Denise Scott dives deeper into person centered care and how to get started.
You can read part one of this interview here. As you know, a number of months ago, in an article I wrote about the nursing home industry, I made this statement: “Nursing Homes Suck” which got me in trouble with some people. What was your reaction to that statement and that article?
My initial reaction to that statement was that it hurt. As a former administrator, I know how hard people in nursing homes work. But I agree with your point that most nursing homes operate by getting through a checklist of tasks. When direct-care staff work as taskmasters, residents don’t have many choices or opportunities for meaningful lives.
There’s often a disconnect between what the leadership team thinks is happening and what actually is happening. For example: If your policy states that residents may sleep whenever they’d like like, but you don’t have systems to support that (or supervisors to help make that a reality), it won’t happen.
If I’m a nursing assistant and there’s no easy way to get a resident a late breakfast and my co-workers or supervisor will give me grief for letting someone sleep late, guess what’s going to happen? I’m going to wake that resident up, even if he wants to sleep in.
What are you doing to make the resident experience better for individuals living in skilled nursing and assisted living?
I speak to associations and groups to inspire them to think about their work differently. I share stories to help them visualize what is happening in their organization that they’re probably not even aware of, and how it can be different.
I also support individual organizations through leadership and staff development. I help them to determine the exact steps that will engage staff and support residents. Steps that are right for their unique situation, because although we can learn plenty from other organizations, each organization needs to follow their own path to person-centered care.
If someone took a hard look at their organization and felt they needed to make a change, how would you suggest they start?
I often tell people to start by looking in the mirror. If you’re seeing an outcome in your organization that you’re unhappy with and want to change, take a look and ask: What are we doing (intentionally or not) to support that outcome? For example, earlier we talked about staff being “taskmasters.” Often when staff members start their jobs, they’re given a list of tasks. They’re evaluated annually based on a list of tasks, and their supervisors hold them accountable to….you guessed it…a list of tasks. Why, then, are we so shocked when people won’t step outside of their tasks?
There are plenty of free resources online that you can use as well. On my website, I have links to a few that I’ve had the honor of helping to create. These tools can help you assess where you are and give you ideas on next steps to take.
Is it possible to do person-centered care and still make money?
Person-centered care can actually make you more money. It creates an engaged workforce, which is proven to increase productivity. It also decreases turnover and its related costs. Engaged staff create a better experience for customers (patients, residents, and family members) who then tell their friends in the community. Referral sources hear these stories. Research shows that person-centered care communities have higher censuses, greater revenues, and better clinical outcomes.
One myth about person-centered care is that it requires a lot of money and huge environmental changes. That’s simply not true. It’s certainly ideal to make some renovations, but I’ve seen incredible changes in organizations that were focused first on renovating the systems, processes, and thoughts that stood in the way of change.
One of my favorite stories is of a CNA who identified a resident who was very unsteady after taking a certain medication. The CNA took it upon herself to tell the nurse. The reply? “What are you, the doctor?” The CNA felt so belittled that she vowed never to tell that nurse anything again.
Those five little words create a disengaged employee. If she’d felt comfortable sharing, who knows what could’ve happened? Maybe a fall could have been prevented, saving paperwork and more staff time (not to mention the resident’s health!). Maybe a readmission could’ve been avoided, which damages our reputation with the local hospital.
In the organizations I love to support, the first priority is and will always be the resident’s well-being.
That’s what person-centered care is all about.
You can follow what Denise has to say about person centered care at her website Denise B Scott.
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From LinkedIn Groups
Thank you so very much on sharing the premise of “Person Centered Care”. One of the most important articles I have read related to qualify of life and living.
As a former Regional Manager in Southern California Senior Care Licensing, this is something I have been advocating for many years. I also believe the task of this culture shift is forthcoming and a needed marketing strategy as residents in assisted living exercise their voice, executives embrace meeting not only direct care needs but also person centered needs and desires in a home like environment; community care assisted living v.s. institutionalize care.
Great Job on sharing.
By Myron Taylor
Thanks for your thoughts Myron! The shift is happening already in many organizations and those that don’t embrace it are going to find themselves at a disadvantage in many ways, including those that you explained so well.
From LinkedIn Groups
Nice article Steve, thanks for posting it. I agree with Denise as you can see on my website BeHome4Ever.com. Denise is right in that not only does there have to be a willingness to change how we think and view care and all of its processes, but there has to be a top down transformation of processes as well as the support systems that drive behavior such as employee evaluation systems, extrinsic and intrinsic reward systems, and the implementation of Strategic Human Resource Management (SHRM as it is called). The beauty of transforming to person-centered care is that a facility doesn’t have to go crazy and do it all at once. A facility can start by forming a transformation team where all stake holders are represented equally is a great start. Document the mission, vision and values the facility is striving for and then form a list of procedures and processes in need of redesign, and detail who the change agent will be for that process and potential impacts. Pick the easiest one first to have short term success and build momentum. Assure employees that nobody will lose their job as a result of transformation (part of SHRM). Build momentum with additional successes and create feedback loops to determine how well the transformation is coming along. The most important thing in all of this is not to forget to celebrate success frequently – it’s a terrific momentum builder. This approach was first coined by Dr. Edward Demming in the 1950’s. It is nice to see that this form of thinking is catching up to the long term care industry. It is way overdue.
By Thomas M. Lorenz
Thanks for that input Thomas! It is WAY overdue and you did a nice job outlining many of the important pieces of bringing about change. We so often forget a very important part of all of this…celebrate your successes!
From LinkedIn Groups
I hear this person centered theme piercing through again. Awesome. Denise is right on.
By Charles Morales
Glad it resonated with you Charles!