Communication Map

Engaging Staff in Individualizing Care
Communication Map


Pioneer Network is pleased to share this Communication Map for Engaging Staff in Individualizing Care piloted through our National Learning Collaborative, funded by The Retirement Research Foundation and based on B&F Consulting’s method for Engaging Staff in Individualizing Care. B&F’s method builds a communication pipeline from the staff closest to the resident to clinical and operational leaders. This enables organizations to respond immediately and effectively to residents’ needs. The Communication Map illustrates how this communication infrastructure is essential for effective care delivery to ensure positive resident and staff experiences, and good organizational performance. The fifty-two nursing homes who worked with five state culture change coalitions and four corporations to incubate B&F Consulting’s method found these four foundational organizational practices to be mutually reinforcing, as depicted in the examples in this Communication Map.

The four incubated practices together provide the infrastructure for engaging staff in individualizing care to continually improve quality of care and quality of life outcomes. These practices are:

  1. Consistent assignment
  2. Shift Huddles
  3. Quality Improvement (QI) closest to the resident
  4. Involving consistently assigned CNAs in care plan meetings

These practices, used together, create a system to accelerate clinical improvement by capturing and applying staff’s deep timely knowledge of residents’ individualized needs, customary routines, and daily condition. The practices provide daily mechanisms for the staff closest to the residents to work with the rest of the care team to design and use effective interventions that improve each resident’s quality of care and life, and ultimately result in better organizational outcomes.

Every nursing home’s success depends on its ability to know and serve its residents, and these practices provide a pipeline directly from the source. The resident’s experience depends on the quality of communication and teamwork among immediate co-workers and across all departments.

Evaluators Amy Elliot, PhD and Sonya Barsness, MSG developed this mapping tool based on the experiences of incubator homes. It depicts how these foundational practices facilitate communication throughout the organization so that all the staff can have a daily way of sharing how each resident is doing. Through this sharing, they then can work together for the best care of each resident. The map also illustrates what happens when this valuable information about residents is not shared among co-workers or across all the organization. Use the tool to map your current communication process and discover opportunities to strengthen your communication infrastructure.

Click here to download a pdf of the Communication Map Comparison

The communication map is described in the following sections:

  • Communication Map Comparison – This is an organization-level map. It compares the flow of information and problem solving when nursing homes do and do not have consistent assignment and huddles in place. It maps how crucial information from the resident and the staff closest to the resident do or do not get shared with the rest of the care team, and how that affects delivery of care at the organizational and the individual levels.
  • Mary’s Story – This is an individual-level map. This section illustrates the importance of the communication infrastructure by showing how it works through the story of a resident. Mary’s experiences and the problem-solving that staff use to support her are explored with and without consistent assignment, huddles, QI closest to the resident, and CNAs in care planning.
  • Scenario Storyboard – What happens to Mary when she exhibits early signs of a clinical problem? This one page side-by-side comparison explores the differences in the processes and outcomes of homes with and without opportunities for staff to proactively get Mary the help that she needs and thereby decrease the likelihood of adverse events.
  • Practical Applications – This section shares examples of implementation from incubator homes and also provides opportunities to reflect on how this type of communication happens in your organization.
  • Results – This section outlines qualitative and quantitative results of incubator homes working with these practices in the field.
  • Handbook – Implementation Handbook for Engaging Staff in Individualizing Care.