In CARE’s experience, there are several ways of improving the quality of care and quality of life for CARE’s clients, as well as other consumers in the health care system, beyond legislation, regulations, or lawsuits. CARE proposes to identify targeted initiatives to collectively promote these goals.
Perhaps the best way to explain this approach is through a concrete example: Existing federal and state regulations require a care planning process in nursing facilities that involves the participation of an inter-disciplinary team working in conjunction with the resident and/or the resident’s legal representative (such as a guardian like CARE). These regulations, however, do nothing more than codify accepted standards of practice in nursing; the process is familiar to all nursing professionals.
At the core of the development, monitoring, and updating of a good care plan is the care plan conference. When done well, these conferences can be one of the few opportunities for different disciplines, together with CARE as guardian, to come together and drill down into the details of the most appropriate, individualized care plan for the CARE client.
However, CARE has found that the care plan conference has become rote and ineffective in many nursing facilities. Rather than bringing together the various departments – nursing, medical, dietary, social services, therapies, activities, and housekeeping – for a collaborative discussion focused on a particular resident, the “conference” has become nothing more than brief reports from different department representatives with no strategic collaboration.
CARE believes, as an example of a targeted initiative, we could help reinvigorate the care plan conference and the care planning process. This can be done through the establishment of clear expectations, making a point of what CARE, as guardian, wants to see in the care plans and expects in the care plan conferences. As the consumer, CARE can hold the nursing facility accountable to meet these expectations, and not necessarily in an adversarial manner. Bringing a “we’re in this together” attitude, CARE can help bring resources to bear to make the better care planning process happen – the establishment of protocols on our end for care plan conference preparation, helping to establish the agenda for the conference in advance, providing in-service trainings to nursing facility staff on the process, etc. Sometimes, merely bringing attention to the issue can have a salient effect, causing providers to dust off their own policies and procedures and breathe new life into them.
CARE believes this type of targeted initiative is reasonable, necessary, and effective in creating positive change. Such initiatives would be selected in a thoughtful way, most likely targeted to address key issues that have been identified through CARE’s experience as guardian for so many people. Each initiative would have its own stated objective and implementation plan. Depending upon the issue and the defined objective, each initiative may have its own related media or public awareness campaign.