Sticking Together JGS Pegs ‘Magnet Status’ As Its Latest Goal In The Quest For Quality

Jewish Geriatric Services Inc. has been moving in a very specific direction over the last few years: forward.

 

Through a series of new programs, policies, and projects all geared toward improving the overall quality of the post-acute and long-term care facility, from employee satisfaction to organization and, above all, patient care, JGS has created a cohesive set of new procedures that essentially amount to a gradual culture change aimed at achieving excellence.

But staff at JGS are far from finished. The facility has recently embarked on the long process of applying for Magnet™ status through the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Assoc. It’s a unique move, given the ANCC’s Magnet Recognition Program®, which establishes standards of excellence for health care facilities, has never before been applied to a purely post-acute organization such as JGS.

“It’s going to require a partnership with the ANCC,” said Alan Rosenfeld, president and CEO at JGS. “We’re having dialogue now on how we’ll be judged, since Magnet has primarily applied to acute care hospitals in the past.”

But it’s a partnership JGS is ready to create, as the application process for Magnet status represents the latest in a long line of quality improvement initiatives the company has undertaken over the past three to five years, all implemented to improve the overall quality of care at the facility, attract new and skilled staff in both clinical and non-clinical departments, and remain on the cutting-edge in the post-acute and long-term care industry.

Finding Their NICHE

And this won’t be the first time that JGS has paved the way for other long-term care facilities by becoming involved in health care delivery improvement initiatives. The organization, which consists of the Julian J. Leavitt Family Jewish Nursing Home, Ruth’s House assisted living, Spectrum Home Health Care, Wernick Adult Day Health Care Center, JGS Family Medical Care, and Genesis House, is currently an active participant in the NICHE program (Nurses Improving Care of Health System Elders), a research program based at New York University. Three years ago, JGS applied for inclusion in the NICHE program, which focuses on the development of ‘best practices’ for the elderly, and became the first post-acute system in the nation to do so.

The relationship has afforded JGS the opportunity to incorporate new policies and practices at the facility to address several common health and safety issues, such as slips and falls or skin breakdown in long-term care environments, by using NICHE-researched and tested procedures.

“NYU develops the practices through evidence-based activities,” said Barbara Macdonald, director of Professional Practice and Nursing Outcomes at JGS. “Essentially, it keeps us on top of things by showing us how we can do things better overall.”

One such aspect of post-acute care delivery that NICHE helped identify as an issue for many working in the industry was that of hospitality, and the need to teach employees specific customer service skills in order to alleviate stress and create a system-wide way of doing things, according to JGS Chief Operating Officer Linda Donoghue.

“It seems small, but when a nurse has to administer meds to 20 people and there is only an hour to do so, you can imagine how pressure builds,” she said.

Through a partnership with Johnson and Wales University, we have developed a hospitality training program that addresses the need for those types of customer service skills.”

And the staff took it seriously, said Donoghue. Members participated in training and also helped to create a training video for new hires, both clinical and non-clinical, which identifies key moments when stress can build in a post-acute environment, and how to best deal with those moments.

“In a human environment, you need those extra skills,” Donoghue said. “NICHE specifically identified the pressures to perform well through its research, and we were able to respond by implementing skills training.”

Researching For Answers

JGS hopes to augment that research component of its structure even further, by conducting some studies of its own on-site. Through a second partnership with UMass Amherst, JGS already works with professors and students from the UMass School of Nursing, who offer added assistance in implementing new quality-of-care practices, according to Donoghue. She said she hopes to see that work expand through a research group or council, consisting of UMass researchers and JGS staff.

“The professors are now with us two days a week working to implement quality initiatives,” Donoghue said, “And there are opportunities for research, especially among our nurse population, that could help us to create more system-wide policies.”

Rosenfeld added that there are several aspects of health care delivery in post-acute settings that could be further addressed through added research, including the pervasive issue of medication reconciliation, which is key in ensuring that patients are receiving all of the prescriptions they need and none that could potentially react with other medications or aggravate health problems.

“When a patient is discharged from one health care facility and transferred to another, meds needs to be properly carried over, transcribed, and documented,” he said. “With two, three, or four physicians prescribing medications for one patient, that’s not an easy feat.”

Further, many falls and balance issues within the elderly population could be prevented by properly reconciling medications, he said, adding though, that preventing falls is another extensive issue.

“Vision loss, hearing loss, gait and balance issues, and chronic diseases all need to be taken into account,” Rosenfeld explained.

Addressing all aspects of every issue that faces patients as well as caregivers, ancillary staff, family members, and others associated with day-to-day operations at JGS is the overriding theme when it comes to all quality initiatives, noted MacDonald, including the fledgling work with the ANCC to pursue Magnet status.

“Magnetism draws nurses to facilities,” she explained. “It will make it clear that we honor and appreciate our nurses, and that we can provide an excellent place to work as well as excellent care.

“But there is also a very real quality component to this,” she continued. “It will keep us up-to-date and thinking critically, and will get the word out that this is a place for current nurses. It will also help us promote continued education and certification among our nurse population.”

Stuck on an Idea

Donoghue concurred, adding that achieving Magnet status at JGS has been a “twinkle in her eye” for some time, and she feels with so many successful quality initiatives underway, JGS is poised to make history once again.

“It’s going to take time and a lot of effort, but we’re ready to take the plunge,” she said. “And it won’t be a one shot thing. It’s going to create a whole new way of life, and we’re ready.”