To find out, Berta assembled a team and, in Fall 2018, launched a new initiative with TREC: the Sustainment, Sustainability, and Spread Study (SSaSSy). Working with the same seven Manitoba care homes that participated in SCOPE during its first pilot, Berta’s team set out to assess the extent to which SCOPE quality improvement processes had been maintained, while also interviewing care aide staff to find out what influenced, enabled, and detracted from the sustainment after SCOPE concluded.
Cited detractions included frequent new policies and staff turnover, while enablers included supportive directors and policy-makers who helped implement SCOPE team initiatives.
A second aim of SSaSSy was to test the impact that “boosters” might have on extending quality improvement practices longer than seen in the past.
Boosters are post-SCOPE supports (i.e., education, motivation, reminders) that SSaSSy’s research team would provide via in-person meetings (when possible due to COVID-19 protocols), emails, training sessions (called “learning congresses”) and virtual meetings.
Participating care homes were randomly selected to receive different levels of boosters: low or high. A low-dose team would receive one check-in call with a SSaSSy quality advisor at the midway point of the trial, while a high-dose team got three calls, one roughly every three months.
“Our quality advisors are experts from the field of quality improvement,” Berta explains, adding that they also work closely with SSaSSy researchers.
The check-in calls were for progress checks, troubleshooting and discussing next steps. Sponsors (a.k.a. care home directors or decision-makers) were also given opportunities to speak with quality advisors about team dynamics and care aide leadership.