Building a positive atmosphere for teamwork can be challenging for the nurse assessment coordinator (NAC) in the best of times. Combining various personalities, managing multiple priorities, and juggling several deadlines all at once is no small task. Add into that the demanding environment of a long-term care facility and you’ve got a recipe for a stressed-out team, and possibly a broken workflow.
You may be thinking there’s already enough to do during each day without having to worry about the quality of your teamwork. But the truth is that quality person-centered care starts with a strong interdisciplinary team (IDT). You all act as key players in meeting the needs of the residents. As such, you need to be able to depend on one another.
Here are some tips on how the NAC can strengthen the IDT—even in stressful situations.
- Matching priorities
One of the most common stressors for the nurse assessment coordinator is all of the moving pieces.
“For each resident, you have multiple assessments that all have different due dates, and then you have to multiply that by how many residents you have in your facility. This results in many different assessments that are coming due and cycling through both the Medicare and OBRA assessment schedules. On top of that, you have all the unplanned assessments—whether it's unscheduled Medicare OMRAs or unexpected discharges—that also have to be squeezed into that timeline,” says Jessie McGill, RN, RAC-MT, and curriculum development specialist for AANAC.
To exacerbate that stress, the NAC must rely on various members of the interdisciplinary team to complete each of their pieces on time. And often the IDT members have different priorities than the NAC. After all, they have their own required tasks as well. And since the NAC owns the MDS process, it’s not uncommon for assessment-related tasks to fall to the bottom of the IDT members’ to-do lists.
McGill recalls a situation that she found herself in several years ago:
“I was waiting for the social worker to complete a care area assessment note, so I could complete and lock the assessment. It was the last thing left for that assessment. However, the social worker ended up having an upset family member come in and spent the majority of her afternoon resolving the family member’s concerns. She simply wasn’t able to get to that CAA note that day,” she says. “It wasn’t that the social worker purposely did not complete the CAA, but another matter came up that took priority over that task.”
When your team has priorities that don’t align—which it inevitably will—it can cause a breakdown within the team.
The solution, says McGill, is to always have a backup plan.
“For every task that has to be done, there should be one or two people who can also complete that task as a backup—whether the social worker has an assistant, or the NAC herself or himself needs to be the backup. There are ways that the team can work together to develop a good support and backup system,” she says.
In some cases, you might find that a member of the IDT consistently puts off the assigned MDS task, and constantly calls on someone else for backup.
“That shows that there is a true breakdown in the process or the workflow,” says McGill. “The MDS should have a high priority since it drives the resident-centered care plan.”
In that case, McGill advises speaking to that team member directly to resolve the issue.
“Have that conversation explaining what needs to be done and when. Identify the barriers. And see if it’s something that can be overcome,” she says. “If that does not resolve the situation, then escalate the concern to the IDT member’s supervisor to let them know of the ongoing issue of not meeting MDS deadlines.”
2. Communication, communication, communication
Poor communication is one of the major causes of misunderstanding and stress in the long-term care workplace—and it’s all too common.
Developing a strong communication system is key to strengthening the IDT.
And it can be as simple as cultivating good email practices.
“Emails are great when you need to communicate a task, share a link, or communicate quickly with the entire IDT at one time. But be sure when you’re using emails that you are straight and to the point. My personal rule of thumb is if it’s longer than three bullet points, there needs to be a face-to-face or a phone conversation. Once you get past three bullet points you’re going to lose someone’s attention and they may not get to the actual task that needs to be done,” says McGill.
It’s also a good idea to give people deadlines. For a NAC, assessment deadlines become second nature, so it’s easy to forget that other team members may not have the same awareness of them that you do.
“There are so many moving deadlines and completion dates of the MDS. The rest of the IDT members are not the experts in the RAI—in the scheduling and completion of the assessments. Let them know exactly what needs to be done and by when,” says McGill.
Finally, consistency is key.
“Establish a consistent method of communication, so your team knows what to expect. If one day you’re going to call, and the next day you’re going to announce it in a meeting, and the next day you’re going to email, there is no consistency of process to the method of communication. Developing a very consistent method of communicating other IDT members’ responsibilities can help keep everyone on the same page. And if everybody’s on the same page, you usually have a smoother-working machine,” says McGill.
3. Boosting morale
It’s no secret that the long-term care facility can be a stressful work environment. Facilities operate on a shoestring budget. They’re often understaffed, and the turnover rate is a persistent issue nationwide—which in turn leaves the remaining staff in even more of a lurch.
These kinds of conditions can lead to low morale within the IDT. And while it’s the job of the executive staff to plan and approve expenditures related to employee appreciation, there are small things you can do to help build a spirit of camaraderie among the staff.
“I’m a firm believer that a please and a thank you go a long way. Acknowledge someone’s presence and the tasks that they’ve done. If you see them go above and beyond, recognize those actions, as well as simple acts of everyday kindness. Recognizing someone for good, accurate charting, or complimenting a resident on how good they look, acknowledging the nurse aide that helped that happen. So many times we only hear about what is not done or not done correctly, which can further deflate morale. Taking the time to appreciate and acknowledge even the littlest things can go a long way,” says McGill.
Or you could consider brightening up the workday in other small ways, such as hosting a small competition, like bringing in crossword puzzles to the break room, and offering a candy bar as a reward to the winner. Or bringing in a plate of homemade cookies for the staff.
These gestures may seem small, but they can go a long way in cultivating a positive atmosphere and making people want to come to work each day. And when the employees are in a positive frame of mind, it can only enhance the overall team.
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