I was pleasantly surprised to see a follow-up article in the Philadelphia Inquirer regarding the Philadelphia Veterans Nursing Home and how it managed to make tremendous improvements with respect to patient care and safety. As we recently discussed, this VA facility miserably failed to provide adequate care for its patients. Less than one year after reports documenting; bed sores, filthy living conditions and general patient neglect was made public, the facility has implemented changes that dramatically improve patient care.
Seven months after the embarrassing report was made to VA officials, an unannounced inspection revealed ‘dramatic improvements’. After an in depth inspection including: meeting with every resident, talking with many resident’s families, physically examining patients and reviewing medical charts, inspectors learned that in every instance, the facility properly cared for each patient.
When addressing bed sores alone, inspectors could not find any patients who developed bed sores (also referred to as: decubitus ulcers, pressure ulcers or pressure sores) at the facility within the last five months due to improper care. This improvement in terms of pressure sure management is particularly impressive given the earlier report of the facility failing to intervene after noticing gangrene and maggots on a patients foot.
So how did the VA manage to turn around a troubled facility?
1) Make providing quality patient care a priority.
2) Learn where problems existed and investigate the full extent of the problems.
3) Reduce the number of patients.
4) Replace top-level managers who allowed poor conditions to exist during their tenure.
5) Hire more staff and specialists.
6) Ask an ‘outside’ organization to do an independent assessment.
Too often we (myself included) are too quick to write an under-performing facility off as just a ‘bad’ facility. The remarkable turnaround implemented at this VA Nursing Home demonstrates that change can come about.
Not surprisingly, as this situation reinforces, change must come from the top. In the case of private-sector nursing homes, parent companies, administrators and managers must take the initial steps towards improving patient care.