KEYWORDS:
Nursing homes; collaboration; PRO; organizational structures; sustainability

BACKGROUND:
PROs were given an opportunity to participate in a licensed nursing home pilot project.

OBJECTIVE(S):
The project's objectives were to improve immunization rates in licensed nursing homes and develop a model of collaboration in the licensed nursing home environment

METHOD(S):
Corporate offices were approached for collaboration, with 9 agreeing. Communication was established by the PRO with the corporate-identified contacts. A sample of 15 participating facilities receiving interventions and five control facilities were selected by the Centers for Disease Control and Prevention. The goal of PRO was to offer resources, build a confidential, voluntary environment for collaboration, and create a framework to improve immunization rates in facilities. Corporate participants were queried as to the preferred method for communication. Introductory letters and sample timelines were presented for review. Participants were asked to identify barriers and internal pressures, with adjustments within project guidelines being made to facilitate collaboration

RESULT(S):
Of the 20 participants in the sample, there was complete adherence to the timeline. There was a 100% response rate to the participating/non-participating and cost-effectiveness surveys. 100% of the chart reviews were conducted. Entry into the facilities, cooperation levels of the internal staff, and access to medical records were without conflict.

CONCLUSIONS(S):
Projects must factor in the regulatory and time constraints of licensed nursing homes. Optimized models of care are often not feasible in every environment. It is vital to have an understanding of organizational design and culture when building sustainable relationships. The organizational design can serve as a framework for structuring communication with facilities. Project managers must gain an understanding of the licensed nursing home “grapevine” to open doors to the dimensions of the organization's culture and individual psychology.

LEARNING OBJECTIVES:
To understand the importance of organizational assessment before implementing projects.
To understand intrinsic and extrinsic factors impacting the nursing home setting.