Health Screening – A Core Component of Infection Prevention and Control

Since early 2020, communities have been mandated to screen all staff and visitors as per CDC guidelines for infection control. This has considerably increased the burden on operators to establish and execute community policies for screening, record keeping, and conformance to state and federal mandates. With the resurgence of COVID cases, and with the relaxation of visitation restrictions, the workload has only increased for community team members.

The almost daily discovery of new COVID variants implies that health screening is here to stay!

Fortunately, there are new technologies available that alleviate the screening burden on operators. Here are some key benefits of Health Screening technology that operators should carefully consider in deciding if this technology will deliver an ROI for their community.

Automation

The right technology can automate your screening process. This can free up your staff and team member who could currently be multi-tasking between their pre-COVID responsibilities and new screening tasks.

Screening Throughput

With the reopening of communities to general visitation a key issue of concern is screening throughput. The ability to quickly and easily screen visitors and staff becomes important from an exposure and infection control perspective. Screening using a staff member is rate limited by both the visitor and by the screener. The right screening technology not only increases throughput, but also could ensure compliance by visitors and staff.

Error Minimization

Manual modes of screening lend themselves to user entry errors, as individuals could incorrectly record screening parameters such as temperature measurements. A fully automated temperature screening system eliminates data entry errors supporting your compliance processes.

Risk Reduction

Body temperature scanners minimize risk of exposure to your team members who are using a non-contact forehead thermometer for temperature measurements. If visitor sign-ins require no staff assistance, they reduce the risk of exposure of staff to asymptomatic visitors.

Infection Control

Touch-free screening systems can substantially reduce, even eliminate, the need for constant wiping and cleaning. Not all screening systems are touch-free, so it is important for operators to ensure that the technology they are evaluating supports a touch-free mode of operation.

Easy Record Keeping

Cloud-based screening system eliminate the need for storing paper records, resulting in savings from multiple perspectives – paper, storage, and compliance records. This can reduce operational expenses for cost-conscious operators. Additionally, the right system can make it quick and easy to generate reports to state surveyors when required.

Given the current and future needs for routine health screening, the ROI on the right technology can be substantial for operators. Clearly identifying your goals and the challenges you are trying to resolve can help in determine the true value of the specific features for your community and maximize the return on your technological investment.

On a final note, keep in mind that the health screening is just one component of your overall infection prevention and control processes. Carefully consider how it will support your organization’s compliance as well as how it fits your community and staff workflows.

Maximizing length of stay by preventing falls in assisted living

As we slowly emerge from the pandemic, innovative administrators and operators are fast evolving their environments to adapt to the growing realities of protecting their communities to ensure business continuity while balancing costs. With all communities being adversely impacted due to sub-optimal census and visitation restrictions, a focused approach to maximizing length of stay can become a strategic advantage for operators.

One factor which profoundly affects length of stay is resident falls. While resident falls is common occurrence in all communities and is the undisputed leader of the reason for incident reports, operators continue to struggle with developing a standardized approach to solving this problem.

Here are some important suggestions to consider in developing a successful program to prevent falls.

Make Environmental Improvements

Remove clutter in and around the resident, e.g., areas rugs, secure electrical cords, tape edges of carpet to floor, to avoid resident tripping. If not already done, install grab bars in all bathrooms, to help residents stabilize themselves as needed. Raise toilet seats to make it easier for residents – proximal extremity lower limb weakness is common in the elderly! Make shower chairs available and encourage use on shower days. Ensure visible lighting on the way to the bathroom as most falls occur during trips to the bathroom.

Physical Considerations

Ensure use of a suitable assistive device cane or walker as appropriate. Help residents wear appropriate shoes (no flip flops!) at all times to minimize fall risk. Right size clothing – many seniors lose height with age as well as osteoporosis. If they have not adjusted the length of pants to their current height, they could trip and fall, especially when they are in a hurry to go to the bathroom or when multi-tasking. Cognitively impaired residents will find it easier to wear pull on pants rather than ones with belts and buckles which are difficult to unfasten when they are in a hurry.

Resident Health & Wellness

Encourage regular eye checkups as macular degeneration is very common and ensure use of clean eye-glasses if applicable. Periodically review resident medications with primary physician as some are known to increase risk of falls. Seniors need to get adequate hydration as dehydration is a fall risk. As individuals age the thirst mechanism is impaired and regular prompting and reminders to hydrate may be required to prevent dehydration. Regular blood pressure measurements, especially for residents on specific types of medications such as anti-hypertensives and anti-depressants, may be required to lower the risk of falls.

