Early detection, teamwork and patient and family engagement have driven the success of Friendship Village in St. Louis, Missouri with preventing unnecessary hospital utilization for its residents and earned the facility the distinction of being an INTERACT® Center of Excellence.
Friendship Village focuses on the implementation of various tools and methodologies of the program, including Care Paths, which guide caretakers through clinical situation decision-making, Stop and Watch, which aides in early symptom identification, and advance care planning tools, which involve not only staff but families of residents.
“It is an all hands, eyes and ears, on deck approach that is the cornerstone of our success,” according to Stacey Zerban, Skilled Nursing and Rehabilitation Administrator at Friendship Village Sunset Hills. “It has brought more attention to details. We assess what we can do to prevent an admission, but if we have to send someone to a hospital, there is a quality assurance tool we use to look back 24 hours and help the team assess whether there was something that could have been done differently.”
Patient and family engagement begins when a resident moves in so staff can understand their goals and expectations. The high level of communication, which was important before COVID-19, became critical during one peak of the pandemic. Zerban said that prior to the pandemic, family communication about a change in a loved one’s condition could alert staff and help avoid a trip to a hospital. Zerban said everything changed during a span of about one year when families were not in the buildings.
“Families really had to rely on my staff’s eyes and ears to pick up on those nuances that might signal a change in condition,” Zerban said. “And then my team had to communicate with families as early as they could before something would turn into a panic situation. We needed to communicate everything to the family to keep them informed so that there were no surprises.”
Keeping residents out of hospitals prior to COVID-19 was important but that sense of urgency was elevated when transmission rates skyrocketed in hospitals. While the various tools of the INTERACT® program strengthened care processes in Friendship Village’s facilities, the use of them became a potential difference between of life and death.
“We didn’t know how important this program would be until the pandemic, and you really have to use those Pathways and work with the doctors and families to make sure that everyone is on the same page,” Zerban said. “We work through care paths designed by some of the best physicians and hospital professors in the country. It helps our nurses become better clinicians at the bedside and understand why we are doing this, what we are doing and why it is important.”
The most important tool to monitor resident health conditions became Stop and Watch. While it was put in place and highly effective prior to COVID-19, Stop and Watch added an even more valuable level of care and monitoring that involved all staff, not just the clinical team.
“When you start to train your housekeepers that their eyes are just as important as the nurses, you get that many more people caring for residents,” Zerban said. “It’s the same with our activity team and our food and beverage staff. When you get young people, who are working in dietary, for example, to have a role in taking care of our residents, that is the recipe for success with this program and what I think separates it from a lot of programs.”
Friendship Village continues to implement elements of INTERACT® into their residents’ care, and the training elements offered through the program provide clinical staff with the knowledge and confidence that they do not have to immediately call for an ambulance anymore. Residents can be treated and remain in their home unless it becomes absolutely necessary to admit them to a hospital.
For more information about the free, downloadable INTERACT® program and the recently updated tools including COVID-19 and other clinical information, visit https://pathway-interact.com
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