This article is sponsored by Real Time Medical Systems (Real Time). In this Voices interview, Skilled Nursing News sits down with Kathy Derleth (RN, BSN), Real Time’s Senior Clinical Account Manager, to learn what SNFs can do to “Get Back to the Basics” in 2023, including overcoming challenges, and how data-driven technologies can help prioritize care and improve patient outcomes. Kathy also provides her insights into the steps SNFs can take to best prepare for the year ahead.
Skilled Nursing News: What career experiences do you most draw from in your role today?
Kathy Derleth: Throughout my 41 years of clinical experience in long-term care, I have found the greatest pleasure in caring for patients and leading nurses, both in the profit and not-for-profit sectors. No matter what the role, the heart of nursing really hasn’t changed.
Nurses enter the profession to make a difference in patients’ lives, but the demands of the industry, the ever-changing regulations and the staffing crisis have had a substantial impact on the provision of care. I learned it was pivotal to streamline processes and documentation wherever possible.
Drawing on my nursing experiences in the field, I found that when I provide tools to support critical thinking and promote care coordination alignment, it allows nurses to work at the top of their license. More importantly, it puts valuable time back into caregivers’ days to do what they do best — coordinate and deliver the best care to patients.
What does “Getting Back to the Basics” mean, and why should it matter to SNFs?
Derleth: Recently, the SNF field has been largely focused on COVID and infection control. Policy changes over the past two years have diverted leadership’s time and attention. When I say basics, I’m referring to the foundational processes and systems of nursing from which the rest of the processes are built.
To me, exceptional quality of care involves meeting the mental, physical, and psychosocial needs of those that we care for. A few examples include fall and pressure ulcer prevention, ADL function support, and chronic illness prevention. Those are priorities across the board, from CMS and ACOs to value-based plans. Prioritizing the needs of those that we care for can help us get back to the basics and maintain our value to all stakeholders, especially patients.
What are some ways SNFs can “Get Back to the Basics” in preparation for 2023?
Derleth: SNFs can achieve this through the 3 Cs Framework: Collaboration, Communication, and Commitment. I think SNFs need to understand what a vital role they play in the health care continuum, and staff need to understand what that means for their duties in the day-to-day. Streamlining key automated data and integrating with foundational systems and processes help SNFs maintain compliance.
The last few years were not easy for leadership. Successful leaders had to work across boundaries. They had to help employees break out of their roles and silos to participate in key decisions that shaped the organizations. We must communicate to staff why we’re doing what we are doing, who’s listening to them, and what goals we impact together.
When I say commitment, I think about quality assurance. It’s a requirement in long-term care, but not everyone does it well. We must commit to expected successful outcomes, and routinely meet and evaluate our progress. Building interdisciplinary teams that have a high level of communication and collaboration will lead to data transparency as it relates to varying types of patients and their needs. Change is difficult, but when leaders step outside of their comfort zone, stay persistent in their pursuit of quality, and show resilience – the success of the business will follow.
What are some of the challenges that SNFs face in implementing those practices?
Derleth: Besides the obvious industry staffing challenges, the day-to-day nursing operations are largely determined by what’s happening right this second. The ever-changing regulations and requirements have begun to highlight the need for long-term care to be a better value partner across the continuum.
We’ve all heard of the great resignation, and many seasoned nurses are at the end of their careers, leaving long-term care altogether. Hiring new nurses that aren’t just new to long-term care, but also to nursing in general, creates a lot of unforeseen challenges. When you add in the expectations around SNF ratios, the industry fails to represent the most supportive environment for new nurses.
Being able to provide consistent expectations for reporting, documentation, and clinical standards is critical to staff continuity in a frequently chaotic environment of change. Whether CMS, hospitals, payers or ACOs, all stakeholders have different goals. That is why assuming a patient-centric perspective of quality care will always bring forth the best results.
What are some solutions to those challenges that you just mentioned?
Derleth: Nurses need to have time for early interaction and assessment to prevent serious or adverse events — things like accident prevention, risk indicator scoring, and medication management. If we look at engagement across all staff members and each shift, the clinical morning meetings are foundational to communicating with the staff around priority care management.
When we get too busy to maintain these basic systems such as clinical meetings, risk meetings and care plan meetings, it leads to rehospitalizations and other negative outcomes. The results of delayed interventions also produce more nursing-required paperwork and an extensive, regulatory plan of corrections that overwhelm the staff.
Data analytics solutions like Real Time can help support staff and free up their time for patient care. Risk scoring gives staff the jump on intervention of care and provides the best line of sight into a patient’s clinical condition.
With those solutions in mind, what are some ways Real Time can help SNFs “Get Back to the Basics” in 2023?
Derleth: Turnover is inevitable, and data analytics solutions like Real Time will be key in helping new and existing staff excel post-COVID. There are so many new technologies to explore, but we’ve got to move beyond EHRs alone. Now, we are learning the difference between predictive analytics and interventional analytics. We’re able to gain access to the charts for real-time metrics and outcomes. That’s a game-changer for long-term care and value-based care
The industry previously used old, MDS-submitted data or claims data, which was all historical in nature — it was old by the time we got it. With Real Time’s Interventional Analytics solution, programs can sift through large amounts of structured and unstructured data, alerting the care team when a subtle change in condition occurs.
Now, they can prioritize their care, their intervention, and their assessment to make sure a negative outcome doesn’t occur. There are 900 tags of deficiency potential in long-term care. We’re not always going to be able to keep it together but having technologies like Real Time in place to institute and analyze basic data will be critical to future success.
Finish this sentence: “The top strategy that care providers should employ in 2022 to best prepare for 2023 is…?”
Derleth: Using interventional analytics to streamline health care delivery, support core systems and allow nurses to respond quickly to patient changes.
You may view this article on the Skilled Nursing News website, here.