The effectiveness of care manager training in a multidisciplinary plan-do-check-adjust cycle on prevention of undesirable events among residents of geriatric care facilities

Aim: Undesirable events, such as falls, aspiration, and pressure ulcers, are associated with functional decline and lower quality of life among older adults. This study describes the frequency of such events among residents of geriatric care facilities and assesses the effect of training care managers in a multidisciplinary plan-do-check-adjust cycle on preventing such events. Methods: This was a Japan-based, non-randomized cluster intervention study. The intervention group comprised geriatric care facilities from which care managers had attended a training course, while the control group comprised facilities with care managers who did not receive this training. Six-month pre-admission and 3-month post-admission incidences of undesirable events were collected from both groups, and the two groups were compared. Results: Valid data were collected from 862 residents (416 and 446 from the intervention and control groups, respectively) from 130 facilities (60 and 70, respectively). Three-month post-admission incidences were 27.8%, 20.0%, and 11.3% for falls, fever, and pressure ulcers, respectively. There was no difference between the groups regarding post-admission incidence for any event type. Training care managers reduced the post-admission incidence of pressure ulcers among residents with a history of such ulcers. Conclusions: The training of care managers in a multidisciplinary risk-management cycle was not effective for preventing falls, fever, or pressure ulcers. Results underscore the difficulty of preventing risk events in geriatric care facility residents even with organizational training efforts. The authors believe it is important to share such risks with residents and their families. Geriatr Gerontol Int 2021; 21: 842–848.