Improving InterRAI care processes in long-term care homes: A constructivist grounded theory.

OBJECTIVE: To provide an in-depth understanding of the care processes involving the use of the Long-Term Care Facilities (LTCF) tool in Nova Scotia, Canada. Specifically, this constructivist grounded theory study explored the perspectives of long-term care (LTC) residents, substitute decision-makers (SDMs), and nurses, with the aim of improving residents' care. METHODS: A constructivist grounded theory study was conducted in LTC homes in Nova Scotia, Canada, between September 2022 and April 2023. Data were collected through 38 semi-structured interviews with residents, SDMs, nurses, supplemented by 41 field notes and 10 analytical memos. Data were analyzed using constructivist grounded theory methods.Results:The emerging substantive theory was developed primarily from the perspectives of nurses and LTC management, while residents' and SDMs' perspectives provided contextual and supportive insights. The participants described InterRAI LTCF care process improvement through relationship-centredness, intentionality, and effective change management. If implemented properly at the point of care, these strategies could facilitate consistent care improvement for LTC residents. CONCLUSIONS: The findings have important implications for practice, policy, and future research. Care process improvement in LTC settings requires attention to relational, organizational, and technological factors. These implications are particularly relevant for LTC management, point-of-care nurses, and LTCF software designers seeking to enhance the quality and consistency of residents' care.