Healthcare Risk in Nursing Homes in 2021
Our frontline healthcare workers have been valiantly managing risk for their patients, families, and themselves throughout the global pandemic. To them, we owe a debt that will be hard to repay and one we should not forget moving forward.
Many healthcare lessons have come out of the pandemic, and one is the need to better manage risk in settings where patients are frail and at high risk for adverse outcomes. Understanding, identifying, addressing, and documenting healthcare risk helps nursing homes with compliance, encourages staff engagement, effectiveness, and productivity, and supports residents’ quality of life. Here are a few things you need to know about healthcare risk management to help your residents, partners, and others in 2021 and beyond.
Understanding Healthcare Risk
The risk caused by frailty magnifies many other potential problems plaguing nursing homes, such as staffing shortages, medical and prescription errors, slip and fall injuries, staff injuries, and resident elopement. To this end, we must more aggressively consider the risk of infection and the need for scrupulous infection control practices as being paramount to the usual risks that abound, aside from and beyond the current pandemic.
Identifying Healthcare Risk
Assessing every resident for their degree of frailty and the entire facility for the degree of facility frailty burden is an important first step in a comprehensive assessment of healthcare risk. Staffing ratios can be adjusted based on a unit’s exposure to risk from frailty. Likewise, a proactive approach for those residents most likely to fall or have another adverse outcome is supported by identifying frailty.
Finally, knowing the degree of frailty in an individual resident provides information to target those individuals most likely to be seriously impacted by COVID-19 or any other infection. Infection control surveillance is enhanced by identified frailty-associated risk.
Addressing Healthcare Risk
In nursing homes where frailty is not formally addressed, high-risk residents can be identified by experienced clinicians and professionals with an understanding of the cognitive and functional status of a resident. Both of these factors contribute significantly to frailty and provide more valuable information than the “eyeball” assessment for frailty. Minimum Data Set (MDS) information, where cognition and function is assessed, will also be helpful. Proactively identifying risks before they can cause issues is the key here.
As the risk management team carefully reviews every aspect of the nursing home’s care delivery model, it will be important for specific high-risk residents, such as those with dementia or other cognitive disorders, to be assessed. Their risk can then be documented and incorporated into a comprehensive, facility-wide risk management program. Staff training programs on risk management also can incorporate measures for managing healthcare risk.
Documenting Healthcare Risk
Healthcare monitoring organizations require detailed records of injury incidents as part of the regulatory oversight process. Documenting injuries, no matter how slight or seemingly insignificant, helps nursing homes avoid expensive fines and penalties. This documentation can be of great value in cases where residents or family members file legal claims against a given facility.
Likewise, documenting individual risk potential for adverse outcomes along with the proactive approaches taken to mitigate the risk is beneficial to care and to avoiding unwarranted litigation. With a risk management plan in place, nursing home facilities can more adequately provide care without incurring excessive risks, adding value to resident care.
Healthcare Risk Matters
In 2021, wherever you care for those with chronic illnesses, frailty, or other vulnerability, an understanding of their risks will be important to their clinical care. Identifying any risk early and often allows nursing home professionals the opportunity to forestall, reduce, or manage resident healthcare risk from frailty.
Please contact us to learn more about frailty and its impact on risk.