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Innovations in Long-term Care Delivery: How the Pandemic Optimized Care

The pandemic disrupted all aspects of the American healthcare system. Long-term care, in particular, was significantly impacted. Leadership and staff were challenged to keep residents safe and cared for while simultaneously mitigating infection risk for themselves and residents. Unfortunately, the task was nearly insurmountable with inadequate PPE, staff shortages, and virus surges.

But long-term care staff rose to the challenge. Amid the chaos, they found new ways to deliver optimal care to America’s frailest population. As a result, long-term care has seen a development of innovative approaches to care that will last long past the COVID-19 pandemic.

Enhanced Infection Control

Before the pandemic, many skilled nursing facilities trained a special team in high-level infection control when a resident had a contagious illness or infection. Those thoroughly trained nurses, housekeepers, and dietary team members worked together to care for the infected resident and mitigate the spread.

When the pandemic hit, skilled nursing facilities needed to train 100% of their staff, even maintenance team members and other floor staff that were not direct caregivers.

“Everyone needed to be trained to properly wear a mask, wash their hands, and wear gloves. It was a huge task,” says Deborah Franklin, Senior Director of Quality Affairs at the Florida Health Care Association. “Many communities didn’t have an infection preventionist yet, as CMS had just rolled out that requirement and the guidelines weren’t clear. Skilled nursing facilities also had inadequate PPE. It was no one’s fault. It was just something we weren’t prepared for.”

Now, Franklin says there’s a deeper understanding of infection control among all staff members at long-term care communities. The pandemic facilitated this universal knowledge among staff, residents, and visitors.

“We’ve also recognized we need more private rooms. Some facilities have voluntarily turned their semi-private rooms into private rooms to prevent the spread of infection,” she says. “There are also increased sanitation stations for residents and visitors, making it easy and accessible for everyone to do their part in preventing infection. Everyone plays a role in keeping residents safe.”

Collaborative Partnerships Formed Among Hospitals and LTC Communities

When the pandemic hit, hospitals were already staffed with infection preventionists. Franklin says hospitals began loaning their infection preventionists to skilled nursing facilities to help educate and train staff on infection prevention. Some hospitals even sent PPE to skilled nursing facilities in need.

“In almost 35 years of doing this, I have never seen that level of collaboration among hospitals and long-term care communities. It is so in-depth now that I don’t think it will go away,” says Franklin.

This collaboration is improving the care residents receive through transitions. For example, after a hospital stay, Franklin says the increased communication has made the discharge back to the skilled nursing facilities more seamless.

“We are collaborating more on the continuum of care. So whether it is discharging a resident after rehab or a hospital stay, we communicate better and make sure care delivery isn’t halted or interrupted. That has been really positive for residents,” she says.

Bigger Focus on the LTC Workplace Experience

Staff burnout and fatigue were rampant in long-term care as the pandemic continued. A 2021 survey conducted by the Kaiser Family Foundation and the Washington Post found that 56% of assisted living and long-term care workers reported burnout. 

Franklin says leadership in long-term care communities recognizes the need of their staff. She says some facilities offer staff aromatherapy rooms, chiropractic services, massage therapy, mentorships, and counseling services.

“There are also facilities conducting stress management and resilience training for staff, and there are many long-term care employers offering robust mental health services to their staff,” she says. “When staff feels good, mentally and physically, this is when they can deliver the best care to residents.”

Individualized Communication for Caregivers and Families

Franklin says resident families were desperate for communication at the pandemic’s beginning. “Families were calling, emailing, texting––any way to find out what was going on in the facility, not just specifically with their loved one.”

Franklin says tech companies quickly rose to the occasion and developed various apps for skilled nursing and assisted living facilities to send messages to families. “We saw a fast roll out of wonderful communication apps that facilities are still using now and will continue to use to communicate information to residents’ families.”

Care plan teams also used video conferencing tools to meet with families and caregivers, even from out of state. Franklin notes this keeps all family members in the loop on their mom or dad, not just the adult children nearby. 

“Long-term care providers are innovative, creative, and can solve whatever problem they face,” says Franklin. “The COVID-19 pandemic was incredibly challenging, but it was the genesis of some major innovations in care delivery. I couldn’t be prouder of the leadership and staff who display an unwavering commitment to resident care.”