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IN PURSUIT OF EXCELLENCE - by Mary Lawson

 


Excellence is a choice. It does not discriminate; it is FREE, available to anyone who chooses it.  It is that simple; make the choice to pursue the challenge of excellence. Living the choice is painful; even so, all great things involve some degree of pain.

In the profession of direct support, excellence in service is a true rarity. There are many dedicated direct support professionals across the country working in organizations that are understaffed, and underfunded, leaving the direct support employee, overworked and underpaid.

 In the pursuit of excellence and quality of service, consider the following twelve tips for those of you who choose to begin your journey toward excellence in direct support.

Choose today.

Know what your customers “vision” is.

                Each person has a dream and a picture of how they want their life to be. As a DSP you need to know and hear that, from each person.  Not just what was captured on paper at a     meeting, but build on that by listening to the person you are serving.

Be a mentor.

                The definition of a mentor is a wise or trusted counselor or teacher. As a DSP teach, coach and guide everyday. 

Spend time getting to know your customer.  

                Discuss with, your customer, what expectations and goals they have set for you as their mentor, teacher coach and guide.

Ask for commitment

                Ask your customer for their commitment to the process as well as establishing yourcommitment level to your customer.

Know what tools and resources you will use together.

                Be prepared.  Find out what you will need, get it, and move on, No excuses here

Prepare, daily, plan for tomorrow

                Set goals for each time you are together. Write them down, be concrete specific and detailed soeach person knows what the expectations are.  Ex. today you accomplished laying out the  pattern and cutting the wood.  Tomorrow we will bolt the shelves together and sand the wood.             

Meet regularly

                Establish a set time that you will be working with your customer. Keep as consistent as possible. We all know there are detours on the road, but don’t get lost here. Get back on the established road, quickly.

Debrief progress

                Once a month devote time to discuss progress that has taken place, what each of you haslearned in this process, what adjustments might need to be made and PLAN.

Invest Yourself.

                As a DSP you need to be “present” when you are side by side with your customer. You have tobe immersed in the process and the purpose for there to be progress.  FOCUS, no distractions.Turn off the cell phone, no water cooler conversations going on while serving your customer.

Teach someone else,

                We have all heard the saying – you will learn the lesson faster if you teach someone else. When your customer has accomplished one piece of the goal no matter how small, support them toshare their knowledge and skills with other people.

Launch – Soar – Fly

        Evaluate what you have taught,

        Support your customer to do it alone

        Evaluate what you have learned.

Repeat!  You are on your way!

Staying Busy by Kristy Dominy

It seems that sometimes we stay some busy worrying about the big stuff (ISPs, ISP data, Billing) that we forget the little stuff. We have been taking a closer look at our demographics report and see that some items have not been updated since we started using Therap in 2011. So we have declared this month a “Spring Cleaning” of our offices, our storage, and of Therap. Even though we know that contact information can sometimes be a moving target, this information is vital in case of emergency. And then there is the ever embarrassing one person floating out there of unknown sex or of unknown mobility, etc. that you know is an obvious oversight. It is an easy fix, it is just taking the time and making it a priority that we were missing. Hopefully we are going to be on the right track from here on out!

Federal Government Delays ICD-10 Implementation by Vicki Erdie

 

Looks like we have some additional time on the ICD-10 transition.

“The delay was part of the Protecting Access to Medicare Act of 2014 recently passed by Congress and signed into law by President Obama on April 1, 2014. New York Medicaid will adhere to the new federal compliance timeframe for ICD-10 implementation and eMedNY will not accept ICD-10 codes until October 1, 2015 at the earliest. ”

 

 

Import Blood Glucose records from meter/insulin pump by Lorelei Glenn

This morning, as I am getting ready to go to my endocrinologist appointment for my Type 1 Diabetes, I was thinking – wouldn’t it be nice if we could import blood glucose records into Therap from meters and insulin pumps? I know that most current meters and insulin pumps have the capability to import/export all information from a period of time using an online web-based system built for the meter/pump. Instead of manually inputting the information into Therap it could be loaded daily or weekly and included as part of an ISP Program!

I’m still trying to get my doctor’s office to look at my online records instead of having me print out and bring or fax to them, but at least the capability exists.

Milton’s Training Tip Titillation – Tip # 2: How to “Spice Up” Therap Training by Milton Neuenschwander

Milton NeuenschwanderEvery organization using Therap has to do it, there is no getting around it; staff must be TRAINED on how to use Therap! But what is the best way to teach new staff on how to use Therap?

