Category Archives: Staff

Tool to Invite Patient Engagement May Be Helpful for Retirement Communities

The BMJ (formerly British Medical Journal) has just published, An Invitation to Patient and Family Engaged Care for Consumers: What it is, Why it Matters and How Patients and Families Can Engage.  I think we may find it very helpful here at Collington and in other retirement communities as a way to think about patient engagement and partnership.

This short document, of which I am listed as a co-author, explains the concept of patient engaged care, describes and briefly summarizes the Planetree – National Academy of Medicine framework synthesis of the research into the impact of this approach, and perhaps most importantly, then specifically welcomes and invites patients to become engaged and partnering team members. (Note that my blog, attempting to summarize the very rich and detailed original Planetree-NAM paper, into which I had some input, is here.)

The BMJ response includes our offered model “Dear Patients & Families” letter, which could be used generally by medical institutions to explain, welcome and support full engaged participation.

For example, it references and summarizes the research as follows:

The good news is that research shows that patient and family engaged care leads to better relationships between you and your healthcare providers. It helps keeps patients safe. It reduces healthcare costs and keeps people from being unnecessarily readmitted to the hospital. Patient and family engaged care makes healthcare staff feel more connected to the work they do, which makes for a better experience for everyone.

Some of its specific invitations and suggestions to patients are as follows:

  • On your next visit to your healthcare provider, ask them if they have seen the framework for patient and family engaged care. If not, direct them here: https://nam.edu/pfec.
  • Ask your healthcare provider if there is a way for you to be involved in improving care. For example, ask if they have a patient-family advisory council.
  • Ask to be part of the organization’s leadership or government team. Ask if patients are included as board members, for example.
  • Ask to be with your loved one at all times, if they want that. Question why there are restrictions to visiting patients. If having visitors is not beneficial to your healing process, enlist the support of your care team to set parameters for guests.
  • Ask that a Care Partner or family member be present and engaged for all conversations about your health.
  • State your feelings. They matter just as much as your physical condition.
  • Get involved in research. Ask about how your condition is being studied and how you can help.
  • Let your care team know how you like to receive information.
  • Ask to see and contribute to your medical record. If you don’t understand what you read in your medical record, ask questions until you do.
  • Tell your care provider what your health goals are – in your own terms (for instance, being able to walk up a flight of stairs, being able to play with your grandchildren without getting winded, etc.)
  • Come to doctor’s appointments prepared. Bring a notepad with questions, your medication list and any other pertinent personal healthcare information.
  • Create a medical biography about yourself. What conditions and medications have you had in the past? What are you currently experiencing? What are your goals for the future?
  • Act like you belong. Be a teammate, not a subject.

I think the last one, “Act like you belong. Be a teammate, not a subject,” sums the whole approach up perfectly.

I very much hope that medical institutions will want to include this letter in their intake, on-boarding process for new patients, and to encourage staff to use its suggestions as a framework for discussions with patients about a team approach and its specifics. It, together with the underlying NAM framework, could also be an excellent too for staff training at all levels on how not just to have an engagement discussion, but to make all discussions team discussions.

If this approach because a standard in most institutions, then we will truly be on the way way to a greatly improved system.  And the same is true of Collington!

P.S. This post is an edited version of one I did in my Patient Partnering blog.

Appreciating Jodi Cramer As She Leaves Collington

Yesterday we experienced the Collington Community at its very best.

At a party in the Auditorium, we said our thankful and heartfelt goodbyes to Jodi Cramer as she leaves Collington for a new job, much closer to her home.

There is something so special about how Jodi, as part of the Dining Services staff, reached out at a human level to so many residents.  As you will see from the various remarks (and hugs) on the video below, Jodi has evoked some very strong feelings of thanks.

Indeed, one of her greatest legacies, also underlined by the video, is the changing of vision of what is possible in terms of connection between staff and residents.  Below is the video, shot last year, which Jodi’s perspective on her role is used to link together a number of residents’ thoughts.  That surely fits.  (No, that is not Jodi’s picture!)

Thinking through how we can build on and enhance that legacy, and the values of community as extended family that it reflects, is a good challenge for the Strategic Planning Group.

A Personal View on The Broader Opportunities in Our New Horticulturist Position at Collington

It’s good news that we at Collington are hiring a horticulturalist to make the most of our wonderful 125 acre wooded and lake campus.

And, if we take advantage of the opportunity, it would be wonderful news.

Obviously, the new person (formal job description here) will be able to coordinate and improve our existing campus landscape efforts.  As the online description says:

This Community Horticulturist serves as the “proprietor” for the campus; and duties encompass all aspects of landscaping maintenance including annuals, perennials, shrubs, trees, irrigation adjustments, grasses, aquatic plants, hardscapes, trash, snow related events, recycling cleanup, etc. The associate is responsible for consistently evaluating and maintaining the designated landscape as well as providing guidance and support to residents on their landscaping needs. This position will work in partnership with the maintenance team to provide community snow coverage and removal; supports the maintenance team with projects as needed.  All tasks utilize the best organic practices.

With the right person, the job could be even more exciting, and make an even bigger different to our lives.  One of the really unique things about Collngton is how much our residents are already involved with the landscape here, including leading our becoming a Certified Wildlife Habitat, being deeply engaged in clearing and cleaning-up (video link), and of course having a very active Grounds Committee.

