results-driven site visits go far beyond the
“done’s” and “not done’s.” Rather, they
are an important opportunity to get the
whole picture, the “feel” of a community,
and observe how caregivers are effectively
delivering quality care—or not.
One step Back
Of course, it’s important to have a corporate philosophy and culture that emphasize
quality as being of foremost importance.
But the best mission will fail unless the
right people are carrying it out.
“You’ll never be able to inspect it all.
Quality starts with hiring and training,”
Colon says. When interviewing a prospective hire or reviewing an employee’s
performance during a site visit, Colon
recommends following the “dinner rule”:
Could you see yourself (or residents, for
that matter) enjoying dinner with this
If that sounds like an inexact science,
it is. The point of the exercise is to trust
your own instincts about your employees’
instincts, and surround residents with
“people who know quality when they see
it,” Colon explains.
In the ongoing pursuit of quality, Sunrise also emphasizes the importance of
training employees to become familiar
with residents’ interests and past lives,
and treating them as the individuals they
“No person should be looked at as
an accumulation of diagnoses and care
needs,” Colon adds. “If we don’t know
the resident at that level, we can’t serve
Executives, too, need to personify
quality assurance. When visiting communities, connie Arden, RN, a regional risk
manager at Tampa, Florida-based
horizon Bay senior communities, believes it is
important for executives to demonstrate
their expectations about quality through
their own actions. If Arden comes across
a problem or oversight at the community,
for example, “I’ll fix the problem myself,”
she says. “I fix it, I model my actions, and
then train and retrain as necessary.”
transcending the “check up”
How do community-level associates greet
the notion of the next site visit by the corporation’s peer reviewers? If the answer is
mostly synonymous with “fear and dread,”
then the review team may not be headed
for a constructive experience.
“We have state surveyors. An easy mistake to fall into is to mirror that process
for your own program,” Colon explains. In
other words, if you treat internal reviews
as an “auditing” process, they can easily become too punitive. “If you take that
approach, you won’t get the best results.
People will hate the process.”
Experts say the goal in any mock survey, announced or unannounced, should
transcend “checking up” to make sure the
› The “dinner rule” is one way of
quickly assessing a prospective
caregiver’s ability to fit into a
community’s quality care culture.
Could you see residents enjoying
dinner with this person?
› Corporate benchmarks don’t
cut it when it comes to measuring
quality care; you’ve got to be
willing to ask your residents and
families for feedback.
› Rising acuity levels among
assisted living residents is
impacting quality care delivery.
However, one expert says, the
pursuit of quality should remain
loyal to a holistic approach to