I wrote about my client's miserable treatment at a local hospital's emergency room recently — and was hit by an avalanche of mail...
I wrote about my client’s miserable treatment at a local hospital’s emergency room recently — and was hit by an avalanche of mail describing much worse.
That’s why I like to toss out some good news occasionally — not to make you feel “happy days are here again,” but to put things in perspective. No matter what happens to us as a society, each of us needs to have our little pocket of grace to hold onto, a sense of optimism that there are still good people in the world doing good things.
This month, Qualis Health, a nonprofit organization in Seattle that works to improve the quality of health-care delivery and outcomes across the nation, presented Awards of Excellence in Healthcare Quality to six outstanding health-care providers in our state. The categories included large urban hospitals; rural critical-care providers; information technology-driven health care; nursing homes and home health care. Each submission required concrete, demonstrable evidence of success.
Of the six organizations that were honored, five are in Eastern Washington, which I find remarkable since all providers in the state were eligible. The one on “our” side of the mountains is Providence Hospice & Home Care of Snohomish County in Everett.
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Providence has provided home health and hospice services in Snohomish County and Camano Island for 30 years. This year, Qualis Health honors the organization for dramatically improving the bereavement services of its hospice program. (Hospice is specialized care for people in the last stages of dying, making their remaining time as full and comfortable — pain free — as possible. Bereavement is support for their survivors, usually lasting a year.)
Hospice services are one of the true success stories of the health-care system, established in England and transported to this country, quietly, about 30 years ago. Medicare and other insurers pay for it. Some services, such as bereavement, are mandated but not reimbursed, meaning they’re often provided scantily.
In 2006, Providence partnered with two university master’s programs in counseling psychology — at City University and Northwest University — to train student interns to provide ongoing bereavement services to clients’ families. Each student received 35 hours of training, then provided 15 hours a week of unpaid work for a year, providing a total of 3,192 volunteer hours, or more than $98,000 in unpaid bereavement services, for a net cost of zero. Family and student evaluations have proved its success.
My favorite honoree (because I’ve written so often about the failures in eldercare) is in the nursing-home category. The winner this year is Hillcrest Manor and Rehab Center, a 60-bed nursing home in rural Sunnyside, Yakima County. Built in 1970, Hillcrest looks like any other facility. However, its philosophy of care — called “Culture Change,” which it adopted in 2000 — delivers superior quality that’s light-years ahead of most.
Nonetheless, Hillcrest still suffered from a common problem: high staff turnover and absenteeism. Most nursing homes rotate their nursing assistants frequently from one group of residents to another, meaning that staff and residents don’t get to know each other or build relationships. In 2005, Hillcrest’s staff turnover was 84 percent (the state’s average is 71 percent).
After training from Qualis Health, Hillcrest embarked on a program called “consistent assignment,” meaning the same nursing assistants care for the same residents, getting to know them better and bonding with them. Staff turnover fell to 59 percent in 2007. Absenteeism dropped 16 percent in a single year. The day-shift staff liked it immediately, but the swing-shift staff preferred to continue to rotate — until they tried consistent assignment and, after a month, adopted it permanently. The nurse’s aides even took over their own scheduling, based on their residents’ health needs and preferences.
But the real improvement is in the quality of care. Pressure sores dropped 66 percent from 2006 to 2007, and other areas of concern — such as falls, weight loss and psychotropic medications — have also remained low. When staff know their residents’ needs, their histories and their likes and dislikes, the “care relationship improves exponentially,” says Mary Arthur, Hillcrest’s administrator.
To read more about Qualis Health and its honorees, go to www.qualishealth.org.
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without planning or forethought. Aging Deliberately tells us
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Her Web site is www.agingdeliberately.com. More columns