Navigating the ROP Changes: Are You in Compliance? 1 1

Transcription

1 Navigating the ROP Changes: Are You in Compliance? 1 1

2 Track Your Progress Over Time 25 Antipsychotic PIP Project 20 Antipsychotic Rate Sunshine NH Rate National Average 5 0 Jan Feb Mar Apr May Jun Jul Aug Sep Navigating the ROP Changes: Are You in Compliance? 1 2

3 Making QAPI Dynamic Motivation for Adult Learning Educate Motivate QAPI Innovate 1. Social relationships: to make new friends, to meet a need for associations and friendships. 2. External expectations: to comply with instructions from someone else; to fulfill the expectations or recommendations of someone with formal authority. 3. Social welfare: to improve ability to serve mankind, prepare for service to the community, and improve ability to participate in community work. 4. Personal advancement: to achieve higher status in a job, secure professional advancement, and stay abreast of competitors. 5. Escape/Stimulation: to relieve boredom, provide a break in the routine of home or work, and provide a contrast to other exacting details of life. 6. Cognitive interest: to learn for the sake of learning, seek knowledge for its own sake, and to satisfy an inquiring mind. Knowles, Malcolm. (1986) The Adult Learner: A Neglected Species. Houston: Gulf Publishing. Navigating the ROP Changes: Are You in Compliance? 1 3

4 Motivate the Millennials They want positive feedback Signed poster of appreciation Recognition in front of their peers They want to feel fulfilled at their job They are technologically savvy They want to feel inspired Organizational Culture Can be defined by a company s mission, goals, and values Culture is defined by those things that influence the working environment itself and the behaviors of those who work there Your culture has its own spoken and unspoken rules of conduct voices careers/articles/ /3 ways tomotivate millennials at work Navigating the ROP Changes: Are You in Compliance? 1 4

5 Why is it important? Those unwritten rules that govern the care delivered in your nursing homes These unwritten rules play directly into staff turnover and employee satisfaction Negative culture can lead to sub optimum care Motivate by Leadership Concept Leadership Management Motto Do the right thing Do things right Challenge Change Continuity Focus Purpose Procedures Method Strategy Schedules Outcomes Journeys Destination People Potential Performance Questions Why? Who? What? When? Where? How? Time Frame Present to future Past to present Navigating the ROP Changes: Are You in Compliance? 1 5

6 Make the Staff Heart Connection Walk a mile in your shoes Staff scavenger hunt Front line staff participate in I care plan meetings Thank you for being a lifesaver Staff become resident for a day Team Building Use Learning Circles for Problem Solving Sunshine Jar to start off meetings Red Carpet ceremonies to reward hard work Create a group of imagineers the sky is the limit Navigating the ROP Changes: Are You in Compliance? 1 6

7 Empower Resident Relationships Making QAPI Dynamic Let staff be dream catchers Memory boards Prom night Fashion show Educate Motivate Innovate Virtual Cruise QAPI Navigating the ROP Changes: Are You in Compliance? 1 7

8 Create C.S.I. Investigators Care Scene Investigation Put the participant in the driver s seat Participants receive a crime sheet that they can use during the workshop to keep track of clues Witness Testimony Real Life Situations Navigating the ROP Changes: Are You in Compliance? 1 8

9 The Case of Smiling Faces Nursing Home: A Pressure Ulcer Mystery Witness Testimony: The Wound Care Nurse Navigating the ROP Changes: Are You in Compliance? 1 9

10 Witness Interview: The CNA (currently under Federal Witness Protection) The Conclusion: We Solve the Case Grab your Investigation Case Sheet to crack the mystery case Navigating the ROP Changes: Are You in Compliance? 1 10

11 Another Workshop Idea: Encourage Interaction in Workshops What s Wrong with this Picture? Another Mystery Mrs. Jones is about to develop a pressure ulcer. In our quest to prevent it, what s wrong with the picture? Navigating the ROP Changes: Are You in Compliance? 1 11

12 What is wrong with this picture? What else is wrong? Navigating the ROP Changes: Are You in Compliance? 1 12

13 Nutritional Clues Case Solved! It s all in the evidence Navigating the ROP Changes: Are You in Compliance? 1 13

14 The Annual Pressure Ulcer In-service Is your in service: The same old same old? Scheduled on payday? Enough notification for staff to plan to be present? Enough chairs to sit down comfortably and listen? Navigating the ROP Changes: Are You in Compliance? 1 14

15 The Barrier Reef Barrier Reef Exercise See the water beading up on right hand? Navigating the ROP Changes: Are You in Compliance? 1 15

