September 30, 2010 |

Free Web resource illustrates methods of honoring resident choice

Pioneer Network has launched ‘Promising Practices,’ a Web-based resource for providers who are navigating the revisions to the Centers for Medicare & Medicaid Services (CMS) Interpretive Guidelines. Providers have indicated interest in tools and resources for nursing homes to operationalize the guidelines, which are all about resident quality of life, person-centered care, and a home environment.

Promising Practices in Dining is the first topic in Pioneer Network’s Web resource, with Promising Practices in Home and the Environment expected next. It consists of three main parts: Examining the Institutional Dining Experience, Creating Promising Practices, and Promising Practices – Your Stories. It contains research from experts in the dining field, testimonials from providers who have experienced the changes themselves, and regulatory tools from CMS. Graphics are also utilized to offer visual explanations of content, like this one that illustrates how the resident is at the core of multiple processes that affect him or her:

Additionally, the Promising Practices in Dining tool is filled with “Mythbusters” like the one below:

Readers are then directed to an answer to the myth that in many cases includes real world advice or examples from providers who have successfully navigated the change, like the following:

After Initial Increases, Budget Neutrality, and Cost Savings

Linda Bump explains that initial food costs may increase with new enhancements, but as staff learn resident preferences and plan for them, those costs “reestablish within budget” (2004-2005).

Eric Haider similarly says that staff learn what residents prefer and how much of each item to prepare, minimizing waste. He attributed a savings of $20,000 per year to this process (Rantz and Flesner, 2004).

This is also the experience of the facility identified in Linda Handy’s book Surveyor M.O. for Nutritional Care (F325) that there are “budget increases at first until you figure out who is going where,” “less prep,” residents “usually eat what they take which means we are not feeding the garbage can as much as we used to” and budget is now “actually more efficient and more effective” (2009).

Also by avoiding the pre-plating of food, unused food may be used as leftovers following guidelines at Tag 371 or even as “planned overs,” both of which reduce costs according to Linda Bump (2004-2005).

All Promising Practices are grounded in a framework that allows providers to reference relevant F-Tags and revisions to the CMS Interpretive Guidelines. Other factoids and suggestions, along with links to different culture change tools, are provided throughout.

Additional resources have also been compiled. For example, readers will have access to the following materials:

· Dining Research and Relevant Findings

· Regulatory Tools

· Dining Implementation Strategies

· Dining Policies and Procedures

· Dining Implementation Checklists

· Costs Associated with Dining

Pioneer Network is asking providers to “Share Your Promising Practice.” When a reader clicks on the graphic to submit a practice, a questionnaire appears asking them about their own dining practices. Responses and experiences may be shared with the broader Pioneer Network community.

Click here to access the Promising Practices in Dining resource.

Allison Lantieri is communications consultant at Pioneer Network.