Do You Have a Program Designed to Reduce Fall Risk?

Senior woman in wheelchair with caregiver

How do you use technology to mitigate resident fall-risk & maximize independence?

The risk is real
The awareness related to fall risks over the last few years is staggering. One in five hip fractures results in a death within a year of the incident. One in four seniors that fall and fracture a hip, who used to live independently, spend at least the next year in an assisted living or nursing home environment. It’s also a little concerning how little, as an industry, we’ve done to mitigate the risk. Fall detection is largely a waste, the damage is done, and unless the resident is unconscious automated fall detection devices do little more than let you know the horse is out of the barn.

What can you do?
Fall prevention programs need to be comprehensive and targeted. Do you evaluate the medications your residents are taking and develop specific and targeted prevention programs if their medication puts them at increased risk? If a resident has had a previous fall, do you know the likelihood of them falling again compared to those who have never had a fall? Are you putting technology and processes in place to create an environment which reduces a resident’s risk of a repeat incident? Knowing the precursors of a fall is a critical component to prevent it from happening.

For further reading on the risks related to falls and the possible outcomes, often life threatening, visit the CDC’s Website on Falls for Older Adults .

If you don’t currently employ technology to prevent a fall then contact your sales representative
(sales@tel-tron.com) to talk about what it takes to be successfully implement a fall prevention strategy.

To learn more about the benefits of Tel-Tron’s unique fall management technology, click here.

Maximize the Potential of Your Emergency Call System

Are Senior Living Management Teams Out of Touch? The Senior Care Investor www.seniorcareinvestor.com thinks so. In a year where many strong companies in our market grew at an impressive clip, others faltered. During these periods of growth the challenges of bringing on new buildings in different states of disrepair, staff members from different performance cultures, and resident occupancy varying greatly by geographical market have restricted earning potential for even the industry leaders. To steal a quote from the SeniorCare Investor’s most recent publication, “When someone figures out how to profitably run a large chain but maintain a mom and pop feel, then that company will top the return lists every year.” Whether you are the mom and pop provider or you’re trying to create that feeling within your community, personal attention to detail and a level of concern for the quality of life and security of your residents is what creates the “I’m home” feeling.

Being there when a resident needs you, responding with the same passion you would to your own family, being able to know when you miss and make it right; these are just the first steps to creating the feeling of home. You’ve got dinner, the air conditioning, the community bus, and putting green to worry about. Let us tell you when to worry about a resident’s security and emergency health needs require your attention. Let us take care of the compliance to your internal policies.

There is amazing new and innovative technology being created every day by us and companies like ours that goes under-utilized. Many of you already own it and just aren’t taking advantage of what you’ve already bought. All you have to do is invest the time to better understand how knowing what you don’t know can change the lives of your residents.

Here’s a quick tip to ensure that your key team members are really in touch with what happens at the front lines of your communities. Follow the steps below to enable a notification sent directly to your cell phone every time a resident waits more than ten minutes for assistance. You may think your front line is staffed appropriately and responding with the same passion you would, but this will let you know for sure.

Log into your Auditrak reporting package at www.auditrak.com and select the My Auditrak tab.

Select the Contact Methods link on your My Auditrak page and ensure that your contact information is correct.

 Once your contact information is correct go back to your My Auditrak tab and select the link for Event Notification Setup.

If I were interested in Emergency Call events I would select that option from the list, it’s the last item listed in the above image, then select the option for Report after and change the value to 10 minutes.  If I select SMS as the notification option I will now receive a notification every time an Emergency Call at the selected community reaches 10 minutes without being responded to by the staff onsite.  This will give any executive a real time feel for what’s happening at the community level.  Allowing you to intervene and change the experience of your residents in nearly real time can make the difference between the feeling of home and the feeling that they are alone an uncared for.

If you’re interested in having a discussion or seeing a demonstration about how the systems you already own can allow your team to better focus their time on what matters most and ensure that leaders in your company know when things aren’t right on the front lines send me an email at mgraham@tel-tron.com or give me a call at 386-523-1078 so we can start the changes today.

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.

MOTOTRBO, Engenius, and the many other mobile ways we can alert your on-the-go staff …

Let’s say you operate a large assisted living property that spans several buildings over several acres.  Maybe even an entire gated community with hundreds of detached cottages and casitas.  Chances are your first responders to emergency call events will be your security staff who typically will carry portable, two-way radios that operate in the 400 to 470 MHz licensed frequency spectrum, possibly using repeaters to span your property.  To annunciate emergency calls to two-way radios, we offer text-to-speech voice and, in the case of the very cool MOTOTRBO, text messages that appear on the radio handset.

