Corporate Systems and Safe Resident Care

We shift from facility-level thinking to the corporate level and lay out what a systems-based approach looks like when an organization has multiple facilities. We also argue that a system only protects quality and compliance when corporate leaders verify it is truly being carried out.
• corporate mission and vision translated into usable policies and procedures
• leveraging corporate resources and talent to support facility teams
• a replicable “Guardian Angel” rounding program as a measurement system
• using rounding data to drive actionable quality improvements
• adding targeted checks when trends emerge such as resident falls
• monitoring as the critical step to confirm implementation and effectiveness
Please feel free to reach out to Verity Consulting at VerityTeam.com if you'd like further assistance with your healthcare compliance needs.

Transcript

Welcome And Compliance Disclaimer

SPEAKER_00 0:06

Hello, I will be your host. My name is Deanna Five. I am a registered nurse and healthcare analyst. Let's get started.

SPEAKER_02 0:16

The views or opinions expressed in this podcast are for informational purposes only, not intended as legal or professional advice, and may not represent those of Verity Consulting. Although we make strong efforts to make sure our information is accurate at the time the podcast episode was recorded, Verity Consulting cannot guarantee that all information in this podcast is always correct, complete, or up to date. All information in this podcast is subject to change without notice.

The Guardian Angel Rounding System

Verifying Execution Through Monitoring

Key Takeaway And How To Reach Us

SPEAKER_00 0:43

Welcome to the next installment of systems-based approach to managing healthcare quality and compliance. In this segment, part two, I'm now going to focus on the corporate level. So as I was talking to you a little bit about facility level, this will just be certainly an expanded view where corporations with many facilities will look at it from a very broad perspective. Hopefully, we'll have a framework in place that will allow for a solid systems-based approach where all policies and procedures are in place to support quality of care and follow regulatory compliance. So that's where I'm going to focus today on this episode. And that's my goal. I will say, just generally speaking, my experience as a external monitor working on a corporate integrity agreements, my work has been with corporations, a multitude of corporate structures that have a multitude of facilities, some with very good systems that, well, the systems are there. It's just the execution of the system, the monitoring. Is the system working? Is it being implemented? And that's where things can really run askew. So I'll talk a little bit more about some of those things in the next minute or two. So first of all, let me just start off with: first of all, a corporation has a mission, a vision. It has a framework of policies and procedures in place to say this is how we would like to execute our mission and vision, and our policies and procedures should direct what we want to see happen. And corporation has certainly greater resources, more manpower, a talent pool, hopefully, of persons that can help develop and build good systems across the different individual facilities to make sure resources can be deployed to help help there. And there are going to be some diverse, there's going to be some challenges with each entity. How can we work together to make sure I can use my talent to help your organization? So I'll talk about a couple of examples of what I'm meaning in that regard. But really, at the end of the day, how do we leverage our collective expertise? When you have a corporation, there's so much knowledge and skill. Hopefully, it's being deployed in such a manner where the personnel at the corporate level are bringing that talent and skill to the facility level. And again, the facility level should have its own skillful and folks who are very knowledgeable. How can we work together to put into place or have rather follow some corporate level systems-based approaches to ensure that quality of care is in place? So let me just stop right there. So I'm going to give an example of what I'm talking about. Okay. So let's say we have a corporation that has built a system to monitor, measure, keep their finger on resident, quality of care, satisfaction, environment of care, overall safety of care. Okay, so for an example, I've heard many facilities across the country have different names for it, but there's one that comes to mind off the top of my head, and it's called the Guardian Angel Program. And what that means in this example is this corporation, let's say, has this program where the facilities will operate a program that each facility will follow the same thing, same pattern, same program. The department heads will be assigned to a caseload of residents, resident rooms, and they will make rounds. And when they make rounds, they'll have a tool that the organization has developed, and that tool must be completed, and the tool will measure resident information, key information. It'll look at, it'll inter it'll require interviewing the resident, it'll require looking at the environment, those kinds of things. That data is collected, that information is taken to a meeting, it is shared with, in many cases or most, the nursing home administrator, executive director. That information is processed and shared so that meaningful, hopefully, information is gathered so some actionable measures are taken. So it's a system, it's a system-based approach, and it's replicated. It's everybody knows the system. So if, for an example, I'm the oh gosh, the dietary supervisor, and I have an assigned resident caseload, but I'm going to be on vacation. And so somebody could step in, another person can step in and go do my guardian angel rounds and use this same tool. We have a system in place and it can continue on. Everybody knows how to do it. It continues. So that's a systems-level approach. And the corporate level, the corporation knows that it's it's happening in every facility across the nation, uh, in the region, however, the corporation has facilities. So that would be just one example, okay? So it's a systems-level approach, and it's designed to measure or gather health care quality and to also gather some healthcare compliance uh information. All right. And it's it's really a nice way, it's just a simple example here, it's a nice way for the team to uh use their skills and their talents to maybe say, you know, I have a different uh viewpoint here. I think there's other information we may want to add to that. Here's an example of what I'm talking about. So, say for an example, you know, across the corporation, we're identifying a concern with, oh, resident falls, residents are falling. And the corporations identified this is a concern across the corporation. So this could be something that could be added to that tool, that rounding tool in some form or another. So the corporation would identify how that could be done. Okay. That could be a means to gather information or to say, hey, when you're on your rounds, look to see if, you know, for example, residents' call lights are placed near them, or whatever the example might be. Okay. So these are tools, these are there are systems that this is the using the tool, doing the rounds is a system. All right. And it's all in alignment with the mission and vision of the corporation based upon policies and procedures, guidelines. Now, here is something I really want to emphasize. As a monitor uh conducting corporate integrity agreements, I look to find out is the corporation checking to see if this system is in place? Is it is it working? Okay. Because as a as a corporate integrity agreement monitor, I'm focused on systems, okay? And if if if there if there is a system but no one's checking to see if it's if it's in place, then that's a concern for me. Okay. So what I'm gonna ask is, are are the boots on the ground? Are the corporate folks, the regional folks, whatever the case might be, are they there? Are they are they looking to see, are these guardian angels being done? Are they being done as the corporation has asked them to be done by the policy, the procedure? Are the corporate persons involved in those rounds? Because at that time they can really see, hmm, boy, some of these elements of this rounding aren't making sense. There's some things that maybe need to be modified or or we need to add some features to it. Okay, so I just wanted to put that out there. And it can really be the the guardian angel tool can be a really effective measurement tool to gather some data, to give us feedback on this system, this guardian angel system. And so look at looking at it that way is, I think, very meaningful for the organizational to organization to measure how well quality of care is being provided. So it is a systems-level monitoring mechanism. That's where I'm coming from in that regard. So when we're looking at corporate level monitoring, you will have to adjust in many cases for facility level differences. But I see that as something that can be done. That's a positive because you're going to have people bringing different talents and different perspectives in to some of the unique characteristics of a facility. And I think that's a good thing because you'll you'll I've worked with corporations that are across the country, and I've seen some very different perspectives that come into some of the system interpretations. And so just some thoughts there. So it's good to have a system. A corporation has a role in making sure there are sound systems, but I will emphasize as I close here, the system is not really very worth much unless someone's out looking to see if they're in place. And that's where the corporate level folks need to come out and make sure they're in place and educate if they're not and be great role models for the staff who are out there doing it on a day-to-day basis. Thank you for listening. Thank you for listening. Your time is appreciated. We hope you enjoyed this episode of Vital Compliance Insights and found this to be informative. Please feel free to reach out to Verity Consulting at VerityTeam.com if you'd like further assistance with your healthcare compliance needs. Stay tuned for the next episode.