September 10, 2007
St. Mary's receives national award for continuity in quality health care
Of the 17,000 nursing homes in the country, St. Mary’s is one of only 13 to earn a 2007 national quality improvement recognition award
By Linda Scherer
Imagine a health care facility allowing its residents to set their own daily schedule. The residents decide when they want to wake up in the morning, when they want to eat their first meal, and are able to make other meal choices throughout the day.
It is an innovative idea that St. Mary’s Care Center in Winsted adopted in August of 2006 after planning for almost a year before implementing it.
The benefits have been amazing. “It makes it easier on the staff. We can show that if we just let residents wake up by their body clock they will have a better quality of life. Happier residents make for a happier staff,” Administrator/CEO of St. Mary’s Care Center Andy Opsahl said.
St. Mary’s is continually striving to improve on its current quality health care and is one of the reasons it has earned the 2007 National American Health Care Association (AHCA)/National Center for Assisted Living (NCAL) Quality Award.
Of the 17,000 nursing homes in the country, St. Mary’s is one of only 13 nursing homes to receive the award this year.
The award will be presented at the AHCA/NCAL’s annual convention and exposition, Sunday, Oct. 7 to Wednesday, Oct. 10, in Boston, Mass. Accepting the award will be Director of Nursing April Anderson, Rehabilitation Floor Clinical Manager Kristi Fenske and MDS Coordinator Shellie Otto.
Opsahl, who has been head of St. Mary’s since November 2004, explains that the award is based on continuous quality improvement.
“It is reflective of the quality care we provide right now, but also that we have systems to back up those results and make sure those results will continue,” Opsahl said
Originally from Mora, Minn., Opsahl was an assistant administrator at Lexington Health Care in St. Paul before coming to St. Mary’s. It was an inner-city facility that dealt with a lot of rehabilitation and transitional care.
He also grew up with parents who had been working with long term health care for as long as he can remember. His step-father started numerous health care facilities throughout the state.
Many evenings, family conversation around the dinner table would be about leadership and management, Opsahl said.
Given his past experience in health care, and enjoying the problem solving part of his job the best, Opsahl has helped his staff move through some major changes at St. Mary’s in the short time he has been there.
“I like the possibility of creating something good or new or different,” Opsahl said. “To offer not only to your employees but to the community.”
The dementia program has been one of the areas that has seen a lot of changes.
To create a better environment for the dementia residents, it was suggested that their behavior might improve if they were allowed to sleep later, and have meals accommodate their own schedule.
When the dementia floor changed its routine, the entire system of the facility was altered and all workers involved had to change too.
Previously, a day in the center would begin with the housekeeping staff turning on lights at 7 a.m. and beginning its cleaning routine.
“It created a bottleneck. Everything needed to get done by 8 am,” Opsahl said. “Ninety-five percent of the residents had to be up before 8 a.m. We would have to wake up 70 people to get them ready in the morning. The residents felt demeaned to get up according to our schedule, and that is not good for them.”
Now, lights are off until 8:30 a.m. Opshal describes a calmer environment. Residents are more rested. Because residents with dementia are rested, their behavior has improved, Opsahl said.
New residents coming in don’t have to adjust to a new schedule either.
Lucille Fleischacker Meyer of Winsted is at St. Mary’s for just a short term stay while she is going through therapy. She was very positive about the opportunity given her to sleep in that morning.
“I had a long, long day yesterday. It was my first time out and I got so tired. I stayed in bed until almost 10 a.m. Then I got up and went right to church,” Meyer said.
With a different morning routine the meals have changed too. The breakfast has been replaced with a continental breakfast for people that are early risers. Everybody else can get up when they want.
The center prepares two main meals offered after the continental breakfast. Also, a substantial snack and an evening snack. The nutrition is the same and seniors maintain or gain weight which is a good thing, according to Opsahl.
“The Minnesota Department of Health is completely sold on the eating plan,” Opsahl said. “They can’t force anyone to do it, but they have seen the quality results.”
St. Mary’s staff is a dream team
April Anderson, director of nursing, came to St. Mary’s as an interim director about three years ago. She liked the spirit of the center and the teamwork that was happening.
As a consultant for a major corporation, Anderson had been in approximately 3,000 to 4,000 nursing homes. After two weeks she went to Opsahl and asked if he would consider her for the director position.
“I have never regretted it. I can’t say it enough. St. Mary’s is a dream team,” Anderson said.
She complimented Opsahl.
“He is always willing to look at new things. He is a visionary,” Anderson said.
“We talk to everyone that comes in and ask what would you like to see? What would you want improved? We have a quality improvement system board where we ask for suggestions every month from the employees,” Anderson said.
