VERY Key Metrics – Ignore At Your Own Peril

Tel-Tron powers the systems technology at roughly 1,000 retirement communities, improving the quality of life for over 100,000 residents. We work with over 200 senior living clients and have a very long-term understanding of the good, bad and ugly of senior housing management.  I’ve been tempted to start a blog series on things I would do if I owned a senior living company or community.   Given the challenges we’ve helped folks through this week,  that temptation is growing harder and harder to resist.

Let’s consider this post the prologue to that series, which will provide a behind-the-scenes, outsider’s, perspective on some very fundamental changes senior living executives could implement that would change everything for them.  Here is an example.

Visual Management of Staff Response to Resident Emergencies

Here are a few snapshots from a daily dashboard – available to any Tel-Tron user – from Auditrak.com.  Check out these statistics and see if you agree with my recommendations.  This is a real-life 80 unit assisted living community, with a fairly aged population.  The staffing levels are similar to sister communities of similar size, but the needs here are apparently greater than the staff can handle effectively without intervention.

Take a look at the activity level for just the last 24 hours on this real-life emergency call system.  What we see is a disaster. If I were the Executive Director of this community, this would have my undivided attention.  What I see is that in the last 24 hours, there have been 74 emergency calls, most of which originated from a resident pushing their wireless necklace pendant.  The balance were from pull cords in the bedroom, with only a small number of alarms originating from a pull station in the bathroom.

Daily Activity Snapshot

THE AVERAGE RESPONSE TIME IS 42 MINUTES!!!!  The longest alarm took 6 hours.  One has to assume that the 6 hour alarm has some explanation, but the average is 42 minutes.  In fact, a resident living at this community would be far better served by calling 911, rather than using the emergency call system installed in the community.  What, I ask you, other than poor training, indifference, lack of understanding could cause the people responsible for caring for these residents to think this average is acceptable.

Let’s look at a Chart 2, also for the last 24 hours, which will show us the call distribution by hour for the last 24 hours.  What we see is that the average number of calls per hour is approximately 4.  There appears to be a peak before the dinner hour, and again between 10pm and midnight.  Even still, these peaks only represent 7-9 calls an hour.  Not a very heavy workload by any measure.

Chart 2

Next, let’s take a look at some performance gauges that this community has set for itself, using their own targets, in the three areas relative to staff response.

Performance Gauges

We already discussed the average response time.  Notice their own internal target is 5 minutes, with 8 minutes being allowed.  The longest response time has been discussed already, too.  The last metric, % of responses outside their target threshold, 72%.  An overwhelming majority of their resident emergencies are taking staff longer than 5 minutes to respond.  I know.  Not every alarm is an emergency.   However, there is no way to know the real alarms from the non-emergency alarms until staff responds.  It is imperative to treat each alarm as the real thing, or else when there is a real alarm it will be a disaster.  Worse yet, an avoidable one brought on by complacency.

Last chart.  This one is about profitability, which may make hiring more (or better) staff a reality for this community.  This is a chart that shows the top users of the emergency call system.  Take a look.

Frequent Users (and abusers)

Remember, there were 74 emergency calls in the last 24 hours.  These 7 residents alone accounted for 71% of the calls placed over that period.  They should be paying more than others.  Whoever is in room 218, if this is continuous over time, should be paying even more than the other 6.  They are using the emergency call system 3X as often as the person who is number 3 on the list.  Assuming each alarm takes 5-10 minutes of staff time, this single resident is getting 1-3 hours of staff time  - daily – that other residents aren’t receiving.  I’d charge for that somehow.

Surely there are a number of factors that go into determining how much a resident pays for assisted living services.  The amount of staff time consumed by excessive use of the call system should be among them.

These are just a few examples of the kind of data that is available on the Auditrak.com service.  These 4 charts are on a daily dashboard that is emailed to executive directors (if they request it), making review of the numbers almost effortless.  Failing to review these numbers – which is apparently the case at this community – results in poor performance across the board.  My guess is that their resident surveys aren’t that great either.