Taking Healthcare by Storm: Industry Insights with Haley Moore & Jennifer Graley

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Haley Moore, NHA, and Jennifer Graley, RN, from Valley Center.

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. 

This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-GEN-071924-GK

Transcript

Welcome to Taking Healthcare by Storm, Industry Insights, the podcast that delves into the captivating intersection of innovation, science, compassion and care.

In each episode, Quality Insights Medical Director, Dr.

Jean Storm, will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists and brave patients navigating their own healthcare journeys.

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

Hello, and thank you for joining us today on Taking Healthcare by Storm.

I am Dr.

Jean Storm, Medical Director of Quality Insights, and I am so excited and delighted for our two guests to join me today in this inspirational conversation.

Today, we are being joined with Jennifer Graley, RN, and Haley Moore, NHA.

Jennifer Graley is the Director of Nursing at Valley Center in South Charleston, West Virginia, and Haley is the Nursing Home Administrator at that facility.

And I will just say, I have personally witnessed the culture change that they can accomplish in a facility as I've worked with both of them.

And today, we are gonna be talking about resident and family engagement at Valley Center.

Jennifer and Haley, thank you for joining us.

Thank you for having us.

Yes, I'd second that.

Thank you for having us.

We're glad to join.

So let's start off.

Can you tell us how you came to do what you do?

Well, it was pretty easy for me.

I knew early on that I wanted to make a difference in long-term care, just because with my family's history, a lot of folks in my family, several of my grandparents had and battled with different forms of dementia.

And I just, I recall spending some time in the nursing home, observing quality and environment at a really young age.

And that really drove me early on to want to pursue a career, not only in healthcare, but specifically in long-term care.

Yeah, that's really important.

And I think your heart really needs to be in it.

It's challenging.

Have you lived in West Virginia all your life?

Yes, I've always lived in West Virginia.

My dad was military, so he kind of was all over the place, stationed in Hawaii and whatnot, but I have always resided in West Virginia.

Very nice.

I will say I lived in West Virginia for a time and actually was a medical director at Valley.

And I feel like my heart is still really in West Virginia.

It's kind of that type of place.

And so how do you feel the culture changed in long-term care facilities on a whole during the pandemic?

So, during the pandemic, it was hard on not only the staff and residents, but family members.

I just remembered, I could still remember the day, March 6th, 2020, just everything really shutting down.

And at the time, I was at a facility two and a half hours away from home.

So that was hard, because I really didn't understand how my world was gonna change in terms of work responsibilities and whatnot.

Just because when this happened, and I watched nursing homes really all around the country, experienced major devastating outbreaks, our facility, thank goodness.

And I think just because West Virginia just was kind of late to the game in terms of the COVID spike, I was thankful because we really didn't see our first positive until halfway into the year that the pandemic began, so we were very thankful for that, but just what we had to do to ensure that we didn't go through outbreaks, which was really that we followed CMS and CDC guidelines and just the visitation restrictions, PPE, we're wearing PPE at a level that healthcare workers, I don't think we're ever used to.

Mask compliance, wearing, donning and doffing PPE correctly, they never really were used to that kind of world.

So, I'm studying that right now from a different perspective in my thesis, but so that's a whole other conversation, but yeah, just, I think it impacted everyone, just in a very negative way.

And I don't think that, I don't think any of us are really fully recovered from what that did to us, mentally, as healthcare workers, but also just the world.

You know, so I think it really changed the way we operated, the way we treat infection prevention, which is, you know, that I never, as an administrator, I mean, we knew basic things.

But I, you know, I just to share, I'm not, you know, clinical by trade.

So I never really engulfed myself with that kind of knowledge, but I really, you know, wanted to ensure that I could do my part to ensure that we did not, you know, constantly have to go through major outbreaks or I could prevent, you know, people that are very vulnerable from getting COVID, at least to the best of my ability.

And so I think it changed with what we're expected to, you know, have knowledge of to prevent any kind of devastation from happening at our facilities.

So I mean, it changed in that regard.

