Three tips for better nurse engagement that drives quality care

Nurses are the heart of every healthcare organization. Not only are they passionate about providing expert care, they are also educators, counselors and their patients’ strongest advocates.

While caring for nursing home residents can be rewarding, it is also quite challenging. Working long demanding shifts in a high-stress environment can lead to burnout and high turnover, which can quickly result in sub-optimal care and increased medical errors. In fact, a research report from the University of California San Francisco found that the median turnover rate for nurses at long-term care facilities is 44%, which is significantly higher than the average for the healthcare industry.

Nursing engagement is key to preventing complications and reducing medical errors and mortality rates, according to research by Gallup. Engaged nurses are more responsive to their residents’ needs, more efficient and effective when providing care and less likely to experience burnout or leave their place of employment.

So how can your skilled nursing facility improve nursing engagement? Here are three tips:

1. Encourage and value nursing input

Include and involve nurses throughout improvement initiatives and allow them to be active participants in decision making that impacts the organization, patient care and their nursing role. Nurses will be more engaged if they know their input matters.

2. Ensure accessibility and responsiveness

Nurses need to know they have a committed leadership team behind them. Take steps to make leaders accessible to nurses and responsive to their needs. This builds a trusting relationship, which will drive greater levels of engagement and commitment to your organization.

3. Recognize nursing contributions

Honest and meaningful recognition of a job well done increases loyalty and engagement. Find ways to recognize the many contributions nurses make to their residents and your facility.

Whether done in a public forum or through personal, one-on-one communication, showing appreciation improves nursing morale and instills a sense of pride.

Want to learn more? Discover how ABILITY CAREWATCH can keep your nursing team on the right track with quality initiatives.

 

ABILITY and design®, ABILITY® and CAREWATCH® are trademarks of ABILITY Network, Inc.

The three priorities nursing leaders should have for the rest of the year

This year has been a roller coaster so far, with influenza and COVID-19 wreaking havoc in healthcare facilities across the country and world.

While many of us may still be in recovery – or even survival – mode it’s important to not lose sight of the longer-term goals for your team and organization.

Nurse job satisfaction

If you want high quality of care, your nurses’ overall satisfaction with their job is vital. It’s easy to see that happier nurses are going to offer a better patient experience than ones who are miserable. And the research backs it up.

The American Nurses Association’s National Database of Nursing Quality Indicators (NDNQI) collects information from U.S. hospitals to help healthcare organizations pinpoint areas for improvement. Using that data, researchers have found a direct link between nurses’ job satisfaction and patient outcomes. For example, they noted that a 25% increase in nurse job enjoyment over two years was linked to a quality of care increase between 5% and 20%.

That job satisfaction quotient may be particularly challenging right now. After months of turmoil and stress, with potentially more to come, don’t forget to check in on your nurses to find out how they’re holding up. Schedule one-on-one meetings to talk things through and evaluate how they are doing.

However, the biggest key to job satisfaction is improving staffing and nurse scheduling, especially when it to comes to nurse-patient ratios and helping nurses preserve their work/life balance. Learn how ABILITY SMARTFORCE Scheduler can help with both.

Turnover

Turnover has a direct link to job satisfaction. If nurses are unhappy, they are more likely to quit.

In 2019, we saw the turnover rate for bedside RNs decrease 1.3% and it stands at 15.9% right now, according to the 2020 NSI National Health Care Retention & RN Staffing Report. While a dip in turnover is certainly good news, it’s still too high and the cost can be devastating.

In fact, according to the same report, the average cost of turnover for a bedside RN is $44,400 and, ranges from $33,300 to $56,000. For the average hospital, we’re talking about losses in the $3.6 to $6.1 million range. Most can’t sustain that. Besides, we’re already facing a nursing shortage as it is, and you can’t afford to lose good people.

Again, after prolonged upheaval and stress, many of your nurses could be thinking about quitting or even leaving the profession altogether. Prioritizing their job satisfaction is critical to keeping them onboard.

Training and nurse development

Developing staff is one of the smartest ways to both retain nurses and attract new ones. It’s also a way to increase the overall skill sets and value of your staff. With every skill they learn, they improve your organization’s ability to provide a high quality of care.

It’s critical to provide in-house training and development programs to keep their clinical skills fresh. However, also provide training that goes beyond that. Training in communication, conflict resolution and leadership makes nurses more capable in their current roles, while also preparing them for future management and leadership roles.

The challenge is often creating the time for them to take training on top of long shifts. Still, it’s important to do so, if you want the best and brightest nurses working for you.

