Why Five-Star ratings should measure staff retention, not staff ratios

The Five-Star Quality Rating System reports the results of health inspections, staffing and quality measures. I suggest we replace the current staffing measure with one tracking staff retention. Here’s my logic: The existing staffing score is the ratio of nursing staff to residents, taking care needs into account. In allowing for self-reporting of the data, … Read more

On power, teamwork and communication

Having enough of it at work, I tend to avoid drama in my entertainment choices unless it involves aliens or post-apocalyptic nonsense. My family and I are currently enjoying the creative spectacle of Project Runway “Teams” version from a few seasons ago. In it, the judges of the clothing design competition repeatedly make the point … Read more

Self-disclosure: What your staff needs to know about revealing personal information to residents

As “Eileen” suggested in the comments section of a recent “Dr. El” blog, disclosing personal information can be a good way to establish a more intimate connection with residents. While self-disclosure can create warmer relationships, there also can be unintended and unwanted consequences to revealing such details. In contrast to psychologists who study interpersonal interactions … Read more

Taking teamwork to a deeper level

When we think of teamwork in long-term care, we envision a group of dedicated specialists working together to provide the best care for our residents. They read notes from other disciplines, bounce ideas off colleagues at the nursing station and convene care plan meetings. In reality, teamwork in long-term care is much more complex. Teamwork … Read more

Enhancing organizational communication improves outcomes, reduces adverse incidents

McKnight’s Long-Term Care News frequently notes stories about rogue employees engaging in illegal and disturbing behavior and then trying to cover it up after the fact. There are regular reports about intra-organizational systems that fail, leading to wrongful death lawsuits and other problems, such as this one about a resident who died from scabies. Occasionally … Read more

A gift from LTC families

A study of interactions between families and healthcare providers published in the BMJ this month sparked my interest. It showed that improving communication between the two groups reduced harmful medical errors by 39%. As if that vast reduction in medical errors weren’t enough, it was caused by harnessing the input of team members who don’t cost facilities … Read more

Ways to increase trust, reduce hospital transfers

In McKnight’s Long-Term Care News this month, there was a report on a study examining factors that contribute to transfers of frail residents from skilled nursing facilities to emergency departments. Using focus groups of residents and family caregivers, researchers found four main contributors to the transfers: “(1) doubts about the quality of skilled care facility nurses’ assessments; (2) perceptions … Read more

The added value of social workers and psychosocial services

The top recommendation in the April 9 McKnight’s article “Researchers share 6 tips to improve nursing home care for blacks and Latinos” was to include a social worker on staff in the facility. “Great,” a reader commented, but “ask CMS … if they will pay for it.” Perhaps, though better yet, social workers will pay … Read more

12 steps to starting a new job with serenity

Here’s my latest article on McKnight’s Long-Term Care News: 12 steps to starting a new job with serenity In my last column, “How to quit like a shrink,” I outlined ways to exit a nursing home that solidify the connections made there and offer the opportunity for healing. Assuming you’re not independently wealthy, what follows … Read more