Where are they now?

The Safety Program
Bortz Health Care of Traverse City

Traverse City, Mich.

2002 OPTIMA Award Winner

For the staff members at Bortz Health Care of Traverse City, it started each night as a heightened sense of awareness. Between 6:30 and 8 p.m., some residents would experience a peculiar burst of energy-the phenomenon known as geriatric sundowning-and staff readied itself for the increased frequency of wandering, falls and aggressive behavior that would follow.

The Safety Program, created to manage resident behaviors and prevent falls specifically during this sweet spot of evening care, has remained effective and “essentially unchanged” since it won the 2002 OPTIMA Award, says administrator Mark Crane. Indeed, perhaps the most noticeable change has come to its name, now called the Winding Down Program. The Quality Assurance Team, formerly the Continuous Quality Improvement Team, still performs quarterly reviews of the program’s success, along with a review of falls by shift for each nursing station to look for developing patterns.

“It is essential that there is a management-level understanding of why a program exists and knowing the actual measurable outcome of the program,” Crane says in support of keeping the Winding Down Program an active feature of his facility, which he has led since 1995. “The role of management in a facility is to keep doing those things that are successful and that create a safe and homelike environment for our residents.”

-Kevin Kolus, Editor

Butterflies are Free
Life Care Center of Sarasota
Sarasota, Fla.
2005 OPTIMA Award Winner

End-of-life programs can be one of the more complex initiatives to successfully pull off in a facility. Beyond the need for a specialized clinical acumen, these programs require an educated workforce sensitized to the sacred experience of dying. But actually maintaining an end-of-life program throughout the years, particularly when a facility’s long-term care population does not frequently turn over, can prove to be one of the greatest challenges.

“If staff doesn’t use it every day, they can forget how to do it,” says Nina Miller Willingham, senior executive director of Life Care Center of Sarasota, which developed the OPTIMA Award-winning Butterflies are Free program. In 2005, Life Care Center wrote that the butterfly signifies “moving from one life to another.” The program’s focus has never wavered since implementation, and it continues to comfort residents and families on this journey as originally intended.

“I can’t stress enough just how important it is for our associates to respond to the needs of the family, not just the patient,” Willingham says. “Whether it is helping the family to identify signs and symptoms of pain or distress in their loved one, or providing food and beverages to family at no cost as they keep their vigil, the relationship between the associate and the family needs to be very close.”

-Kevin Kolus, Editor

Upgrading Respiratory Services
Silvercrest Center for Nursing and Rehabilitation
Briarwood, N.Y.
2006 OPTIMA Award Winner

Recognized as home to the largest chronic ventilator unit in New York State, Silvercrest Center for Nursing and Rehabilitation has grown from its origins as a 48-bed unit to a 80-bed Ventilator Service. Its goal, achieved with a thorough multidisciplinary approach, is to eventually wean patients off vent dependency. Over the years, the Silvercrest Vent Team has continued to pursue new technology and care to help its patients breathe easier. “We were invited by the Division of Long Term Care of the New York State Department of Health to work in collaboration with the University of Albany’s School of Public Health to develop the curriculum for ventilator care and provide training for all state surveyors,” says Janet Berding, Director of Respiratory Therapy.

Since winning the OPTIMA Award in 2006, Silvercrest has enhanced its vent program by adding a Palliative Care physician; instituted a Family Support Group; implemented a house-wide electronic medical record, including standardized respiratory care orders and assessments; and expanded in-house services such as PICC line insertion, bronchoscopy, gastrostomy tube insertion and more.

To help a population that might not be able to speak, Silvercrest’s vent unit is participating in the Blom Tracheostomy (Pulmodyne Inc.) Tube System clinical trial. Facility staff is also educating vent teams around the country through publications and presentations.

-Sandra Hoban, Executive Editor

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