MOTOTRBO Licensed 400 MHz Digital Radio

Motorola’s MOTOTRBO™ professional digital two-way radio handsets are rugged, and have LCD screens that can display emergency call alerts. [See http://business.motorola.com/mototrbo/US/docs/MOTOTRBO_System_Brochure_1_08.pdf] The MOTOTRBO technology also provides two independent channels for the price of one FCC site license* (a second channel doesn’t require a second repeater — two channels are supported on a standard 12.5 KHz channel).  A common deployment scenario is to dispatch emergency calls out over one channel, and retain regular two-way voice for security personnel on the other channel.  Since we’re an authorized Motorola Application Developer (we developed a way to interface with our emergency call systems), we can also use Motorola’s Customer Programming Software (CPS) to tailor your MOTOTRBO system to suit your property needs. *Note: A FCC site license is not necessarily required. So-called “dot frequencies” are available (shared amongst many users) that do not require registration.  However, a FCC site license will guarantee no interference from others operating on the same frequency. Consult with Tel-Tron or your local radio dealer.

Two-Way Licensed 400 MHz Analog Radios

What if your security or care giver staff doesn’t carry text-capable digital radios? It is still a predominantly single-channel analog world out there for two-way radios, with many low-cost models to choose from. If your property uses a type that has PTT (push-to-talk) relay and audio inputs at the base station, consider our text-to-speech offering. When there is an emergency call event your radio-carrying staff will hear, for example, “Attention, Emergency Call, Apartment 101.” Similarly, when the emergency call event is cleared or reset, they’ll hear “Attention, Emergency Call, Apartment 101, Clear.”

Engenius Unlicensed 900 MHz Cordless Phone “Radio”

Does your staff need to be able to place and receive regular telephone calls and be in contact with each other over a large area, and at the same time be able to receive emergency calls?  The Engenius DuraFon 1X Long Range Industrial Cordless TM Phone System may be right for your facility. [See http://www.engeniustech.com/telecom/products/details.aspx?id=103.] EnGenius cordless phones allow up to 36 users to share 4 lines, and include push-to-talk radio, call transfers, and text messaging. The DuraFon 1X will also allow users to loudly broadcast to another user, a group of users, or all users. Emergency call alerts may be displayed as caller ID text (e.g., “Emergency Call, Apartment 101) and/or voiced by the Tel-Tron automated attendant.

Unlicensed 900/2400 MHz Cordless Phones

Less sophisticated and inexpensive cordless phones may be used by smaller assisted living facilities (generally low-power and cannot be “repeatered”).  As above, emergency call alerts may be displayed as caller ID text, and/or voiced by the Tel-Tron automated attendant.

Onsite Pagers

Unlicensed Pagers (those things from the 1980’s) are still a popular, low-cost way to alert your on-the-go staff.  Generally the transmitter base is powerful enough to reach across a large building.  Pagers are just one-way devices, without any voice capability.  Emergency call alerts may only be displayed as text messages on the pager screen.  [As a staff convenience, we also offer a popular “reminders via paging.”  For example, a particular caregiver may receive a page that states “Mary Jones, Apartment 101, Doctor Appointment, 10:00 am.”  [See http://www.tel-tron.com/scheduledreminders.php ]

Cell Phones

Nowadays, it’s a sure bet that your entire staff carries a personal cell phone. Most properties of course ask their staff to keep their personal cell phone in a locker while on the job to minimize distractions.  But some members of your executive staff may desire to be informed of emergency call events via a SMS text message on their cell phone.  We offer a high-degree of programmability when to send alerts; frequently Executive Directors only want to receive an SMS text if an emergency call event is not cleared within, for example, 10 minutes.  Such alerts can also easily be scheduled: the ED receives the alerts during the day, the Associate ED at night. [See http://www.tel-tron.com/ethernet.php ]

In summary, whatever mobile device your staff carries, we probably have an off-the-shelf way to alert them with Tel-Tron emergency call alerts.  Check out our website for other device examples (such as the Cisco IP phone).  [See http://www.tel-tron.com/cisco-phone-radio-paging-mobile.php ]

It’s your building. How will you know…..

. . . . if something goes wrong.  

If you are like me, silence is golden.  It means that the world around you is running like it is supposed to.  It means that all of your staff members are operating in full.  – But — What if something isn’t right?  What if your staff screwed up their response to an emergency call last night, but didn’t tell you.  Wouldn’t it be nice if you were alerted?  After all, you are in charge.  

I speak with many executive directors who manage their world with a flow that seems organic in nature.  With the help of a Tel-Tron, enterprise level emergency call system, they are able to do their tasks with the confidence that their staff is working as hard as they are and no stone goes unturned throughout the day.  The Tel-Tron system, alone, does not allow them to achieve this, but it frees up their mind from worrying about one small problem that comes with life threatening consequences. 

 From time to time, all of the staff is tied up with other functions and an emergency call may take longer to respond than normal.  Nobody likes to talk about it, but it is a reality.  Sometimes, things go haywire. 

The calm, cool and collected ED has a notification set up in Auditrak that sends a message if that e-call is not re-set within 7 minutes or what ever time frame is appropriate.  This is the time when the ED wants to be involved.  That Ed may go the entire day or week and never have contact with the wireless emergency call system that was installed in the building.  However, when things go wrong, it’s time to act. 