Regular physical exercise and conditioning needs to be core component of any fall prevention program. Daily exercise for lower extremity strengthening, chair exercises, chair yoga, tai chi can be safe for seniors with varying levels of immobility, under supervision. Use of physical and occupational therapy as appropriate can help maintain limb function. Adequate pain management can make exercise easier and implementable.

While there is no magic pill to prevent falls, a structured fall prevention program which considers the above-mentioned elements can potentially minimize falls and help increase length of resident stay. Periodic observation and review by care teams for these factors can be made part of the program. These factors should also be considered when developing new-hire orientation and onboarding programs, as care-team execution is key determinant of successful program to reduce and/or prevent falls.

This information is provided by S. Sanjay Gopal, MBA., PhD., and Dr. Visa Srinivasan, MD. Sanjay is the founder & CEO of the CareSynchrony® platform for senior living. Dr. Visa Srinivasan, MD, is a recognized Alzheimer’s expert and leading geriatrician. As the Director of the Health-First Aging Services, Melbourne, Florida, Dr. Srinivasan has been serving the needs of seniors and caregivers in Florida for over 17 years. For more information, contact Sanjay Gopal Health at 321-282-7730 or via email at sanjay@sanvishealth.com.

Strategies for reducing residents’ stress in a post-pandemic world

Over the past year, COVID-19 has completely transformed the world, resulting in devastating economic, physical, and psychological consequences. Leading geriatrician Dr. Visa Srinivasan says that “Seniors are disproportionately affected by COVID-19 because of their increased vulnerability to the virus. The stress from quarantine has disrupted their daily routines, and as a post-pandemic world becomes more imminent, many seniors are struggling with getting back to normal.” Nowhere is this truer than in senior living communities, where residents have had the additional challenge of being isolated from their loved ones.

How can operators evolve and adapt in this environment?

To enrich the quality of life of their residents, administrators should consider adopting these 6 strategies:

  1. Structure – During periods of anxiety, the brain functions better with the predictable routine. Residents need to maintain a structured routine in order to cope better with stress.
  2. Daily exercise – Physical exercise not only nourishes the body, but also calms the mind. Residents can go for walks around the community or join an exercise class with other residents. Make use of available technology, such as YouTube tutorials and guided exercise videos to lead residents through simple exercises that can both distract and engage them.
  3. Social engagement – It is important for residents to participate in their communities and stay in contact with their loved ones. Operators can schedule Zoom and/or FaceTime calls between residents and families to lower resident anxiety. Oftentimes, having a designated staff member for orchestrating these Zoom meetings is the best approach.
  4. Hydration – Ensure that residents stay properly hydrated to avoid unnecessary hospital visits for dehydration and constipation. Both of these conditions can lead to confusion and agitation, which inhibit a resident’s ability to enjoy their life.
  5. Cognitive stimulation – Residents need to be cognitively stimulated in order to prevent underlying anxieties from surfacing. Through activities such as word puzzles and brainteasers, residents can flex their brain muscles and continue to stay engaged with the community.
  6. Nutrition – Resuming communal dining (when regulations permit) in smaller numbers with physical distancing following CDC guidelines is helpful to remain socially interconnected. Residents could already feel isolated and bringing the meal to the room not only prevents them from social interaction, but also causes them to eat less and have a weight loss. It has been shown the seniors eat better when they have company.

An additional recommendation is to promote positivity in residents’ daily lives. This might mean that caregivers not forwarding or sharing negative news about the pandemic, and continuing to engage residents reminiscing about pleasant events in their lives and in pleasurable activities/hobbies.

Ultimately, encouragement and support from their communities can empower residents to adapt to their new norms. The 6 strategies outlined above not only help communities adapt to the changing needs of their residents, but also ensure enrich residents’ quality of life.

As we navigate out of this pandemic, let’s all work together to transition to a new sense of normalcy.

Dr. Visa Srinivasan, MD, a leading geriatrician and Director of the Health-First Aging Services, Melbourne, Florida. A recognized Alzheimer’s expert, Dr. Srinivasan completed her training & fellowship at the Cleveland Clinic Foundation, Cleveland, OH, and has been serving the needs of seniors and caregivers in Florida for over 17 years.

Body Temperature Scanners – A new normal in senior living?

Because of the coronavirus pandemic, new requirements regarding staff and visitor screening have been mandated, including measuring and recording body temperatures. There are new technologies available that alleviate this burden on an already taxing workload. These technologies have additional features like artificial intelligence, facial recognition and mask detection that can offload some of these new requirements while enhancing your quality of service. Now is the time to learn more about these technologies and to ask yourself:

“How could temperature scanners help my team and our senior living community?”

