PICOT

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Discussion

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The uniqueness of Continuing Care Retirement Communities (CCRCs) needs to be maintained as their services are extended. Learning from the market, the demographics of the immediate area, and the changing needs of older persons is the first step towards strategic expansion. CCRCs need to advocate for health, independence, and care continuity in a person-centered manner. The SQUIRE 2.0 framework fosters responsible expansion through contextual awareness, theory-guided interventions, and careful evaluation (Ogrinc et al., 2015). Adapting expansion plans to the surrounding area's values, interests, and needs facilitates scaling and sustaining healthcare ecosystems.

One of the most critical aspects of a CCRC's growth plan must be developing successful, not competing, relationships with the hospital and other long-term care organizations. Partnerships with local hospitals, university programs, and telemedicine providers may enhance specialist care and reduce hospital readmissions without compromising the CCRC's goal. Using external knowledge and internal autonomy, CCRCs may become major healthcare players. Integrating electronic health records and predictive analytics for resident health monitoring increases operational efficiency and resident outcomes, harmonizing with SQUIRE 2.0's "systems" approach to linked healthcare services (Ogrinc et al., 2015).

Growing without losing its identity requires a solid communication strategy that defines the CCRC. Comprehensive care, resident empowerment, and aging continuity must be promoted in community marketing. Service design should include regular needs assessments and stakeholder input to enhance quality (Brown et al., 2021). It creates a feedback-rich environment where growth attempts match resident and community expectations. Transparency in decision-making and resident and family participation in governance committees may strengthen community ownership and reduce alienation as the organization grows.

The importance of ethical considerations in growth cannot be overstated. Expanding too quickly or without enough infrastructure might undermine care quality and staff well-being, breaking quality improvement framework ethics (Ogrinc et al., 2015). Before implementing interventions, CCRCs must consider opportunity costs, such as diverting resources from current programs, and rigorously analyze treatments. Sustainable development must be iterative and led by real-world data, as SQUIRE studies treatments and adapts depending on contextual input. CCRCs may grow while retaining their identity and value to communities by following this balanced, ethical, and data-driven plan.

References

Brown, H., Jacobson, S., Cockrell, M., Sutt, J., Allen, K., & Copeland, A. (2021). A Five-Step Stakeholder Communication Plan for More Effective Natural Resource Management. Journal of Extension, 59(Autumn 2021). https://doi.org/10.34068/joe.59.04.06

Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2015). Squire 2.0 (Standards for Quality Improvement Reporting Excellence): Revised Publication Guidelines From a Detailed Consensus Process. American Journal of Critical Care, 24(6), 466–473. https://doi.org/10.4037/ajcc2015455

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Adapted from the PICOT Questions Template; Ellen Fineout-Overholt, 2006. This form may be used for educational & research purposes without permission.

Template  for  Asking  PICOT  Questions  

INTERVENTION  

In  ____________________(P),  how  does  ____________________  (I)  compared  to  

____________________(C)  affect  _____________________(O)  within  ___________(T)?      

THERAPY  

In  __________________(P),  what  is  the  effect  of  __________________(I)  compared  to  

_____________  (C)  on  ________________(O  within  _____________(T)?    

PROGNOSIS/PREDICTION   In  ______________  (P),  how  does  ___________________  (I)  compared  to  _____________(C)  

influence  __________________  (O)  over  _______________  (T)?  

 

DIAGNOSIS  OR  DIAGNOSTIC  TEST  

In  ___________________(P)  are/is  ____________________(I)    compared  with  

_______________________(C)  more  accurate  in  diagnosing  _________________(O)?    

ETIOLOGY  

Are____________________  (P),  who  have  ____________________  (I)  compared  with  those  

without  ____________________(C)  at  ____________  risk  for/of  

____________________(O)  over  ________________(T)?      

MEANING  

How  do  _______________________  (P)  with  _______________________  (I)    perceive  

_______________________  (O)  during  ________________(T)?  

         

Adapted from the PICOT Questions Template; Ellen Fineout-Overholt, 2006. This form may be used for educational & research purposes without permission.

 

Short  Definitions  of  Different  Types  of  Questions     Intervention/Therapy:  Questions  addressing  the  treatment  of  an  illness  or  disability.     Etiology:  Questions  addressing  the  causes  or  origins  of  disease  (i.e.,  factors  that  produce  or   predispose  toward  a  certain  disease  or  disorder).     Diagnosis:  Questions  addressing  the  act  or  process  of  identifying  or  determining  the  nature  and   cause  of  a  disease  or  injury  through  evaluation.     Prognosis/Prediction:  Questions  addressing  the  prediction  of  the  course  of  a  disease.     Meaning:  Questions  addressing  how  one  experiences  a  phenomenon.    

Sample  Questions:     Intervention:  In  African-­‐American  female  adolescents  with  hepatitis  B  (P),  how  does   acetaminophen  (I)  compared  to  ibuprofen  (C)  affect  liver  function  (O)?     Therapy:  In  children  with  spastic  cerebral  palsy  (P),  what  is  the  effect  of  splinting  and  casting(I)   compared  to  constraint-­‐  induced  therapy  (C)  on  two-­‐handed  skill  development  (O)?     Prognosis/Prediction:     1)  For  patients  65  years  and  older  (P),  how  does  the  use  of  an  influenza  vaccine  (I)  compared  to   not  received  the  vaccine  (C)  influence  the  risk  of  developing  pneumonia  (O)  during  flu  season   (T)?     2)  In  patients  who  have  experienced  an  acute  myocardial  infarction  (P),  how  does  being  a   smoker  (I)  compared  to  a  non-­‐smoker  (C)  influence  death  and  infarction  rates  (O)  during  the   first  5  years  after  the  myocardial  infarction  (T)?     Diagnosis:  In  middle-­‐aged  males  with  suspected  myocardial  infarction  (P),  are  serial  12-­‐lead   ECGs  (I)  compared  to  one  initial  12-­‐lead  ECG  (C)  more  accurate  in  diagnosing  an  acute   myocardial  infarction  (O)?     Etiology:  Are  30-­‐  to  50-­‐year-­‐old  women  (P)  who  have  high  blood  pressure  (I)  compared  with   those  without  high  blood  pressure  (C)  at  increased  risk  for  an  acute  myocardial  infarction  (O)   during  the  first  year  after  hysterectomy  (T)?     Meaning:  How  do  young  males  (P)  with  a  diagnosis  of  below  the  waist  paralysis  (I)  perceive   their  interactions  with  their  romantic  significant  others  (O)  during  the  first  year  after  their   diagnosis  (T)?