To see firsthand how you can improve your staffing process, request a demo of ABILITY SMARTFORCE Scheduler.

 

ABILITY and design®, ABILITY® and ABILITY SMARTFORCE® are trademarks of ABILITY Network, Inc.

Skilled nursing facilities to receive break on reporting staffing data

The Centers for Medicare & Medicaid Services (CMS) has extended timeline requirements for reporting direct staffing data in skilled nursing facilities. The extension is part of a series of blanket waivers to CMS requirements that is designed to relieve bureaucratic stress on SNF staff as they implement infection control programs to combat the COVID-19 outbreak and protect residents.

Under CMS regulations, skilled nursing facilities are normally required to report information on direct staff – anyone responsible for the hands-on care of residents – to the CMS in a uniform format at least quarterly. The waiver applies to data pulled and submitted electronically to CMS through the Payroll-Based Journal (PBJ) system.

The reporting requirements whose timelines are being waived include:

  • The work category for each direct-care staff member
  • Resident census data
  • Staff tenure and turnover
  • The number of care hours performed by each staff member per day
  • Designation of direct-care staff as facility employee, agency worker or independent contractor

Skilled nursing facilities that are overwhelmed by their response to COVID-19 infection or prevention do not have to submit paperwork to take advantaged of the relaxed timeline for reporting direct staffing data. Because the timeline extension was part of a blanket waiver by the agency, it automatically goes into effect for all skilled nursing facilities. The measure, which was announced on April 24, is good for 60 days. That timeframe could be extended based on the ongoing impact of the COVID-19 pandemic.

The extended deadlines for reporting staffing numbers do not apply to data that was due to CMS for its April reports. That data should have been collected before a public health emergency was declared on Jan. 31.

The timeline extension was part of a large series of blanket waivers issued by CMS to help skilled nursing facilities better address and cope with the COVID-19 crisis.

 

Source:

Director, CMS Quality Safety & Oversight Group, April 24, 2020,  memorandum to State Survey Agency Directors. https://www.cms.gov/files/document/qso-20-28-nh.pdf

 

ABILITY and design® and ABILITY® are trademarks of ABILITY Network, Inc.

CMS temporarily lifts MDS reporting timeline

Skilled nursing facilities will see the timeline requirements for reporting the Minimum Data Set (MDS) to the Centers for Medicare & Medicaid Services (CMS) extended as they work to keep residents safe during the COVID-19 pandemic. CMS announced at the end of April that it would provide a blanket waiver for MDS reporting timeline so facilities could focus their energy on infection control programs that could help slow the spread of COVID-19.

The timeline waiver applies specifically to regulations listed under 42 CFR 483.20. The MDS data under that code documents and monitors residents’ conditions by assessing cognitive patters, vision, communication, mood and behavior, psychological and social health, physical function, continence, diagnoses and condition, medication, treatments and procedures, activity and discharge planning.

Some of screenings affected by the timeline waiver include:

  • Pre-admission Level 1 and Level 2 screenings, which are typically required within the first 14 days of admittance
  • Quarterly review assessments, which are required at least once every three months
  • Annual assessments, which are required at least once every 12 months
  • Assessments that mark significant changes in a patient’s condition within 14 days of those changes

Under normal circumstances, all MDS data collected during resident assessments must be encoded within seven days and reported to CMS within 14 days.

Because the waivers were a blanket order issued by CMS, skilled nursing facilities do not have to file any additional paperwork if they will be delaying the reporting of the eligible MDS. The waiver does not apply to MDS required for CMS’s April 29 reports, as that data would have been collected before a public health emergency was declared on Jan. 31. The blanket waiver is in effect for 60 days, though there is a potential to extend the waiver.

 

Source:

Director, CMS Quality Safety & Oversight Group, April 24, 2020,  memorandum to State Survey Agency Directors. https://www.cms.gov/files/document/qso-20-28-nh.pdf

 

ABILITY and design® and ABILITY® are trademarks of ABILITY Network, Inc.

CMS waives hospitalization requirement for SNF patients

The Centers for Medicare & Medicaid Services (CMS) has announced it will waive several requirements for SNF residents impacted by COVID-19. The measures, which were announced at the end of April, are intended to help facilities adapt quickly to accommodate residents – and to help ensure residents are eligible for needed benefits – in light of the COVID-19 pandemic.

Some of the waivers related to SNF patients include:

Hospitalization requirements

With the blanket waiver, patients will be eligible for CMS coverage without the usual prerequisite of three days of prior hospitalization if they have been displaced or been affected by COVID-19.

