By Jon Anderson, PT, Senior Therapy Resource

The pandemic has changed so many things in our daily rituals, and at Legend New Braunfels the facility quickly found itself with less referrals, resulting in decreased skilled and overall census. The facility is known in this quaint community for its fast-paced rehabilitation program and more recently unique treatment approaches surrounding memory care. In an effort to collaborate and ensure patients in the facility avoid the hospital, the facility implemented the Stop and Watch tool along with Grand IDT Rounds.

The Stop and Watch tool allows any employee to document a change in a patient, providing a direct line of communication to the nursing team for further assessment. Bob Said, RN, DNS reports that initially this was looked at as perhaps creating more work for the nursing team, and there were questions surrounding whether a non-nurse would be able to utilize the tool effectively and appropriately. However, it has been quite the opposite. The nursing team provided training to all clinical staff, including the therapy department, on how this tool can be used to effectively capture an early change in condition.

Over time, the recidivism rate was impacted, which created less work for the nursing team. Bob was quick to point out to the team of nurses he supports how much time was saved by having to do fewer orders and assessments as part of the discharge/readmission process, while keeping the patient happy, healthy and out of the hospital by identifying these subtle changes. Jayna Owens, SLP, DOR for New Braunfels, agrees that this strong collaborative clinical approach has led to breaking down silos: “By leading in a way that it’s OK to step on each other’s toes, and even encouraging to do so, we are able to partner early and address clinical issues rather quickly.”

Both Jayna and Bob, along with Amber Thompson, PTA, LNHA, have also shared the importance of doing daily grand clinical rounds on every patient in the facility. Bob reports, “At first it’s a huge undertaking and can quickly eat up your day. Our first grand round took three hours to complete, and you question if this is efficient. But like anything new, you create a process, and over time it becomes faster. We now have it down to about 1.5 hours.”

Jayna and Bob both agreed that the time spent upfront at the start of the day has paid off, we now actually have more time later in the day because we already addressed the majority of the clinical issues in the morning. “You have a better understanding of all the patients,” says Bob. “You know the care plans are being followed because you look at it daily, and whether we knew it or not, we were elevated in the eyes of the front line staff because they see you on the floor daily in every resident’s room. No one’s left behind.” Amber, Jayna and Bob all agreed that these two new things are here to stay, even after the pandemic. ”We have really been pushed as leaders, and this has allowed us to better support the ladies and gentleman, along with creating more open lines of communication with the staff.”