The Importance of Personalized Care Practices
David Farrell, Vice President of Subacute Operations at Telecare, recently delivered a keynote presentation at the July 2015 CAHF & QCHF Institute & Summer Conference. His talk was on "Person Centered Care Practices to Lower Rehospitalization Rates and Reduce Antipsychotics."
The presentation focused on ways to bring patient-centered care to nursing facilities. "Taking an individualized approach to care: that is the story," said David. "Telecare is actually really tuned into that. The mental health field is actually ahead of the nursing home field in terms of individualized, person-centered care."
Person-centered care was utilized to eliminate physical restraints in nursing homes. He emphasized that the same approach can be used to reduce antipsychotics. The FDA has issued a black box warning alerting prescribers to the danger of using antipsychotics for people with dementia. “However,” David said, “some nursing homes have been slow to heed the warning.” David brought this sensitive issue up in the presentation by using artwork created by his daughter to depict what the “institution” does to people. Introducing artwork to present on challenging topics is a growing trend. Artwork brings a neutralized way of showing what needs to be talked about without offending those you are presenting to.
One of the slides featured a picture of a man sitting in a facility in a wheelchair, slumped over a nursing station. David used this illustration to introduce how care facilities need to change their thinking. “Loneliness, helplessness and boredom are the outcomes of living in an institution. Person-centered care is the antidote.”
Care facilities need to address quality of care and quality of life. The focus needs to shift away from the rigid structure of having every client adhere to the institution’s schedule. The staff have to accommodate people’s normal and customary routines.
David joined Telecare in June 2015. As a licensed nursing home administrator who has spent over 30 years in the health care profession, David has advocated for patient-centered care using quality improvement practices. David is also a published author and nationally recognized leader in the post-acute care field.
During his keynote addendum, David highlighted Patient Safety Huddles, as a way to get rid of the top-down structure to a more inclusive conversation. "It's a much more collaborative meeting," he says. "The nurse's role is to facilitate and look for teachable moments." David explained that the front line caregivers do most of the talking during an effective, Patient Safety Huddle.
Such access of knowledge connects the dots with clients who exhibit at-risk behaviors and who are in the most need of help. "It's one thing for a staff member to know a client deeply, but there is a gap if they don't have a systematic way to share what they know with the other staff. You need a way to harness the collective knowledge of staff about each client. Huddles are an effective way to accomplish that.”