Some NHs reported that lack of staff time (55%), staff resistance (44%), or staff turnover (11%) were challenges but only 11% reported significant implementation problems. None cited a lack of administrative support. All sites reported they were satisfied with the AE materials, training and support,

and all (100%) said they would recommend the PCC goal and materials to other NHs. Staff reported that it took an average of 15 minutes (range: 5–30 minutes) to complete resident interviews. They indicated that most residents did not have trouble answering questions, although some needed reassurance that NHs wanted to hear residents’ candid feedback. In telephone follow-up interviews, site coordinators touched on the value of the interview for residents. They reported that p38 MAPK inhibitors clinical trials residents felt “validated by being asked questions about their preferences” and “comforted because they felt they were heard and able to make choices.” Sites also discussed benefits of using the PCC toolkit to enhance care planning,

communication, staff development, and QI. In terms of individual care planning, providers commented that the toolkit “gives… each person a voice or control over their daily care” and “helps us update preferences as a person improves or declines to what is important at AZD6244 in vivo that time in their lives. It has made us more aware that preferences change, sometimes daily.” Most sites reported that they had the same person conduct the preference and satisfaction portions

of the interview, but upon reflection some said they would choose to use a different person for each component in the future. Sites noted that the AE PCC toolkit is useful as a training tool—“it provides an example of what PCC looks like in action” —as well as to strengthen teamwork. It offers a “resource to bridge the communication gap about resident preferences, which are known by one staff member but not another on a different shift or when a staff person is filling in for another.” Sites also remarked on the value for CNAs: “Traditionally, Cytoskeletal Signaling inhibitor our CNAs are not involved in identifying resident preferences, and preference information was not always relayed to them … CNAs liked getting to know resident preferences before providing care and found it helpful. We had a lot of positive feedback from them. Finally, providers underscored the benefits for QI. One coordinator said, “The tool takes the anecdotal slant out of the equation when determining the degree to which a facility has infused PCC into their approaches.” Another commented, “This toolkit gives me a great way to measure and track my facility’s ability to uphold resident preferences. By allowing the resident to rate their satisfaction, it allows me to focus in on the weak points of my facility’s care.” A third coordinator remarked that the tool provides “an opportunity to benchmark internally… as well as with other facilities. PCC remains a challenging, though highly desirable, goal for long-term care providers.