Our organization implemented a series of strategic initiatives that proved highly effective in reducing and addressing staff turnover. We were able to surpass our goal of a 10% decrease, achieving a notable improvement in this area. One of our key objectives was to improve staff morale, resulting in strategies to implement and create an effective week-long Staff Appreciation Week. This event was designed to acknowledge and celebrate the contributions of staff members throughout the facility who were, at that point, managing daily tasks while maintaining personal and facility morale. Our Appreciation Week was planned meticulously and included several activities. We began with ‘Pamper Yourself’ sessions, where staff members were treated to breakfast and provided with special collateral, such as Spa Day gift bags.

Subsequently, ‘Serving our Community’ initiatives saw staff crafting gift bags and thank-you cards for distribution to sister facilities and corporate offices, garnering unprecedented acknowledgment from recipients. We then had ‘Serving our Community’ initiatives, where staff members crafted gift bags and thank-you cards for distribution to our sister facilities and corporate offices. Our efforts were recognized in internal and external corporate communications, which included a visual portrayal of our staff’s activities, which helped to foster a sense of pride and accomplishment among our team members. At the end of Appreciation Week, we organized a special event where staff members engaged in crafting personalized gifts and thank-you cards for our patients. This initiative was designed to foster reciprocal gratitude gestures and emphasize the importance of mutual appreciation.

As part of our strategy, we presented each staff member with a ‘Bee Kind’ branded T-shirt emblazoned with affirming messages to spread positivity at work. This served as a constant reminder of our efforts to create a supportive workplace environment and make our facility an overall better place. One of our key focuses was enhancing communication, which proved to be highly successful in further bolstering staff morale. Our commitment to fostering a supportive workplace environment has led to a more organized and encouraged staff, which is essential for the success of our organization.

This facility underwent significant administrative changes during the CSC PIP Project, including appointing a new Interim Administrator and Director of Nursing to oversee the project’s execution. Amid this transition, the facility successfully completed a State survey that mandated the completion of a comprehensive POC Summary. Despite the organizational shifts and challenges faced by the facility, the dedicated staff achieved an outstanding reduction in resident falls by 16.8% since the start of the CSC PIP Project.

The success of this initiative was attributed to implementing an enhanced admission process designed to capture detailed histories of new residents’ falls. This information was then used to develop more comprehensive care plans tailored to mitigate fall risks and deploy appropriate interventions. The institution also introduced a pioneering Risk Watch program to meticulously identify the root causes of resident falls. This program ensured the implementation, review, and refinement of targeted interventions to address these concerns effectively.

The staff’s commitment to reducing falls was commendable and pivotal in achieving this remarkable reduction in resident falls. Despite the administrative transitions and challenges faced by the facility, the team’s dedication to the well-being and safety of its residents was unwavering. Introducing the enhanced admission process and the Risk Watch program has benefitted the residents, improving their quality of life and reducing the risk of falls.

Throughout the CSC Project, which began in January 2023, the facility has achieved a remarkable 1.6% reduction in facility-acquired pressure ulcers. This is an outstanding achievement, surpassing the targeted threshold of 2.4%, indicating exceptional results. An in-depth analysis conducted to understand the reasons for this success revealed that new staff members needed more orientation and training regarding pressure ulcer prevention. Furthermore, challenges related to time management in executing these protocols effectively were also identified as contributors to the problem. To address these issues, the facility introduced a comprehensive Train-the-Trainer Course specifically tailored for new hires during their orientation. This course ensured that all existing staff members received updated training to facilitate a more thorough on-floor orientation experience when interacting with residents. Emphasis was placed on the consistent implementation of an appropriate turning and repositioning regimen, incorporating the utilization of anti-pressure boots and wedges as deemed necessary, as part of a proactive strategy to mitigate the occurrence of facility-acquired pressure ulcers. These efforts have been highly effective in reducing the incidence of pressure ulcers and ensuring the health and safety of residents at the facility.

