Benchmarking at Merindah Lodge
Benchmarking at Merindah Lodge
Merindah Lodge: About our Facility
Merindah Lodge is an aged care facility located in the township of Camperdown, in Southwest Victoria. The facility is part of the South West Healthcare regional health service and offers 28 high care and 7 low care residential beds as well as respite care. Merindah Lodge has a very stable workforce comprising of Registered Nurses, Medication endorsed and Enrolled Nurses. The goal of management and staff is to provide high quality care to residents, which promotes a lifestyle that includes dignity, quality and choice.Merindah Lodge: Where are we and where are we Heading?
Merindah Lodge identified, when benchmarked with like facilities throughout Australia, low daily funding per resident. The facility was in fact receiving the lowest funding per resident per day in their benchmarked group. Merindah Lodge was earning on average $112.00 per resident per day in ACFI funding.
Where to from Here?
Management held strategic planning meetings with the aim of identifying issues and exploring areas where further improvements were required; the following important factors were also recognised;
- Improving documentation to support claims was required
- Staff found ACFI documentation time consuming.
- Staff education was considered a priority
A member of the Management team was initially seconded for three days a week to work on the goals and development of an action plan.
We asked staff to work alongside us to improve on our current practices to ensure that we are capturing in our documentation everything we knew that our staff were doing for the residents and that our documentation supported our ACFI Claims. Because if it is not documented we cannot claim it!
Our ACFI coordinator had also done some calculations which showed that with accurate documentation we could reap even greater rewards.
We were not asking staff to document things which do not happen, we are just educating our staff on ways to improve documenting the things that they do!!!!!!!!!!!!!!!!!!!!
Networking and Planning
Management spent some time networking with other organisations, including QPS Benchmarking partners, with the objective of better understanding ways to identify what staff do, assist with staff education and how to document appropriately. The information gathered was then used to develop staff education plans which were completed over the next two-week period.
Staff mapping and brainstorming was done during early November 2013. A tick chart was devised with all the ACFI questions. Three residents were chosen for the day and staff would be monitored during provision of care. Feedback sessions were conducted with staff at the end of shift to detail the observations of their daily tasks and from this staff could appropriately document the daily care needs of residents. Management were always accessible to staff to answer any questions.
The education calendar was set out, with three twenty-minute sessions per week allocated, commencing on the 11th of October 2013. Each week the sessions focused on one ACFI question. Staff was given a copy of the description of the question, from the ACFI User Guide and a copy of the answer pack. Staff was then able to understand how the ACFI score was derived. Case studies were used in these education sessions to relate in a practical situation and display what they were reading was appropriate in the provision of daily care to residents.
A number of innovations were devised to assist staff:
- Flip cards were made to attach to staff name badges. The flip cards have ACFI domain and questions and could be referenced by staff during assessments.
- New forms were devised to make the daily flow charts much easier and streamlined for staff to read.
- ACFI documentation was placed in bright orange folders, as this was a visual reminder cue.
- Behaviour charting and continence went back to paper based, for ACFI only. This was something the staff recommended.
- On the daily staff allocation sheet, staff responsible for doing the ACFI documentation for that shift had an orange dot beside their name. This was so that staff was accountable and couldn't pass it on to the next shift.
Resident ACFI reviews commenced at the end of November 2013. To ensure staff was not overwhelmed with too much paperwork, resident assessments were spaced out. The workload was spread out to ensure enough time was allocated for correct and concise documentation. Regular feedback was provided to staff throughout the assessment process to keep them informed on how documentation was going, with regular emails sent out with updates.
The Hard Work was Worth It!!!!!!!!!!!!
It was recognised that for the ACFI assessment process to be a success and sustainable, it would take a continued team effort from management and staff. Keeping an open line of communication to staff was very important in keeping them motivated and enthusiastic.
A tremendous effort from management and staff, enabled the facility to exceed expectations of improving funding to at least the average of other QPS benchmarked facilities as displayed in the table and graphs below.
The improvements to the ACFI assessment process are ongoing and management acknowledge the tremendous contribution and efforts of staff in achieving these results. The long -term plans are to continue:
- With regular reviews of every resident.
- Ongoing staff education, with April 2014 the next scheduled date.
- Make education every 3-4 monthly.
- Continued staff involvement with mapping and brainstorming, the next to occur before new reviews occur.
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