Quality Activities?  Prove It!

Adapted from Adult Day Care Therapeutic Activity Manual

by Jennifer L. Norman & Edward R. Horton

 

Those who administer adult day center programs assume that they are consistently providing high-quality care and service.  Yet, increasingly centers are being asked by prospective clients, families, funding sources and regulatory agencies to provide documentation of client activities and outcomes.

 

There is also the question in adult day services of who defines quality service.  Is it the participant?  Is it the participant’s family?  Is it the local Area Agency on Aging or other third-party payers?  When it is recognized that the participant and the payer often are not the same, it is not always easy to decide who is the primary customer.  This makes it all the more important for adult day service providers to be able to give evidence of quality care in measurable, objective form.

 

Staff at Pennsylvania Hospital’s Adult Day Health Center began to adapt the concepts of continuous quality improvement (CQI) originated by the Joint Commission on Accreditation of Healthcare organizations (Joint Commission) to prove what we say we do.  At the time, there were very few models that dealt directly with adult day services and quality improvement and measurement.  CQI was implemented because it was a proven and respected method of outcome measurement.

 

In its effort to gain broad recognition and reimbursement for the service it offers, adult day centers now face system credibility and cost-benefit analysis.  Documenting and measuring client goals and daily programming can only help adult day centers achieve professional respect, adequate reimbursement and consumer value.  A CQI approach to adult day center programming creates the very systems and procedures that are the point of departure for customizing services to fit unique individual needs.

 

Implementing a program of CQI is also an important marketing factor.  To date, most adult day center programs have been nonprofit and have not had to aggressively market their services.  But we are now beginning to experience changes in the marketplace.  Demographically, America is aging rapidly.  That is, the sheer number of elderly in our society is growing at such a pace that supplying for the needs of this group has become big business.  This is beginning to attract profit-seeking entrepreneurs into the market of services for the elderly, including adult day services.  All indications are that the trend toward increased competition will only continue.  In such an environment, those adult day programs that can deliver the highest return in terms of quality care for the least expense will certainly prosper.  Improving quality while maintaining or reducing cost through increased efficiency and effectiveness is what CQI is all about.

 

Finally, CQI leads not only to payer and client satisfaction but also to staff satisfaction.  One of the most unnerving experiences staff members can have is the sense of not quite knowing exactly what to do and what is expected.  An adult day program’s written policy and procedural standards, which encompass the CQI process, foster security among adult day center staff members--a security that in turn fosters staff creativity and productivity.

 

CQI is clearly not a passing fad, receiving attention today but soon to be forgotten tomorrow.  It is a proven methodology.  It is an industry standard that supports activities most appropriate to an individual’s level of functioning.  It helps to create individual care plans that meet the special needs of impaired adults.¥

 

Reprinted from The Information Source for Adult Day Centers®, November 1997