Background: The Hill at Whitemarsh is a retirement facility in Lafayette Hill, Pennsylvania which has three bundles of services for residents termed levels of care (LOC). Meeting are held routinely by medical and administrative staff to determine if an individual needs to move to a different LOC to improve her/his quality of life and safety. These meetings require integration of medical, functional, cognitive, social, and subjective factors often requiring input from several staff members. In this project, we seek a checklist for staff members at the Hill to use at the LOC meetings to ensure important points of discussion for a patient are not missed.
Methods: We began our research by interviewing the Hill staff including the CEO, director of nursing, social worker, director of recreational therapy, nurses, and nursing assistants. Next, we generated several iterations of the checklist. Then, we implemented the checklist at the Hill in several level of care meetings, and the responses of the staff were recorded.
Results: We identified a project at the Hill, interviewed key personnel, iterated, and implemented our design. Although staff admitted that the checklist captured important points of discussion for each patient, it was not thought to improve the decision-making process because decisions were often made without all the information included in the checklist.
Conclusions: In this project we found a need to improve the LOC meeting by making a tool to integrate complex impressions from multiple people; however, our solution did not adequately capture the flexibility needed in LOC meetings. A future tool would quantify both the important factors and how important they are in deciding.
Schultheis, Grant; Safian, Nicholas; Ezeonu, Sopuru; Klein, Austin; and Snyderman, MD, Danielle, "Using a Checklist to Guide Discussion in Level of Care Meetings at the Hill at Whitemarsh" (2020). Phase 1. Paper 4.