“The residents come to know you better and trust you,” says a CNA of the changes a nursing home experienced after implementing consistent assignment.

The new system also benefits the home’s direct-care workers, according to a one-page report (pdf) by the Iowa Foundation for Medical Care, the Medicare Quality Improvement Organization for Iowa. “The staff have ownership and they are loving it,” says Assistant Administrator Deb Pascoe. Staff chose the neighborhoods they wanted to work in and divided resident caseloads.

The report describes an initiative by Wyndcrest Nursing Home in Clinton, Iowa, which piloted the change on one shift for several months before introducing it on others. “It’s important to remember that change takes time,” Pascoe explains. “Pilot testing provided us with an opportunity to work through problems before implementing it facility-wide.”

Pascoe said the commitment and positive attitude of the home’s leadership were also key to the initiative’s success. The unit director and nursing supervisor met with each neighborhood weekly to work through barriers and answer questions.

Pascoe credits consistent assignment with helping to improve the home’s clinical measures, especially in pain management and pressure ulcers. “It enables our staff to know the residents’ needs and respond quickly,” she says.

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org