Our Performance Improvement Project (PIP) team did a great job completing a root cause analysis on why we are seeing increased resident rates of unintended weight loss. They found one of the root causes is some residents are skipping breakfast.
The team planned these interventions:
- Individualize resident therapy times based on their preferences. Assure therapy times don’t interfere with meal times.
- Schedule therapy appointments after 10 am for those residents preferring to sleep later in the morning. Give them time to eat breakfast before their therapy appointment.
- Keep high-calorie “finger food” snacks and beverages in the therapy department. Offer these snacks to each resident after their therapy appointment.
- If a resident refuses breakfast before their therapy appointment, offer them a high protein/high calorie drink to finish after therapy.
Our weight loss PIP team has been working hard implementing changes on our transitional care unit (TCU) to ensure that all residents who want breakfast receive it prior to therapy in an effort to prevent weight loss. During their initial assessments with new residents, the therapists are having conversations with the residents to individualize therapy schedules based on their preferences, asking questions about what time they like to get up in the morning, when they’d like therapy, when they’d like breakfast, etc.
It turns out that didn’t always work. For example, some residents said they would like to get up early and have therapy. But on some days they weren’t up in time for the early appointments, therapy was trying to reschedule and some of them were missing breakfast again.
The team came up with a great idea to solve this problem. They now have a huddle at 8:30 am every morning on the TCU to quickly review the therapy schedule with the nursing assistants, see if it will work out, leave time for breakfast, and make any quick changes to meet the needs of each resident. It seems to be working! In the last two months, only three residents had an unexplained weight loss compared to 12 the two months prior to starting this PIP. It also turns out the snacks in the therapy department are a big hit!
To make lasting improvements, we are learning how important it is to involve all departments as we work to change the way we do our work.
How can our long-term neighborhood teams come up with changes in the way they do their work to prevent unintended weight loss?