This article is sponsored by PointClickCare. This article is based on a Skilled Nursing News virtual discussion with Terri Weckle, Senior VP of Senior Care Operations at PointClickCare, Jessica Zook, Director of Health Information at Providence Healthcare and Nicole Kaufman, Chief Innovation Officer at Everest Management Solutions. The discussion took place on June 15, 2022. The article below has been edited for length and clarity.
Skilled Nursing News: This session is Connecting Providers and Families, Despite Staffing Challenges, and Limitations. Without further ado, I would love for our panelists to spend a minute, or two introducing themselves.
Nicole Kaufman: I’m very excited to talk to you today about such an important topic in our industry. Everest Management Solutions is a skilled nursing, assisted living and independent living strategy development firm. I’m very excited to talk about what we’ve learned over these last few years.
Terri Weckle: I am the senior VP of our senior care operations at PointClickCare. Again, very excited to talk about this topic today.
Jessica Zook: Providence Healthcare is a skilled nursing facility and assisted living facility. We’re actually a ministry of the Sisters of Providence, so we’re right next door to the mother house. It’s really special to get to serve that community. I’ve been in healthcare for 15 years, and here at Providence for seven, so it’s been a pleasure, and it’s been a nice place to grow.
SNN: This first question is for you, Jessica. What strategies has your organization implemented to facilitate better communication between staff, and residents’ families?
Zook: One of the platforms we were able to implement is called “Cliniconex.” Cliniconex is a way to send out customized messages in mass, and it pulls information directly from PointClickCare from the profiles tab, and that’s how it knows who to send this information to. In the state of Indiana during COVID, the governor decided that we need to keep families up to date with the COVID status of our building. This tool definitely came in handy, and then we’ve also been able to utilize it in other capacities too with scheduling care plan meetings, and things of that nature, but it’s definitely been a time saver.
SNN: Nicole, this follow-up is for you. What strategies have your clients implemented to bring communication full circle?
Kaufman: We all know that communication is critical, especially coming on the other side of the pandemic, where there was a lot of interest in being aware of what was happening within communities on a day-to-day basis. It really isn’t rocket science. What we’ve seen our clients lean into is a commitment to documentation within the medical record. Utilizing systems that are there and available within PointClickCare, and others that allow for the staff that is going through changes in this labor market.
There’s a lot of turnover with people who need to understand what’s going on with a resident, or with a patient within a skilled nursing community, and the ability to document well, so that no matter who walks in, and looks at that record, you’re able to understand what’s going on with Ms. Jones, so that if her mom calls or if her daughter calls that there is a clear level of understanding around how you can best care for that loved one. Leaning into the traditional standard commitment to documenting well, so that there is a level of awareness in that single source of truth, the health record.
SNN: Nicole, looking a little bit more closely over the past year, or two, what have you seen work, and not work in terms of avoiding the communication breakdown?
Kaufman: Stress is prevalent right now. The labor market has really put some difficult decision-making on the table as it relates to how your staff, and how you can make sure you’re caring for residents in the best way possible. What we have seen work is adding a layer of general communication coming from the leadership clinical teams within organizations. How can you make sure that you are sitting in the morning huddle right before shift change, the ability to look eye to eye, and talk about what’s going on so that in the passing of different members of the team, or if there is a new clinical leader that’s there, clinical team member that you are looking, and talking together to make sure that people are on the same page?
What hasn’t worked is avoiding conversations with staff, and allowing the stresses of the day to prevent your basic leadership functionalities from actually coming to fruition. Our directors of nursing, our clinical leaders, what we see work is them getting on the floor side by side with that caregiver who might be with a staffing agency, or the new five people who were in your orientation, and to really have that type of camaraderie and collaboration from the beginning. We’ve seen that work a lot.
SNN: What types of collaborative tools can organizations consider that drive efficiencies even when, as we all know, resources are scarce?
Weckle: When I think about collaboration tools, I really think about them as software that’s really designed to help people come together, and work against a common task to obtain a specific goal. In the context of the discussion today around really connecting the providers with families, I think there are some very specific tools that come to mind that are really effective in that. Things like communication type tools, whether that be a way to securely message on-demand, an individual, or secure email, an individual about a specific item of interest right now today.
Maybe, something that’s going on with mom, for example, or whether it be something that’s more automated, and being able to actually send out an automated email to folks letting them know about an event that’s happening in the facility, or quite frankly, maybe even an outbreak that’s happened, and what’s happening with it. I think that there are those communication tools that we’re seeing a lot of traction, and interest for folks and really drives efficiency.
You think about if I had to get on the phone, and call every family member to let them know about an outbreak, or let them know about a care plan meeting that’s coming up, how time-consuming that is. That time can be redirected towards really great patient care, right? I think there are other tools too though when we think about things like a move-in, or an admission event, the paperwork that’s involved in that, moving those to more of an electronic format, and being able to share that electronically to send out to family members to get the signatures that we need.
