Results released from visits by Cypress Health senior managers to long-term care facilities

Written by Matthew Liebenberg

Results released from visits by Cypress Health senior managers to long-term care facilities

The Cypress Health Region is using the results from the annual visits by senior management staff to long-term care facilities to make ongoing improvements to the quality of care provided to residents in these facilities.

The Saskatchewan Ministry of Health released the findings of the 2015 tours by CEOs of health regions on Nov. 25.
Minister of Health Dustin Duncan has implemented the annual CEO tours in 2013 after family members of long-term care residents raised concerns at the provincial legislature. CEOs of the 13 health regions are required to visit all long-term care facilities under their jurisdiction every spring and submit reports to the ministry on what is working well and what can be improved.
Cypress Health CEO Beth Vachon said these visits provide a snapshot in time for each long-term care facility in the health region.
“We hear some consistent things year over year and that areas where we focus on what we hear, we see some improvements,” she mentioned. “So I think that gets acknowledged as each year goes on.”
She emphasized service provision in long-term care facilities is a priority issue for the health region and members of senior management make frequent visits.
“We’ve been extremely focused in the Cypress Health Region on long-term care,” she said. “That’s been a big part of the work that we’ve been doing over the last five years. So we’ve been in our facilities on a regular basis for always. We’re always visiting our facilities and talking with staff and families and residents. It’s not like we go in once a year and do this tour and get our feedback.”
She is confident senior managers are able to receive accurate information from these visits about any issues of concerns in the facilities.
“You’ll see from the results this is pretty well balanced,” she said. “We ask those questions — what’s working really well, and what are some ideas for improvement. So it’s always that opportunity to contribute in a way that isn’t negative or pointing the finger at somebody. … We are truly seeking that input for how we can improve things. So when you do look at the reports it’s fairly balanced. It’s not all good and it’s not all bad.”
Positive findings
The findings from the 2015 long-term care tours indicate numerous positive issues. There are resident-centered care with flexible breakfasts and sleeping time, residents are asked for their preferences, families feel welcome, meal are generally good, there are more activities for residents and they are included in day-to-day activities, there are regular resident and family council meetings, facilities are clean and well maintained.
There are also positive remarks about the quality of care for residents. They look well cared for and happy, there is good washroom protocol, wound care, skin protocols and medicine reviews.
The information from the tours identify various issues of concern at different facilities that require attention. Quality of care issues include the consistently of care and wait times to receive assistance, nail care and pain management. The frequency of recreation programming and the need for one on one activities are highlighted.
Concerns found
There are some concerns over menu quality and variety in meals provided, the quality of soup and the nutritional value of prepackaged foods. It was indicated resident-centered care should acknowledge individuality of residents, and some needs were expressed with regard to information sharing about the upcoming move to the new long-term care facility in Swift Current.
Concerns were raised about inadequate staffing levels and staff coverage, as well as the attitudes of some staff towards residents.
According to Vachon, the implementation of flexible breakfasts in facilities has been a significant improvement.
“In the past, going back 20 years, everybody was up and dressed in the dining room by eight o’clock waiting for breakfast, while the reality is that not everybody wants to be up at that time,” she said. “So one of the big changes that we’ve made is allowing people to sleep until they’re ready to wake up and get up. … That’s one of the areas I think we’ve made significant improvements and our staff have really embraced allowing people that flexibility in their day.”
She noted health region officials are working on improvements to a frequent concern from residents about the time they need to wait to receive assistance from staff.
“We often hear from people that they need help quicker for things like assistance in the washroom,” she said. “So that’s definitely one of the things that we know we’re trying to improve.”
The health region has launched a purposeful rounding initiative to anticipate people’s needs for assistance. Staff will therefore visit long-term care residents at frequent intervals to provide them with additional assurance. Staff will check on things such as pain management, that everything is within reach of residents to avoid falls and if people need to go to the washroom.
“It gives our residents peace of mind to know that somebody consistently through the day is coming and checking,” she said. “Our staff do that on a regular basis, so it’s not like we’re starting something that hasn’t been happening, but rolling out a formal program allows us the ability to actually determine is it happening, are there other changes within the system that we need to make in order to ensure that we can anticipate people’s needs more effectively than always just waiting for the call bell to ring.”
