Table 4 Summary of results pertaining to processes of care
Intervention | Source | Effectiveness | Cost | Randomised design | Key findings |
|---|---|---|---|---|---|
Dementia-specific care | |||||
 Person-centred care (PCC) vs. usual care (UC)  Person-centred environment (PCE) vs. UC  Both (PCC + PCE) vs. UC | [39] | + + Unclear | + + + | Yes | Person-centred care has the potential to reduce agitation and aggression in residents living with dementia Disparate implementation methods and mixed findings suggest a need for future research to examine the cost-effectiveness of person-centred care as well as different methods for assessing clinically-relevant quality of life |
 PCC vs. UC Dementia-care mapping (DCM) vs. UC | + + | + + | Yes | ||
 Dementia-care mapping (DCM) vs. usual care | [30] | 0 | 0 | Yes | |
 A.G.E. dementia care program (activities, medication guidelines, educational rounds) vs. usual care | [27] | + | + | Yes | For an additional cost, activity programs and psychiatric care can reduce behavioural symptoms, antipsychotic medications, and restraints, as well as increase activity participation rates for residents with dementia |
Integrated care | |||||
 Multidisciplinary Integrated Care model vs. UC | [22] | Unclear | + | Yes | There is limited cost-saving potential for integrated care in nursing homes If there was unmet care, a multidisciplinary integrated model could address this gap; however a trade-off must be made as to whether the additional benefit is worth the additional cost |
 Integrated care vs. traditional care | [21] | NA | + | No | |
Quality improvement initiatives | |||||
 Advance Directive program vs. usual care | [25] | 0 | – | Yes | Activity programs aimed at reducing health care utilisation and hospitalisations have the potential to create cost savings from a broader health care perspective |
 INTERACT II tools (interventions to reduce acute care transfers) | [43] | + | + | No | |
 Multifactorial fracture prevention program provided by a multidisciplinary team vs. no prevention in newly admitted nursing home residents | [33] | + | + | No | |
 Multilevel intervention with expert nurses vs. monthly info packs on ageing and physical assessment | [26] | + | + | Yes | It is possible for facilities in need of quality of care improvements to build the organisational capacity to improve while not increasing staffing or costs of care |