Louisiana success stories

LA Success Stories
Quality improvement endeavors can often feel overwhelming, but chances are, you can learn from the experiences that another physician, hospital or nursing home has had in a similar situation. Coupled with support from Quality Insights Quality Innovation Network, learning what has worked for others — and what didn't — is a valuable strategic planning component. 

We encourage you to read the success stories, contact us for more information, and also let us know if you have a Quality Insights' success story to share.

Courtyard Manor Retirement Home: The Secret to their Pain Management Project Success

2/22/2017
Courtyard Manor Retirement Home is a small facility in the large town of Lafayette, Louisiana. This nursing home has caring owners that visit with their residents at least twice a week, making sure both staff and residents are treated like family. According to Director of Nursing Mona McCall, “Our goal is to make sure the residents are enjoying their life.” That is why, in the late summer of 2016, when Courtyard Manor realized their pain management quality measure numbers were rising, staff was moved to action.
 
Courtyard Manor Administrator Dawn Miller, empowered Darlene Picou, the MDS coordinator and the team leader for staffing, to begin this targeted improvement project. As the team leader, she laid out the plans for a multi-disciplinary approach. Darlene educated her team on the fact that most of their residents suffer from varying degrees of pain, and this directly links to depression and weight loss. She knew that if residents do not move, are not active, and do not have their minds challenged, they are more likely to suffer from pain.  
 
The team and Medical Director, Geoff Mire, MD, began the work of improvement. They engaged with Quality Insights to solicit tools and resources to get to the root of what was driving their numbers. Once they analyzed their data, they developed a plan that they knew would succeed:
 
  • They make sure to assess pain for every resident, at every shift. For those residents with cognition issues, staff receives ongoing training in observation techniques. If a resident reports an increase in pain for more than two days, interventions are put into place. Interventions include:
  1. Activity staff review the current care plan to see if modifications to therapy are warranted and adjust as needed.
  2. Staff tries exercise, relaxing techniques, distraction techniques, and/or just getting the resident to enjoy the outdoors. They do whatever it takes to relieve the pain for the resident.
  • Effective communication with the physician is key so he can evaluate the current pain regimen. 
  • The therapy center staff will continually strategize for non-pharmacological interventions, which is vital to control pain.
  • The music and memory program is rotated among the residents so all can benefit.
  • The team moved away from PRN pain medication orders, choosing to implement a care plan that works best for the resident.
  • Pain levels of the residents are reviewed every morning at the QA meeting by the multi-disciplinary staff.
Darlene is particularly encouraged by the positive impact of the music and memory program. She states, “Once you put the headphones on someone that does not communicate, and they smile and begin to tap their feet, you are just overjoyed that you brought them quality of life.”  The team decided early on to not focus on the number of the quality measure, but what was happening on the floor with each and every resident. 
 
The hard work has paid off. The pain rate has dropped 84%, and is now two-and-a-half times below Louisiana’s state average. According to Dawn, “We are family and we just want to focus on their quality of life.”  
 
For more information on Courtyard’s success story, or to receive the tools and resources they used for improvement, please contact Quality Insights’ Nursing Home Team Leader Julie Kueker