So, I would see part of the job being fostering and building on that enthusiasm to engage even more residents in the enriching of our campus of nature island.  Little steps like committing to buy our own chipper make engagement so much greater.  There is also so much room for community education on our environment and how to love and improve it.

There is even another possibility.  More and more ageing experts are discovering the value of horticulture therapy (a term I only just learned).  As the above-linked website of the American Horticulture Therapy Association Says:

Horticultural therapy is a time-proven practice. The therapeutic benefits of garden environments have been documented since ancient times. In the 19th century, Dr. Benjamin Rush, a signer of the Declaration of Independence and recognized as the “Father of American Psychiatry,” was first to document the positive effect working in the garden had on individuals with mental illness.

I know it works for me.  Imagine more of this at Collington:

A therapeutic garden is a plant-dominated environment purposefully designed to facilitate interaction with the healing elements of nature. Interactions can be passive or active depending on the garden design and users’ needs. There are many sub-types of therapeutic gardens including healing gardens, enabling gardens, rehabilitation gardens, and restorative gardens.

What makes a garden therapeutic? The basic features of a therapeutic garden can include wide and gently graded accessible entrances and paths, raised planting beds and containers, and a sensory-oriented plant selection focused on color, texture, and fragrance. Learn more by reading AHTA’s characteristics of therapeutic gardens.

What a great job that could be!

Collington Director Marvell Adams reassures staff team that they are all “part of a large and close knit international family” and that “Collington stands firmly shoulder to shoulder with all of you”

Obviously, this is not as easy time for those of us who believe that all human beings are brothers and sisters, that diversity is a strength not a weakness, and that we are obliged to act in accordance with those beliefs.

It is important, and may become even more important as time goes by, that we feel part of a community that understands this, and can act appropriately based on it.

I am again proud of Collington, and hope that we can be a national model, as I here report the efforts made by our Director to support those who may need it.

Here is the full text of the letter sent by Marvell to the staff today.

January 30, 2017
 
Dear Member of the Collington Team,
 
Each and every one of you reading this is a part of a large and close knit international family here at Collington.  We represent numerous countries from all over the world and proudly celebrate that diversity throughout our community.
 
As you undoubtedly are aware, an executive order recently signed by President Trump placed a ban on immigration into the United States from certain countries.  This ban is currently being challenged within our judicial system.  Be that as it may, I feel it is important for you to know that Collington stands firmly shoulder to shoulder with all of you.  We welcome with open arms all individuals.
 
In writing this letter, I am reaffirming Collington’s commitment:
 
“To encourage and welcome all people without regard to race, color, gender, sexual orientation, religion, national origin, or any other characteristic protected by law, to live in our communities and to serve on our staffs and boards.”
–  Excerpt from our Values & Practices
 
As a reminder, you have access to our Employee Assistance Program (EAP) which can help with a variety of personal concerns including legal matters.  You can utilize this service at no cost to you and confidentially by calling Carebridge Employee Assistance Program toll-free, 1-800-437-0911, for immediate consultation.  Brochures with more information can be picked up in Human Resources or by visiting http://www.myliferesource.com (website access code:  XEGKX).
 
Thank you for all you do in service to the Collington Family.
 
Sincerely,
 
Marvell Adams
Executive Director

Here is the cover note that Marvell sent to the Board of Directors with the above.  It includes some important background information.

Dear Collington Board Members,
 
Today I shared th[is] letter to all staff of Collington.  I am sharing with you as well for your information and knowledge of how we are supporting our staff.
 
For those that may not know, a significant portion of our staff are Muslim and/or immigrants and the recent executive order has many of them fearful even though they are all either naturalized citizens or permanent residents of the US.  As one staff member said to me today, “Collington could not exist without immigrants that come here to work.”
 
Thanks and be well.

Marvell

I would urge residents to share with friends in other communities who might find this a useful model.

I would also remind that there are online tools to help people with such issues, as discussed here.

Strategic Planning Engagement Report

Last week, at the Community Meeting, Executive Director Marvell Adams shared his presentation on the status of, and questions for, strategic planning.  I would strongly urge everyone to take a look at the whole thing.

Marvell presented one slide for each of the Working Group areas, focusing on questions that the groups have been and might focus on.  Here are two of particular interest to me, at least:

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Generally, I would make the point that these are intentionally big questions. They encourage not an incremental, but a blue sky approach to the future of our community, one that builds on our strengths, but that aims for a community much more engaged in the world.  This obviously reflects in part the sense that this is a different time.

Each of the slides lists the co-chairs of the Working Group, and I would urge you to think about these questions and give input and ideas.

A personal note:  I have occasionally been met by some resident skepticism about the ultimate decision-making process for the strategic plan.  As someone who has been a resident member of both iterations of this Committee, and have watched all its steps, I want to reassure you that huge respect is being given to resident ideas, values and the input process. I am absolutely confident that the ultimate plan will deeply respect this input — indeed would be simply impossible without it.

If anyone needs more reassurance, let anyone involved in the process let know — or join it yourself.

But, first of all, look at the whole presentation.

This slide shows all the areas of work.

groups

Thanks to all.