Assisted Living Best Practice
Pamela Rooney, MA, CALA
Ellen DeBel, RN

The Longview Assisted Living Residence
Christian Health Care Center
Wyckoff, NJ
Christian Health Care Center
Pamela Rooney, MA, CAlA
The Longview
Assisted Living Residence
Best Practice Opportunity
Revise fall prevention and reduction program.
Develop additional programs to enhance health and wellness.

Our goal – Create a comprehensive, multi-disciplinary, innovative program to:
* enhance overall quality of life,
* promote safety and wellness, and
* decrease likelihood that residents will fall.
Balancing Choice and Safety
Open exchange of communications during Resident Council and Family Update Meetings
Include residents in individualized service-plan meetings
Encourage participation in annual resident/family satisfaction survey.
Facilitate regular resident/family meetings to discuss care concerns and solicit feedback into the service planning process.
Interdisciplinary education focused on safety
and wellness.

The Longview Assisted Living Residence
Prides itself on providing services, amenities, and surroundings that compliment and enhance the lives of our senior residents.
Strives to respect privacy in all aspects of our program.
Promotes the right to select a lifestyle that best suits each individual’ s preferences.
Recognizes each resident’ s individuality and unique personality as a focal point when service plans are developed and executed.
Views the individual as a whole person.
Provides for the physical, spiritual, and emotional needs of residents.
Offers personal assistance and health services designed to maintain the highest quality of life, dignity, autonomy, and choice.
Balancing Safety with Independence
Open communication with residents is essential.
Discuss resident safety issues privately and respectfully.
Utilize effective teaching strategies with residents.
Enable residents to recognize their strengths and weaknesses.
Spend time with and offer support to residents who are in the process of accepting the need for increased assistance.
Resident choice, dignity, and independence during these situations is imperative.
Core Principals at The Longview Assisted Living Residence
Foster independence
Encourage choice and independence
Promote individuality
Maintain dignity
Protect privacy
Balance resident rights with caregiver responsibility toward safety

Promote Clinical Excellence
Recruit and retain outstanding talent.
Staff education: upon hire, annually, and ongoing
Interdisciplinary team meetings held weekly to review resident concerns; address issues which conflict between resident choice and safety.
Acknowledge staff for honoring the philosophy of assisted living.
Service excellence initiatives: Y.E.S cards, thank-you notes
Hourly rounding on residents

Ellen DeBel, RN

Director of Health Services
The Longview
Assisted Living Residence

Interdisciplinary Excellence
Develop programs using a multidisciplinary team approach (Nursing, Activities, Physical Therapy, Occupational Therapy, Pharmacy, Physician, Administrator, Admissions, etc.)
Review current, evidenced-based literature.
Identify practices which promote very good outcomes.
Include those practices in your program protocols.
Ongoing staff and resident education.
Include residents in the planning process.
Promote health, wellness, and safety.

Examples of Programs Implemented by the Interdisciplinary Team
Resident/Family Safety and Wellness Expo
Fall prevention
Strengthening exercises
Pain management
Using the emergency call system
Memory loss
Medication safety
Infection control and prevention

Food safety
Physician-led education groups
Walking club
Advanced directives
Tai Chi
Wii exercise group
Healthy eating habits
Diabetes management
Electronic medical record education

Quality Improvement
Evaluate ongoing effectiveness of programs:
* Weekly, monthly, and quarterly performance
improvement monitoring
* Collect data, review, and share with interdisciplinary team to
provide ongoing evaluation regarding effectiveness of
improvements attempted.
* Strive to maintain positive gains.
* Review opportunities for improvement with team.
* Secure feedback about reasons why targeted goals are not being
* Revise action plans as needed to align with new goals.
Quality Improvement
Use feedback to improve your processes.
Quality indicators should target high-risk, problem- prone, high-volume, regulation-driven, safety and wellness issues specific to the assisted-living population.
Develop indicators with input from interdisciplinary team members, department leaders, administrator, and senior leaders.
Communicate quality improvement data and goals with all staff on a consistent schedule.
What Does Quality Mean to Us?
Caring for the whole person physically, emotionally, and spiritually
As employees, each action, word, and deed should contribute to the compassionate and loving environment we seek to provide our residents.
Activities Designed to Enhance Strength, Endurance, and Wellness
Physical -wellness programs six days a week
Fit for Life (hand weights optional)
Traditional exercise
Tai Chi
Walking club
It’ s Never 2 Late (IN2L) -Versatile computer system that offers physical, spiritual, and intellectual activities and entertainment designed specifically for seniors.
IN2L physical programs: bicycle pedals for a virtual bike, flight simulator, steering wheel, gas pedal, and brake pedal for virtual driving

Fall Reduction and Prevention
Program has undergone a major transformation this past year.
Team met every two weeks for six months to work on project goals.
After six months, additional disciplines were included to secure input on how program could be improved.
Unique opportunities were identified to reduce falls while promoting independence, choice, dignity, and safety.

Fall Reduction and Prevention
Evidenced-based assessment tools and interventions from acute, long-term, and home-care settings were reviewed.
Our team decided to customize our program and make it unique to our residence.
Interventions appropriate to the assisted-living setting were selected.
New products were reviewed and trialed for effectiveness and appropriateness.
A custom fall-alert logo was designed.
Fall Reduction and Prevention
Fall-alert logo placed on charts, service plans, and, with permission, on doors and walkers of residents who had fallen or were at risk to fall.
Conducted education and question/answer sessions with residents before program was implemented to inform of program rationale and goals.
Residents supported the idea and expressed appreciation for the team’ s efforts to help them avoid falls and involve them in the process.
Our falls screening and intervention tools provides selected interventions and suggested equipment to prevent or reduce risk of falls for each resident.
Fall Reduction and Prevention Tips
Never stop trying to try to reduce and prevent falls.
If others see you believe in it, they will eventually support the process.
Administrative support is crucial.
The entire team must be part of the process.
Involve staff at all levels to facilitate understanding of how their input and ownership of the process is a reflection of their talents as health-care professionals.

Tips to Help You Develop Quality Programs in Your AL Setting
Secure the assistance of a quality-improvement professional.
Demonstrate the value of how change can positively impact outcomes, improve quality of life and services, improve revenue, and help an organization become known for outstanding care.
Communicate data about quality improvement monitors so the team knows how it is doing with attempts to fix problems.
Ongoing feedback must be solicited.
Problem solving should never stop.
Review and plan budgets carefully; operating and capital budgets must provide adequate resources to support quality programs.
Use your resources effectively and efficiently.
Tips to Help You Develop Quality Programs in Your AL Setting
Involve interdisciplinary staff in the planning process.
Once the program is developed, monitor effectiveness and goal attainment via quality improvement indicators and input from resident satisfaction surveys.
Benchmark progress and share results with team members.
Reinforce what is working well.
Identify opportunities for improvement; revise action plans as needed.
Be creative; think outside the box
Customize your programs when other ideas do not fit your needs!

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