Her enthusiasm for St. Mary’s is obvious as she lists all of the things that make it so unique.
St. Mary’s is a Benedictine health care system promoting the four core values of hospitality, stewardship, respect, and justice.
“I tell the nursing staff the Golden Rule, ‘Do unto others what you would have them do unto you,’” Anderson said.
The nursing staff recently began electronic charting, called Point of Care documentation, which was just implemented this summer and has been very successful.
All of the necessary information provided by the nurses, nursing assistants and rehabilitation personnel is entered into a computer program.
“We are the only one in the rural area using electronic charting. North Memorial Hospital isn’t even using it yet,” Anderson said.
By having the patient information in the computer, it is easy to read, and “Doctors hook right into us and they can even work from their homes,” Anderson said.
Anticipating the needs of staff without a lot of computer knowledge, a Squeak Squad was built in to support and train the inexperienced. The squad’s motto is “You squeak, we tweak.” They have been made available to all staff on all shifts.
In addition to the electronic charting, software called smart therapy interacts with the electronic charting system to bill outpatient and inpatient therapy.
“It frees up an entire day for the staff so they don’t have to spend it on billing. That makes an impact on our patient interaction,” Opsahl said.
Therapeutic recreation manager Michele Muller, who also handles spiritual services and works with volunteers, has been at St. Mary’s since 1984 right out of college at St. Cloud State University.
She has a degree in recreation and a minor in therapeutic recreation.
Activities that are offered at St. Mary’s are based on residents’ assessments, Muller said.
Mass and communion are offered five days a week. Other activities include bingo, picnics, outings like visiting Carlson Apple Orchard, bowling, reading, and current events. Sunday afternoon there is an accordion player who comes. This is something new the care center has been offering and the residents seem to like it, Muller said.
“I try to provide programs that fit the interests of the residents. At our resident council meetings we ask them what they want to see. What do you want to do? Any concerns?”
Muller also feels the facility works together as a team.
“One of the things that I think we can be proud of is our dementia care,” Muller said. “We have trained everyone in dementia care and have started programs that just focuses on our garden level with dementia. It is a different program for people with shorter attention spans.”
Muller considers Fr. Eugene Brown’s presence a blessing. Also, having Sister Mary Ellen McGraith present.
“Sister Mary Ellen McGraith has been a God sent. She does the spiritual visits, the programs and she gets the volunteers for the liturgy groups,” Muller said.
A St. Mary’s resident, Eleanor Yurek Kucera of Silver Lake, who has been a resident at St. Mary’s for one year, could not say enough good things about the facility.
Kucera said, “I like everything. I like the place, I like the people, and I just like everything. I have no complaints. I love it here. If I had to go home it would be pretty hard.”
Always looking ahead to make things better
New ideas and suggestions are continually being evaluated.
As far as future projects, one project Opsahl would like to see is ceiling lifts installed. It would save a lot of effort on the staff’s part to get a patient out of bed, and it would be easier on the patient as well, according to Opsahl.
In therapy, ceiling lifts would allow a patient to walk without fear of falling. An example would be having a ceiling lift installed over a treadmill.
Another possible future change the center is looking at is making the bathing system more spa-like with foot-soaks and manicures. Specially trained people would be involved, allowing residents to enjoy “a day at the spa,” Anderson said.
Old Blue is ready to retire
A new bus is on the care center’s wish list. The current bus, called Old Blue, is 23 years old and in need of retirement.
It is used for family outings to different events, taking patients to appointments, and is used for the needs of assisted living at Linden Wood Apartments.
The new bus St. Mary’s is looking at is a 15-passenger bus with a wheelchair lift and wheelchair tie-downs for four to five wheelchairs with an estimated cost of $48,000.
Todate, it has received $26,500 which has been collected through the efforts of a few community members who are working to make the bus possible.
The bus task force is comprised of Helen and Woody Yager, Dick and Joan Genty, Jean and Jan Kappel, Bill Fynboh and Berdine Johnson.
St. Mary’s began in 1960
Arthur “Barney” Kappel, the first president of St. Mary’s board of directors, was one of the many people involved in the efforts to bring a hospital and nursing home to Winsted.
The idea began in about 1956 from a Winsted Civic and Commerce Association meeting.
“At first, only a hospital was in our thoughts, but then we got to thinking, ‘Why can’t we have both a hospital and nursing home,’” he said.
“At that point the idea really caught fire in the community and area. From then on the objective was both,” Kappel said.
Organizers asked the Benedictine Sisters of St. Paul’s Priory to take over and supply the nursing staff. After some hesitation, the Sisters agreed if the Winsted community would back the hospital financially.
The dedication for the hospital and nursing home was in 1960. The hospital wing was closed and converted into a clinic in 1989.