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Providence Mount St. Vincent

Quality of Care Impact



"When you care for people you need to care for the whole person including their emotional and spiritual self." – Sister of Providence.


Quality of Care Impact Quantitative Findings

  • An internal study that compared resident health in 1995 and 2001 found that the number of residents who needed an indwelling catheter fell from 12 to 1; the number reporting a decline in activities of daily living fell from of 82 to 3; the number reporting weight loss fell from 20 to 3; the number requiring body restraints fell from 22 to 2; and the number of residents with pressure ulcers fell from 11 to 2.
  • Although tracked as percentages instead of number of residents, 2008 Centers for Medicare & Medicaid Services quality indicator data remained consistently strong with many measures significantly out-performing the national average including only 3 percent of residents with indwelling catheters and only 7 percent of residents whose ability to move about and around their room worsened. The percentage of residents who lost too much weight was also well below the national average at 2 percent. Seven percent of long-stay, high-risk residents had pressure sores while 1 percent of long-stay, low-risk residents had them. Only 1 percent of residents were restrained. (see above graphs). 

Quality of Care Impact - Qualitative Findings

1) Create an inclusive community and "home" for residents, families, and the outside community that is constantly communicating and reinforcing resident-directed choice and focus.

  • "Clinical still cares about clinical and regulatory but we also balance that with caring about our 'home' for residents." [As an example] "We have a resident that loves to spend time with me. She has diabetes and typically doesn't enjoy exercising. So, I ask her if she wants to join me when I need to leave the neighborhood for a few minutes. It's the clinical value added of having her walk a 1000 feet a few times a day coupled with spending time with her and building a relationship." – Neighborhood Coordinator

2) Work is organized around maintaining resident's autonomy and preferences with inclusive language supporting residents to be "known" as individuals instead of medical conditions.

  • In one example, a resident of a Mount neighborhood was losing weight and staff were concerned. This elder, an English woman, loved to drink tea. In this instance, the staffs' understanding of the resident's likes and preferences was extremely powerful. Working with dieticians and clinical care, staff utilized traditional English "tea times" to fortify her tea. The result was an elimination of weight loss for the resident and proud, empowered staff.

3) Inter-disciplinary, cross-trained teams operate throughout the organizational structure with an objective of putting residents before task and taking advantage of synergies in the organization.

  • "Our social worker captured the social history and communicated his story to the neighborhood staff directly. We didn't have to read about him on paper and his story never went through more than two people before it was heard. We know he likes the Sea Hawks and he'll enjoy the activities where all of the men get together"- Neighborhood Coordinator explaining how she was able to comfort the wife of an incoming resident with such personal and specific information about the husband. 
  • "If we can develop a creative, reasonable way to do it, we'll do it. Who would want to give up their home?" – AL staff describing ways to support residents with increasing frailty to stay in apartments.

4) A relatively flat organizational structure with the resident at the top of the organizational chart is prioritized (allowing for effective communication among and between inter-disciplinary teams and residents).

  • Excellent clinical care occurs within the context of a decentralized model. Although each nursing neighborhood has a unique culture, this requires additional information, education and training to establish some standardization in assessment of areas such as pain. Instead of dictating to a senior clinical staff member, the development of standardization methods is achieved by asking questions and communicating with teams to understand differences and similarities in the current process and then educating each team on new processes. The Mount reports success with this type of assessment.

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