“Making It Personal” Resident Satisfaction

1. “Making It Personal”Resident Satisfaction Dan Burns, LNHA, Administrator, Brentwood, ME Renee Looker, LNHA, MS, Executive Director, Forestview of Wareham, MA 2011 Quality Symposium Innovative Practices Panel – Resident Satisfaction Thursday, February 17, 2011

2. Approach and Deployment • Approach: The methods used to accomplish a process. Show that they are appropriate and effective and repeatable (systematic) • Deployment: The extent of which a program has been implemented. The breadth and depth of application of the approach across departments and work units PLAN DO

3. Learning and Integration • Learning: What did you learn through evaluation and improvement. Organizational learning is achieved by research and development, evaluation and improvement cycles, workforce and stakeholder input, best practice sharing and benchmarking • Integration: The harmonization of plans, processes, lessonslearned, resource decisions, actions, results, and analyses to support key organization wide goals STUDY ACT

4. Forestview of Wareham • 175 Bed Facility • 49 Bed Transitional Care Unit • 40 Bed Secure Dementia Unit • 86 LTC Beds • 56 Bed Main Feeder Hospital • Goal is to make Forestview the Facility of choice for our customers.

5. Brentwood Rehabilitation and Nursing Center • 78 Bed Facility • 37 Bed Skilled Rehab Unit • 41 Bed Secure Dementia Unit • Referring Hospitals • Maine Medical Center (637 Beds) • Mercy Hospital (230 Beds) • Mid Coast Hospital (92 Beds)

6. FV APPROACH • Try to Accomplish • More holistic approach to healthcare • Improve our Dining Services • How Identified • Looked for a new niche • My Innerview Survey Results • Pinnacle Survey Results Solution • Mind, Body & Spirit Program • Reiki, Meditation, Aroma Therapy, Music Therapy, Body Massages, Hand Massages and Sleep Kits. • Dining Selections Menu • Weekly on TCU and Daily for rest of building

7. BW PLAN • GENESIS OF PLAN • Gather data • Identify concerns • Create steps to carry out plan • 2. Identify Concerns • Prioritize concerns • Dining Times • Meet Medical Director • 1. Data Gathering Techniques • Interview residents – Abaqis • Angel Care Program • Family and Friends Meetings • Pinnacle Survey Feedback • ED rounds/interviews • Resident Council Meetings • 3. Create steps to develop plan • Change delivery times of meal carts to meet the desired dining times of the residents on the different units. • ED to personally introduce Medical Director to new residents

8. Discussion (Approach / Plan) • What steps/efforts did you take in determining your approaches? (Research? suggestions from Colleagues? Families? Residents? Others?) • How did you prioritize your areas of focus to improve resident satisfaction?

9. Implementation Mind, Body & Spirit Program Offerings were made to the full house. Dining Daily Menu posted on units Menu read over intercom daily TCU with weekly menu’s Other units request alternates Notification Mind, Body & Spirit Program Added brochure to admission packet Care Conferences Dining 1 on 1 with TCU Residents Mailed letters to families Resident Council, Care Conference Menus posted in every room FV DEPLOYMENT

10. Implement the Plan BW DO • Change delivery times of meal carts to reflect desired dinning time of residents – Skilled residents wanted to dine later. • Executive Director to walk the facility with the Medical Director and personally introduce him to the new residents.

11. Discussion (Deployment / Do) • Did you implement by hall, or shift, or unit, or all at once? • How did you notify staff, residents, families, and customers of the change? • How did you get support for these new processes/programs? (formal and informal leaders?)

12. Measure Mind, Body & Spirit Survey before and after treatments Feedback Dining My Innerview Survey Results Pinnacle Survey Results Feedback – Resident Council and Dining Committee Continuously measure by asking for feedback and survey results Goal Mind, Body & Spirit Decrease anxiety and pain Increase relaxation and quality life Dining Enhance dining experience Increase quality of food scores FV LEARN • Performance discussed with • PI Committee • Resident Council • Staff in meetings and posting survey results

13. Are the plans we created having the desired effects? Yes Share results at PI, Standup, Resident Council meetings Continue with plan, but also continue observations and interviews. This is not a one-and-done process. BW Study Gather Data Observations and Interviews • No • Share results at PI, Standup, Resident Council meetings, etc. • Continue with aspects that are working. • Document and share with staff and residents these findings.

14. Discussion (Learn / Study) • How did you measure success of your implementation? • How often do you measure and who do you share the results with? • What changes have you made?

15. Changes Made Mind, Body & Spirit Added Meditation (can be a resident run group activity) Dining Trayless dining – 2 units Café – Soup, Salad, grilled Sandwiches Changes Impacted Results Mind, Body & Spirit Positive feedback from Residents, Families and Staff Dining Restaurant style dining in assistance dining rooms Café opened January 2011 FV INTEGRATE 2011 Program (To meet our customers needs) Addiction Program (Alcohol, Drugs, Food etc)

16. Continue monitoring process, for aspects not working create action plans and share with residents and staff (meetings). Dining TimesMeal cart delivery times were changed. During interviews we found that some residents felt like it wasn’t a success. We discovered that some residents on that side of the hall needed more time with assistance and it slowed down the delivery time for the residents that did not require much setting up. With resident and family approvals we moved some residents bed assignments and put residents with similar dining assistance together. This made the process of delivering meals and feeding work much smoother. ED introducing Medical Director to new residents We began doing it at 11:00 a.m., but half of the residents were in therapy at the time (not the desired outcome). Met with the staff and fine-tuned the process. Staff suggested that the ED and Medical Director check the Therapy Board to see the times the new residents will be getting therapy and schedule the introductions around those times. We have done this and we have changed our introduction times around the residents’ schedules, not ours. We ACTED on this aspect and it has been a success ever since. BW ACT

17. Continuous Loop Make Changes as needed Observe/Interview Share Information Document

18. Discussion (Integrate / Act) • How have you integrated these new activities into existing programs to sustain effectiveness? • If you had to implement your approach again, what would you do differently? • How are these new programs supported by all key stakeholders?

19. Thank You!!! “Making It Personal”Resident Satisfaction Dan Burns, LNHA, Administrator, Maine daniel.burns@kindredhealthcare.com Renee Looker, LNHA, MS, Executive Director, Massachusetts renee.looker@kindredhealthcare.com