Reducing rehospitalizations and antipsychotics top-of-mind for long-term care providers at AHCA/NCAL convention

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Developing effective relationships with hospitals begins by joining, initiating or hosting a cross continuum team at a long-term care provider's campus, an expert in senior care said Monday.

A skilled nursing facility provider can start the conversation by reaching out to the head of case management at a hospital, the vice president of quality, or the director of post-acute care, advised Laurie Herndon, MSN, GNP-BC, ANP-BC, the director of clinical quality at Massachusetts Senior Care Association. She presented on “Developing Effective Partnerships with Your Hospitals,” at the American Health Care Association/National Center for Assisted Living convention and expo in Washington, D.C.

After inviting the members of the partnering hospital's team for a visit —  and inviting members to look at the SNF's data —  those involved on the long-term care side also have to show up, Herndon said.

Members of the hospital executive team “notice and they remember,” Herndon said. She also recommended a “Patient Tracer Experience,” where a hospital nurse follows a discharge patient to a SNF as an observer.

In one case, the nurse described it as “an eye-opener,” and discovered how much paperwork her case manager was sending. The next day she was able to change the discharge paperwork process, Herndon noted.

Long-term care providers should also be prepared to not only discuss their data, but have answers on questions related to the field. This includes an answer to “What do you say about the Five Star system?” and “What do you say about staffing?”

In addition to managing relationships with hospitals, providers are focused on new strategies related to helping residents with dementia. In a session on skill-based dementia consulting, Erin Bonitto, MS, ADC, the founder and lead coach at Gemini Consulting, discussed new approaches. The goal for antipsychotic reduction was recently set to 30% by the end of 2016.

These ideas include approaching residents by getting below their eye level but still making eye contact and using a “sparkling facial expression.”

“Everyday communication patterns do not work for a person with dementia,” she said. “Even if we are communicating in a pleasant and professional way.” Caregivers, especially women, can also fall into the trap of “up-talking,” where their voices rise at the end of a statement or question.

“Remember to speak slow and low,” Bonitto advised. “That vocal pattern makes it easier to hear.”

Bonitto, who is presenting dementia coaching for assisted living providers Tuesday morning, said there's increased interest in finding strategies to reduce psychotropic use.

“Hands-on dementia communication coaching is not just about that it brings the resident pleasure, purpose and peace,” she told McKnight's. “But now we can link it to antipsychotic reduction.”