It saves a lot of time for not only the admission team that has to go through that process of creating all of that, and monitoring that it comes back, and making sure that it gets into the right file at the right time, but also just the presentation that it gives to the families. When they get a much more professional packet that’s able to be electronically signed, I think it just heightens the reputation of the facility. I think there are lots of opportunities there as well, that we see that our folks are really leaning into today, and getting some great efficiencies from.
Kaufman: We were talking earlier about how telemedicine and telehealth have been a nice tool that has allowed communication to really expand with families, where doctors are very interested upon admission to have a telehealth conference, where maybe, a loved one is not in the state, but they are allowing for that family conference to occur through telemedicine right there with the doctor. Leaning in on that tool, which I think really was optimized as a result of the pandemic, and the lack of access that family members had, we’ve really seen that turn the corner, and families feel like they are very quickly involved in care planning, and that they have more access to physicians, and nurse practitioners.
SNN: We certainly have seen the growth of telehealth, and virtual communication has been a shining star through COVID. It’s interesting to see how that has progressed, and perhaps, where that might go going forward. What kind of tools are you seeing that organizations yourself can use to drive efficiencies? As I understand that resources are very scarce, and every time is precious.
Zook: Over the last several years, we’ve been fortunate enough to be able to implement many tools in our facility that facilitate collaboration. One of the things that we did was implement PointClickCare Connect. This platform allows us to pull information directly from the hospital’s EHR, and bring it directly into PointClickCare. Things we pull in our medications, diagnoses, immunizations. Our admissions nurse no longer has to manually type in all of that information, just you could click with a button and it flows in. That’s been very well received and a huge time saver with our staff.
Another thing which has been talked about is telemedicine. With the help of a grant, I was actually able to build our own telemedicine cart. It’s just a fancy computer on wheels, but it has a nice big monitor. So people can see their provider that’s got nice speakers for the hard of hearing, it’s got a nice camera and microphone system. Being able to facilitate that provider resident, and that visit and make that productive.
By keeping them in the building, we also are not tying up our van drivers so she can help on the floor more. Also, our nurses really enjoy that because they get to be part of the conversation with the provider. They can truly be an advocate for that resident and be there not just read about it later in a progress note going, “Well, they didn’t address that, she must have forgotten to mention this.” That’s been a huge thing for them as well.
Another way we’ve actually been able to utilize this cart is during staff meetings. When staff gives us feedback, which we get a lot of now, one of the staff feedback I heard was staffing. We have these monthly hour-long mandatory staff meetings. If they live an hour away, they drive an hour, come here for this hour-long meeting, and then drive an hour home. It was really awesome to be able to give them the opportunity to attend virtually, so we can see them on the screen, they can see us, they can participate like they’re really there.
Then at the end, we get this report that actually documents the amount of time that they were on the call so we can compensate them accordingly. That’s definitely been well received, and it’s another way that we’re utilizing this tool that wasn’t necessarily thought of at the beginning.
We implemented a CRM with insurance verification. My team needs all of this information in order to better take care of this resident right from the beginning from an admission. CRM was a nice tool for my admissions team to use to gather all of the information necessary that the rest of my team needs. Then upon admission, all of that information flows directly into PointClickCare’s chart. Now, my team has everything they need to best care for that resident. It really has been a nice tool as well.
I am a huge secure conversations advocate. For those of you that don’t know, secure conversations as a module within PointClickCares. Of course, documenting in PointClickCare and part of the medical records, putting in progress notes and doing assessments of course, that’s part of the medical record.
Secure conversations as a way to have a conversation with your team members, that’s not necessarily part of the medical record. It’s really nice to have those candid conversations among our team, but still be able to access that through the patient’s chart. At first, we implemented this with a nurse practitioner that really enjoyed it, and then she left us. I’m like, “Okay, well, how else can we utilize this really neat tool?” Now, our dietary team, therapy, nursing, interdisciplinary team, even our medical director, all of these people are able to benefit and have these conversations about residents to make sure we’re all on the same page.
When the nurse does get a question from that family member on a Saturday that maybe didn’t get to attend that care plan meeting, our nurse has the tools and information needed to be able to answer that family member’s question, and what an awesome feeling that our entire team gets to be in the know of what’s going on with that resident at that particular time.
Another thing that we implemented that my dietary team was really excited about was Nutrition Management Essentials. I’m trying not to sound like a salesperson, but I really am excited about these things. I am a PointClickCares nurse, so I nerd out about all of these.
Nutrition Management Essential, the system we used to have, did not communicate with PointClickCare, and so we had to have a dietary member. Mainly patient name, demographic information, allergies, diets, textures, preferences, all of this information had to be input and heaven forbid it changed, which, of course, is always changing. All of those updates have been manually done. How do we make sure that that happens in a timely manner? It really was not the best-case scenario.
This excerpt has been edited for length and clarity. To watch the full discussion on video, please visit:
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