How does engagement measure up?
Charles de Vilmorin
In our role as providers serving our residents, we are tasked to address their needs and desires in the most person-centered way. Making sure we take into account who they are and where they are cognitively or physically is of the utmost importance.
How does one evaluate the quality of this engagement process and how well we're doing? It all starts with understanding a resident's needs, creating a plan, implementing it and evaluating our efforts.
When measuring engagement of residents in skilled nursing care there are several levels of assessment that should be used. First, a provider must be able to track how they are meeting the needs of the population they are serving. Second, they must compare resident preferences and needs with the effectiveness of current recreational activities to enhance positive outcomes for each resident.
Finally, in order to be successful, the provider should look carefully at their current and desired business outcomes. They must understand that if they are good at using Person-Centered Care (PCC) planning to match the needs of the population they serve with desirable recreation activities, then this will in turn lead to positive health outcomes that can be marketed to the larger community and result in better resident and staff satisfaction.
Examples of appropriate PCC approaches include:
- If you have 10 residents who spent time employed as teachers before retiring, it would be beneficial to bring these individuals together to speak of their common experience and provide activities for the group that allow them to use skills from that profession. For instance, an opportunity to teach a lesson to their peers based on subject matter they enjoy or read a book to children.
- It is not uncommon for a person experiencing Alzheimer's Disease and Related Dementias (ADRD) to express frustration when they can no longer communicate their needs effectively to care partners. To address the wandering or aggression that may arise in this situation, care partners should take the time to talk to family and friends of the resident to understand their hobbies, interests, tastes, past profession and life events so that they can tailor recreation activities to match those unique preferences and experiences of the individual. A resident in distress will appreciate being known in such a personal way.
There is now a robust number of studies that show the evidence-based benefits of PCC in positively impacting the health and psychological well-being of older adults in nursing home facilities. In light of this, it is common practice for providers to want to advance PCC recreational strategies for residents in order to positively impact their health outcomes.
As researcher Kimberly Van Haitsma, Ph.D., and her team point out in their 2016 research, published in the Annals of Long-Term Care: Clinical Care and Aging, the advancement of PCC can only take place when a provider has the appropriate tools and methods to evaluate if the consumer's needs are in fact being met and what areas there are for quality improvement. The researchers developed a Preference Match Tracker that was based on the fact that customization of care cannot be done effectively until resident preferences are fully understood. This Tracker was unique in that it could measure whether a resident's preferences were actually being fulfilled; something that the current CMS MDS 3.0 tool doesn't examine.
The interesting thing with these approaches is the ability to measure our ability to engage and serve our residents based on their needs or desires. As we know, once we measure, we can start managing, operationalizing and optimizing our practices which in turn truly enables PCC.
Furthermore, PCC cannot be scaled without having a correlation to a provider's desired business outcomes. To have a thriving business, providers must be able to positively influence health outcomes for residents, by tracking both resident preferences and PCC outcomes then making adjustments if current recreational therapies used are not resulting in improved health outcomes over time.
Technology can be a cost-effective and user-friendly way to both track the preferences of residents in skilled nursing facilities and quantitatively link those preferences to healthcare outcomes after recreational therapy takes place. It is essential that providers have the tools that they need to measure in order to manage both the health outcomes of their customers and the bottom line of their business.
Charles de Vilmorin is the CEO of Linked Senior.