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One Vision Hosts Consistent Assignment Conference

May 2, 2014

Over 100 people came together on March 6 in Mt. Pleasant, Michigan, to take a deep dive into implementing consistent assignment in nursing homes. The conference, titled “So Happy Together,” was sponsored by Michigan’s One Vision: Moving Forward initiative. One Vision is a coalition of consumer, provider, governmental, worker, and culture change organizations working together to resolve questions and obstacles to implementation of person-centered practices and other culture change initiatives in Michigan’s long term care community.

Consistent assignment is gaining in popularity as a “best practice” and is considered a fundamental requirement for person-centered care and quality outcomes. The intent of consistent assignment is for the same care partners (be it certified nursing assistants, home health aides, or personal care attendants) to support the same clients/elders each time they work. This consistency lays the groundwork for “deep knowing” and meaningful relationship between care partners and clients. When clients and care partners are deeply known to each other, they look forward to seeing each other, there is better opportunity for follow-through in care, and they have better opportunities to notice subtle changes in conditions that prevent hospitalizations.

The day began with statements from Michigan residents on why deep relationships are so important:

“I’ve been here over six years and I love the people. They are wonderful. I’ve gotten to know all my caregivers. They are from different walks of life and it’s very interesting. I was a busy person in my life and when they told me I could never walk again, I didn’t handle it well. I was angry. But here, I have found friendship and community in the last six years. My caregivers take the time to talk to me when there is something I don’t understand. My caregivers are wonderful friends to me.”

“It is really scary when I wake up and see some strange face staring at me. How would you like it? It doesn’t feel good to have to repeat myself over and over for some new person who may not even be there tomorrow. It makes me feel like I don’t have anyone who really cares about me.”

“Changing staff is like changing OB doctors right before you give birth…you’ve spent nine months getting to know someone in the most intimate ways and then when it really counts some stranger who you know nothing about and who knows nothing about you walks in the door and you’re supposed to just accept that they can be trusted with the only thing we have…our life. Now you tell me, does that make any sense to you?”

“I am often awake at 7 a.m., laying in my bed just listening to the noise of the day shift coming and talking. And I listen for the footsteps and voice of Karen. When Karen is working I know it will be a good day. Karen knows me well; she is my friend. Karen has such kind hands.”

“Heck, I wish my aides lived here! When my girls are with me I feel safe and loved. I never have to repeat my likes and needs; they just know me and I know them. I consider them my daughters; and even though the new girls are nice, they are still not my daughters.”

Featured speakers included:

  • Carol Scott, Field Operations Manager for the Advancing Excellence in America’s Nursing Homes Campaign,
  • Nicholas Castle, PhD, Professor at the University of Pittsburgh, and
  • Susan Misiorski, Director of Coaching and Consulting for PHI.

Scott shared information about the consistent assignment goal in the Advancing Excellence Campaign, and showed participants how to access tools and resources on the Advancing Excellence website

Dr. Castle presented his research on consistent assignment indicating broad support for the practice among both directors of nursing and CNAs, reduction in turnover and absenteeism, and improved resident and staff satisfaction. 

Misiorski shared practical steps to implement consistent assignment and facilitated a panel discussion of providers from three Michigan nursing homes that have successfully implemented this best practice.

“I really enjoyed being a part of this conference” Misiorski said. “I have seen first-hand the benefits of consistent assignment, and, like with any change, challenges come up during implementation that can feel like a struggle. I thought the provider panel was particularly helpful in talking about how to overcome barriers.” 

Panelists included representatives from Masonic Pathways in Alma, Thornapple Manor in Hastings, and Holt Senior Care and Rehab Center in Holt.

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