Participants believed that the quality of life for residents referred to Ms. Cote for behavioral consultation was definitely improved because staff are able to provide better care to this difficult population. Although no formal evaluation has been conducted, anecdotal feedback from survey staff, ombudsman and providers indicated that the consultations have led to changes in plans of care that have had positive results for both residents and staff. The survey staff respondent indicated that based on informal feedback she has received, the education and support given to staff has decreased medication use among the residents and has also decreased the number of discharges due to behavioral issues. In her experience, in homes without support, the staff had on occasion become so frustrated with problem residents they would discharge the resident to an acute care setting and refuse to readmit them, preferring to take the deficiency citation rather than continue dealing with the resident.
There has been no formal evaluation of the impact that the Best Practices program or the increase in minimum staffing requirements have had on quality of care or quality of life. Providers reported adopting ideas presented at the Best Practices workshop, particularly the one on Nutrition and Hydration and incorporating these practices in to their quality improvement programs.