Risk Management in Senior Care: the Case for e-Training

I was talking with a client of ours the other day and she shared a story that I can relate to all too well. She was asking staff for their feedback on the new e-training system that they have been using – just happened to be our system, aQuire Training Solutions.
“Believe it or not,” she said, “I kept hearing comments like this: ‘I learned so many new things’ from my staff. The most eye-opening thing for me was that this is content I’ve been teaching in inservices for years – it’s not really new!”

What Debbie was commenting on – and what I’ve experienced first hand – is that staff don’t remember. They don’t remember what you said during an inservice – or a dozen inservices. Maybe it’s because we tend to schedule inservices on pay-day, and staff could be just a little tiny bit preoccupied with how badly they need that check.

Maybe it’s because staff are either on their way out the door for the day (mentally clocked out), not really checked in yet - or not quite awake (quality training for night staff probably doesn’t happen during their regular sleeping hours).

Whatever the case, it seems like a lot of the time staff just aren’t listening. And in my experience, that’s troubling.

Troubling because training topics are things that staff really need to know. It’s not “hey – here’s a fun idea to do with your family this weekend” kind of stuff. It’s the kind of information and skill development that means the difference between quality care and just eeking by.

It is also the training that makes the difference during survey or when litigation is threatened.

Did you train staff on this? When? Where’s the documentation?

And then when someone asks the employee, “Have you had training on this specific topic?” and the employee says “No – I don’t remember ever being trained on that!”

Your sign-in for the inservice training isn’t going to carry much weight. You can say, “I know we covered that information,” but if your staff doesn’t remember it, and say they have never been trained on it, guess what – you’re in trouble.

And that’s where e-training can save the day. Not only do you have documentation of training, you have the EXACT content that the training included, a test that the employee had to pass to earn a certificate, and validation that the person was tuned in and trained on the topic.

And if you, like most companies, have a blended approach to training – some stuff you still have to cover in inservices or seminars – our newest module, the Training Tracker will let you document that training on the same page as the e-training. One click of the “Print” key and you’ll be able to document full training compliance for every employee.

And if you’re like me, one of the things that keeps you up at night is managing the balancing act of meeting increasingly rigorous licensing requirements and avoiding threatened lawsuits. Lose your balance on either one, and you’ll pay in time, money, and reputation.

Sort of makes implementing an e-training system a no-brainer.

The Ethics of Truth

The past couple of weeks have been ones in which truth-telling has taken a bath. One of my personal “good guys,” Eliot Spitzer, was found – well, you know where.

And while my local newspaper endorsed Barak Obama in large black editorial typeface, my periodical of choice, Time Magazine, ran its own editorial about why newspapers should never write an endorsement of a candidate (makes them look less objective, was the reasoning).

Then in this week’s Time, a columnist shared his day’s tasks: run, eat, drop off kids, vote for Barak.

It makes me think about an issue of ethics that I’ve believed in for some time: transparency.

I remember precious little else from my undergraduate education, but this one bit of extemporaneous advice from a professor stuck with me and rang true: as people setting ourselves up to help and guide other people, the most honest thing we should do is post, for everyone to see, our own personal guiding beliefs. Then, people who chose to accept our help would know what they were getting into.

It rang true to me then, and it rings true to me today. What guides me, as a person, will deeply affect the advice and assistance I give you.

As an educator, dedicating this phase of my career to training the next generation of senior care providers, my personal beliefs profoundly affect how I craft the learning experience.

My staff has been immersed in the creation of the first online course to train Certified Nursing Assistants in the state of Oregon, a project jointly sponsored by my company, aQuire Training Solutions, and the Oregon Health Care Association.

Part of what every nursing assistant must know to pass the state exam is a set of procedures for providing specific care tasks to individuals; things like transferring from bed to wheelchair, and assisting with a shower.

The state posts these procedures, step by 101-step, on their website. Instructors must teach the steps exactly as the state sets out.

As we were creating learning activities to help students learn these steps easier I felt myself getting more and more agitated – couldn’t figure out why, until I realized – and shouted, “These steps sound like we’re moving pieces of furniture!”

We’re teaching students the steps, but we’re adding in, for every step, a sample quote of what the student might say to the individual as the step is being taken.

We’re not caring for pieces of furniture. We’re caring for individuals – with losses, with needs, with real human lives.

My own beliefs show through in every aspect of this course. I think that the course will be better for it – but that’s for you to judge. My beliefs are pretty much out there for everyone to see…

Watch the movie…you’ll get it!

Life-Saving Support Systems - it's our time to act

In among all the political news today was a story that caught my eye: the suicide rate of people in my age group – between ages 45 and 54 – has soared in the past five years.

Overall in that age group the suicide rate increased nearly 20%; for women, the increase was 31%. This is in sharp contract to the suicide rates in other age groups, which either increased only slightly (teenagers) or actually decreased (senior adults).

Of course, no one can do a factual study to find out why, but many theories are being discussed. I have my own theory: we’re feeling increasingly more stressed with pressures of being sandwiched between our responsibilities as parents (many of us still have young children, having waited to start our families until our 30s or even our 40s) and our parents, most of whom are living longer – not necessarily independent – lives.

If you google the term “Sandwich Generation” you’ll see with page after page of stories, web sites and blog discussions. This is not an isolated experience – it is nearly universal within this age group.

Of our own personal friends, the vast majority are feeling the pressure. In the past 12 months, three of our closest friends lost a parent. All had increased their visiting, their work load (to help pay for needed services) and their own involvement in their parents’ lives. All had children at home or in college. One was even fighting her own battle with breast cancer at the same time.

Is it any wonder that some people simply say, “Enough!”?

As professionals involved in providing services to seniors, what are we doing to support the people in the middle? What more CAN we do? Support groups often aren’t the answer for people who are already running every day and evening of the week. Virtual support, email support and simply being available to listen may be one of the most significant things we can offer.

Certainly, taking some of the caregiving responsibilities off of the shoulders of maxed out kids can make a tremendous difference.

Silverado Senior Living has been taking this assistance on the road, so to speak, by offering services in the homes of individuals who are not yet ready – may never be ready – to move into a community living environment.

The Assisted Living Federation of America (ALFA) calls this approach “assisted living without walls”.

I can only imagine the relief that the families of those being served must feel.

Another option is the Quiet Care system – one which, when we previewed it in my office a couple of weeks ago, one of my team members immediately said, “I need one of those today!” For individuals trying to focus on work tasks, all the while worrying about a frail parent at home alone, the relief can be immeasurable.

There’s no doubt that the increase in suicides among the “sandwich generation” is a combination of many factors; perhaps we, as a profession of senior care providers, can step up with even more tools to provide solutions.