Teresian House
Executive Summary
EXECUTIVE SUMMARY
Motivation for Change: A change of leadership and an organizational and strategic assessment revealed opportunities to enhance quality of life and care for residents.
Goal of Change: To fulfill the Sisters' commitment "to treat people in their charge with love, respect, and concern, employing a wholistic approach to care."
Assessment Steps: Surveyed residents, families and staff; Evaluated strengths and weaknesses of multiple aspects of the organization; Redefined mission and goals; Focused on areas of concern to create solutions; Created an organizational structure with the resident at the center.
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PRE-TRANSFORMATION |
POST-TRANSFORMATION |
| Five floors of skilled nursing units with many semi-private rooms. |
Fourteen 12 to 20 person skilled neighborhoods with 100% private rooms and private baths. Carmel Garden for 50 residents suffering from Alzheimer's dementia. |
| A large centrally located dining space and separation of living and gathering spaces. |
Dining areas in each neighborhood. Staff and resident workspaces are no longer segregated. All spaces in the community are designed to promote residence independence. |
| Large, centrally located nurses' stations |
Cabinets incorporated into the living space now serve as work spaces for staff. |
| Lack of autonomy for residents in activities and schedule. Staff were task driven and organized work around delivery of care and staff preferences. |
Activities are meaningful. A Resident Centered Care program helps residents to maintain personal schedules based on preferences. Resident choice is documented in the care plan. Staff is trained to identify physical, psychological, and emotional conditions that require special attention. Medical care and therapy is one-on-one for the resident to ensure individualized treatments and results. |
| Staff-resident interaction not a priority. Centralized departments. |
Consistent assignment of residents with care assistants. Staff are cross-trained and able to help residents with multiple requests. |
Examples of "AH HA" Moments: 1) Change doesn't happen overnight; 2) Educating surveyors can be challenging at first; 3) Initial turnover should be expected at the beginning; 4) Leadership is crucial.
Impact on Quality: Consistently high Resident Satisfaction Assessments; Full census; 0% use of restraints; 0% use of agency staff; 100% of staff and 100% of residents interviewed utilized words that describe Teresian House as a cohesive unit (e.g. family, team, home).
Impact on Business: Turnover decrease by nearly 20%; 40% of staff have been with Teresian House for 5 or more years; 100% of leadership staff have been with Teresian House for 10+ years; Teresian House experienced a 30% increase in admissions applications 1 year post implementation and a 45% increase by Year 4; Positive operating margins; Even at an extremely conservative scenario of $50,000 total yearly revenue per resident, Teresian House still generates $750,000 in additional revenue over the national average (100 bed assumption) and $350,000 in additional revenue over the New York average (based on occupancy).
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