Guest Columns

Quality care goes beyond clinical measures

Rita Mabli
Rita Mabli

At senior care facilities, it's easy to get caught up in the numbers – the percentages and ratings that earn awards and boost state and Medicare rankings. But we know that what's most important is dealing with people as a whole. While the data points – how many residents need antipsychotic medications, are injured in falls, or report pain – are important clinical measures, they represent only a snapshot of an organization's culture and all-around quality of care.

At United Hebrew of New Rochelle, we believe the best way to get good numbers is to start by looking at each resident as a whole person with distinct interests, joys, opinions, and frustrations, as well as medical needs, and managing their care plan accordingly.

Case in point: In 2013, we began a program called Dementia Connections, in which we trained staff who interact with the patients on our Nightingale dementia unit to better understand how cognitive impairment affects a person. We gave this training not only to the nurses, but also to the food service, environmental services and the engineering department– anyone who came into contact with the residents.

We asked the staff to recall how it feels when you are sad or bored or when you know that you are right but you are being told that you're wrong. When you are told, for instance, that you need to take a shower and you are certain you just took one.

The results of this training were immediate. Residents who exhibited behaviors such as kicking and biting dropped significantly. Fewer residents needed antipsychotic medications.

Staff encouraged residents on the 84-bed unit to take walks, something many of them had not done. New pictures on the walls gave them something to walk to, and to talk about. Walking more reduces falls because leg muscles are strengthened, and having an activity helps folks to socialize and remain engaged.

Our music program also reaps fine results. We hired a full-time music therapist to lead our residents in sing-alongs and to research and find songs from the childhoods of residents who come from diverse backgrounds and various foreign countries. (Our therapist can sing songs in seven languages.) It is well known that music therapy improves mood, reduces stress and depression, lowers blood pressure, and takes people's minds off aches.

Our holistic approach to patient needs is one reason that United Hebrew has built a  “Campus of Comprehensive Care” that offers a full range of care for seniors and the elderly. The campus includes facilities for skilled nursing, rehabilitation, assisted living, memory care, independent senior housing, and home care services. That allows us to readily step up care as a resident's needs change over time.

These and many other programs and approaches have created the optimal quality of life for our residents, and recently we were recognized twice for our skilled nursing facility. We received the prestigious American College of Healthcare Administrators' Eli Pick Facility Leadership Award, and we also have earned a place in the top tier of New York State's Nursing Home Quality Pool rankings since 2012.

So what are our numbers? The ACHCA, an industry leadership association that provides professional education and certification to long-term care administrators, gives the Eli Pick award only to skilled nursing facilities that meet specific criteria. For example, they receive complaints of pain from no more than 1 percent of long-stay patients and 8.3% of short-stay residents. United Hebrew met those criteria for the first three quarters of 2015 with complaints of pain coming from .9% of long-term residents and 7.4% of short-stay residents. (Both numbers are far below the national averages, which were 8.1% for long-stay residents and 17.2% for short-stay residents.)

To be placed in the First Quintile of the Quality Pool, United Hebrew had consistently low numbers of residents who reported being in pain, or who needed antipsychotic drugs, experienced depressive symptoms, or were injured in falls.

We are happy that the honors affirm the philosophy we have always followed at United Hebrew, but the larger reward is seeing our residents feeling safe and comfortable, and knowing that our approach makes for more fulfilling relationships and more joy in their lives.

Rita C. Mabli is President and CEO of United Hebrew of New Rochelle, a multi-service senior care campus in New Rochelle, NY

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Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.

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