What is Hope, really? It can be defined as a feeling of expectation and confidence in the possibility that what we desire, want and expect will happen! It is envisioning good results, good outcomes for our families, our residents, and ourselves. It is positive anticipation that we can make a difference in the lives of others and be the author of our own destiny. With a spirit of Hope, our teams can build a friendly, caring culture and set a positive professional tone in both the work place and at home! We cannot pretend to do the right thing, we must DO IT.

How do we begin to live our Hope every day and build this attitude into our daily lives, and what are the benefits?

Hope builds:

• Loyal and trusting relationships
• Looks for the best in every situation and in every individual life
• Expects ethical and honest behavior
• Confidence
• Personal growth and accountability

Hope results in:

• Conscientious decision making
• Higher Quality of services
• Better Outcomes
• Going above and beyond
• Higher morale
• Pride in a job well done
• Exceeding expectations

Hope is indeed one of the corner stones of the Holiday season and an attitude of expectation and joy. Let’s all strive to have more hope this season and especially in the year to come!

Happy Holidays!

Cherie Rowell, Corporate Quality Liaison

Functional Pathways

These changes have the potential to negatively impact care and the personal lives of caregivers since the demand for detail has risen, i.e. documentation, complicated software, new roles, outcomes tracking, productivity, just to name a few. While these changes certainly create a challenge for the therapy team, they are not insurmountable. The ability to remain positive, flexible and think outside the box is crucial to success!

Coping with change requires proactively seeking a way to be a part of the solution, instead of reacting to, and avoiding, the change.

• Be a proactive learner – don’t wait for someone to “teach” you, seek training for yourself, using whatever resource is available to you

• Seek new ways of accomplishing your job role, ask for guidance/strategies

• Look for the “best” communication tools to enhance your role

• Remain professional and communicate kindly

• Follow up with personal requests that you may have regarding your needs in accomplishing your goals —– remember, we are all trying to cope with change

• REFUSE to have a victim mentality

• Be accountable for your own actions, schedule, having your needs met

• Schedule and plan personal time to enjoy your life, family, loved ones – we all need to reboot – balance is so important

• Practice silent meditation and good breathing techniques if you feel you are becoming stressed and getting close to that breaking point!!

• If all else fails have a silent mantra, song or quote as your “go to” should you need it……………….I know mine is “She’s a Brick House”, hee hee, for when I need to feel particularly strongJ

Hang in there; caregivers are special people and therapists among the best!!

Cherie Rowell

Corporate Quality Liaison

Review the data for your facility on nursing home compare and recognize the Quality Measures that indicate improvement is needed. This is a great place to start focusing quality improvement on since it can have a direct impact on the facility’s star rating. It is also where community consumers often go to seek data regarding the value and benefit in the selection of a long term care center.

Once the quality improvement needs are identified and prioritized, assign team leaders and committee members for the improvement process. Be sure to invite feedback from all caregivers, including family members. The committee will develop the improvement plan and monitor for effectiveness on a regular basis until outlined goals are met.

Cherie Rowell

Corporate Quality Liaison

Identifying and prioritizing the community’s quality improvement needs based on state surveys and internal auditing, is a crucial first step. In addition, selecting the “right fit” for leadership on a specific committee can make or break the process. Initially, leadership should start at the top with executive personnel promoting a culture change and encouraging participation from all members of the facility in an open venue. Expectations should be clear cut and support provided to the individual leadership teams as well as need materials, training and other resources.

Development of a steering committee with facility executives and key leaders such as Administrator, Director of Nursing, Director of Rehab, and RNAC to lead and direct individual QAPI team leaders that are focused on a specific quality indicator is recommended. Establishing an expectation of open communication and respect will encourage all leadership and team members to put forth their most creative ideas and work towards excellent quality indicators.

Cherie Rowell

Quality Liaison

Having lost my Dad recently, I can speak to the need for skilled services to promote a sense of independence and well-being right up to the very end of life; how very important it is to the individual to maintain a sense of dignity and retain their abilities. Our independence is what drives us as human beings and being able to support and care for our resident’s during this time is priceless.

