WE WEDN DNESD ESDAY Y 3/21/18 21/18 10:45a :45am-12: 12:15pm 5pm Cindy ndy DeGroo oot t BSN, N, RN, , CDP Rive ivers rside ide Senior ior Life e Commun mmunities ities-Bou Bourbo rbonnais, nnais, IL cdegr egroot oot@R @RHC.net HC.net
I have the right to determine how best to meet my needs It must include me, my family and team in decision-making My care must be nurturing, compassionate, empowering and respectful My care should optimize my physical and psychosocial well-being “Nothing About Me, Without Me”
“See me for the person I am” “See me for all the things I believe, care about and love to do” Please don’t diminish my personhood just because I need some assistance with activities of daily living Person- Centered Living Matters….produced by Dementia Action Alliance Reflects on 5 people living with Dementia and how PCC helps them more fully www.youtube.com/watch?v=OZXeXHJX_1A&t=165s www.youtube.com/watch?v=o_lIcihpIYQ
Ri Right t Way? Wrong ng Way?
Define Person-Centered Care/Person-Directed Care Define Culture Change Identify a Well-Being Framework to share in your community to bring Well-being to life Discover one community’s lessons learned along their culture change journey Obtain & Identify tools & resources to use in implementing Person-Centered/Directed care practices in your communities Share YOUR Successes in Culture Change/Person- Centered Care Journey!
“Well -being is a much larger idea than either quality of life or customer satisfaction. It is based on a holistic understanding of human needs and capacities. Well-being is the most valuable of all human possessions… Dr. Bill Thomas, “What Are Old People For” The Ultimate goal of Culture Change is…”Well - Being for all” ◦ Includes all care partners, elders, employees, family members, volunteers, community ◦ Care is a 2-way street ◦ Our focus should be on ensuring growth and well-being for all involved in the relationship
Acknowledges that the quality of our relationships is the key to our success
IDENTITY-Being well-known, having personhood, individuality, wholeness, have a history GROWTH – Development, enrichment, unfolding; expanding, evolving AUTONOMY – liberty, self-governance, self- determination, choice, freedom SECURITY-freedom from doubt, anxiety, fear, safe, dignity, respect CONNECTEDNESS alive, belonging, engaged, connected to the past, present, future, connected to personal possessions
MEANING-significance, heart, hope, import, value, purpose, reflection, sacred JOY-happiness, pleasure, delight, contentment, enjoyment
Relationships between the staff & residents are at the heart of care Systems and structures are developed to support those relationships TEAM TIME: Write down what your day of a “LIFE WORTH LIVING” in your amazing community
Strength Possibilities Dreams Goals Our Resident’s Best ability to Function What they “CAN” do, not what they “Can’t do”
https://www.youtube.com/watch?v=EFRkFPPh2hw
A transformation in philosophy and practice to de- institutionalize care and create resident- centered/directed approach in all aspects of life….YES, in the beginning it was focused in Long Term Care. Now…it’s practices are applicable in MANY post -acute entities
TR TRADITIO TIONAL NAL CARE RE RESIDENT-CENTERED CARE Residents wake up, go to bed, Re Residen ents ts are told d eat, and bathe when they when to wake e up, go to choose to. bed, eat, and bathe he Staff alter their work routines based d upon on to honor the resident’s insti titutio tutiona nal sch chedule dules s preferences and set routi tine nes
Resident Routine Dining Experience ◦ Honor Their Choices ◦ Café-Open 6:30a-6:30p ◦ Consistent Staffing- ◦ No assigned seating Individualized Service Plans ◦ Come when you want Hiring/Training New ◦ Memory Care-Staff eat with Employees ◦ Applicant Shadows Residents Meaningful Resident ◦ Kitchens built in Engagement neighborhoods ◦ ASK THEM! Responding to Pull Cords Resident Centered Council ◦ Consistent Assignment-staff ◦ Welcome Committee ◦ New Resident Social know resident’s routine
Consistent Assignment Huddles Involve C.N.A.’s the frontline team members in Care Plans/Service Plans QI Huddles-involve those closest to the resident
“ The same residents are cared for by the same caregivers on at least 85% of their shifts” The Advancing Excellence Campaign AKA “Permanent” or “Dedicated” Assignments www.youtube.com/results?search_query=advancing+ excellence+consistent+assignment
“Consistently assigning the same care givers to the same nursing home residents every day” - David Farrell 2007 Refers to assignments for nursing assistants only – including C.N.A.’s and Unit Helpers Readily extends to Charge Nurses, Social Workers, Housekeepers and others
To never know who your caregiver is To always have caregivers that don’t know your preferences To know that you may not see that person again There is a possibility that a single resident could have over 21 or more direct caregivers in a week – that is 42 pairs of hands performing intimate care!
Residents have more control over their care Improved Clinical Outcomes Reduction in Skin Impairment Build positive relationships Increase resident and family satisfaction Improve staff satisfaction Lower Absenteeism Decreased Staff Turnover Quicker awareness of clinical problems Improve staff accountability Improve communication between shifts and with other disciplines Improve Quality Outcomes!!!
SUCESSFUL TIPS ◦ Be prompt ◦ Start on time ◦ Be prepared ◦ Keep Notes ◦ Share/post discussion points ◦ Thank those who participated/offered input TYPES ◦ Stand Up – all team members ◦ Post Fall ◦ Safety ◦ Shift Change
New Residents At Risk Residents Changes in condition Rehospitalizations Pending transitions/discharges Incidents/Accidents QAPI News, announcents Kudos/Celebrations/Recognitions New Staff
Relationships closest to the Resident: Nursing Housekeeping Activities Culinary Volunteers All Team Members RESIDENT AS THE FOCUS
Began 20yrs. Ago – Pioneer Network Movement Our Team over 10yrs. Ago wanted to “CHANGE THE CULTURE”…”RESIDENT’S FIRST” ◦ We were adding on…great opportunity ◦ Staff Education/Development – Senior Life Institute was born. ASSISTED LIVING IS CHANGING….from Social Model to…???? Aging in Place…Growing Needs of Residents….we were starting down the “Institution Path”…NO WAY!!!
Life fe is a r remarka kabl ble e journe ney. y. Health impacts every step - how we connect with others, how we express our potential, how we pursue our dreams. At Riverside our mission is to provide healthcare experiences that are just as remarkable. We do this for each and every person, regardless of their personal or economic circumstances. We offer our highest thinking, our kindest touch, and our strongest commitment to excellence.
Acknowledge A I Introduce D Duration E Explanation T Thank You
QUALITY – ◦ organizations cannot continuously improve systems and processes until they progressively improve interpersonal RELATIONSHIPS! THE END-USER – ◦ People closest to the End User have essential contributions to Quality Improvement
Celebrate How To Live Our Mission Daily Discover Our Foundation For Relationships ◦ Professional Standards of Behavior – “I RESPECT” ◦ Code of Conduct – Team Relationships ◦ AIDET/SMILE with EVERY Customer Encounter Analyze data Manage perceptions to make a difference Our goal is to set you up for success! Another goal at Riverside is for every patient, visitor, volunteer, physician, student, and employee to say:
Growing Trusting Relationships Consistent Communication Monthly Team Meetings Shift Report/Walking Rounds Wellness Rounds Huddles ◦ Care Approaches – Memory care ◦ Post Fall/Incident
Trust Walk Inspirational Stories ◦ The Journey of Dementia ◦ Punctuate Your Life
Evidence Based Interview questions Clear Expectations Obtaining references If valuable candidate-schedule shadowing Welcome Communication Orientation Classes – Priority to attend Post Orientation1:1 30-60-90 day Rounding by Educator
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