Transitioning Our STOP AND WATCH Program into a True Conversation

By Kari Rhodes, MS, CCC-SLP, Therapy Resource – Keystone – West, TX
At Legend Oaks of Fort Worth, there have been a fair share of ups and downs in communication. As with most skilled nursing facilities, there are some struggles to get nursing and therapy on the same page, especially regarding changes in a patient’s condition. However, a recent change in structure for daily morning meetings has made a significant impact on both communication and patient care.
Initially, staff were encouraged to complete paper STOP AND WATCH forms that were turned in to the charge nurse. This was helpful in reporting noted changes, but it did leave room for improvement. Papers were misplaced, the change was forgotten, or multiple forms may be completed on one resident.

Staff were then trained in entering the STOP AND WATCH forms on the clinical dashboard in PCC. This improved the chance that the alert was seen by more people and addressed by a clinician. Unfortunately, the electronic alerts also were, at times, inadvertently left unaddressed by a busy nurse or well-meaning staff member.

Fortunately, what has been an amazing change for the team at Legend Oaks Fort Worth was a very simple addition to the morning meeting. In addition to reviewing metrics and culture topics, our ED implemented a review of the daily STOP AND WATCH alerts for the whole team to address. Each alert is discussed by the team. What condition or behavior caused the alert? What was done to address the change? How is the resident doing on a daily basis? This has significantly increased the topic of conversation regarding change in condition.

Here at Legend Oaks of Fort Worth, we are continuing to strive for improved care and communication. This simple change in a system that was already in place has opened the door for more conversation, increased discussion regarding change of condition, and decreased discharges back to the hospital.