About 20 years ago, during a consulting visit to a long term care community, the Director of Nursing was sitting at a computer (rare back then) entering incident data into a spreadsheet. When I asked what she was doing, she said, "My QA reports are due today and I haven’t input any of the incident data. I usually take the reports home and update the spreadsheet, but I ran out of time."

When I reviewed the spreadsheet it was pretty impressive. It allowed me to identify trends and produce graphs and charts. It was all that and a bag of chips!

But there are serious issues with spreadsheets. Let’s talk about the pitfalls of using spreadsheets for tracking and trending incidents and accidents in our communities.

By the time they arrive at your community, the survey team has already chosen the first phase resident sample. It isn’t magic—they have the same tools our communities have: a current CASPER report and the two federal forms: the 672 and the 802.

So why don’t we use them ourselves? Wouldn’t it be great to have your own “resident sample” that mirrors the surveyors'? You should also be using these tools as part of your QAPI and PIP process to improve QMs and health inspection reports!

As we travel around the country visiting communities and partnering with them for improved outcomes, we often identify areas of risk associated with incident trends and tracking. In a perfect world there would be no falls, elopements, burns, or lacerations—but the world we live in isn't perfect! Unfortunately, neither are many of the systems your QAPI committee depends on to keep on track and reduce incidents with injuries.

The best claim is the claim you never have to file—so reducing risk is a big deal for us. Our parent company, HealthCap, visits nearly every member on their premises every year to help them deliver better quality to their residents, families, and employees. The visits involve a mix of consultation, data gathering, and analytics. As a by-product, we help reduce claims.

After 15 years of working with member communities, we've consistently seen four top ways to reduce risk across communities.

When we talk about risk management, we often overlook one important aspect of how we provide care to our residents: staffing. So, let’s talk about staffing. How do you staff your community: are you staffing by acuity, census, or “clinical acuity”?

The long term care industry has regulations that require you to be attentive to the quality of care and quality of life you deliver to your residents. Communities should place a much greater emphasis on the Quality Assurance/Performance Improvement (QAPI) process, coupled with a proactive and ongoing risk management program.

Providing exceptional care in an SNF or ALF today involves much more than simply having good care providers and staff. If you’re striving to decrease the number of falls and other incidents, you may need to usesome strategic thinking and investigative work. In particular, you may be looking for valuable information about patterns in the number and type of incidents, and how these could be corrected with the right number of nurses at the right time.

If your senior living organization consists of multiple communities, you know it’s essential for each community to report its risk management data to the regional and corporate leadership. The incident data you receive are your “eyes and ears” when you can’t be at each community all the time.

The American population is changing—and that means important shifts for long term care, too. When we hit the mid-century mark, caregivers and communities will be working with a population that looks very different from what we see today.

Your organization manages adverse events much like everyone else. Someone, likely a pretty high-functioning nurse, accumulates paper incident reports manually or from your EHR system. They periodically type them into a spreadsheet, then sort them and count the different types of incidents by community. They do a pretty good job of it, even though they complain that they aren’t very good at Excel, that some buildings don’t report consistently, and that they can’t get anybody’s attention with the results that are often murky at best compared to benchmarks that they can’t find.

Let’s put aside the qualitative aspects of incident reporting and let’s overlook the most important aspect of your current incident reporting and adverse event management process—that it doesn’t work as well as it should and could. Let’s focus on one simple thing: how much does it cost you?