Here are seven questions to consider as you evaluate the technology options:

1. What are the “real-world” benefits of this technology?

The advantages of temperature scanners are automation and high throughput of taking and recording body temperature measurements. Scanners also minimize risk of exposure to your team members who are using a non-contact forehead thermometer for temperature measurements. If visitor sign-ins require no staff assistance, they reduce the risk of exposure of staff to asymptomatic visitors. However, to truly minimize risk exposure for staff and residents, visitor/staff screening needs to be completely touch-free, which is difficult to find. Many systems on the market today still require some button touching and will need to be sanitized after every visitor, which is more labor-intensive, increases operating costs and is more prone to contamination.

2. How does temperature scanner technology support CDC and health department compliance?

Temperature scanners on their own may not be sufficient for compliance. Federal and/or state mandates require record-keeping of more than just body temperature measurements, such as documenting and tracking responses to COVID-19 specific screening questions. It would be wise to look beyond screening questions and see how the scanner systems can help you with documenting detailed information about visitors, such as the reason for visit and resident contacts. Carefully considering how the systems would fit within your overall visitor/staff screening process – both from a routine workflow and compliance perspective – can help determine the fit of the technology for your environment.

3. What is the temperature scanner technology?

The scanners are all basically the same in that they detect the presence of a person, measure and display their temperature and sound an alarm, if necessary, based on preset thresholds. Additionally, most (but not all) units can detect if an individual is wearing a facemask, and several units also offer facial recognition to identify the person, if pre-registered in their database. The temperature measurement is conceptually similar to how non-contact forehead thermometers work in that they measure the surface temperature. The scanners run on either Android or Linux operating systems. Android systems could future-proof your investment via additional apps that can be loaded to extend functionality. Depending on your specific need one of these could be a better fit than the other.

4. How does your staff benefit?

Depending on the features implemented, the impact of this technology is different for the receptionist/concierge, than for your other staff (e.g. business office, maintenance). Questions you should ask yourself include: How automated is your community, or how automated do you want it to be? What are your “visitors hours” and which entrances are you staffing and during which hours? This is a key determinant of your return-on-investment (ROI) if your community workflow includes a concierge or receptionist

5. How does temperature scanning fit with your current technology?

Most of the devices available have the ability to control door locks and integrate into a community’s access control system. Questions to ask: Do you need this integration capability? What door access technology have you deployed? While integrating the devices with magnetic door locks may be beneficial, make sure that the scanner you are investigating works with the RFID or key-card system that you already use. Investing in a new key-card system is a non-starter for most communities as it increases costs and can cause additional work for staff and complexity for users. Weigh your options carefully when evaluating this functionality and its fit for your community.

6. Do you need facial recognition?

Most of the devices support facial recognition. While this could be useful in certain cases, its primary use would be for recurring visitors, such as staff and health providers. Investigate how easy it would be to set up facial recognition and to keep it updated as you add staff and providers to your community. This is an area where the software applications that are included with the scanner needs to be carefully evaluated for ease of use.

7. How does the scanner address HIPAA & Privacy Concerns?

Most of the devices have the ability to capture and store a digital photo of the visitor, and also the measured temperature values. Determine where the data will be stored and how easy it would be to retrieve it at a time of need. Almost all of the devices store data locally on the scanner itself for a period of time and most devices can optionally store it on a cloud server. If it’s the latter, then data privacy should be a primary concern. Questions to ask: Does retrieving data require any special software? In a time of need can any person on your management team easily retrieve the data? It is unwise to ignore HIPAA and data privacy regulations. Given the current conditions, ask and make sure you know how your information will be protected, accessed and backed-up.

Clearly identifying your goals and the challenges you are trying to resolve can help in determine the true value of the specific features for your community and maximize the return on your technological investment.

On a final note, keep in mind that the body temperature scanner is just one component of your overall screening and workflow optimization process. Carefully consider how it will support your organization’s compliance as well as how it fits your community and staff workflows.

TeleHealth – A Friend with Many Benefits

When it comes to screening staff and visitors, what’s your next move for cost effective screening?

Since early this year the coronavirus pandemic has forced administrators and executive directors to screen all staff and visitors for COVID-19 symptoms and risk exposure. Facility operators are under tremendous pressure to follow screening guidelines to ensure the safety of both staff and residents while controlling costs and maintaining business viability. With the resurgence of COVID-19 cases, it’s apparent that staff and visitor screening will be required for the foreseeable future, possibly well into 2021 or longer.

