The article below was originally published in the January 2019 issue of the South Dakota Medicine Journal published by the South Dakota State Medical Association.
Author: Stephan Schroeder, MD, CMD, CMQ
Medical Director, South Dakota Foundation for Medical Care
Our monthly articles often dwell on quality improvement areas and encourage providers to consider changes and focus on upcoming challenges. This month we decided to highlight achievements and notable programs in the area of long-term care. Endless regulatory and reimbursement changes can leave caregivers and facilities under constant economic and social pressure. They are expected to maintain mandatory reportable metrics to stay licensed and competitive. This data is made available to the public through tools such as Nursing Home Compare.
While quality improvement and reporting metrics are demanding and important issues, there are also efforts undertaken to improve lifestyle and personal care. They are aimed at making patients and families recognize they are in a patient-centered facility and truly at “home’. Example areas of engagement may include games, puzzles, art therapy, support groups and pets (real or toy). Visits from youth and community groups can be frequent and helpful. Residents may receive benefit and feel useful when assisting staff in maintaining the facility environment.
One such program that has recently been expanded to South Dakota facilities is Music and Memory. Established under a grant from the Centers for Medicare & Medicaid Services (CMS), it involves the use of personalized music playlists on iPod or mp3 devices in an attempt to help residents with cognitive and physical challenges. Great Plains Quality Innovation Network (QIN_, in conjunction with the South Dakota Association of Healthcare Organizations, the South Dakota Health Care Association, the South Dakota Department of Health and Office of Licensure and Certification, offers support for these services in participating facilities. Hopefully, this program can improve well-being and reduce adverse behavior with the need for medication. Music can help patients recall precious memories and assist adjustment to long-term care facility lifestyle.
Another area that Great Plains QIN staff assisted was organizing a training series for long-term care facility staff to learn about caring for dementia patients. It consisted of presentations in three communities across the state designed to educate and involve all levels of employed facility staff. It offered a basis for understanding and dealing with dementia patients. As an example, the facility in Highmore sent a very large percentage of their total staff to learn how to assist in caring for these demanding residents. There are countless similar efforts in long-term care facilities across our state involving various sized communities and remote locations. Providers caring for adults, regardless of their specialty, need to be aware of the social environment of their nursing home resident patients. In the demanding world of long-term care, there are many projects undertaken to make those facilities as much like a true “home” as possible.