It changed from the regulatory side and what we're expected to be compliant with in a big way.

And so, I mean, I think there's so much I could say on that subject, but in short, it changed a lot for us.

Yeah, I was going to say, like, you don't feel that the culture in the facilities has kind of returned to its baseline like that it was prior to the pandemic.

Oh, no, I think that's going to take quite a while before we ever reach.

And I don't think it'll ever be the same.

But, you know, I still see facilities that are not even opening their dining rooms, you know, and, you know, doing activities completely different.

So I mean, I think there's there's a lot of change that's going to need to occur.

But I know, you know, my focus is to get it to be to being a home again.

You know, we're we are a home first and foremost, and I think our government, I think our companies, a lot of us lost that, you know, perspective that this is a home with people that have rights.

Yeah, that is I mean, that's such an important thing to remember.

So you know, talking about you talked a little bit about some buildings that don't have their dining rooms open.

So infection control is still a challenge, even though we learn so much during the pandemic.

We're still fighting that infection control site.

Absolutely.

And I think I think a lot of, you know, I think a lot of facilities, their their teams are just are scared of going into that.

I guess maybe, you know, scared of going into that outbreak mode again, although it's it's changed.

And I don't think a lot of places have realized, you know, we move on.

You know, we move on with, you know, cultivating a culture where it is a home, you know, and I think a lot of people have forgotten that.

So I do think it's going to take a long time really for for facilities to get caught up to to that pre pandemic mindset.

Yeah.

So, you know, closely linked to infection control or vaccinations.

Do you feel that residents and families are still cautious about vaccinations?

Well, I would say I can't even say that it would be 50 50.

I mean, I do think there are a lot more that are more educated.

I know staff are more educated, you know, because we have to ensure that they are, you know.

So they're more they understand it better.

I'll say that.

Families though, I think a lot of people like just the general public are just like, you know, when when they announce the end of the pandemic per se, you know, they're just like COVID is not here anymore.

So I mean, I still have families like if we have, you know, because it doesn't take much for us to go into an outbreak if we have one resident or three staff that triggers an outbreak.

So, you know, we've had that here and there because people, you know, they go out of town, they go to family gatherings.

I mean, it's inevitable.

But the spread is what we can prevent.

And I think a lot of families and even residents feel like, you know, COVID just went away and they're shocked when they hear that, you know, it's come back.

So that's been a battle.

And just, I know one thing that I do is just to keep them updated, you know, with what's going on.

And our infection preventionist does a really good job on, you know, notifying of this is where we're at, you know, this is what we need you guys to do when you come into our home.

And we, you know, we send out family notifications, like this is where we're at, you know, this is how many staff members we have that are positive, this is what we're doing about it.

If you have any concerns or issues, just opening up that floor to say, Hey, if you notice something, let us know.

And, you know, most recently, we had a little uptick, we had a couple staff members that were positive.

So of course, you know, we alert our families and residents about that.

It doesn't stop, you know, unless it's like a mass, you know, outbreak, it doesn't really stop visitation of any sort.

Can you still hear me?

Yes, I can hear you.

I was just going to jump in.

We were joined now by Jennifer Graley, RN, who's the director of nursing.

I really appreciate you joining us, Jennifer.

I know you're super busy and being pulled in a million directions, as is every director of nursing.

Oh, I'm honored to be on here with you.

I love you.

Yeah, just to decide, I worked with Jennifer when I was the medical director, so we can go way back.

We were talking a little bit about vaccination.

How do you feel like the residents and families are getting their information about vaccinations now?

Well, I think it's just kind of like the way we get our information.

You're going to have your anti-vaxxers that kind of have their theories and policies, and then you're going to have your people that follow the public's health initiatives and do their best to protect everybody.

And I say we probably have like a broadband of both groups of people here.

Yeah, I can understand that's challenging.

So what about resident council at Valley Center?

When I was there, I think I was there maybe about six months ago or maybe a little bit more.

We were talking about resident council.

So tell us how resident council works at Valley.

So I'll chip in.

