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Why Are Your Residents “Gaming” the System?

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By Susan Saldibar

Press…Press...Press (repeat).

A resident is pressing her call button every 5 seconds. Over and over again. What’s the emergency? There is none. Not yet. But she may need to go to the bathroom in another 30 minutes and wants to make sure someone comes to help her in time. Smart lady. She’s gaming the system. Too bad she has to.

Nothing provides a starker contrast to “person-centered” care than a resident having to navigate around a call system. What’s wrong here?

I spoke recently with Jacquie Brennan, Vice President of Vigil Health Solutions, (a Senior Housing Forum partner). Jacquie tells me that she hears these kinds of “chronic button pressing” stories frequently. The reasons vary depending on the community and its particular challenges. Jacquie tells me that some communities she visits tell her they struggle to organize and motivate an ever-dwindling staff to respond quickly and efficiently to the needs of their residents. One of the symptoms? Chronic button pushing.

We talked about how communities might better address this problem without having to add staff or cut corners in the quality of care. Here are two areas that, collectively, may help eliminate the need for residents to hit the call alert button over and over again.

  • Creating standards and benchmarking. We’ve covered the subject of call response time standards before. Back in 2015, Jacquie floated the idea that benchmarking call response times might benefit senior living communities. She got a few comments, each of which expressed enthusiasm for the idea. One responder even thought standards already existed and was “surprised to read that there are no industry standards” for call system response times.

    But for those communities that pay attention to call response times, the results speak for themselves. Consider a time study Vigil did with 500 communities. “We recorded an average response time of 8 minutes for calls that are not related to system supervision,” Jacquie told me. “The top 10% of sites averaged a 2-minute response time.” That’s more like it!

  • Saving valuable staff time through sensor technology. There are several ways that technology can come to the aid of an overworked staff. A good example is using sensors to determine normal movement patterns and alerting only when these patterns are broken. As an example, Mr. Jones’ normal behavior may be to sleep through the night. So if sensors detect he has left his bed, an alert would let a staff member know to check on him. Otherwise, he can be left alone to enjoy his sleep. One less “check-in” for staff to make. Multiply that by several residents and you are freeing up considerable time for staff to be more responsive when that call comes in.

How would all this help that 85-year-old woman hitting the call button over and over again? “When we use sensor technology in smart ways, staff members are able to focus their time on those residents who really need their help, rather than spreading their care across all residents, all the time,” says Jacquie. “Furthermore, developing standards increases awareness. When we are aware there is a standard to be met, we are more attuned to meeting it,” she adds.

It’s no secret that one of the top issues in skilled nursing and long-term care is the concern over neglect. Fairly or unfairly, many families continue to have nasty images of loved ones unable to get out of bed, lying in a wet bed, or lying on the floor after a fall. They have images of buttons being frantically pressed to no avail.

Residents should have confidence that when they hit a call alert button, they will get a response in less than 10 minutes. Better yet, with the right sensor technology in place, help should already be on the way. No pressing needed. That’s a goal worth aspiring to.


For more information about Vigil Health Solutions, please visit their website.


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