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 The Road to Gold

Steady gains in quality bring the promised gold for a Utah skilled nursing center.

 

Andrea AstonLike athletes making their way up to the top spots on the medal stand, the leadership and staff at the George E. Wahlen Ogden Veterans Home, a skilled nursing facility (SNF) in Ogden, Utah, have worked their way up the ladder to reach the pinnacle in attaining the Gold level of the National Quality Award for 2019 from the American Health Care Association/National Center for Assisted Living (AHCA/NCAL).

Andrea Aston, director of social services at Ogden, tells Provider that over the past five years the facility that cares for mostly men who have served in the U.S. military has charted a steady course in quality achievement. First, the community received the bronze quality award in 2015, then silver in 2016, and now gold in 2019.

“We really loved the idea of the AHCA/NCAL National Quality Award program, and so we started our journey with the bronze award and thought, ‘this is a cool award to be recognized for,’ and from there we looked into improving our processes even more,” she says. “That really is when we started looking at the big picture and decided this was a journey we wanted to take.”

Ogden and its 225-strong staff care for 120 residents with an average age of 75. As a veterans home, all of the residents save for 11 are men. The criteria to get in are to be a veteran, a spouse of a veteran, or a Gold Star parent, Aston says.

Get on the Train

In explaining how the facility worked its way to gold, she emphasizes the importance of getting more than just the top echelon of management on board. “This is not a one-person job. You have to have the buy-in of everyone,” she says.

“When we got the silver, even then we knew there were many things to improve on. We actually took a year off from the awards program after the silver as we knew we were not ready yet to be recognized as a gold facility.”

During that year off in 2018, Aston says she and others charged with getting even more staff involved in the quest for gold really “hit the floor running” in seeking to make improvements from the 2016 silver performance.

“It was eye-opening for the whole staff. We really had to change our frame of mind, and we did that by opening up a dialogue for everybody to have a chance to jump on board. We really just tried to make it fun,” Aston says.

Making the Grade

In striving to make the journey to better quality fun, Ogden and its employees, from the line cooks to upper management, focused on shaping their work to meet the Malcolm Baldrige Performance Excellence criteria, which AHCA/NCAL uses as the foundation for its Quality Award program.

These standards cover areas like leadership, strategic planning, and customer service. Communicating what Baldrige is all about to Ogden’s employees was all part of the process, Aston says.

“We asked who wants to be a part of this, and then we broke it down into category meetings. We made Baldrige standards part of our all-staff meetings, too, really for everyone to get a chance to be involved,” she says.

Putting Theory into Practice

The quest for gold was not a matter of reading off lists of standards, but instead a series of practical steps to improve processes and thus make residents’ lives and care better, Aston says.

“There are so many things we did to make these improvements,” she says.

One example came in how staff managed behavioral issues and the use of medications to calm individuals. Using the quality goals established by AHCA/NCAL, the facility decided to focus more attention on innovative nonpharmacological methods to improve behaviors.

“One thing we did was to create a Namaste culture as we wanted to honor the spirit within Namaste, and we also added staff trained in this area,” she says.

“We trained our whole staff as well so when a resident is having a bad day, instead of medications and interventions, we turn to things like aroma therapy, healing touch massage, reflexology, herbal medicine, increased presence of nature, light therapy, and music therapy,” Aston says.

Satisfaction Reaches New Highs

A spillover effect of the gold award status, and the years it took to get there, is that job satisfaction has never been higher. “We know the residents love the one-on-one attention they receive, but it is also the staff. Satisfaction has shown improvement from being able to provide more individualized care to residents,” she says.

There is also something larger at play, in working for a skilled nursing center and giving great care at a time the general public may not get the message of what long term and post-acute care is all about.
“I talk about that all the time, the perception of the public on what we do. It is not in the news that we achieved this quality standard but there is news when there is neglect or abuse [in a facility somewhere in the country],” Aston says.

“Honestly, I have worked in multiple SNFs [skilled nursing facilities], and I feel there is a huge misunderstanding out there, because everywhere I have worked has been awesome at caring for residents. There are a lot of good people trying to do good things,” she says.

That optimism about being at the forefront of providing excellent care and the corresponding honor of reaching gold status has left everyone at Ogden excited for what they achieved and what comes next, Aston says.

“It really is a journey, and any organization should get excited about getting into the mindset of making improvements,” she says.

Five Named Gold Recipients

Including Ogden, there are a total of five providers that earned the 2019 Gold – Excellence in Quality Award through the AHCA/NCAL National Quality Award Program.

The four facilities that joined Ogden are: Christian Health Center, a SNF and assisted living community in Wyckoff, N.J.; Parker at Stonegate, an assisted living community in Highland Park, N.J.; The Villages Rehabilitation and Nursing Center, a SNF in Lady Lake, Fla.; and Vista Pacifica Convalescent, a SNF in Riverside, Calif.

“The Gold Quality Award is the highest honor a facility can receive that recognizes its quality of care,” said Mark Parkinson, president and chief executive officer of AHCA/NCAL. “These recipients are role models for our sector, and because of their years of hard work, dedication, and passion, they are improving and will continue to improve lives every day. This recognition is more than well deserved.”
 
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