Renewal of benefits

The provision also allows residents who have exhausted their long-term care benefits to renew their SNF benefits without having to begin a new benefit period if they were prevented from completing and renewing their previous benefits due to the coronavirus crisis. To be eligible, their benefits must have been renewable under normal circumstances.

Pre-admission screening and annual reviews

With the waivers, SNFs will be able to admit patients who have not yet had their Level 1 or Level 2 admissions screenings. Instead, facilities will have up to 30 days after admitting patients to perform the required screenings.

Resident transfers

To allow facilities to create cohorts to care for residents who have been diagnosed with COVID-19, CMS is waiving several transfer requirements, as long as a facility has agreed to receive a resident from another facility. Cohort agreements can allow for the transfer of residents with COVID-19 to allow stricken residents to be isolated in one facility, or residents who test negative for the illness can be transferred to other facilities to protect them from a COVID-19 outbreak within their current facility.

Blanket waivers automatically go into effect, so facilities do not need to submit applications when they take advantage of the waived requirements.

With these waivers, facilities must continue to track infections and infection control measures. Find out how ABILITY INFECTIONWATCH can help your staff track all of the necessary data.

 

Source:

Director, CMS Quality Safety & Oversight Group, April 24, 2020,  memorandum to State Survey Agency Directors. https://www.cms.gov/files/document/qso-20-28-nh.pdf

 

ABILITY and design®, ABILITY® and ABILITY INFECTIONWATCH® are trademarks of ABILITY Network, Inc.

CMS places SNF inspection scores on temporary hold

To help protect skilled nursing facilities against COVID-19 outbreaks, the Centers for Medicare & Medicaid Services (CMS) began focusing inspections on infection control programs in March. With that change, many facilities are not being examined according to the usual schedule, potentially skewing the public quality rating system to negatively impact the ratings of facilities that are being inspected.1 To maintain the integrity of the system, CMS announced April 24 that it would place a temporary hold on the domain of the Nursing Home Five-Star Quality Rating System.

Through the duration of the hold:
• All SNF star ratings will remain consistent for the duration of the hold
• Results of inspections performed after March 4 will appear through a special link on the CMS Nursing Home Compare page
• CMS inspections will continue to focus on infection control programs and immediate threats to patient safety, based on complaints.

The hold will affect all inspections performed after March 4. Results of inspections performed after that date were posted to the public on April 29. Inspection results will continue to be posted as the data is able to be finalized and uploaded to the site. CMS did not reveal an end date for the hold of the rating system.

The announcement regarding the Five-Star Quality Rating System came along with other announcements about CMS requirements for skilled nursing facilities, including staffing data and the Minimum Data Set.

While ratings for skilled nursing facilities will remain unchanged for the foreseeable future, it is important for nursing facilities to diligently maintain their infection control programs to protect residents and staff, and to be prepared if an inspection does occur. ABILITY INFECTIONWATCH can help your facility track the data it needs to monitor its infection control program. Find out how.

 

Source:

1. Director, CMS Quality Safety & Oversight Group, April 24, 2020, memorandum to State Survey Agency Directors. https://www.cms.gov/files/document/qso-20-28-nh.pdf

 

ABILITY and design®, ABILITY® and ABILITY INFECTIONWATCH® are trademarks of ABILITY Network, Inc.

Four best practices for nurturing a collaborative nursing culture

True collaboration – where joint communication and decision making occur among all the members of a healthcare team – is a cornerstone of quality care. Studies have shown healthcare teams who do not trust, respect and collaborate with one another are more likely to make a mistake that could negatively impact the safety of patients.

Fortunately, you can apply four best practices to nurture a collaborative nursing culture.

1. Foster open communication

Regular and routine communication and information sharing is essential to building transparency, collaboration and resident-centered care. Adopt methods and tools that enable frequent, clear communication, such as a handoff template, briefs, huddles, debriefs and mobile alerts.

2. Create a safe space for information sharing

Nursing teams deserve an environment that is respectful, nonpunitive and reinforces the value of each member’s input. Develop communication guidelines that promote an open exchange of information through listening and constructive responses while discouraging any ridicule of questions or opinions.

3. Encourage shared responsibility

Nurses need to understand their individual roles and responsibilities within the team. Clearly outline who will have leadership roles and how decision making will be shared across the team, so they can collaboratively achieve the team’s goals.

