Improving care conferences/staffings

cpnegrad07 · Nov 16, 2010

I am looking for suggestions in improving resident care conferences/staffings. Our current approach is an interdisciplinary meeting involving social services, RN manager, and a member of the therapy team (dietary is in attendance on occasion). The resident and any family/friend is welcome to attend. This usually translates into 5 to 6 people involved in the meeting. Having only worked in two facilities, both of the same organization, I can only assume that this is more or less the standard in long-term care. In today's current environment, organizations need to find ways to exceed customer expectations. This can prove difficult to do with seemingly, ever-increasing staffing cuts, budget limitations, and securing qualified employees. I am looking for tips and techniques to improving the experience for residents and their families. This may include location, approach, and documentation. For example, at times we will attempt to meet the family in a "living room" setting as opposed to the "board room" approach. Another might be offering coffee, juice, and water to those in attendance. I think that this can help all of us in making our residents and families feel more welcome. I am hoping that as this post evolves it will help each of us in seeing the different approaches out there and give our residents what they deserve.

We have the pt's nurse-for-the-day do the RN part because she is more likely to know something about the pt than the mgr (tho the nurse may have the pt for the first time that day! But she has a 3-day report already filled out from the day before giving her some info). We meet in a board room with MD, social, PT, OT, psych, RN, pt and fam (every other meeting, and without them as an interval meeting). On the downside, we schedule 20 minutes and hold to it, so it can be rushed, esp for the first meeting when the civilians are trying to catch up with the process and the lingo). And we have a speaker phone for any fam who can't make it. We try to speak to the pt, not about the pt. I wish we would all use common language to describe the FIM status, but we don't. I wish we had more time, but we don't--of course, i (as a nurse) am not in charge of that, like everything else.

SitcomNurse, BSN, MSN, EdD, RN · Dec 9, 2010

We request everyone from the IDT who has a necessary and important part to report, be present for the Care Plan Meeting.

We discuss the plan of care as we have enacted over the last 14 days.

We have it in a day room, where there are comfortable chairs, and a dining table (almost thanksgiving long) so it doesnt look 'board-roomy" but we also hold meetings in the board room when needed.

We have even had the care plan meeting in the residents room.

The idea is: We are taking care of your loved one. This is what we are doing, discussions occur, but if you have a specific concern/ need for something to be changed, then you need to schedule a meeting with that individual department.

We are not impersonal, we are not confrontaional, we are concise. We expect the family to be so also.

You want to see what therapy is talking about, come to therapy and watch him, you are coridally invited.

You want to see how he does with meals, come to lunch, you are cordially invited. You want to chat with someone, I have a million resources to get for you. But you have 15-20 minutes for this meeting. I have 4 other people to have meetings on today, plus run a unit.

All the tea in China isnt going to make a residents family feel as good as the words and actions of the care team.

Feel free to serve cakes etc. but dont ecpect PT/OT to sit there for the meeting with that going on. They have a schedule to keep, residents to see. It has been this way for 13 years, and I have never had a complaint, and yet, have had many families thank me for taking charge, taking control, understanding etc. exactly what was going on, and presenting it in a clear way.

Good luck with your "culture change". I will always do what is asked of me, and if that means serve coffee, then so be it. But I will not be subject to a dietary conversation of 30 minutes when I am the Nurse.