Intervention | Source | Effectiveness | Cost | Randomised design | Key findings |
---|---|---|---|---|---|
Enhanced staffing levels | |||||
 30–40 min of RN direct care time per resident per day vs. less than 10 min | [20] | + | – | No | Enhanced staffing levels have the potential to create cost savings from a societal perspective Increasing nurse staffing in nursing homes demonstrated net reduction in re-hospitalisation, pressure ulcer presence, and urinary tract infections Enhanced PT and OT services delivered improved functional status and reduced nursing costs Occupational therapy has the potential to reduce secondary care costs including hospitalisation, and may uncover unmet needs for services |
 Physical therapy and occupational therapy (PT/OT) staffing levels: 1:50 vs. 1:200 | [28] | + | – | Yes | |
 1.0 FTE occupational therapist vs. usual care | [35] | + | + | No | |
 Off-hours physician coverage via telemedicine vs. on-call physician | [34] | + | – | Yes | Facilities accessing off-hours physician coverage via telemedicine had fewer resident hospitalisations than those facilities who did not utilise the telemedicine program or those who only had access to an on-call physician |
Staffing configurations in specialised models of care | |||||
 FTE comparisons in Green House model vs. traditional institutional care | [36] | None | + | No | Green house facilities provide more direct care time to residents compared to traditional units/facilities There is an increase in direct care FTEs, which is offset by a reduction in administration and support staff FTEs |
 Direct care time in Green House vs. traditional skilled nursing facilities | [37] | + | – | No | |
 Special care unit (SCU) vs. traditional unit | ± | + | Yes | Costs of care are higher on SCUs and in SCU facilities, than non-SCU facilities Special care units provide more direct care time to residents compared to traditional units/facilities | |
 SCUs vs. traditional units in SCU facilities  SCU facilities vs. non-SCU facilities | [24] | None None | 0 + | No | |
Staff education | |||||
 Implementation of an evidence-based education and best practice program vs. usual training | [29] | + | + | Yes | Evidence-based education programs show potential to reduce falls compared to non-evidence-based training The potential for cost savings is highly dependent on the true cost of falls |