Vachon acknowledged staffing is always a challenging issue and the health region needs to balance the needs of all communities and the staffing requirements of the different health services.
“We would love to have a higher staff to resident ratio,” she said. “I don’t think there would be any facility in the province that wouldn’t want to have as many people as they possibly could. So we function within the resources that we have.”
She emphasized the health region is responsible for those decisions on staff allocations and not the provincial Ministry of Health.
“We receive our money from the government and then as a region we decide where those resources need to be,” she said. “It’s not the government that says this facility gets this many staff. Those are decisions that are made at a region level.
The feedback received from some facilities during the CEO tours indicated that residents sometimes feel not all staff are warm and engaging.
“I think in any workplace, whether it’s health or any other business, there are people who may not portray the values and the personality and character that we want to portray, especially when you’re working with people,” she said. “So staff get evaluations, the managers do deal with concerns as they’re raised, and sometimes it’s just a matter of coaching people to understand what it was that might have offended or upset somebody.”
Cypress received Urgent Issues Funding
The Cypress Health Region has received one-time funding of $530,000 from the Urgent Issues Action Fund that was created by the Ministry of Health in October 2013 to address priority issues on long-term care facilities across the province.
“We’ve done a ton of things with that money,” she said. “We were very thoughtful about how we wanted to use that money and I think we’ve covered a lot of ground actually.”
The health region used the money for renovation projects at different long-term care facilities to create a more home-like environment. Some of the funds were also used for education and training of staff.
“There was lots of consultation on how we would use this money when we were doing things like renovating and decorating,” she said.”Our resident and family councils worked with us on that as well as the residents themselves and the staff.”
Some funds were used to improve activity programming for residents and to provide education to long-term care staff about the model of care. This education included presentations by Dr. Jenny Basran, a Saskatchewan geriatrician and expert in long-term care.
Another education component was a virtual dementia tour for staff to provide them with a better understanding of dementia.
“It simulates having dementia, so the sensory kinds of things, and allows people to experience what that feels like to bring understanding and compassion to those residents we work with that have some form of dementia,” she said.
There were various improvement at different long-term care facilities. In Herbert the lounge and foyer area was renovated, including a feature wall and fireplace, new furniture and a coffee station where residents can have a cup of coffee with their visitors.
In Leader the entry and lounge area was painted and they replaced some lighting and furnishings. Renovations in Cabri included new lighting and furnishings and some repainting. In Gull Lake new doors and handles as well as new closet doors and organizers were installed in resident rooms, and new chairs were placed in the dining room. New self-opening doors to the exterior patios were installed in Shaunavon, Ponteix and Eastend.
Renovations in Gull Lake, Herbert and Cabri included the removal of nursing stations to reduction the institutional feel of the facility.
“So taking out those big nursing stations that make it look like a hospital and finding another areas for our staff to work within when they need to charting and have conversations and phone calls that actually are away from the main central areas,” she said.
Some funds were used to implement a new long-term care electronic charting system, called PointClickCare.
“The region actually invested about $400,000 in that with region money, but where we were using the Urgent Action Fund is that there is about a $45,000 licensing fee that goes every year with that and we’re using some of that towards implementing the electronic charting for long-term care,” she said.
The health region also improved staffing in Maple Creek by adding one full-time continuing care assistant position, by increasing the hours for the nurse B position in Shaunavon and by converting a nurse A position to a nurse B position in Leader.
“So what a nurse B does is they have the oversight of care planning and coordinating care every day on the floor,” she explained.
Vachon emphasized health region officials are always looking for ways to make improvements that will benefit residents in the long-term care facilities.
“Often times, when something is working well in one facility, we know that it will work well somewhere else because it’s the same kind of care, but also acknowledging that every community has it’s unique character,” she said.
“So really, it’s about things like flexible breakfast now being available throughout the region, looking at purposeful rounding, looking more  at one on one activities and that individual time with people. Those are the things that we know are adding value to the lives of residents that we serve and I think that our family members give us good feedback on that as well.”

via SW Sask News – Prairie Post – Prairie Post

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