4. Promote constructive conflict resolution

Different perspectives, backgrounds and areas of expertise can inevitably lead to differences of opinion and conflict within a nursing team. Failure to properly address conflicts often leads to more issues and negatively affects team morale. Establish a conflict resolution process that educates team members on how to acknowledge, manage and resolve any conflict in a positive and constructive manner.

There’s no doubt that a collaborative nursing culture leads to more efficient and effective resident care. In skilled nursing facilities, breakdowns in communication can lead to medication errors, resident injuries and other poor outcomes. When healthcare teams commit to the common goal of elevating resident care by bringing together each member’s unique knowledge and skills, everyone wins.

Coming soon! In our next installment of this series, you’ll discover three tips for improving nurse engagement in your skilled nursing facility.

See how SNFs across the U.S. help their clinical teams collaborate to elevate resident care with ABILITY CAREWATCH.

 

ABILITY and design®, ABILITY® and CAREWATCH® are trademarks of ABILITY Network, Inc.

3 statistics your patients wish you knew about patient payments

Your patients are always your first priority. That said, to best serve them, you need to maintain a financially successful organization. And, with increasing patient responsibility across healthcare sectors, this means that you need to capture more patient payments – without compromising the patient experience.

How can you do that? Let’s take a look at three statistics about healthcare payment systems and financial responsibility that can help you capture more revenue while improving patient satisfaction.

80% of patients would consider switching providers for more convenience1

Historically, patients didn’t do much “shopping around” for healthcare providers, but that’s changed a great deal over the past few years. With increasing healthcare costs and other factors, today’s patients are weighing their options.

When most people consider “convenience factors,” they think about proximity to the patient’s home or workplace, hours of operation, and other aspects that improve or reduce convenience for the patient. But these aren’t the only convenience factors in a patient’s life. Offering convenient patient payment options can help more than you might think.

61% of patients would consider switching providers for a better payment experience2

Nearly two-thirds of patients would consider changing healthcare providers to achieve a better payment experience. Consider what this could mean for your organization if you offered flexible, convenient options – such as automated payment plans and 24/7 online payments. Breaking down patient payment barriers may help you improve patient satisfaction and capture more revenue at the same time.

70% of patients are confused by their medical bills3

Finally, a significant majority of patients find their medical bills confusing. When patients don’t understand their bills, they’re more likely to set them aside, unpaid. On the other hand, when patients have a clear understanding of their patient statements they are more likely to pay what they owe.

And, when you offer online patient statements with email notifications, you can make it even easier for them to pay with direct links to your patient payment platform.

Want to discover how ABILITY SECUREPAY and ABILITY Patient Statements can help you provide the convenience and flexibility your patients want? Request a demo today.

 

Sources:

1. “Effortless care experiences,” NRC Health, accessed April 21, 2020, https://nrchealth.com/resource/effortless-care-experiences/
2. “3 ways to empower patients and improve collections, Physician’s Practice, accessed April 21, 2020, https://www.physicianspractice.com/medical-billing-collections/3-ways-empower-patients-and-improve-collections
3. “14% of consumers struggle with patient financial responsibility,” Patient Responsibility News, accessed April 21, 2020, https://patientengagementhit.com/news/14-of-consumers-struggle-with-patient-financial-responsibility

 

ABILITY and design®, ABILITY® and ABILITY SECUREPAY® are trademarks of ABILITY Network, Inc.

How to tell nurses they can’t have the day off

Nurses work hard and they deserve a break. That’s why it can be especially troubling when you have to deny them a weekend or holiday off. Or when you can’t accommodate a last-minute shift change request.

Your inability to do so is understandable. You’ve spent hours – or days – creating the perfect nurse schedule, and any change is hard to accommodate. You must prevent overtime, ensure fairness across your staff, and make sure you have the right people with the right experience and skills assigned to every shift. Those types of decisions are hard to make quickly, and it often is just easier to deny any changes.

The problem with saying “No”

Each time you deny a time-off request, you’re taking a chance that nurses call off sick anyway. If you say “No” enough, some nurses may generally stop asking for shift changes and time off, and instead, go straight to calling off sick. Ultimately, you are left short-staffed.

Fortunately, most nurses won’t do either, because they are committed to their jobs, their employer and their patients, but that doesn’t mean they’ll be happy about it. Regularly denying nurses more work/life balance and control over their schedule leads to burnout and lowered morale, both of which are leading causes of turnover.

Set ground rules to curb the problem

Establishing policies and putting a structure in place will limit the amount of inappropriate time-off requests you receive, while also enabling you to plan and schedule more effectively.