A common objective is to streamline the screening process to reduce work effort, ensure compliance to state and federal mandates, and minimize cost. This raises an important question on most administrator’s minds:

“How can technology help me in making screening easier, keep me in compliance, and still be cost effective?”

Here are 8 tips to ensure you receive the most value from technology investments for screening staff and visitors:

1. First understand limitations of manual screening

When it comes to screening there are two approaches manual or through a computer system. Manual screening is simple to implement, can be done by any staff with little training, can work without dependence on technology, and has a low “cost of acquisition”. However, it is both time and labor intensive, costly (since it requires a full-time employee), necessitates space for storing binders, has propensity for human errors and potential delays in communication, makes generating reports for state surveyors cumbersome, and “does not scale” when communities fully reopen for visitors as your staff can get overwhelmed with social distancing requirements. Do any of these apply to you?

2. Review the pros and cons of technology enabled screening

Computerized screening can overcome many of the drawbacks of manual screening resulting in significant cost and times savings. Done right a full-time employee (FTE) would not be needed and reporting for surveyors can be quick and efficient. Other benefits include real-time alerts, reduced workload on staff, 24/7 availability, and scale to accommodate anticipated rush of visitors once communities finally reopen. Drawbacks of computerized screening could include a higher initial “cost of acquisition”, possible staff training, maintenance cost (e.g. monthly subscriptions), and possible dependence on WiFi/internet connectivity.

3. Understand and enumerate your goals

Each organization’s goal for digitizing screening could vary and evolve with time. Goals might include cost savings, time savings, lowering staff burden, improving “curb appeal” for tours, and reassuring families through state-of-the-art technology deployment. Understanding and acknowledging goals can ensure you are selecting the ideal technology for your environment. Gathering the viewpoints of all departments in your organization can help you develop a checklist of goals and use it for your decision making.

4. Gather More Information

How many staff members are involved in your community operations, and what are the average number of healthcare providers who deliver services on a daily basis? If you have a moderate to larger size community with a diverse staff, and/or have high frequency of external providers and family visitors coming into your community then digitizing this screening process for both staff and visitors could provide a substantial return on your investment. Also, ask yourself how the data you gather might change with time. It is probably safe to assume that the volume of visitors will increase significantly when communities fully reopen. Review historical pre-COVID data for your community as a reference point.

5. Understand the real costs of any technology you are evaluating

When considering investment costs, take into account the acquisition cost as well as the long-term cost of maintaining the technology. Most digital technologies include a monthly subscription cost. Projecting the sum of the acquisition cost and the monthly subscriptions over a 3 year period, and comparing it to the direct labor costs can provide you with a good start to determining the ROI of technology adoption.

6. Don’t ignore what it takes to implement technology successfully

Take into account the time involved in training your staff on procedures and protocols, and how new staff can be on-boarded after the initial “go-live” period. If the solution is easy to use, implementation is not only faster at the beginning, but maintenance should also be easier on an ongoing basis, especially if you have high staff turnover. Look beyond the sizzle as you evaluate the options and ask questions such as – Will my staff take to this? Who needs to be involved if something goes wrong? Can your maintenance team help?

7. Inventory your infrastructure and environment

What is your existing infrastructure? Gone are the days of technology silos. Communities may have a door access control system in place already for staff, and newer technology may or may not be required to fit in this environment. In almost all cases, network connectivity would be required, so you need to check this first. If you have other IT systems you might have a desire for a screening system to work in concert with other technologies you have invested in. Again key questions to ask yourself – How does this fit in with my existing infrastructure? Do you need it to?

8. Budget and plan ahead for technology

This is probably the most difficult challenge in adopting new technologies. What is my budget? Can I afford it? Organizations large and small are under considerable financial pressure because of COVID-19. You might need to be creative in identifying capital sources for deploying technology to support their operational desires. You might need to find a solution you can phase-in over time. Working with your financial team as well with vendors who value community partnership can result in positive outcomes and win/win(s). Ask yourself – Is there a way I can tap into my operating budget to finance the technology implementation?

On a final note effectiveness of any system is dependent on the confluence of three factors – technology, people and processes. A holistic approach with the right technology can automate screening, make it cost-effective, and also provide benefits such as visitor contact tracing that otherwise would not be possible.

Visit Sanvis Health to learn how new breakthrough solutions such as SentinelTM All Access Management can keep you safe while ensuring care continuity.