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Long-Term Care Survey Alert

Quality Improvement Tips:

12 Real-World Ideas for Improving Staff and Resident/Family Satisfaction

Published on Thu May 21, 2009

Providers share inside strategies.

Ask a group of nursing home providers who's doing what to keep their residents, families, and staff happy, and the hands start flying. That's what happened in an interactive presentation by Jennifer Pettis, RN, RAC-MT, C-NE, at the March 2009 American Association of Nurse Assessment Coordinators spring meeting. Here's a rundown of what seems to be improving staff satisfaction for various nursing facilities:

1. Partner with local nursing schools. One participant noted her facility offers an extended orientation and preceptorship to nursing graduates of two local nursing schools. The new staff doesn't come with "baggage" in terms of practices learned in other places. And now nursing staff wants to be preceptors, the AANAC attendee noted.

2. Groom your own professional staff. One facility offers tuition reimbursement for CNAs who want to go to nursing school or for LPNs who want to pursue an RN degree.

3. Reward everyone for a good survey. When a survey works out well,staff receives a jacket or shirt.

4. Offer inservices and gifts that really mean something to staff. That includes bonuses at holiday time or a dinner party for staff.

5. Provide a safety net for those in need. One facility has set up an employee foundation to which staff can make voluntary donations. Then staff members submit requests to use the funds for an employee in need ---for example, a staff person's house burns down, or perhaps a staff member's spouse passes away and the person can't pay for a funeral.

6. Engage CNAs as peers. One facility uses consistent assignments in caring for residents. When a primary assignment becomes available, CNAs and other staff do the interviews to select someone who will be a good fit in caring for a resident.

Now for Improving Resident/Family Satisfaction ...

AANAC conferees also weighed in with some simple -- and novel ways -- to meet resident and family needs.

7. Allow residents to bring their pets to live with them in the facility. One participant noted that this gave her facility a competitive edge as other facilities in the area had no-pet policies.

8. Meet with residents and families once a week to make sure everything is going OK. This approach can address small complaints before they snowball into a major complaint.

9. Implement hourly rounding. Staff checks with the resident each hour during the day and evening shifts to see if the person is in pain or has to go to the bathroom, etc. The facility has found that many times the resident's or family's request doesn't involve a clinical issue; so they assign non-clinical people to help out with the rounding during busy times such as lunch. The residents view the approach as a sign that staff cares about their needs. The facility has also found that residents no longer have to put on their call lights to get their needs met.

10. Post the charge nurse's name in the resident's room each shift. The CNAs post the charge nurse's name on a Velcro board each shift. The facility found this approach helps residents/families feel more in control and preempts them from having to repeatedly find out whom to talk to if they have a concern.

11. Implement a menu-style meal ordering system. In one facility, staff provides menus for the upcoming meal and takes the residents' orders. The kitchen prepares the meal as the residents order them.

12. Require the first person to see a call light to answer it. That includes managers who aren't qualified to provide clinical care. If the resident has a clinical issue, the non-clinical staff person tells the resident that his caregiver will be there in five minutes. But 50 to 60 percent of the time, the staff finds the resident wants something that anyone can do for him.

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