Residents' increasing acuity drives need for talks, education, data collection

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Residents' increasing acuity drives need for talks, education, data collection
Residents' increasing acuity drives need for talks, education, data collection

NEW ORLEANS — As shifting demographics and changing consumer preferences contribute to residents' increasing acuity needs in assisted living communities, it's critical to clarify with staff members what your community and they are able to do and what you and they are willing to do, Liz Jensen, RN, MSN, RN-BC, clinical director of Direct Supply, told those attending an educational session Tuesday at the 2017 LeadingAge Annual Meeting & Expo.

“The ‘able' calls into account regulations, licensing, your business model, existing staff,” she said. “What are you really able to do? And then, once you know what you're able to do, what are you willing to do?”

Part of the process should be to think about what competitors are doing and about what residents and their families expect, Jensen said. She recommends having the conversation as a team.

“Many times … acuity just seems to be happening. We seem to keep responding to it as need be, but we really haven't taken the time to stop and define what we're really going to be able today, what we're really going to be able in the next six months, and what we're really going to be about a year from now,” she said. “So having that conversation with your team about what you're really able and willing to provide is really critical.”

Additional training may be needed so that nurses and other caregivers feel comfortable and confident working at the top of their licenses, Jensen said. “I talk to nurses frequently who feel pressure to provide more care than they feel they have the support to provide,” she said. “As we think about what we're asking the business to absorb and change, we really need to think about the nursing teams as well.”

Rising acuity levels also are a good impetus for communities to begin collecting outcomes data if they aren't doing so already, she said.

Areas such as adverse events, medication errors, falls, falls with injuries and rehospitalizations prevention are good factors to measure and address, Jensen said.

“These are high-risk, problem-prone areas that we tend to see drive litigation and drive rehospitalizations,” Jensen said, “so if you're looking for a place to start — if you are getting your quality assurance and your performance improvement team together ...I would always recommend starting with your high-risk, problem-prone areas.”

These areas also are wise places for communities to collect data that can be shared with staff as the community sets goals related to falls prevention and other metrics. Data sometimes counters expectations, so having data to support care decisions can be motivating, Jensen said.

“Data collection ‘is especially important if you're looking to partner with other groups like insurance companies or hospitals to do a project with you.' ” Jensen said.

The LeadingAge meeting ends Wednesday.

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