Minimizing Preventable Illnesses: A Person-Directed Case Study

April 09, 2014
Laura Beck, The Eden Alternative
Heroes in Prevention making a difference at Rolling Fields

Proactive approaches to preventing illness can transform quality of care and quality of life.  There are even more gains when organizations create fully integrated performance improvement strategies that keep in mind the overall well-being of all involved.  Why is this important? Clinical care is often managed in a vacuum, separate from practices that support person-directed care. Likewise, federally-mandated performance improvement initiatives, like QAPI, are often seen as separate from other internal efforts to improve the quality of care.

Rolling Fields, a care community in Conneautville, PA, can speak for the powerful role person-directed care plays in improving clinical practice.  In 2013, they piloted a new Kimberly-Clark protocol for reducing preventable illnesses that solidly confirmed what they already suspected.

“Kimberly-Clark had tried the same protocol in medical model nursing homes and was not successful,” says Kim Braham-Moody, administrator of Rolling Fields.  “Our outcomes revealed something very different.”

The pilot program involved the collection of several levels of data.  The ultimate goal was to predict when an Elder might get sick with an upper respiratory tract infection or UTI, and try to prevent it from developing.  Certain indicators were tracked over time, and current data was compared against equivalent data from the past.  The demands of the protocol were extensive, but Rolling Field’s team was up for the challenge.

“There is no way that this process would have worked in an institutional model without empowered teams,” says Braham-Moody.  “Given everything Kimberly-Clark wanted us to do to collect the range of data they required, it would take a culture based on empowered teams to really pull it off.  I think one of our team members said it best when she said, ‘quality follows culture.’”

Noting that employees in institutional settings are often afraid to speak up about what’s not working, the Rolling Fields team feels that the success of this initiative was Certified Nursing  Assistants knowing that they could control the process and not needing to take everything through administration first.

“The CNAs were the ones that spent hours making sure all of the moving parts were in place,” says Braham-Moody. “This is exactly what QAPI is trying to do, which is having hands-on care partners handle decision-making.  It simply isn’t driven by the hierarchy, it’s driven by the people who provide the hands-on care.  And once they know they have ability to make a difference, it’s completely out of my hands.”

One significant outcome of the pilot process for Rolling Fields was the creation of a new team role –an Elder Well-Being Coordinator.  This individual now effectively connects the dots between different clinical processes, eliminating the tendency to silo quality improvement efforts within the organization.

To learn more about Rolling Fields’ outcomes and lessons learned, join us on Monday, April 14th from 3-4 pm ET for “Minimizing Preventable Illnesses,” the first event in a 3-part webinar series entitled Person-Directed Clinical Practices – A QAPI Strategy

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