Yeah, and then you could chip in too.

So what we do is we invite all the residents to resident council.

And that means, you know, activities is going room to room, letting them know and it's on their calendar.

So they're, you know, the calendar is posted throughout the center.

They know when the date is.

But just as a reminder, because we want the max participation, you know, our mindset is we want to tackle any kind of problem, you know, before really it blows up, honestly, because we know that that's how it works.

So we eat the frog, you know, that perspective.

But we want, you know, we want the max participation as possible.

Residents will join in the dining room and it's really their meeting, you know, we may we facilitate it, we ask permission if we can join as the, you know, administrative team, which this this center is kind of different.

They like all the department heads to participate.

So we do our best as possible and try to get everybody, you know, like dietary, environmental, etc.

to participate so that they are aware of what, you know, the residents praises or concerns just kind of where we're at.

So that's kind of how we have it set up.

You know, we have a president and a vice president that kind of co-heads, co-head facilitates the meeting and it's open for discussion.

So that's that's kind of how we run it.

Jennifer, do you have anything to add?

No, I mean, I enjoy going to resident council because I would I prefer for them to tell me what we can do to fix, you know, any issues that might be in the facility.

I know food is always a big issue they like to talk about, and I really like their feedback because it really does make a difference in what they get to enjoy.

I agree.

So you feel like the residents are really eager to provide input for important issues?

Yes.

Yes.

That's fantastic.

So what about the family forum?

So Haley, you and I kind of talked about the family forum last time I was there because this is the first one that I had heard of in any facility.

And I think I've been medical director at six facilities across two states.

So let's talk a little bit about the family.

I'm calling it a family forum, but I think you have a specific name for this forum, correct?

Yes, I call it the Family Involvement Committee.

I started this at another center that I was at previously.

And I started it actually during COVID, because they weren't really aware of what was going on, but they would constantly get phone calls or just updates from their loved one.

And they would always follow up with me via email or phone call.

But we were at a point where we did daily Zoom meetings, and then we tapered down to weekly Zoom meetings, and then we made it like a monthly touch base kind of deal.

So, I just thought, why not have a Family Involvement Committee that's kind of treated like Resident Council in a way where we kind of review the same data.

And we talk about what's going well, what's going not so well, and how we can make it a better living environment.

That's really the goal is just like Resident Council, we want to make it the best home-like environment as possible.

That's what the goal of the Family Involvement Committee is.

And my hopes were still not where I need it to be at Valley.

But my hopes is that we have a big committee that essentially runs itself, and they feel able to bring those concerns or volunteer involvement.

So there's just a lot of opportunity with the Family Involvement Committee with the relationship to the facility.

Kind of like a PTO would be for a school.

Yeah, exactly.

Yeah, I think that's a great idea.

Is it hard to get families interested to actively participate?

I think it's just so new here.

And in the past, I don't think they were used to having that kind of forum or even that kind of voice.

And so I think that's what's kind of been the holdup.

But I'm seeing at least two to three new people at each meeting.

So that's a positive sign for me.

Eventually I want the same people to be able to come to the meeting all the time.

And so I think it's opened up a whole other window of communication.

Yeah, I can imagine.

And at the meetings, are families, are they eager to provide input on important issues?

Yes, that's what we really start off with.

We really just say, hey, this is a, don't hold anything back.

We want to know the good, the bad, the ugly.

And I think just opening it that way gives them the autonomy to share their concerns.

And I think the proof has kind of been, I'll just say the proof's in the pudding.

Our Google reviews have, they're honest reviews.

They're not reviews that we have been like, hey, please give us a Google review.

These are Google reviews that people have left.

Families have left because they feel the difference.

They feel that connection towards our staff.

Just giving that autonomy back to them, I think has been a big changing point for Valley Center.

Yeah.

And I will say, I bet communication is like the key for making families feel comfortable with what's going on.

So what is the best way of you found to communicate with families?

Well, and I think Jennifer would agree to this.

I think just be giving them that 9-1-1 line, you know, giving them the cell phone number.