As a Staff Development Coordinator, every month during company orientation I take 1-2 hours to try and teach a group of new staff on the basic elements of Therap. So I set up my computer and projector, I have the group of new staff sit in nice comfy chairs, I turn down the lights, and I start my presentation. It never fail that 30 minutes into my presentation, I have a handful of new staff laying their heads down and succumbing to the forces of boredom and sleep deprivation.

Which brings us to our next Training Tip Titillation – How to “Spice Up” Therap Training. Through my experience as a trainer, I have come across many ways on how to “spice up” training in order to arouse your participant’s interests, keep them engaged, and retain information. So the following is a selection of the best tips I have for “spicing up” Therap training.

Tip #1 – The Beginning: Arouse Interest, Set the Mood, and Create Anticipation

Good trainings will have a beginning, middle, and an end; and so we will start at the beginning. At the beginning of training you will need to get everyone’s attention and arouse their interests by making them wonder, “What’s going on here”? You will also need to set the mood right away, so that everyone feels comfortable, everyone realizes that they are in for a good time, and everyone wants to playfully cooperate. Lastly, you need to create anticipation by making them think, “this is going to be a cool training that is going to help me.” So here are the tips on how to do that…

  • Give Them Something to Do – One of the best ways of getting you audience involved in the training is by doing something together as a group. We like to call these “Icebreakers”. One of my favorite icebreakers is to take a stuffed animal and I toss it to members of the audience. Whoever catches it introduces themselves to the group and then tosses it to the next person. Quick, simple, and very involved.
  • Show an Intriguing Picture, Slide, or Video – Youalready have a computer and projector set up, so before the training starts show your participants an intriguing picture, slide, or video. Just look at the picture I posted in this blog. I guarantee that it caught your attention and you wanted to read and see how this ridiculous picture relates to training (it is a picture of me dressed up like Garth, from Wayne’s World, during a Blizzard Ball tournament in Montana)
  • “Hang Out” Before You Start – Shake hands and say, “hello” to as many audience members as you can. Even if you work with these people every day and they already know you. Spending time with your audience before you start does two things; (1) helps loosen you up – you will be more relaxed and ready to go once the meeting actually starts, (2) it shows that you care.

Tip # 2 – The Middle: Prove your Point, Use Examples, and Explain Why

The middle of your training is the “meat & bones” of your presentation. It usually is the section of your training that involves stating facts, presenting examples, and speaking technical jargon; however, if you starting flinging around too many facts, examples, or technical jargon your training can quickly turn into “nap time”. So the following are some examples of how to keep your students’ attention and make them think that what you are telling them is in their best interest.

  • Have an Agenda – all your best trainings and meetings have an agenda or outline of what the students should expect from the presentation. An agenda also keeps the trainer on task and on time. The agenda that I would recommend for Therap Training is the “T-Checklist” (Therap New User Training Checklist) which can be found by following this link:

http://support.therapservices.net/download/attachments/6260218/Therap_training_checklist_Nov_2012.pdf

  • Encourage Hands – On Experience – One of the best ways to make sure that your students don’t get bored and start to day dream during your training is to keep their hands occupied. The best way to do this for Therap training is to make sure that all participants have their own personal laptop, computer, or mobile device in front of them to follow along with the training. Furthermore, provide each trainee with a copy of the “T-checklist” so they may check off the tasks as they are complete.
  • Know Your Student’s Name and Use Their Name During Your Training – This is a very simple technique to guarantee you have someone’s attention, but it works and it is my favorite. When you start to notice that one of your staff’s focus is starting to drift away from the training; say or write their name when giving examples. I guarantee that if you use someone’s name when writing an example of a T-log (and then read what you wrote), you will immediately get that person’s attention.

Tip # 3 – The End: Wrap Up, Call to Action!

It’s almost over and the training must come to an end, but don’t end with a dud. But instead ask yourself, “What do you want your staff to do now that they have experienced this well-prepared Therap Training?” Your ending to your training should also involve a wrap up of the presentation and be a powerful motivating event. So here are some tips for ending your training:

  • Summarize – One of the easiest ways to end your Therap Training is to provide your staff with a summary of the different modules that were taught as well as the importance of using these Therap modules for documentation and communication purposes.
  • Proclaim a “Call to Action” – A fun and “cheesy” way to end a Therap Training is to have everyone raise their right hand a quote an unofficial Therap oath. For example, “I, state your name, promise to be the best Therap User I can be. This means that I will be committed to writing daily T-logs, documenting GERs when incidents occur, tracking Health issues to the best of my knowledge, and sending SComms when I have questions to be answered.” Or you can just make up your own.
  • Always End on A Positive Note – One of the positive ways in which I like to end Therap trainings is to give compliments to my students. I tell them how great of staff they are going to be now that they have been properly trained in using Therap. This makes them feel great about themselves, and hopefully feel great about the fact that they had to go through the training.

