Nursing home leaders share COVID-19 infection prevention lessons learned

Not only are nursing homes and their vulnerable residents among the hardest hit by COVID-19, they also run the risk of being fined if there is a significant spread within the care setting. In a recent infection prevention roundtable hosted by Medline, leaders say they’ve come a long way since the outbreak first began, and have identified the resources they need to enhance preparation efforts for infectious disease outbreaks.

“We moved from a wild unknown to being very strategic about controlling the things that are within our control, like testing, access to testing, proper use of PPE, policies and procedures and visitations – things that we know will reduce the spread,” says Erin Hennessey, CEO of the Health Dimensions Group.

Rather than focus on placing blame or resorting to calling COVID response a failure, Hennessey and other experts say facilities need to look back to effectively advance infection prevention efforts.

Roundtable participants identified three key lessons they’ve learned this year to help set themselves up for a successful future.

1.      Increase funding for staff and promote engagement

COVID-19 has heightened the critical role staffing plays on emergency preparedness and response. Compared to acute care facilities, which may have one nurse for every two to three patients per shift, a nursing home or an LTAC facility may have only one nurse for every 10 to 15 patients. Similarly, staffing resources are among the biggest differences between one star and five star rated nursing homes.

“The average length of stay in a nursing home can be nearly two years. The facility becomes the patient’s home, which can increase their risk of exposure to infectious diseases. In order to manage these outbreaks more effectively, they need to have more staffing resources and additional funding available to effectively train staff,” says Rosie Lyles, Medline’s director of clinical affairs and a board member for the White House Commission for Coronavirus for Safety and Quality in Nursing Homes.

Hennessey also echoes that staff engagement is key.

“Our communities with the highest staff engagement have really faired the best during COVID-19,” she said. “Clear communication with staff will allow them to play a critical role in the organization’s strategy and help them feel confident in their ability to care for residents during such vulnerable times.”

2.      Shift focus from 5-star rating

Steven Littlehale, chief innovation officer of Zimmet Healthcare, pointed out that leaders should focus less on 5-star ratings as a measure of how well facilities are combatting COVID. “This is because, among the few published studies that look at 5-star ratings in relation to COVID, none reveal a correlation between for-profit status and 5-star rating,” says Littlehale.

He adds, “Five-star is good for many, many things but it’s not good for predicting  if a facility will have residents with COVID-19 or how they will fare if they do.”

Scott Rifkin, CEO of Chief Atlantic Healthcare and executive chairman of Real Time Medical Systems, an intervention analytics solution, also observed no correlation among facilities his company has evaluated. “We look at about 1,000 buildings every day and see no correlation between the star rating of a building and service history and whether they got slammed with COVID,” Rifkin says. “It was just about as random as you can imagine.”

3.      Use data to prepare for the future

Rifkin and fellow roundtable experts encourage facilities to focus on leveraging data from electronic medical systems (EMRs) to uncover insights that can lead to better outcomes. After they first identify what syndromes indicate that there may be a problem, facilities can use data from EMRs to monitor and track syndromes in an automated fashion.

Rifkin explains, “When you operate 30 or 40 buildings, you don’t want to have to wait for the people in the nursing homes to recognize that there’s a problem, because if the process is manual, you’re going to be behind the curve by the time you realize what’s happening.”

Early recognition and data filtered to the right software can give facilities the chance to intervene earlier on and limit negative outcomes. But while facilities have lots of rich data within their EMRs, according to Rifkin, not much of it is being analyzed in a significant way today.

“The ability to harness that information is going to be critical in dealing with pandemics and to achieve the type of outcomes the world expects,” he said.

Attendees of this year’s AHCA/NCAL Convention & Expo can watch the full video of the roundtable, titled, “Approaching Infection Control Using Best Practices from Today, for Tomorrow, and into the Future” through the convention’s list of on-demand sessions.

Learn more about how Medline is helping post-acute care operators be more resilient and prepared.