Systems for Keeping Promises

Often times families, responsible parties or even residents will initiate a complaint to licensing, simply out of desperation. They have made a request to a caregiver or supervisor and were reassured something would result. Yet, the promised care was never received.

As providers, it behooves us to make sure we have systems to capture resident needs and family requests and ensure there is follow-through. This will save us enormous stress in the long run. An excellent example of this took place in a great community recently. A resident has long been prescribed a need medication for pain relief. It is very important the medication is given regularly to effectively control the pain. The community had a problem getting the prescription refilled. Down to only one pill left, the MD finally renewed the prescription. The community faxed it straight off to the pharmacy for filling. The pharmacy did not deliver that evening. Day 1 of no medication. The daughter called to complain and the staff reassured the daughter it would be filled right away. Pharmacy called again. Still no med, but pharmacy promised a late afternoon delivery. This was a Friday. No med delivery again and now there is new weekend staffing. The new staff was unaware to expect a delivery. Day 2 of no medication. Long story short, the resident went three days without needed medication, each day hearing it would soon be there. Was the pharmacy at fault for not getting the med out? Absolutely, but at greater fault was staff for not taking more aggressive measures. All of this could have been avoided with a simple refill roster and staff monitoring requirements. Instead it ended up turning into citations and follow-up visits including licensing and the ombudsman.

Here are some ideas to make sure you have appropriate follow-through in your community:

  1. Maintain a refill roster that is reviewed by staff at every shift.
  2. Use an end of shift report that requires a supervisor’s signature for follow up.
  3. Empower all staff to be able to “do what it takes” to solve problems. Some headaches occur when providers maintain too much control and the community has to wait for one person to solve every dilemma.
  4. Use a formal process for any complaints to ensure a good resolution.

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