The Staffing CSC PIP Project had set a target of 2% for the Facility’s turnover rate, and with the latest data, it was found that the turnover rate was 2.1%. Throughout the project, the Facility remained committed to maintaining proper staffing ratios and implementing retention initiatives to ensure safe and high-quality care for the residents, especially during the ownership transition phase. However, after reviewing the staffing data, it became apparent that the Certified Nursing Assistants (CNAs) made many call-offs during their scheduled shifts, including on weekends. Additionally, the current employees needed to be informed of the Facility’s referral bonus program for new hires.

All CNAs were interviewed to address these critical issues comprehensively and identify the reasons behind the excessive call-offs. Subsequently, the administrative personnel conducted a thorough audit of nursing schedules, leading to strategic modifications that ensured the CNAs got scheduled weekends off rotating to mitigate the risk of burnout. Furthermore, administrative measures were implemented to boost staff morale, including providing increased paid meals and treats across all shifts.

To optimize awareness of the referral bonus program, Qsource collaborated with the Facility management to develop an employee referral flyer that effectively communicated the incentive and encouraged the staff to refer potential new hires.

The CSC collaboratives hosted an informative presentation for Long-Term Care (LTC) facilities in June, which was highly appreciated by the participating facilities. The presentation was well-attended and showcased the expertise of Rhonda Delaney, RN, CWS, CSWS, FACCWS, and Director of Wound Management for American Healthcare Communities. Delaney’s session on Pressure Injury (PI) and Staging was exceptional and included a comprehensive review of essential topics relevant to LTC settings. Attendees gained valuable insights into PI prevention strategies, identifying contributing risk factors, and differentiating between PIs present upon admission versus those acquired during facility residency. Delaney’s presentation also provided attendees with guidelines for accurately grading PI stages. The session concluded with an in-depth discussion of advanced concepts such as skin failure or terminal Kennedy ulcer, which offered insights into forthcoming guidelines to be introduced in October 2023.

The attendees from the participating facilities were enthusiastic about the informative presentation and expressed gratitude for the insights provided. The presentation was highly beneficial, and the attendees commended Delaney’s exceptional session for its relevance and the valuable knowledge it provided. Overall, the presentation demonstrated expertise and critical insights that can help improve patient care in LTC settings.

The facility initiated the CSC Project with an initial fall rate percentage of 38%. The target was set to reduce it to 34.2% by August 2023. However, the facility achieved a remarkable reduction in fall rates, a rate of 21.6%, which surpassed its fall reduction objective. Additionally, the facility decreased falls, resulting in major injuries from an initial rate of 2.2% to 0%, exceeding the targeted goal of 2%.

Recently, the facility underwent a State survey, which required support in crafting a comprehensive Plan of Correction. Qsource provided invaluable assistance in blueprinting the requisite documentation and identifying appropriate interventions to ensure compliance with regulations and uphold the highest resident care standards. This was especially important concerning the notification of resident changes and incidents such as falls or accidents. The facility implemented a fall risk tracking tool to enhance fall prevention efforts further. This tool was designed to pinpoint emerging trends, such as incontinence or medication-related factors, and tailor interventions to address the root causes of resident falls. Staff and agency personnel received thorough re-education on best practices, including appropriate transfer techniques utilizing gait belts, nocturnal resident rounding protocols, and the accurate completion of fall incident reports.

To ensure optimal staffing levels to meet the diverse acuity needs of residents, the facility augmented its workforce through increased hiring of Certified Nursing Assistants (CNAs) and collaboration with agency personnel. The role of staffing adequacy in resident care was recognized, and appropriate measures were taken to meet the needs of the residents.

