I was recently visiting one of my clients for a routine site visit. I’m a tea drinker and love my tea. Unfortunately, this also requires the use of the restroom many times throughout the day. While visiting my client, I used multiple restrooms around the facility, and each time I noticed a very pretty toilet-paper flower in each restroom.

It was made of toilet paper and folded into a flower, including the stem. It was then sitting in an unused toilet paper roll to serve the purpose of the vase. It was such a clever and creative idea, I wanted to know who was behind this craft.

I was pleasantly surprised to learn the new housekeeper did this and she had a reputation for leaving small tokens behind throughout the entire facility. I was really impressed and admire housekeepers for the pride they must have in their job. It also reminded me of other situations in my career when housekeeping was the biggest referral source for rehab.

A few years ago, a friend of mine was trying to think of new and creative ways to generate referrals from the facility staff. She decided to hold a contest and asked every employee of the facility to participate in the challenge. Every employee meant, every employee … nursing, housekeeping, maintenance, dietary, administration, and so on. To win the contest, the employee had to refer three patients to rehab who would be screened by PT, OT or SLP.

Rather than just give three names, the employee was required to explain why they felt these patients would benefit from therapeutic services. It was a fun contest that lasted for two weeks. Rehab received many referrals and the winner was the housekeeper, Mary.

Mary referred three patients to rehab by noticing problem areas and reporting them to the rehab manager. Patient number one was observed “furniture-walking” in her room without the use of her walker. The housekeeper, Mary, always observes any patient clinging to furniture as he or she walks about their room every day while she cleans for them. This patient always looked very unsafe and always made Mary very nervous. She referred this patient to rehab, and after the rehab screen, the patient was able to be identified for physical therapy goals to address the unsafe ambulatory behaviors.

Patient number two was referred for positioning goals. Every day Mary would be pushing her housekeeping cart through the hallway around the same time. And everyday Mary would notice the same patient slumped awkwardly in her wheelchair. On occasion, she would notice nursing attempting to reposition this patient, but within only a few minutes of the repositioning, the patient would be back in the original awkward position.

Patient number three was a referral to occupational therapy. Mary routinely cleaned up the main dining room after lunch. She started to worry about patient number three because it didn’t seem like he was eating very much of his meal. She drew this conclusion because the majority of the meal was scattered on the table and floor. Mary would clean this area every day.

The contest had many positive effects, but it also promoted the concept that the facility staff, no matter what department, was always expected to be the eyes and ears for the residents. If residents were struggling or demonstrated unsafe behaviors, the entire team would be responsible for correcting these issues and promoting prevention, wellness and a safe environment.

So, thank you, again, to all of those housekeepers — and all staff — who take pride in their work and truly serve our residents.