For example, clearly explain to staff:
How to submit a time-off request or shift change. Do you want them to speak to you in person? Send an email? Text?
How far in advance employees should request time off. Many nurse managers are completing their schedules two, three and four weeks in advance sometimes. Let employees know how much notice they need to give you for planned vacations, events and appointments.
How often staff can request time off or swap shifts. Think about your circumstances and what you could reasonably accommodate.
What constitutes emergencies for last-minute call offs. Nursing is one of those professions that is always on call. However, there are situations, like personal illness or injury, or the illness, injury or death of a loved one that warrant time off. Absences to attend a party, concert or some other event aren’t legitimate emergencies. Make it clear what you consider an actual emergency.

What to say when you can’t say “Yes”

Unfortunately, no matter how much you want to accommodate all your nurses’ time-off needs, sometimes you just won’t be able to do so. Follow these tips to take the sting out of your “No.”

Be direct, honest – and respectful. How you say “No” is critically important, so be direct when you deny the request, but do it without being curt, rude or hostile. For example, “I reviewed the schedule, and I can’t give you tomorrow off.”
Offer a quick reason, but don’t blame anyone. Explaining the situation often makes your decision easier to stomach. For example, “The floor is full, and without you, we will be short staffed.” Avoid the urge to point fingers at another nurse for this or that, as that just breeds resentment.
Let them respond. Give them a chance to express their disappointment, but don’t let it turn into an argument. If the discussion becomes heated, you can say, “Let’s take a break and discuss the policies regarding time-off requests tomorrow.”
Empathize with them. Having a request turned down feels awful, especially when you are a hard worker. Acknowledge that and explain you will do everything in your power to ensure you can meet their next request.
Show your gratitude. If they accept your denial graciously, let them know how much you appreciate it. Even if they show some frustration, tell them you appreciate the hard work they do every day.

Turn your “No” into a “Yes” with help from ABILITY

Outdated scheduling processes could be making it impossible for you to grant more time-off requests, especially those urgent last-minute ones.

With ABILITY SMARTFORCE Scheduler, you gain complete control over nurse scheduling and can more easily manage changes.
• See at a glance who is available to cover a shift – keeping overtime, seniority, last called off or credential expirations in mind.
• Empower staff to easily make PTO requests, volunteer for open shifts or swap shifts as needed.
• Fill open shifts caused by sick calls and no-shows in minutes – without making one call.

You won’t be able to satisfy every request, but you can make your scheduling process more efficient so you can say “Yes” more often. Learn more about ABILITY SMARTFORCE Scheduler.

 

ABILITY and design®, ABILITY® and ABILITY SMARTFORCE® are trademarks of ABILITY Network, Inc

Empower your nurses to focus on resident-centered care

Nurses are the frontline of resident care – they spend more time at the bedsides of those in their care than most other healthcare team members. No one knows better than a skilled nursing professional that the best way to achieve better outcomes is to maximize direct contact with each resident. With a focus on individual needs and preferences, nurses can improve quality of care and life for their residents.

Staff nurses aspire to provide the best care possible to their residents, but are often frustrated by a lack of time, resources and autonomy.

Here are three ways your healthcare facility can help your nursing team to be more productive and elevate resident care.

1. Ensure adequate staffing

Making sure that your facility is staffed appropriately is a crucial element to providing high-quality care. Not only does inadequate staffing adversely affect your star ratings, it can overwhelm your nursing staff and result in unsafe care. With optimum staffing levels, your nurses are empowered to provide excellent resident care.

2. Equip nurses with the right tools

Frontline nurses need easy-to-use and readily accessible tools and resources to boost their autonomy and confidence in delivering evidence-based care. Make sure they have:

• Standardized checklists for assessments
• Actionable data to prioritize care
• Access to resources that expand their knowledge base
• User-friendly technology that promotes regulatory compliance

3. Simplify workflows

In today’s healthcare environment, it’s all too common for nurses to feel pressure to increase productivity and report a high administrative workload. Creating more efficient workflows is a frequently overlooked way to give nurses more time to focus on resident care.

Examine current workflows and look for “time-eaters.” One of the easiest ways to improve nursing efficiency is to reduce manual processes. Look for user-friendly technologies and applications that help nurses streamline their workflows and make more efficient use of their time.

Don’t miss the next blog article in this series to learn best practices for nurturing collaborative nursing!

Have you heard how skilled nursing facilities are simplifying quality management? Check out ABILITY CAREWATCH, the easy-to-use application that’s truly elevating resident care.

 

ABILITY and design®, ABILITY® and CAREWATCH® are trademarks of ABILITY Network, Inc.