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Implementing "Systems" into current chaos

Posted

I have "inherited" the role of interim DON at a 60 bed facility with a rapidly changing census where I have been ADON for 3 years. I faced many challenges as ADON due to minimal support for the director. I know where the problems are but not sure what to implement first. There communication between departments is lacking and other IDT members don't seem to follow through with care planning and assessments. We have roughly 25-30 Medicare and the remainder private pay. I am just lost as to where to start. Survey likely to be early September, so any ideas would be awesome! I want routines in place but what's comes first, chicken or egg...

CapeCodMermaid, RN

Specializes in Gerontology, Med surg, Home Health. Has 30 years experience.

Prioritize your systems. Falls are usually a good place to start. Do you have a process to review every fall, care plan interventions, and make sure they are followed through? Anti-psychotic use is a huge issue these days. The second sentence out of the surveyor's mouth this year was "I need a list of every resident who has a diagnosis of dementia and is on an anti-psychotic." Again, do you have a system to track this? The diagnosis for the med, and increases or decreases in the dose and the outcome....

You know what they say: You can eat an elephant one bite at a time.