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Care Manager Insight: The Search for Quality Care

16d37c0a78849c0818cf9d4e038ef6ccQuality patient care: It’s the holy grail of health care … and just as hard to find.

Millions of management hours are spent trying to meet and document quality improvement benchmarks. Marketing material is effusive and glowing with promises of quality care for your loved ones in long term care settings, such as skilled nursing and assisted living facilities.

Yet, quality care remains elusive.

The reality is that most long term care facilities over-promise and under-deliver. Once you flip from the provider side, where you may have a very limited experience within a highly controlled “skilled” environment to a lower level of long term care, what you find will shock you.

Patients and families discover in the world of long-term care that quality care is as rare as a snow leopard sighting.

Well, I saw a snow leopard this week!

Her name is Narinder Kaur and she’s a CNA who works in a skilled nursing facility in San Diego. She is very special… she cares.  I hope her compassion and work ethic is a highly contagious disease that infects all the staff and spreads throughout the industry.

Narinder, they call her “Nari”, simply put more effort into keeping an immobilized brain injured woman dry and clean so her bedsores could heal.  Nari also showed creative initiative in mixing medicated ointments, which worked synergistically together to heal the stubborn bedsores.

The family hired me to make drop in visits to monitor the care and treatment of a pressure sore on this patient’s heel and to make sure that the treatments to multiple coccyx wounds were being done consistently.

As soon as this staff knew that there was an outside geriatric care manager monitoring care and bringing positive reinforcement for extra effort, the CNA with the “right stuff” stepped forward.

Improving a poor level of care is a result of many things. A few of those are: the right patient/staff ratios; increased attention to detail; creating higher expectations for the staff; and recognizing those who consistently meet those expectations.

Middle management is often so busy, that they are not able to verify that the line staff is actually performing their jobs to expectations. Sometimes it takes someone outside the system such as a geriatric care manager or a family member, to push the envelope and cause everyone to up their game.

That’s when the snow leopards show up.

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