Leveraging Artificial Intelligence to Improve Resident Care VALUE, IMPACT & LESSONS LEARNED About Provision Living Headquartered in St. Louis, Missouri, Provision Living operates 13 communities in Kentucky, Michigan, Missouri and Mississippi. Provision Living has clearly defined values that guide the way it operates and serves its residents: Trustworthiness, Responsibility, Achievement, Perseverance, Authenticity, Teamwork, and Kindness. 2 2 Introduction Traditional fall management solutions simply alert staff when a fall may be imminent or has already occurred. Foresite is different. It continuously captures and analyzes data about residents’ real- time movement and then transforms the information into actionable insights. It makes it possible to accurately indicate which residents are at greater risk of falling (and why); when a fall occurs, it provides concrete data about what happened before and after the incident. For veterans of senior living administration and clinical care, those insights may sound like the proverbial Holy Grail of fall management. In fact, they might even seem too good to be true. Yet the experiences of the Provision Living Senior Communities team—including Director of Clinical Services and Compliance Cathy Krege—suggest that Foresite indeed delivers when it comes to predicting, preventing and managing falls. What’s more, it provides a host of other clinical, workforce and operational efficiency benefits. Introduction 3 Foresite: How It Works Foresite has three primary components: software, under-bed sensors and wall- mounted infrared depth sensors. The sensors continuously monitor and interpret residents’ movements. The sensors communicate with the software, which uses artificial intelligence (AI) to transform the data into actionable insights: • Continuous, automatic fall risk assessments. AI and deep machine learning use a multi-factor analysis that includes bed occupancy, bed exits, sit-to-stand time, use of assistive devices and the validated and universally respected Time Up and Go test. Those inputs help stratify residents as “High,” “Intermediate” or “Low” risk on admission, with updates made as a resident’s condition changes. • Fall detection and post-fall intervention. Foresite’s wall-mounted sensors provide a powerful and unique “Rewind and Review” feature. This helps Foresite provides this determine what happened before and after a fall. It delivers information about continuous, detailed the fall: accidental, avoidable, intentional, witnessed or not, including staff monitoring without response. In short, it replaces guesswork with precise information about the fall compromising resident and staff response—enabling timely and appropriate diagnostics and treatment. privacy and dignity or HIPAA • Health trend analysis. By combining continuous resident monitoring with compliance. Its infrared algorithms based on millions of hours of monitoring and validated artificial sensors capture 3-D images intelligence, Foresite alerts on changes—even subtle micro-changes—that but reduce them into two could be related to an existing or emerging health issue. These insights dimensions, which appear as empower staff to independently conduct an assessment of a resident and silhouettes. to take action before a condition develops or worsens, helping prevent hospitalizations and maintain residents’ quality of life. Foresite: How It Works 4 “ With Foresite, I can keep closer watch on safety and quality of care. ” Bringing Foresite to Provision Since the first quarter of 2018, Provision Living has had Foresite fully implemented in 15 resident rooms in its West County Community in St. Louis, Missouri. As Krege explains, the investment reflects the organization’s mission and values: “Caring for this generation is our passion. We want to look at anything that helps us provide better insight, which translates to better care and a better experience for residents and families.” From the beginning, the organization has realized value from the solution and is exploring the potential to extend it to other communities. In fact, Krege is partnering with STANLEY Healthcare to co-develop a management dashboard that will serve up consolidated insights to administrators like Krege, who oversees clinical and compliance matters across the 13 Provision Living communities. “I can’t physically be everywhere all the time, but with Foresite, I can keep closer watch on safety and quality of care across our communities,” she says. “It also allows me the opportunity to truly collaborate with our clinical leaders in each of our communities.” Looking to the future, the Provision Living team sees opportunities to further leverage the solution’s functionality. They plan to apply human intelligence to the data collected to make connections between system alerts and possible conditions or diagnoses—and then incorporate those connections into the management dashboard to enhance visibility and responsiveness. In the meantime, Krege shares the benefits realized and lessons learned to date. Bringing Foresite to Provision 5 The Power of Foresite Too often, the elderly suffer unnecessarily from loneliness, “ Foresite’s wall-mounted dehydration, health and functional decline, and a heightened risk of sensors replace guesswork falls and other injuries. Foresite is a powerful tool for helping residents ” with precise information. live healthier, safer, more vibrant lives with the freedom and autonomy to age safely in place. Families sleep easier knowing that Mom or Dad is always under the watchful eye of the advanced technology. Proactively identify and address clinical changes Immediately following implementation, Foresite was empowering Provision Living staff to deliver higher-quality care. Krege provides the following examples: • Staff were alerted to a resident who had been staying in bed for an excessive amount of time—a situation that may otherwise have gone unnoticed. Lack of activity can suggest isolation and possible depression, both of which the staff was able to address with the resident to prevent any negative outcomes.1 • Foresite flagged that a resident was consistently restless at night. Staff studied what he had been eating and drinking, ultimately recommending he eliminate caffeine consumption after noon. In addition, the doctor put him on a nightly dose of Melatonin. These measures supported better sleep and enhanced overall quality of life. Additionally, they may have prevented over-medication, fatigue, falls, weight loss, malnutrition and/or a urinary tract infection. “The benefit of Foresite is that we will never know the negative outcomes that could have resulted, and neither will this resident,” Krege says. 1 Details have been altered to protect resident and family privacy. The Power of Foresite 6 • Foresite also helped Provision Living observe a gait change in a resident. Caregivers