Well I hope these suggestions prove useful when thinking about how to “Spice-Up” your trainings, especially your Therap trainings. I am always interested in hearing new ways in which to make trainings better, so if you have any suggestions, please feel free to comment.

So in the words of LeVar Burton (Reading Rainbow), “you don’t have to take my word for it, “ instead go out and try these training tips yourself!

Another Cold Day in Nebraska by Tonya Klein

Hi Everyone!

So its a beginning to another month and here we go with another blog! :) I tell ya what this Nebraska weather sure is crazy 70+ degrees one day and then 42 the next and freezing/snowing at night. Nebraska sure does play a good April Fools! :)

Anyways getting on with the task at hand!… I had an issue come to light and I just wanted to share… I went to pull an ISP data report (there is a new great button with the update new button-data collection monthly) and there was no data there actually there was no data on any of the reports I pulled???? I was ready to cry then I got to thinking.. Hummm the staff that would have collected that data no longer works here (that never happens right?), I deactivated her…. so I reactivated her and POOF there it was! So this got me thinking there has to be a better way to pull reports that show data even if it was completed by a deactivated staff? RIGHT? The answer is YES!!! Was I happy to hear that!

I never have used the report library and let me tell ya I am going to start. Whether or not you have an active staff or a deactivated staff the documentation is there NO MATTER WHAT. It is a bit hard to read depending on what you are looking ( lots of data depending on how you pull it) for but, I would suggest using that. All of the information that I needed to find was there. Way better then actually just searching the data day by day by day… I did not want to waste all that time. So just to recap… If you want to find data no matter what go to Agency reports (if you have that access, if you don’t ask for it) Report library and there are so many different things you can look up it’s just wonderful.

Ok well that is all I have for today! Hope you all are having a great week!

Peace out!
Tonya

Training Therap to New Employees by Racheal

Hi There again,

So for those out there that face some employees that may be, for lack of a better word, Technologically Challenged, how do you have them prove that they understand the documentation that you require on Therap? Ensuring that they have those skills and are competent to be able to write a GER, run reports on Intake/Elimination, Enter ISP Data, or even the most basics of reading SComms and T-logs? Here at CSS we have a great staff that created these wonderful  things called competencies. These competencies detail out a lot of information, everything from understanding of our policies and Mission, Vision and Values, to initial trainings on ISP’s, BSP’s, financials and an understanding of using Person First Language and Person Centered Thinking. Along with all that and many other items, it also has a wonderful page that allows you to mark off their understanding of Therap. Now for us, these are all done over a 6 month period, but it’s reviewed at the 1st, 3rd, and 6th month to ensure compliance with Oregon Administrative Rules (OAR’s) and keeps it all neat and tidy in one place.

When your out there Training Therap, how does everyone do it? Therap is so user friendly with T-Girl, Live Help, and the step by step instruction sheets, it’s a wonder someone may not “get it. ” However, there are those out there in the world of Therap that may have trouble or may not be so used to computers. How do you get them there, and prove that they can demonstrate these skills? By creating a competency!! We have a one day training that is spent with anywhere from 5-10 employees and 2 Trainers (even though I’m the only certified one :)  ) that train  the new employees on how to use Therap and what we want from them in regards to documentation. For Example: Therap’s Purpose, Accessibility,What users use therap, How to access live help/My Issues, What to do when arriving on shift with Therap, Demonstration of Access to IDF’s/EDF’s, “My Account”, T-logs, GER’s, SCOMMs, Health Tracking and Running Reports, Contacts and supports, etc. …… and ANYTHING ELSE you wish to add! It’s a great place to keep everything in one place. This way no one can state that they didn’t know how, or was never trained, or never got the help (they should be accessing LIVE HELP, if not asking).

This helps prevent any error in documentation with the excuse I didn’t know how, or no one showed me, or geesh, I never knew that!. We’ve all heard the excuses I’m sure… but with these, not only to you ensure that your staff have the knowledge, but that they can demonstrate it as well! It makes lives easier all around, by knowing, and trusting that the staff you have in place are not only confident in their abilities on Therap, but they have access to help when they need it, and your job becomes easier by having competent staff that know HOW to Document what they need to, Where they need to.

