Project Summary

PCORI has identified COVID-19 as an important research topic. Patients, clinicians, and others want to learn: What are effective ways to prevent or reduce the impact of COVID-19, especially on vulnerable populations and the healthcare workforce? To help answer this question, PCORI launched an initiative in 2020 to Strengthen Understanding of COVID-19 Impact and Inform Healthcare Responses. The initiative funded this research project and others.

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Nursing home residents are at high risk for severe COVID-19 infections. To help prevent the spread of COVID-19, nursing homes can follow national infection control guidelines. But only three percent of nursing home staff have taken an infection control course.

The research team is comparing two ways to train nursing home staff and administrators in infection control practices. The first way uses Project ECHO, a medical learning approach for training and supporting clinicians in evidence-based care. In this study, Project ECHO is connecting experts in infection control at Penn State University with remote nursing home staff and administrators. Training covers topics such as how to screen for fever and symptoms and how to properly use personal protective equipment. The second way uses Project ECHO plus an eight-week refresher course.

Who can this research help?

Results may help nursing home administrators when considering ways to prevent the spread of COVID-19.

What is the research team doing?

The research team is enrolling 136 nursing homes from the Northeast and Midwest United States. The team is assigning nursing homes by chance to take part in 25 weeks of Project ECHO with or without the eight-week refresher course.

Project ECHO includes 90-minute online video sessions held weekly. Sessions include instruction from Project ECHO staff. Nursing home staff also share how they have used infection control practices in daily care. In the first 25 weeks, all participants learn about COVID-19 and strategies for improving care delivery. Participants in the eight-week refresher course learn about more topics based on a training from the Centers for Disease Control and Prevention.

At the start of the study and again 4, 6, 12, and 18 months later, the research team is looking at how many nursing home residents get COVID-19, go to the hospital because of COVID-19, or die from COVID-19. The team is also reviewing a national database to learn about nursing home outcomes and residents’ quality of life.

Nursing home residents and their families, nursing home staff, health insurers, and policy makers are helping to plan and conduct this study.

Research methods at a glance

Design Element Description
Design Randomized controlled trial
Population 136 nursing homes with approximately 24,560 residents from the Northeast and Midwest United States
  • Project ECHO: 25 weekly sessions about COVID-19 and quality improvement
  • Project ECHO plus 8-week refresher: 33 weekly sessions about COVID-19, quality improvement, and infection control

Primary: COVID-19 infection rate

Secondary: COVID-19 hospitalizations, flu-like illness, and deaths; nursing home resident quality of life; infection control program reach, effectiveness, implementation, acceptability, and maintenance

Timeframe 18-month follow-up for primary outcome

Project Information

Jennifer Kraschnewski, MD, MPH
Pennsylvania State University, Hershey Medical Center
COVID-19 Project ECHO for Nursing Homes: A Patient-Centered, Randomized-Controlled Trial to Implement Infection Control and Quality-of-Life Best Practices

Key Dates

December 2023


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Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
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Last updated: November 30, 2022