You would think that giving them your cell phone number, because I've talked to many colleagues and they're like, oh, we'll do that.

You're going to get calls 24-7.

That's really not been the case.

I mean, most of our families are very respectful of time.

They're aware of, you know, what our normal, when I would normally be here, you know, very, very seldom do I get a phone call at midnight, although sometimes I might, you know, if there's a real concern.

But I think just giving them that landline, and I know Jennifer has done the same, that they can call if there's an immediate issue that, you know, they feel that needs to be resolved.

That's amazing that you both do that.

I mean, I think it just brings peace of mind.

I can't imagine not giving it to them.

I don't want them to call anybody else.

Like, I want to own it.

Yeah, I would agree.

So we talked a little bit about what you've learned in Resident Council about what's important to residents, like food issues.

So what are some of the just a little brief list of what are the most important things to residents?

To residents?

Oh, go ahead, Jennifer.

No, you go ahead.

I think you really wanted to say something.

But we said food, so probably that's like at the top of the list, right?

Yes, yes.

And you know, you and I always talked about this when we worked together.

That's the last thing they get to enjoy and have.

You know, a lot of our people, they don't, they can't leave to go to activities.

So this really gives them their enjoyment.

And I know when I have family members who are passing, you know, that's something that the family is involved in as well.

And I think food is probably like the last, the greatest thing that we can do for them at the end of their life.

Yeah, I would agree.

And I think sometimes that goes by the wayside, I think in long-term care facilities, but I would agree.

So, you know, maybe something you've learned in the family involvement council, what is the most important thing, some of the most important things for families?

Well, I would say, you know, most families are already guilty that the fact that they have a loved one in the nursing home and that they could not provide the care, you know, that we can to them.

So that I'll say that first and foremost, they really want to make sure that their person is safe and is comfortable in their own home.

You know, they already have that guilt, I will say.

And so just adding that piece and assurance that somebody is taking care of them, of their loved one, you know, and building that trust is key.

Yeah, hugely important.

So last question, and maybe this is a ranger question, and no answer is off base.

Maybe we can't say any swear words, but no answer is off base.

Dr.

Storm knows I'm on here.

So let's start with you, Jennifer.

This is the same question, so whoever wants to go first, let's say this.

If you were in charge of healthcare in the United States, what is the first thing you would do?

That's a really good question.

I would work with the nursing population and talk about what it means to manage someone's healthcare.

I think sometimes we forget that we have to manage the whole person, mind, body, spirit, soul, and physically.

A person may have a poor prognosis, and we know they're going to have bad outcomes, but that doesn't mean that they can't still have joy in their life.

Yeah, person-centered care is so important.

I agree.

We need to get back to that post-pandemic.

Haley, what about you?

I couldn't agree more with Jennifer, but from an administrator's perspective, we've got to get to...

There's two things.

I think we've got to equip our leadership with...

You can do any kind of skill, right?

But the leadership development aspect, we've got to be able to handle crisis management, emotional intelligence.

That's just one perspective.

And then the other side is we've got to change the mindset of what the regulatory routine is and what that's for and not just be a cleanup.

An audit is what you're doing.

The good things that you're doing should come through, not just the punitive side.

And I think a lot of places are just trained for that.

And I think that's something that we've got to work to fix in long-term care.

It's got to be a relationship.

If we do the right thing, everything will work out.

Do the right thing for the right reason, and then everything will be okay.

Well, thank you so much, Jennifer and Haley, for being here.

I really appreciate it.

I can't stress enough how inspiring you are to me.

I know this we call, we say healthcare heroes, but I say, I'm going to say sheroes.

I love that.

You're both sheroes in my book.

So thank you so much for joining me today.

Thank you for having me.

Thank you for tuning in to Taking Healthcare by Storm, Industry Insights, with Quality Insights Medical Director, Dr.

Jean Storm.

We hope that you enjoyed this episode.

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If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website.

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So until next time, stay curious, stay compassionate, and keep taking healthcare by storm.

Thanks for watching.