The Silver Tsunami is here, and our long-term care system is the most stressed it has ever been, losing more staff than any other sector of healthcare. Older adults and their caregivers are struggling to keep their heads above water as options for care, funding and work/life balance are shrinking.
An astonishing 61% of nursing homes are limiting admissions of older adults due to staffing shortages, according to the American Health Care Association/National Center for Assisted Living. Ninety-eight percent of providers are challenged with hiring staff, while a whopping 99% are requiring staff to work overtime just to care for the residents that they have accepted into their care. Things have to change, but where do we start?
In my previous article, I introduced a new modern concept I coined as Comprehensive Quality Assurance and Performance Improvement, or CQAPI. It is a fancy term for a “back to the basics” concept while broadening the team of professionals to add a multifaceted approach to problem-solving. Now more than ever, as many influencers have stated, “it takes a village…”. This level of crisis management cannot be done alone.
What are the basics, and how do we get back there using this concept? The main two challenges fueling the crisis are 1) staffing shortages and 2) financial constraints due to rising costs related to COVID-19. As an interdisciplinary team, it is urgent that you explore all of the reasons behind why your particular facility or organization is challenged in each of these areas.
Reasons touted for the current staffing shortage are increased burden (overtime and workload), low wages, low satisfaction and lack of flexibility in schedules needed for other familial or caregiving responsibilities in their personal lives. This quality improvement process can positively impact all of these directly and is a great way to start tackling them simultaneously.
According to AHCA, nine out of 10 providers have stated that their number one expense during the pandemic is staffing. Additionally, supplies have catapulted financial strain to an all-time high, as most facilities are working on a negative margin. Innovative solutions that aim to reduce cost of products, processes and staff expenses must be taken seriously.
I mentioned an innovative start-up out of Massachusetts in article one of this series, which has been able to prove that by simply changing out a routine incontinence brief with their “smart” brief, they can considerably reduce product cost, CNA workload and other complex medical conditions that develop from soiled briefs, a challenge that is time-consuming to manage. Talk about a big bang for the buck. One small change can have a ripple effect among multiple areas of quality improvement.
Consequently, if the above quality improvements are made, expenses would decrease in those areas exacerbated by the pandemic. This would allow for organizations to allocate more money towards staffing wages in order to reduce the gap that currently exists, contributing to the crisis between the level of responsibility and wage.
I am not saying that this or any other one product will solve all of your problems. What I am saying is that implementing a modern Comprehensive Quality Assurance and Performance Improvement process and investing in innovations and innovators will be the village that the industry will need to help pull us through these tough times.
Amy Chidester, LNHA, is a certified gerontologist and caregiver advocate, a preceptor in skilled nursing and assisted living and provides consulting services to caregivers, operators, innovative Agetech start-ups, and educational institutions.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
