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The Green House Project

An Evidence-Based Practice

Description

The Green House Project changes the physical and social environment of long-term care by transforming the institutional nursing facility into a small, residential environment that is home to 10 to 12 elders. Each person who lives in a Green House home has a private bedroom, full bathroom, and an opening to a central living area, full kitchen and dining room. Family members, friends, and staff are welcome to join the community at mealtimes and other activities.

Homes are staffed by a team of universal workers, known as Shahbazim, as well as comprehensive clinical teams, and necessary departmental support. Shahbazim responsibilities include personal care, meal preparation and service, housekeeping, laundry, and activities. This combined role puts more direct care hours in the house that allows intensive relationships to form between staff and elders, particularly elders with the highest needs.

Goal / Mission

The mission of the Green House Project is to partner with organizations, advocates, and communities to lead the transformation of institutional long-term care by creating viable homes where elders and others enjoy excellent quality of life and quality of care.

Impact

Studies showed that Green House homes are likely to reduce hospitalization rates among residents, and Medicare and Medicaid costs per resident, when compared to residents in traditional nursing homes. Also, nurses are more likely to spend more hours in Green House homes.

Results / Accomplishments

Results of a retrospective observational study show that the rate of hospitalization per resident over 12 months was over seven percentage points higher in the the traditional nursing home unit relative to the Green House unit. The overall difference in total Medicare and Medicaid costs per resident over 12 months ranged from approximately $1,300 to $2,300 less for residents in Green House homes versus traditional nursing homes.

In another study, overall staffing, care time per resident day, and staff time interacting with residents were compared between Green House homes and traditional nursing homes. Results showed that there were significantly more total nursing (registered nurse, licensed practical nurse, certified nursing assistant) hours spent at Green House homes. Also, Shahbazim and certified nursing assistants spent more time per resident day in total direct and indirect care at Green House homes than in traditional nursing homes.

About this Promising Practice

Organization(s)
The Green House Project
Primary Contact
The Green House Project
2011 Crystal Dr. #750
Arlington, VA 22202
703-647-2311
greenhouse@ncbcapitalimpact.org
http://www.thegreenhouseproject.org/
Topics
Health / Older Adults
Community / Social Environment
Organization(s)
The Green House Project
Date of implementation
2003
Location
USA
For more details
http://thegreenhouseproject.org/research-advocacy/...
https://www.rwjf.org/en/how-we-work/grants-explore...
Target Audience
Older Adults

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  1. Program of All-Inclusive Care for the Elderly (PACE)
  2. CDC COMMUNITY GUIDE: Adolescent Health: Person-to-Person Interventions to Improve Caregivers' Parenting Skills
  3. North Dakota State Long Term Care Ombudsman Program
  4. Senior Companions
  5. Tailored Caregiver Assessment and Referral (TCARE)
  6. Safe at Home

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.
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