engaged the help of a physical therapist who determined the resident was experiencing knee pain requiring further management. Krege says that while this resident had not yet fallen, Foresite surfaced this indication that the likelihood was increasing. Enhance collaboration with families “It can be very hard on grown children when they have to become the ‘parent’ to their mother or father,” Krege says. “This technology gives families the assurance that Mom or Dad is being cared for even better than would be possible with one-on-one care. We can proactively identify what’s going on, and when issues arise, sit down and problem-solve with the families.” Krege notes that in addition to leading to stronger, more positive relationships, this approach reduces the risk of litigation if something goes awry: “Our families know that we are doing everything possible for their loved ones. Foresite reinforces that commitment. I know that the best gift we can give them is having Mom or Dad be the parent again in their final years.” The Power of Foresite 7 Gain precise insights when incidents occur Although Foresite is a powerful tool for surfacing fall risks, falls will still happen. The solution is invaluable in explaining what happened, how and why, and what can be done to prevent a recurrence. Krege says Foresite is especially beneficial with dementia patients, who are not reliable historians. For example, she recalls a dementia resident who recently got up in the middle of the night and fell, resulting in injuries that required medical care. Thanks to Foresite, she was able to inform the family of exactly what transpired. Even better, she was able to see that earlier the same night, a caregiver had checked on the resident, gently patting her back and tucking her in before leaving. “Her relatives expressed how much comfort it gives them to know we’re loving on their mother,” Krege said. Precisely align care plans to clinical needs “ This technology gives families the Determining when residents need to be moved from assisted living to a higher level of care is no longer a guessing game assurance that Mom or Dad is being or a crisis for families. The solution helps track actual acuity cared for even better than would be levels over time rather than making judgments based on one or ” two incidents. It also provides early warnings of decline—giving possible with one-on-one care. Krege time to update the family and provide ample notice about potential changes. The Power of Foresite 8 Reduce risk of worker injury Krege also points to the value of monitoring and analyzing caregivers’ movements. Foresite has helped build on positive momentum in reducing the incidence of on-the-job injuries and the resulting workers’ compensation claims: “Now I can watch how someone lifts a resident off the floor. If needed, I can provide correction right away by reaching out to the community’s executive director, explaining what happened and prompting appropriate training or retraining.” Improve associate experience The other side of the coin? Being able to “catch” associates doing things exactly right. Once Krege observed a resident who appeared to be too sedentary in her apartment. Krege started to wonder if caregivers had been paying attention to her. Rather than accuse the caregivers, she simply checked the system, which gave her visual evidence that the resident in question had indeed been visited and properly cared for. “I love when our people are so good at what they do,” she concludes. “I love being able to brag about them—and now I can back it up with evidence from Foresite.” The Power of Foresite 9 In Her Words: Working with STANLEY Healthcare Provision Living’s Cathy Krege shares her firsthand experience and perspective on working with STANLEY Healthcare: On the power of collaboration: “In my position, I’m constantly doing 50 jobs a day. My clinical leaders are busy, and so are their staffs. Thankfully, the team from STANLEY Healthcare handled everything from implementation to training. It wasn’t even a blip for us. They made it all happen, and I was pleasantly surprised by how seamless it was. The other nice surprise has been the cultural fit with STANLEY Healthcare and what a great partnership we have built.” On staff training and adoption: “Sometimes it’s a struggle to get people trained on new technology. But if you don’t do that on the front end, then the staff isn’t willing to use it. STANLEY Healthcare made the training process smooth and seamless. It wasn’t just a ‘check-the-box’ approach. The trainer from STANLEY Healthcare made sure we truly understood the solution and its implications. She listened to our feedback and addressed our questions. I thought we might have some pushback from our staff because we were adding ‘one more thing’ to their day. Thanks to the quality of the training, that didn’t happen. Our care staff started using—and loving—this solution right away.” In Her Words: Working with STANLEY Healthcare 10 “ It’s the right thing to do for our residents and families. ” Seeing Better; Doing Better The adage asserts, “When you know better, you do better.” Provision Living’s experiences provide a corollary: “When you see better, you know—and do—better.” Based on Krege’s experiences, she believes every senior living community should be investing in Foresite. By unleashing a new level of visibility, senior living administrators can deliver meaningful improvements in quality of care, resident and worker health and safety, and operational efficiency. “Initially we partnered with STANLEY Healthcare on this technology because it represented a real advance that could help us strengthen our competitive advantage,” Krege says. “Now that we’ve experienced Foresite firsthand, we realize there’s another compelling reason to make this investment: It’s the right thing to do for our residents and families. From a clinical and risk standpoint, it’s a no-brainer.” Seeing Better; Doing Better 11 About Over 15,000 hospitals and senior living communities rely on STANLEY Healthcare solutions to empower caregivers. By connecting caregivers to essential information, to each other, and to those in their care, STANLEY Healthcare is committed to enabling caregivers to deliver better care through its portfolio of Safety and Security, Workflow and Operations, and Supply Chain Management solutions. The purpose-driven employees of STANLEY Healthcare share a unified passion for those who make the world more caring and the company lives its mission as a proud supporter of the Alzheimer’s Association® in its fight to end Alzheimer’s disease. STANLEY Healthcare is part of Stanley, Black & Decker, Inc. For more information, visit stanleyhealthcare.com. ©2021 STANLEY Healthcare. All rights reserved. DOC-12-70045-AD stanleyhealthcare.com | 1-888-622-6992 12
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