“The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” —Marcel Proust
I spent much of the winter at several senior living communities in the Midwest, offering my “Bringing Warmth to the Table” training to staff and providers. One particular organization has a mission to become the premier provider of care for seniors in the area. Its leaders realize that being the best means putting residents first—and that means seeing their environment with new eyes.
Even when putting resident needs first is a clear intention, it may take new eyes to see where and how transforming change must occur. Are residents being treated with compassion and respect at every meal? Does staff know what it takes to demonstrate these courtesies and skills?
It’s the small, everyday details that send messages to residents and their guests. These details may truly be invisible to providers and staff who have developed habits in a familiar work environment.
Picture a nursing home in an older building. Residents are seated in a slightly overcrowded dining area, many are finishing their meals. There are several untouched plates of food. At the nurses’ station nearby, two nurses are chatting. At a table in the corner, three CNAs are taking a break. A single food service staff member is bussing tables; the bus cart is overflowing with dirty dishes piled awkwardly high. No one is interacting with the residents, and the residents are not interacting with each other.
What could be improved in this picture?
Let’s start with relationships. In this picture, neither the nurses nor the CNAs are interacting with residents. And they aren’t helping the person bussing tables. There is no evidence of teamwork being applied to the meal, start to finish, and staff aren’t inquiring about resident satisfaction with the meal. Expectations aren’t being met. Social connections with residents aren’t being fostered.
Staff should be reaching out to welcome and connect with residents throughout the meal. A respectful atmosphere would also not allow the bus cart to be the center of attention, and all staff would know how to dispose of uneaten food and beverages discreetly.
These are the kinds of details that the Quality Indicator Survey (QIS) surveyors will look for. The QIS process promises new eyes for nursing home communities, whether providers wish to see or not.
The key components of QIS are: to build better relationships among all stakeholders; to define and achieve higher standards of service quality; to develop sustainable quality systems; and to educate staff on a new set of skills and responsibilities to better meet resident and guest service expectations. With our sample scenario, we can see where all of the QIS components are needed.
During my winter trainings, the goals were to educate on the changing senior marketplace and develop stronger personal and professional skills of staff while adding value to staff’s role as servers. A seasoned CNA in her mid-50s thanked me after her first class and said, “I was wondering why I would need this training, but I could see where I could improve myself in the situations you are describing.”
Whether it is a trainer like me or a QIS surveyor, outside eyes may be necessary to understand and advocate for resident needs, and staff needs as well.
To look at our scenario holistically, we must take into account the needs of all stakeholders. If we want to create a sustainable new picture, everyone must be included in the education and direction the company is headed. Transforming the service culture is most successful beginning one meal at a time, and involving everyone: residents, staff, and providers, working together as a community.