Nursing / Resident Care
Nursing / Resident Care
Measuring a Nursing or Resident Care department's workload is different from other departments because most activities are resident specific. This means you are determining and measuring resident needs, not simply measuring how long it takes to complete a specific task.
The best approach to improve the effectiveness of this department is to develop a resident profile system that shows how much time each resident requires by hour of the day. The key to making this approach work is to make it simple to adjust the profiles and staff assignment sheets for changes in census, acuity levels or resident services.
The best operators find that compassionate, flexible care begins with a detailed understanding and measure of the residents daily care requirements, both individually and collectively.
Case Study #51Judy did not know what to try next. Staff turnover was high. Her core staff was becoming tired from working extra hours. And most distressing to Judy was that the quality of care was not at a level she felt proud to deliver. The Assisted Living Unit was a growing part of a 220 unit upscale retirement / assisted living community. It began as a 40 suite unit and was planned to grow to 80 units within the next six months. Judy didn't know how her department could cope with the current residents, let alone another 40.
It was at this time the Program for Quality and Performance Improvement was introduced at this community. This is how the program helped Judy.
Resident Profiles were developed for each resident outlining the type of care and average number of minutes required to deliver that care by hour of day. This provided Judy with total labor requirements by hour of the day, by resident. She could then summarize the requirements by floor, by Health Care Aide Assignment and by Care Level.
Professional Staff Requirements were calculated by Activity and by time of day. For example, a standard time was established to assist residents with medications by time of day and by location. This meant that Judy could now plan her professional staff schedule around real labor requirements. It showed her the times of day when the professional staff was very stretched and the times of day when the Nurses could provide assistance to the health care aides.
Quality Checks were developed so that Judy could measure quality using a simple 10 point Quality Check Sheet. Judy helped designed 4 such check sheets; The Resident, Medication Administration and Documentation, Suite Condition and Dining Room Appearance and Service. So at any time of day, Judy could complete a Quality Check to see how well the residents' needs were being met. The information was reviewed with all department staff who took an active role to help find solutions to some of the operating problems identified by the Quality Checks.
Assigning work based on the Resident Profiles became a key role for Judy at the beginning and close of each day. Health Care Aides were provided with more detail about their shift and the work was balanced so that the care aides not only had a fair amount of work but they also had an outline of what service to provide to which residents by time of day.
The extra units have been opened and Judy has been able to use her new systems to better plan, assign, follow up and report on the progress in her department. Resident services are provided with what Judy calls "consistent flexibility". The average number of labor hours per resident day has decreased from 1.7 to .9 hours and the service is better than ever.
If you would like to speak to the Executive Director of this community call us, or send us your request.