Behind the scenes, the Granite Falls Hospital and Manor Board is diligently working to take the steps and pool the resources it will need to build the contemporary Manor of tomorrow. In the foreground, scores of nurses, dieticians, housekeepers and other manor and hospital employees endeavor to improve the services of today.
“We’re always looking for opportunities to improve the quality of the lives of residents,” says Granite Manor Registered Nurse (RN) and Quality Assurance Manager (QA), Patrice Schulte. “Nursing home funding is very limited … anything that we can use to help them, we try to seek out.”
Most recently, Schulte and others have sought out a role in Minnesota’s Nursing Facility Performance-Based Incentive Payment Program (PIPP).
Developed in collaboration between the Minnesota Department of Human Services, Minnesota Nursing Homes, Indiana University and the University of Minnesota, PIPP is a program that moves beyond conventional pay for performance. As its chief objective, PIPP encourages and promotes evidence-based practices, collaboration and innovation and risk taking amongst nursing homes with the hope that improved models of care will rise to the surface, able to be replicated nationwide.
In early 2010, Manor staff delved into the extensive PIPP grant application, presenting programming ideas developed during a series of preceding brainstorming sessions. Though it contained several components, most notable in the proposal was an initiative that would completely alter the existing employee framework.
Seeking to foster deeper employee and resident relationships, the idea simply required new facility-wide employee assignments where staff members––from caretakers to custodians––remain in the same areas, allowing them to be with the same residents, as consistently as possible.
“This way residents are able to form more personal relationships with staff,” explained Shulte. “The idea was to make this as much a family oriented environment as possible.”
Residents are seeing the benefits
In the fall of 2011, the Manor received news that its program was one of only 45 projects selected for funding throughout the state. Implementation of the two-year grant began earlier this year. In coordination, four nurses were made Case Managers and charged with overseeing staffing units and evaluating the effectiveness of programs, amongst other responsibilities.
In addition to the restructuring, Schulte said that the new programming is also geared to facilitate steady improvements by continually seeking input from residents and their families while also offering on-going educational opportunities.
Depending on the circumstances, the educational component may cater to staff and/or residents and their families with a wide range of subject matter from nutrition to technology advances.
For the most part, staff interviews with residents have shown them to be quite happy with their current level of care, putting the onus on Schulte and her associates to make enhancements that Manor denizens haven’t imagined.
“As far as care, and their feelings of being family with the staff––they seem to be happy and content,” said Schulte. “I know they would like private rooms and some larger areas, but that’s beyond my control.”
One area where the staff has already begun making improvements, is through the incorporation of easy to use technology. In one instance, staff are utilizing the internet program “Skype,” to help residents to talk to family members face-to-face. In another, a recently donated iPad has been used to aid a male resident who is no longer able to effectively communicate verbally.
Schulte said the man has shown a new interest in life ever since he began using the devices’ various functions to convey his thoughts and feelings.
A labor of love
Once a year, the state will perform its own evaluation of the Manor’s program. If found to be upward trending, the program will be infused with additional funds.
“If we show a certain percentage level of improvement, the state will give an additional allocation based on the extent of improvement and the number ofManor residents at the facility,” Schulte explained.
Of note is that all grant dollars are directed toward programming, never salaries or bonuses. And to those who would believe this makes for an inneffective incentive, Schulte makes it explicitly clear that she and her coworkers are not driven by money.
“The reason anyone works for a nursing home is that they have a passion for making someone’s life better.” she said. “The people who reside at the Granite Falls Manor are living and active members of the Granite Falls community. They are our mothers, fathers, grandmothers, grandfathers, aunts, uncles, friends, and members of the community. We love them… It is our privilege to be a part of their lives.”’