Tuesday, July 1, 2014

Intuitive Care-Consistent Assignment

Marguerite McLaughlin

For many years nursing centers around the country used rotating assignments to fill shifts, take care of resident needs, and basically, get the job done using three sets of 8 + hours shifts. We adopted this from our cousin, the hospital, back when it was believed that clinical care should closely mirror the hospital environment. But, as long term care began to develop its own identity and emerge into a unique style of care, the notion of a rotating assignment became a hindrance to the type of uniquely individualized environment that leaders were trying to create. In order to assure that the unique needs of each individual was being met, rotating assignment would have to be reinvented, so that the same care giver could provide consistent, intuitive care on a daily basis.

“Intuitive” became the operative condition! By spending time with the resident on a consistent basis, staff could learn the patterns of a resident’s daily life, understand what makes them tick, identify preferences and avoid "discomforts."  Staff could be much more able to anticipate residents' needs and enter more deeply into a different type of relationship with the resident. Staff would come to appreciate that, in their new role, they were much more involved in residents' lives, far beyond the daily ADL’s formerly provided. They would go on to become cheerleaders, supporters, secret keepers, motivational coaches, quasi-therapists and family to the residents they served, respected and loved. This one, seemingly innocuous change, in long term care is probably one of the bigger drivers of quality, satisfaction and one of the surest ways to provide individualized care. The two go hand in hand.

Recently, AHCA designed a guide, Consistent Assignment: A Resource Guide,  to support those who are adopting consistent assignment. It provides easy steps and links to resources that help an organization move through each phase of the process from initiation through adoption. Because so many valuable resources already exist, this guide identifies five steps to adoption and then directs you to resources that many have created to support this important change. Among them are resources from: Advancing Excellence Campaign, Rhode Island QIO and RI State Survey Agency and the Pioneer Network. Among the resources are videos, assessments, and magazine articles all clearly gathered into easy steps.

The resources are grouped into steps to help you follow the evolution from rotating to consistent assignment. They look like this:

1. Why switch to consistent assignment?

2. What frontline workers have to say about consistent assignment

3. Preparing your organization for change

4. Engaging families

5. How to do consistent assignment

6. Sustaining the gains

 If you have not yet adopted consistent assignment, consider using this handy resource. It will give you the information you need to make the transition, gain buy-in from staff and board members, as well as provide the resources to make the change. Good luck! Remember, we’re here for you if you need help. Contact mmclaughlin@ahca.org. 401-497-6101

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