The Administrator and Director of Nursing (DON) conveyed that the Performance Improvement Project (PIP) aimed at reducing the use of Psychotropic Medications yielded significant success for the facility. Given the facility’s status as a particular focus for the Centers for Medicare & Medicaid Services (CMS), participation in this initiative served as a proactive demonstration of their commitment to addressing areas of concern and enhancing overall performance. The notable success of the PIP was attributed to a series of targeted interventions implemented by the facility. This included a comprehensive meeting with the facility’s pharmacist to thoroughly review medications, focusing on potential interactions, instances of polypharmacy, and opportunities for medication regimen optimization through Gradual Dose Reductions (GDRs). Furthermore, efforts were intensified to educate both families and residents on the effects of psychotropic medications in the elderly population, fostering informed decision-making and promoting medication adherence. To bolster the effectiveness of these interventions, the facility undertook the initiative of obtaining historical medication records for residents, offering valuable insights into initiating medication regimens and ensuring alignment with appropriate diagnoses and treatment protocols. Notably, the facility surpassed the targeted goal of reducing Psychotropic medication usage by 10%, utilizing methodologies such as Fishbone analysis to identify contributing factors and employing the 5-Why technique to ascertain root causes, thus enabling the implementation of targeted and evidence-based interventions.

After being admitted to the facility, the patient experienced four falls in a short time. The facility quickly realized the severity of the situation and started gathering the patient’s history. They discovered that the patient had previously been a professor at a university and had a routine of early morning activities to achieve maximum efficiency. The facility then took proactive measures to align the patient’s daily care and activity schedule with his previous routine as a professor. They adjusted the timing of his morning activities and added tasks similar to his previous professional responsibilities. These tailored interventions successfully optimized the patient’s care regimen, and he has not fallen since adjusting his daily schedule. This underscores the importance of personalized care approaches in improving patient outcomes.

The facility’s initial fall rate was measured at 29.8%, which was considered as the baseline data. The goal was to bring down this figure to 26.8%, and the team was working hard towards achieving this target. In November, the facility witnessed remarkable progress as the fall rate dropped to 18.2%, which was well beyond the established goal. This marked a noteworthy change of 11.6% from the baseline measurement, indicating the effectiveness of the implemented interventions. The facility’s team worked diligently to implement and refine interventions that helped achieve this significant improvement. A thorough analysis of incident reports, historical interventions, and individual resident falls facilitated informed discussions, enabling the identification of areas that needed improvement. This information led to formulating targeted action plans implemented with utmost dedication. The effort put in by the facility’s team underscores their commitment to ongoing quality improvement initiatives, reflecting a proactive approach toward enhancing resident safety and well-being. By continuously assessing and refining its interventions, the facility ensures that it provides excellent care to its residents and strives to improve constantly.

At the start of the project, the facility had a turnover rate of 10.1%. However, by November, this rate had significantly decreased to 2.6%, which shows commendable progress. Remarkably, by December, the turnover rate reached an unprecedented low of zero percent. These outcomes highlight the remarkable strides made by the facility in mitigating staff turnover. In collaboration with Qsource QIA, the Administrator led efforts to comprehensively address staff satisfaction. A vital component of this initiative involved administering a job satisfaction survey to all staff members. The insights gathered from these surveys proved transformative for the facility, revealing critical areas of staff dissatisfaction and identifying opportunities for improvement.

Using this valuable feedback, the facility leadership swiftly implemented targeted changes in processes and communication protocols. These strategic adjustments addressed underlying concerns and fostered a more supportive and engaging work environment, ultimately significantly reducing staff turnover. The proactive approach taken by the facility, in partnership with Qsource QIA, demonstrates a commitment to continuous improvement and employee well-being. This positions the organization for sustained success.

“Participating in the CSC Quality Collaborative was very helpful. We were able to network/brainstorm, not only with Qsource staff, but with other facility leaders who were working on similar projects. Thanks to the Qsource team for guidance and support. We appreciate you!”

“I cannot say enough good things about this program. We have worked on psychotropic reduction which is right in line with state requirements. This group has helped me with a patient each month this year to reduce the usage for that patient. They brought in a pharmacist each meeting to help also. Our psych rate has been reduced dramatically and last years PIP was a tremendous help with fall reduction. I am looking forward to another successful year with this awesome group. Thank you for all you do!”