Thanks to Foundation Award, Idea Becomes a Movement

June 30, 2017

Receiving a national award is an honor; but when that award lead to action, energy, heightened staff morale, team building, and improved quality of life, it becomes a movement. That is true of the Foundation for Post-Acute and Long-Term Care Medicine’s Quality Improvement & Health Outcomes (QIHO) Awards, where the recipients take a great idea and, through the award, grow it, build on it, revise it, and make it a shining example that inspires others. Ask Marian McNamara, RN, MSN, whose team at Sea View Hospital Rehabilitation Center & Home in Staten Island, NY, won the Foundation’s 2017 QIHO Award for their project, “Enhanced Palliative Care.”

Via a Quality Assurance and Performance Improvement (QAPI) process, the team identified several existing barriers existed to quality care during the end of life and serious illness. They deemed palliative care services were poorly understood both by resident and staff alike. They established two goals--increase engagement of residents regarding palliative care and prevent unnecessary hospital readmissions—to accomplish via an enhanced palliative care program. “The sustainability at our facility is extremely positive due to the buy-in of palliative care principles at all levels. The staff has been empowered to embrace palliative care, as well as curative care,” says Ms. McNamara.

The project has made a real difference. Among the outcomes: palliative care services have doubled in 12 months “because of a better understanding of what they are and how they can be used,” acute care transfers have been cut nearly in half, and 98% of facility residents have advanced directives.

The project was enlightening, especially regarding people’s attitudes about illness, death, and dying. “We learned that people didn’t want to talk about end-of-life issues; we live in such a curative society,” Ms. McNamara says. However, the implications of this are significant. She says, “When we did a retrospective view of charts for people who didn’t have advance directives, we discovered that many went to the Emergency Room and died within 24 hours of admission,” says McNamara. What’s worse, she states, is they died in unfamiliar surroundings without the presence and comfort of their loved ones. “That tugged at my heart strings.”

Ms. McNamara and her team also found out that practitioners and caregivers needed more education on palliative and end-of-life care, so they partnered with the New York State Health Department and were able to offer comprehensive palliative care modules. “When we presented our program at the Society’s Annual Conference in March, several practitioners in the audience expressed amazement that we could obtain such excellent educational materials,” she says. She offered to share the modules with her colleagues; and several practitioners—both at the conference and afterwards—expressed interest in using or adapting these materials for use at their facilities.

Several audience members at the conference were also impressed with the level of staff buy-in Ms. McNamara and her team achieved. “I told them that we used Press Ganey surveys to assess and evaluate employee engagement and determine what we needed to do to increase buy-in,” she says. “I suggested they do this before starting a project. If you don’t have staff engagement, any project will fail,” she stresses.

“I think we’ve done a fabulous job. And we are very proud of our accomplishment. It meant a great deal to be recognized by the Foundation. It helped us to move this program forward and share it with others nationwide,” says Ms. McNamara. At the same time, the award was important validation for people who work hard but sometimes may feel unappreciated. “They do so much for our residents, and awards like this are important validation that their tireless efforts are appreciated.” Ms. McNamara adds, “We have celebrations for awards such as this, and we make sure that everyone knows that we couldn’t have done it without them.” Ms. McNamara has no doubt that recognizing staff is key, and the numbers back her up. She says, “Our attrition rate is unbelievably high. Staff stay for 20-30 years. This comes from treating people with kindness and respect, understanding and addressing their needs, and recognizing them for their role in our successes.”

The Quality Improvement & Health Outcomes Award (QIHO) program provides three awards of $1,000 each to facilities that have implemented programs that improved the quality of life for their residents. These prestigious awards are based on programs medical directors and care teams have implemented and demonstrated to improve the quality of life for their PALTC residents. You can view QIHO presentations here.

The Foundation is now accepting submissions for the 2018 QIHO Program. Click here for more information about the 2018 QIHO awards.