Page 9 - Tale of Transformation

Consistent Assignment to a Unit or Neighborhood
Do we know the residents we care for? Are we able to work with and care for the same small group of elders every day? Or are we rotated from unit to unit? Are we frequently asked to float?
Staff often resist at first. Staff who rotate often resist the idea of consistent assignments. However, if staff can be ‘assigned’ to the same small group (a hallway or neighborhood) consistently, they can get to know all the residents there. This way they can provide a friendly face, consistency in care, knowledge of resident needs, and can begin to develop team. Some staff feel that this is not a good plan because someone would get ‘stuck’ with the most difficult and heaviest of care needs. But, if your group or team that you’re a part of cares for 15 - 30 residents, you can share tasks and help each other within that group. We know it works because even staff who resisted at first, end up saying they would never want to go back to rotating.
Create a team to talk about it. If you do not currently have consistent assignments, encourage the nurses and CNAs to form a team to talk about it. In the first meeting, encourage everyone to speak. Give permission for people to express their resistance. One way to do this is to facilitate the development of a list of the Barriers and Drivers for this change (pro’s and con’s). Once they are all posted on paper or board, talk about each openly – “What other information do we need to gather to work through this barrier?”, or “How great of a benefit is this driver?” or “What facilities are doing this and how can we visit them or hear from their staff?”
(Going down the hall) Betty: My soaps are on.
CNA: We’ll make it quick.
Nurse: After Marjorie, do Mr. Floyd. CNA: Who?
Nurse: 122 on west.
CNA: Will do.
Betty: I like my bath at night.
CNA: I understand but this is your time. Betty: I don’t like going down this hall. (parade of Ladies in Blue)
Visit www.culturechangenow/askpact.html for a free resource - a powerpoint presentation developed and contributed by David Farrell (dfarrell2@riqio.sdps.org) of Rhode Island Quality Partners.
NOTE: also see footnote on page 13 for more information on consistent staffing.
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