As clinicians, we must educate ourselves so that we can be comfortable providing needed skilled care and not be biased in providing that care to the Hospice resident. Functional Pathways has a helpful training tool titled “Pathways to Palliative and Comfort Care” that introduces aspects of care and training to assist therapists in providing clinically appropriate treatment to the Hospice resident.

Cherie Rowell

Quality Liaison

Our old segmented way of thinking must be discarded if we are to succeed clinically and survive financially in this new era of quality driven medical care. Outcomes focused results will be driving therapy reimbursement in the very near future if not already driving it in some markets. Achievement of optimal outcomes requires a team approach and is never driven by one discipline alone.

In this ever changing long term care environment therapy professionals work in, we need to remember that it is important to recognize that we are all spokes on the same wheel. When a team member takes the stance that “it’s not my job”, it can have a negative impact on the resident, the environment, the team and the therapy company. It is not us vs. them……………we are all on the same team!

Cherie Rowell

Quality Liaison

Element 1: Design and Scope –the program must be ongoing and comprehensive, addressing all systems of care (clinical care, quality of life and resident choice), management practices/departments.

Element 2: Governance and Leadership – the nursing home is expected to develop a culture of leadership seeking input from all staff members, residents and their families. Provide appropriate training on the QAPI process as well as sufficient time/tools to meet expectations of the process.

Element 3: Feedback, Data Systems and Monitoring – the nursing home is expected to put systems in place to monitor care/services and collect data.

Element 4: Performance Improvement Projects – When areas of improvement are identified through element number 4, the nursing home will make a concentrated effort to clarify issues or problems and develop a plan to improve care and services.

Element 5: Systematic Analysis and Systemic Action – the facility team will use a data based approach to identify root causes of problems to enable them to make comprehensive changes in the delivery of services to enhance quality of life and care of their residents.

The therapy team is key player in the QAPI process, often able to address clinical problems early and prevent functional declines that can have a negative impact on quality of life of the residents in the nursing home.

Cherie Rowell

Corporate Quality Liaison

QAPI is a data-driven, proactive approach to improving the quality of life, care, and services provided in nursing homes. The aspiration for ever-improving quality is not lost on the therapy industry. For years, we have recorded improvements our clients make during the course of therapy treatment. In light of the constantly changing Medicare requirements for reimbursement of health care services, it is crucial that therapy focus on outcomes and be prepared for a reimbursement system based on those outcomes.

How can therapists partner with the SNF to improve the QAPI process and maximize performance improvement within this setting? Therapy can pro-actively screen residents for functional declines in daily activities, mobility and safety. Frequent falls still trouble many SNF’s and therapy can provide significant education regarding the prevention of falls with injury, strategies for caregivers as well as environmental modifications. There are numerous areas of expertise from therapy that can be shared with the interdisciplinary care team to help enhance the quality improvement process. More discussion on this will be coming in the May Blog!

Cherie Rowell

Corporate Quality Liaison

Providing elite, quality therapy day in and day out is a huge commitment from our team to the clients they care for. All of us have multiple responsibilities, not only for our own health and happiness, but to our families, friends and communities, as well. To also extend the same heartfelt commitment that we give in these areas to the residents we care for is invaluable. The residents indeed become  apart of our lives and enrich our experiences.

Kudos to all the wonderful Functional Pathways therapists that dedicate and commit themselves to providing quality therapy services to our residents!  Thank you for all that you do!!

Cherie Rowell

Corporate Quality Liaison

The caveat here is that unless we put these values into action they will not make a difference in people’s lives!! The true evidence of both our passion and compassion for others is in our actions. Our actions improve the care and services we provide as members of the health care team and can impact us both professionally and personally, on a daily basis. In order to see a positive change in our work settings and personal lives,  it is imperative that we “walk the talk!”

Functional Pathways gives us so many opportunities to pay it back including, participating in the Cookie Jar Fund, nominating fellow employees for the Golden Watermelon Award or Employee of the Month, and sending pics to social media. We have the ability to demonstrate our values and put action to our words, which clearly demonstrates our passion and compassion for each other!

Cherie Rowell

Corporate Quality Liaison