What are surveyors looking for?
Facilities need to be prepared for surveyors to address TIC. Karen McDonald, BSN, RN, vice president and chief clinical officer at Mission Health in Tampa, FL, suggested a few tips:
Have detailed policies and procedures.
Have policies that detail what your residents expect the staff to do and procedures on how the staff will carry those things out. For example, you need to understand the cultural differences of your residents, which can be done through interviews upon admission. This knowledge will help staff create a care plan that is centered around resident needs.
Identify survivors.
Craft your Social Services assessment to include interview questions that help identify survivors of trauma. Questions can be formed to identify military history, survivors of large scale disasters, and survivors of crime such as rape or mental abuse. This way, the team knows who they are. Residents should be assessed on admission and quarterly, and these efforts should be documented, including follow up on what initiatives were put in place to manage traumas or prevent re-traumatization.
Build a relationship with residents.
This may be necessary before they are comfortable enough to talk about trauma, said Beth Gifford, director of social services and behavioral health at Mission Health Communities in Tampa, FL. Document in the records when and how conversations occur and what, if any, follow-up or action was taken.
Initiate regular training.
This isn’t one-and-done. Instead, these trainings should be held regularly and go through the basics. Everyone should get the training and support they need to be effective and comfortable. Keep a record of when and how staff are trained.
Hold regular meetings.
Use these opportunities to discuss TIC and culturally-competent care and address any questions or concerns team members have, Gifford suggested.
Build a collection of educational materials.
McDonald said, “We put a guideline in our clinical protocols that includes examples and addresses special needs such as sign language.” She added, “We have an assessment process that automatically triggers care planning. And we communicate to CNAs about things they should or shouldn’t do – such as not serving certain foods or always leaving a light on.”
“We need to brainstorm ways to know if someone is triggered and how to get this information out to staff. For instance, we can create tasks such leaving the door open, preventing loud noises, or not startling residents,” said Gifford. She added, “We need to circle around and look at things like survey activities. We need to make sure assessments and monitoring efforts are done and documented.”
“We need to brainstorm ways to know if someone is triggered and how to get this information out to staff. For instance, we can create tasks such leaving the door open, preventing loud noises, or not startling residents. We need to circle around and look at things like survey activities. We need to make sure assessments and monitoring efforts are done and documented.”
Beth Gifford
Director, Social Services & Behavioral Health
Mission Health Communities