Areas Of Expertise

IFAS has assembled an interdisciplinary staff trained in public policy, public health, gerontology, epidemiology, psychology, sociology, statistics, survey research, long-term care administration and business. The principal areas of staff expertise include:

Program Evaluation

A hallmark of IFAS' applied research program is a long-standing commitment to program evaluation so that long-term care and aging services providers understand which interventions work for older adults, their families and the professional and paraprofessional workforce.

Evaluation activities include:

• Collecting descriptive information on a wide range of clinical and workplace improvement practices in facility- based and independent housing settings.
• Conducting qualitative or process analyses to determine whether and how particular interventions are implemented in practice, how participants perceive interventions and the regulatory, practice and environmental factors that most influence implementation.
• Assessing the impact of particular interventions on the health, functioning and quality of life of residents, on providers and the larger community and on public and private costs.

For example, IFAS led the evaluation of the Wellspring model, an initiative created by an alliance of 11 nonprofit nursing homes in Wisconsin to improve nursing home quality through comprehensive changes to clinical practice and the prevailing culture in participating homes. The evaluation concluded that the Wellspring model offers a promising approach to improving clinical care and reducing staff turnover. IFAS is now working with AAHSA member nursing homes in North and South Carolina to replicate and evaluate the model.

Knowledge Transfer

Since its inception, IFAS has placed the highest priority on helping providers and policy makers successfully adopt innovations derived from the best available research. IFAS is uniquely positioned to take on a knowledge transfer role.

Organizationally housed within the American Association of Homes and Services for the Aging-which represents nonprofit nursing homes, assisted living and senior housing communities across the country-IFAS researchers and long-term care providers can work together to put practical and feasible evidence-based innovations into practice.

IFAS' knowledge transfer activities are carried out through:

• Symposia and workshops to facilitate information sharing among researchers, providers and policy makers.
• Synthesis and dissemination of evidence-based clinical and practice protocols and strategies.
• Documentation and dissemination of information for providers on the conditions required for innovation to be adopted successfully

For example, IFAS, in collaboration with the U.S. Departments of Labor and Health & Human Services, planned and assembled an invitational symposium on the long-term care workforce to share research on workforce development and improvement interventions and the policy and practice barriers that impede such initiatives.

In an ongoing study, IFAS is working with the Delmarva Foundation for Medical Care and other partners to develop a toolkit to help nursing homes understand the concrete issues they must address before undertaking the adoption of an evidence-based intervention to improve the treatment and prevention of pressure ulcers.

Policy Analysis

IFAS staffers include individuals with extensive experience in the federal aging and long-term care policy arenas. Policy analysis activities are designed to clarify and interpret the impact of federal and state regulation and policy on the implementation and diffusion of new models of care and on workforce development and improvement.

Policy analysis activities are carried out through:

• Preparation and publication of articles in leading health and long-term care journals.
• Preparation of briefing papers and presentation of testimony to policy forums.
• Collaboration with AAHSA policy staff.
• Facilitated information exchanges among long-term care providers, workers and federal and state policy makers.

For example, IFAS staff prepared a briefing paper entitled The Long-Term Care Workforce: Can this Crisis Be Fixed? for the National Commission for Quality Long-Term Care, which laid out the factors that influence workforce shortages and recommended actions steps to reduce them.

Also, in collaboration with several AAHSA state affiliates, IFAS sponsored a series of invitational workshops that brought together policy makers from the U.S. Departments of Housing & Urban Development and Health & Human Services and housing and aging services providers from 18 states to examine the benefits of and policy and practice barriers to models of care that link frail and disabled senior residents of affordable housing to health-related and supportive services.

Epidemiology/Clinical Trials
Observational Studies and Clinical Trials

IFAS staff is experienced in a number of methodological areas that are critical to appropriate study design, implementation and data analysis. Staff is trained in epidemiology and biostatistics and has experience in the design, implementation and analytic activities related to secondary data analysis, primary data collection in cross-sectional, retrospective and longitudinal studies and clinical trials.

• Analysis of national datasets and other public use data sources of relevance to long term care and aging services
• Collaboration with University-based investigators in the design and implementation of new observational studies conducted in the long-term care setting

For example, IFAS staff have completed data analysis of the National Nursing Home Survey and have shown that 1 in 4 U.S. nursing home residents is diabetic. This research will lead to future studies aimed at identifying optimal practices for care management of this large resident population. A new project is currently in development that will involve an observational study to clarify specific aspects of how the Patient Self Determination Act is operationalized when a nursing home resident is transported to an emergency department. The latter project will involve a multi-center study of emergency department admissions and will have direct implications for both policy and practice.