Daily Summary Report - Emailed Automatically

The Tel-Tron Auditrak management reporting tools are especially valuable for the corporate Director of Nursing or Chief Operating Officer.  Again, a silent nurse call system means that emergency calls and personal emergency response calls are getting their responses in a timely manner.  It means there is nothing to worry about in that one small category of their lives.  In short, it means the people that they have spent time and money to hire and train are doing their jobs.  Of course, the COO is not going to run and respond when his/her Iphone starts beeping with a text or email that alerts of the situation, but they will know that something is off and perk their ears up to pay attention.  Maybe repeatedly late e-call responses are a signal that more training is needed? 

That is what the Auditrak event notification system is all about.  Whether it is a late response to an emergency call or a low battery condition in a wireless call station, Auditrak is customizable for the user.  A Tel-Tron emergency call system is not only used to notify the staff when there is an emergency.  It is used to notify management when something in their world has gone wrong. 

Does your nurse call system, call bell system, emergency call system, wireless emergency call system, or personal emergency response system, (PERS) Notify You?

Enough Already. The PC has to go!

Dig hole in sand....Insert head!

All you have to do is read words in this picture, which was taken by one of our salespeople when touring a community that just installed a new emergency call system from a competitor.  WOW!  I cannot believe that someone would actually write that memo – clearly aware of the implications of not obeying – and think that just writing a note makes everything OK.

IT’S NOT OK!   You are tasked with making sure that a resident’s call for help gets answered.  And for lots of reasons, including this one, a personal computer is a completely inappropriate engine for an nurse call system.  In case you can’t read the picture, here is what it says.

“Please do not use this computer to go onto the internet.  This computer runs our nurse call system and is vitally important.  Thanks, Jane.”

Jane – Rather than writing a memo, you should have thrown that system out and replaced it with one that is not computer based.  Can any of you think of a single system that is a life safety device that runs on a Windows computer?  Please leave a comment to this post if you can.

Defibrillators? No.  Airplane Avionics?  No.  Dialysis Equipment? No.  Automobile Electronics?  No.

When you hear about someone who is on “life support,” do you think it would be wise to have that equipment run by a Windows computer?  No way.  So why is it OK to put the lives of senior living residents in the temperamental control of a Windows personal computer?  Short answer….It isn’t!  They freeze up.  They need rebooting.  Software needs updating.  They aren’t battery backed up for longer than a few minutes.  Really the list is endless.

Staff can close the program.  Staff can turn them off (on purpose, or on accident).  And, as in the case captured in this picture, staff can browse the internet while calls for help go unanswered.  It simply isn’t necessary.

On an enterprise quality nurse call system, the main servers, switches, routers and gateways use embedded systems, industrial microcontrollers, sophisticated power supplies, elaborate supervision and battery back-up methodologies.  There are design tolerances measured in sub-1% range.  User GUIs are browser based and access data on the system, but do not control the system.  Visit Auditrak.com, for an example of a killer call system GUI that resides in the cloud.

As I looked at the picture in the beginning of this article, I was so frustrated at the lack of seriousness with which Jane took her role as caregiver.  In fairness, Jane probably did not select that system.  Someone at her corporate office, who doesn’t have to respond to an emergency call – ever – probably picked it as a result of their beauraucratic purchasing system.  Still…the kind of compromise and accommodation Jane is forced into is simply not necessary.  There are other options.

Never Miss a Staff Rounds Check Again!

Many senior living operators have a problem.  There staff is supposed to be checking on certain residents on a regular basis, but there is no way to prove that it was actually done.   A quick software upgrade to your Tel-Tron emergency call system and you can guarantee that you will never miss a room check again.

Simply install a “staff check-in” device in each area where the staff is supposed to show up.  Tell the software how often a staff person is supposed to be in that area (hourly, daily, weekly, etc.).  If the staff check-in device is not used in the time window you set-up, an alert will be displayed on the system, alerting management and staff that a check-in has been missed.

For example….Let’s suppose that you are supposed to be doing 2 hour room checks in your dimentia units.  First, you install a “staff-check” button in each unit.  Then, you tell the system (through the software) that each unit should have a staff visit every two hours.  Now, let’s pretend that it has been two hours and no one has pressed the “staff-check” device in Mrs. Smith’s room.  You will get an alarm on your system – pagers, console, text message – whatever — that says “Two Hour Check Missed – Mrs. Smith, Room 1.”  The only way to clear that alert is to actually go to Room 1 and press the staff-check button.

No one likes to talk about it, but every manager knows that FORCED COMPLIANCE with policies and procedures is the best way to make sure the appropriate actions are taken.   With “Staff Check-In” activated in your community, you can be sure that all of your rounds are being completed.

(You can use this for building rounds at night, too.  Put a staff-check button in hallways, libraries, laundry rooms, or anywhere you want your staff to be on a regular basis.  Then tell the system how often they should be there and you can be SURE that your staff did what they were supposed to do).

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