16 The Daily Post Use a moisture barrier to help protect the skin from stool and urine Barrier creams and ointments only work if they are applied, and applied correctly These creams can be the first line of defense for your elder to stop a pressure ulcer before it develops Treasure Hunt The picture on the right is view from glasses with petroleum Seeing through the resident s eyes Navigating the ROP Changes: Are You in Compliance? 1 16

17 The Daily Post Terrors of the Deep Assist residents to eat as necessary Notify the nurse if there is a decline or change in a resident s eating habits In the dining room, consider using different color placements to identify those that need assistance with eating Navigating the ROP Changes: Are You in Compliance? 1 17

18 Terrors of the Deep Stage 1 Stage 2 Stage 3 Stage 4 The Daily Post Stage IV pressure sores take the longest to heal In some residents, stage IV can develop in a matter of hours; for example, if left on the wrong surface too long Navigating the ROP Changes: Are You in Compliance? 1 18

19 Solving the Puzzle of The Braden Scale* You Just Need Prizes from a Dollar Store Quiz Bowl Based on your favorite TV game show Mobility Nutrition Friction and Sheer Moisture Activity *Refers to The Braden Scale for Predicting Pressure Sore Risk, Barbara Braden and Nancy Bergstrom, 1988 Sensory Perception Navigating the ROP Changes: Are You in Compliance? 1 19

20 Prevention A & P Risk Factors Nutrition Positioning/ Repositioning The best treatment for pressure sores is Navigating the ROP Changes: Are You in Compliance? 1 20

21 Prevention What is the body s first line of defense against infections/microorganisms? Navigating the ROP Changes: Are You in Compliance? 1 21

22 Making QAPI Dynamic Motivate THE SKIN The skin needs to be intact to keep germs out. Educate QAPI Innovate Navigating the ROP Changes: Are You in Compliance? 1 22

23 Innovate with Cutting Edge Best Practices INTERACT TeamSTEPPS IA ADAPT Geriatric Pain INTERACT: Interventions to Reduce Acute Care Transfers is a quality improvement program that focuses on the management of acute change in resident condition. It includes clinical and educational tools and strategies for use in everyday practice in long term care facilities. Navigating the ROP Changes: Are You in Compliance? 1 23

24 Quick Guide to Get Started Quality Improvement Tools This is intended to help reveal opportunities for further implementation. Great to use in a QAPI Performance Improvement Project (PIP). Navigating the ROP Changes: Are You in Compliance? 1 24

25 Team Strategies & Tools to Enhance Performance & Patient Safety TeamSTEPPS Website Initiative based on evidence derived from team performance leveraging more than 25 years of research in military, aviation, nuclear power, business and industry to acquire team competencies Navigating the ROP Changes: Are You in Compliance? 1 25

26 All Modules Can Be Downloaded For Free The Tools of TeamSTEPPS Communication SBAR Call Out Check Back Handoff I PASS THE BATON Leadership Effective Team Leaders Team Events Brief Checklist Debrief Checklist Situation Monitoring Situation Monitoring Process STEP Cross Monitoring I'M SAFE Checklist Mutual Support Task Assistance Feedback Advocacy and Assertion Two Challenge Rule CUS Navigating the ROP Changes: Are You in Compliance? 1 26

27 University of Iowa IA-ADAPT Resources adapt Training Videos Introduction/Overview Assessment Delirium Non Drug Management Shared Decision Making Antipsychotic Selection Antipsychotic Monitoring Family/Patient Information Shared Decision Making Guide Managing a crisis Pocket Guides Overview of evidence based approach + evaluation of problem behaviors Delirium assessment and management Non drug management Drugs that may cause delirium or problem behaviors Antipsychotics guides Other Guides Algorithm for symptoms of dementia Managing a crisis Navigating the ROP Changes: Are You in Compliance? 1 27

28 University of Iowa Geriatric Pain More Resources to Make Things Easy management home training sessions Navigating the ROP Changes: Are You in Compliance? 1 28

29 Quality Insights Can Assist Your Louisiana Quality Improvement Specialist QAPI Resources Action Planning Worksheet QAPI at a Glance QAPI Toolkit Fishbone RCA 5 Whys RCA Goal Setting Worksheet Sustainability Guide Topic Example Documents Examples of our Topic Resources Antipsychotics Trigger Tools, Step by Step Guides to reduction Fall Management Care Plans, Risk Assessments Pressure Ulcer Prevention Skin Care Fair Pain Management Audit Tools, Team Tools Julie Kueker jkueker@eqhs.org Navigating the ROP Changes: Are You in Compliance? 1 29

30 Thank you This material was prepared by Quality Insights, the Medicare Quality Innovation Network Quality Improvement Organization for West Virginia, Pennsylvania, Delaware, New Jersey and Louisiana under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication number QI LA C Navigating the ROP Changes: Are You in Compliance? 1 30