CAHPS Nursing Home survey measures assessed patient-staff relationships. Net promoter score (NPS) assessed patient satisfaction with higher scores (up to 100) indicating respondents were more likely to recommend the SNF. Other measures were based on previous pilots and used a five point Likert scale. Qualitative interviews with patients and families assessed experiences with the life story and changes in care.

Results: Surveys indicated improvements in satisfaction for patients and staff. Patients’ SNF NPS increased by 28 points. On CAHPS measures, more patients indicated staff definitely listened to them (41% pre vs 53% post) and definitely respected their choices/preferences (35% pre vs 46% post). Most patients (75%) reported their life story made them feel understood at the SNF. All family members strongly agreed/agreed the life story improved the relationship between care staff and their loved one and with them. All staff reported they enjoy their work more when they know a patient’s life story and life stories help understand patients’ unique needs and wishes. Staff who strongly agreed they can care for patients based on their unique needs and wishes increased by 52%. Qualitative interviews offered additional insights into care improvements, including humanizing patients and addressing patient anxiety.

Conclusions: Early findings suggest integrating patient life stories into long term care can improve experiences for patients, families and care staff. Given staffing challenges in SNFs, life stories help staff get to know patients quickly and improve satisfaction. Next steps include continued assessment of satisfaction and quality of care, and assessing potential for life story use in care transitions. Using volunteers to conduct life story interviews, including leveraging existing volunteer programs, can make life story programs accessible to scale at many facilities.