Now, for everyone out there, I would like to know how you train? Do you have an easier process? A different one? A similar one? We all have so much to offer, and now I’ll be picking your brains on all the possibilities that are out there. ….

with that… I’m off… :D

-Racheal.

 

 

AHCA survey by Scott Barnette

Hello All,

So we (64 bed ICF/DD) just recently completed our annual AHCA licensing and we did a phenomenal job! As a part of the process we gave the 3 member survey team usernames and passwords to login to Therap and access our documents. We have set them up with  caseloads with view access for all clients(Survey 1,2,3). The surveyors had no issue accessing our support plans/Ipop’s, T-logs, Appointments  and the past years worth of Incident reports. In fact the only thing on paper they needed was the POS (Physician orders) to compare to the MAR on Therap and meds they watched us pass. So i guess the moral of the story is the historically tough surveyors who wanted everything printed out are starting to soften up a bit and embrace this century of the electronic record.

I’ll write again post Delaware conference : )

How to Complete A Quality Assurance Check with Therap. by Racheal

Okay, for those that know me I LOVE the Therap MAR. I tend to keep all my ducks in one basket, so for QA checks, I didn’t want them completed elsewhere, or someplace additional that my staff would have to search for or forget about,  so I added them to the MAR itself, (as that’s what they’re QA’ing anyway). Keeps everything neat and tidy. So here it is everyone, How to complete QA checks using the Therap MAR. :) hope you find it as useful as I do.  I also have a Print outable copy, that’s picture friendly as well if anyone feels up to using it, just shoot me an email and I can zip It off into cyber space for you. :)

How to do QA (Quality Assurance) Checks on Therap

First off you will be tracking this medication on the MAR, similar to a PRN medication. To Do this you will see similar steps in the process.

  1. Click “Add New Medication”
  2. This will now take you to the Medication history page. Here is where you begin to create the QA check.
  3. Under Medication Name:
    1. This is where you enter QA and the time that you want the check done. For example:     “ QA CHECK 8AM”  This should be done at each shift change. Normally, just putting QA check is best, you’ll see later, that you can see the time that the QA was done, showing you for each shift change that It was completed.
  4. For all the medication information. Fill in the medication type for “PRN MEDICATION” and  schedule for “As Needed”.  Leaving it blank will cause the QA section to not work properly.
  5. In the comments section, add the purpose for the QA and include all the items you want staff to QA.  For Example: QA check of all MARS, Bubble packs, Intake/Elimination Data, BSL Entries, etc.
    1. This helps to ensure that staff are acknowledging that they checked to ensure that all the listed items are accurate.
  6. Now when you open the MAR you will see that it is listed in the PRN section.
  7. In order to record the QA, you need to open up the Medication up to Record Data in Detailed Mode.
  8. For the very first entry you should scroll down to “administered”. This will allow for follow ups to be completed. This should be completed by your staff only on the 1st day of the new month.
  9. You will now see that the medication has been administered. This is the VERY First and only entry that should be entered like this. You can now click “view” to see the comments.
    1. By viewing the comments, you’re able to see the time and date stamp and the staff responsible for completing the check. This ensures that they are completed accurately and on time at the beginning/end of each shift or per your QA system and does not allow staff to alter the QA check.

Happy QA’ing Everyone. :) – Racheal.

Residential Moves by Jennifer Kelley

Hello to all of you experts. This is my first Blog and may seem a bit dry but I want to pick your brains
I have learned by trial and error the process of moving individuals from one program/site within our agency to another. Our individuals are set up in programs by site name. So each program is a caseload assigned to staff who work in a department which usually has 3 sites in it. They get 2 profiles, one with the main site they work in and one with the other two sites. Today we are moving several individuals from one site to another – 4 different sites are involved-which may also be in a different department. A day prior- First I enrolled them in the program- and left them in the old- temporarily. Then I copied each ISP program and added it to the new site with a new create date- day of move, and title change (- just added a period or a dash). They can be approved if the create date is the day of move. I submitted them, waiting to approve until the day of the move so they would not show on individual home page. Then the day of move I waited until morning documentation was complete at old site and I d/c’ all programs at old site and approved all programs in new site. I now have to create all new habilitation plans in the new site as Hab plans can not be copied to new site. I leave the old Hab plan approved until the monthly note for the current month is done as we use the Hab checklist for our monthly note. Once that is done I will approve the new Hab plan and d/c the old one. The data for the new month will then appear on the hab checklist- which we use in NY,. At that point I discharge them from the old site. Does this sound right?.Did I forget anything?? If anyone has a better way please let me know. Thanks for your input.

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