Maximizing Long-Term Care Resident Satisfaction Using the Kano Model: A Quality Improvement Project Within a South Dakota Long-Term Care Facility.

Introduction: With the growing demand for long-term care facilities, understanding residents' values is critical to delivering high-quality care and enhancing their quality of life. This project aimed to identify the quality-of-life features most valued by residents to optimize resource allocation and maximize satisfaction.

Methods: A survey assessing 11 quality-of-life features was conducted with residents at a South Dakota nursing home. Participation was voluntary, excluding residents unable to communicate verbally or hear the interviewer. Survey responses were analyzed using the Kano Model, which categorizes features as "mustbe," "performance," "attractive," or "indifferent," reflecting their impact on satisfaction and prioritization. "Must-be" features represent expectations essential to satisfaction, while "performance" features influence satisfaction proportionally. "Attractive" features offer added value by improving satisfaction, without reducing it when absent. "Indifferent" features provide opportunities to reallocate resources toward higherpriority needs.

Results: Thirty-three residents participated in the survey, and analysis of their responses revealed distinct categorizations for the quality-of-life features. Features identified as "must-be" included permission to leave, autonomy in sleep schedules, help when needed, shared decision-making, and security of possessions. Features categorized as "performance" were organized activities, religious activities, and comfortable room temperature. "Attractive" features consisted of enjoying food and staff taking personal interest, while private phone calls were classified as "indifferent." To add prioritization within these categories, importance scores from the survey were incorporated. Based on these scores, the features were ranked in the following order to maximize satisfaction: help when needed, security of possessions, permission to leave, shared decision-making, autonomy in sleep schedules, room temperature, religious activities, organized activities, enjoying food, staff taking personal interest, and private phone calls.

Conclusions: The findings highlight the importance residents assign to quality-of-life features and demonstrate which features residents value most. This allows administrators to make data-driven decisions to efficiently enhance resident satisfaction.