by I Advance Senior Care Welcome to Long-Term Living’s Platinum Products and Services special section
We asked readers to nominate products that helped them do their jobs better and elevate patient care to new levels. Our readers heeded the call and nominated, in some cases, products that, literally, changed the outcome of patient care. The product finalists were chosen by Long-Term Living’s editorial team, who asked product designers to comment on the development process. We hope you find these innovative products worth incorporating into the care plan at your facility.
—The editors at Long-Term Living
CONTENTS
62 Most Innovative Products
62 MX Manager, Plante & Moran, PLLC
63 Dart Voice, DaRT Chart System, LLC
63 SureAssess, Surequest Systems
64 Rehab Optima, GiftRAP Corp.
65 [m]Power, Dakim, Inc.
65 Access Table, Patapsco Woodworks, Inc. and JSR Associates, Inc.
66 TSR 4000 Recumbent Cross Trainer, NuStep, Inc.
66 Stand Guard, Stand Guard of Ohio, LLC
67 Twiddle™Muff, BeauLily, LLC
68 Völkner Turning Systems, James Consolidated, Inc.
68 V.A.C. Freedom® Therapy System, KCI, Inc.
70 Product Showcase
Plante & Moran, PLLC
Contact: Joan Schlagheck
e-mail: Joan.Schlagheck@plantemoran.com
Phone: (800) 827-1280, ext. 29067
Nomination by: Renee Cunningham, Kalkaska Memorial Health Center, Kalkaska, Michigan. We have been very fortunate to have access to this program. The benefits have been an asset to our facility and our residents. We are able to look at so many resources that improve both our finances along with our care. The program can be accessed by all of our team members to allow them to see the areas he or she may have concerns with. We were very impressed with the information available related to this program.
What inspired you to invent/design this product?
Peggy Swartz: As an LTC consultant and former state Medicaid LTC division chief, I understood the significant challenges facing LTC facilities—declining reimbursement and increased demand for quality care. In addition, managers need to analyze the voluminous amount of MDS data efficiently in order to address these issues. We knew that the MDS data held the key to identifying the root cause of clinical concerns and to determining reimbursement. Originally, we developed MxManage as an internal tool for our consultants to use in mock surveys and reimbursement strategies. MxManage was so accurate in predicting survey targets and in identifying missed reimbursement opportunities that clients wanted real-time access to MxManage. So, we transformed MxManage into a real-time, Web-based application that provides the tool facilities need to analyze the MDS data to optimize reimbursement, be prepared for surveys, and improve the quality of resident care by identifying both residents and F-tags at risk.
What were the main challenges you encountered in designing this product and how did you resolve them?
Swartz: One of the significant challenges we encountered in developing MxManage was getting clients to embrace the new technology. It was a bit of a paradox; clients realized the value of having real-time access to the tool at their fingertips, but many have been slow to adopt technology. To alleviate some of the barriers to technology adoption, we developed MxManage as a Web-based, on-demand set of applications with an easy-to-use interface. As a result, clients do not have to worry about hardware or software upgrades—we take care of all of that for them. Making the technology adoption even easier is our customer service approach. To this day, we take a very consultative, high-touch approach to customer training and support. Our client managers work with each client on an ongoing basis on technical as well as clinical issues to maximize the benefit customers receive from using MxManage. Now many of our customers have woven MxManage into their daily workflows, making Quality Stat the foundation for resident care planning and Financial Stat the cornerstone for optimizing reimbursement.
Dart Chart Systems, LLC
Contact: Linda Kunz
Phone: (414) 247-3229
e-mail: dartvoice@dartchart.com
Web: https://www.dartchart.com
Nomination by: Douglas Bulson, Field Ops-LTC Training, East Troy, Wisconsin. I have been fortunate enough to view the beta version of this tool for the future of long-term care, specifically in how facilities can capture much needed data for the highest recovery of funds. The process of validation and review is similar to Meyers/Briggs at the resident and family member level. I believe this is a high candidate for nomination as best new product as we look to the future of data collection needs with as little work as possible while still remaining professional in the roles we need to fill.
What inspired you to invent/design this product?
Linda Kunz: DartVoice was inspired by the added complexity of integrating residents’ voice interviews into MDS 3.0, the new Minimum Data Set assessment tool that nursing homes must perform late next year. DartVoice untangles the language of 3.0 and assists staff members conducting interviews by asking the questions for them. Operating through a computer with two screens, DartVoice provides residents with a friendly and engaging on-screen figure that asks questions precisely as required by MDS 3.0. DartVoice not only provides an efficient method of conducting resident interviews, it provides the best available training method for MDS 3.0 scripted interviews. So even if you don’t use DartVoice to do the interview, it can pay for itself in training efficiencies. Users familiar with Dart Chart’s 2.0 technology are already saying the product complements electronic charting and enables more productive use of facility staff time.
What were the main challenges you encountered in designing this product and how did you resolve them?
Kunz: The challenge was removing the complexities and tight restrictions imposed on clinicians doing the scripted resident interviews. Interviewers are required to ask questions in very specific ways, are limited in how they may rephrase questions that are not understood by the resident, and must capture and code the answer for MDS without interpretation. We were able to successfully meet the challenge. DartVoice untangles and demystifies the interview process, turning complex descriptions into easily understandable terms, therefore enabling interviewers to better meet regulatory requirements. By establishing an improved method of capturing the residents’ voices, nursing homes can provide the best evidence that their facility has heard the residents’ voices. Ultimately, they provide better care for residents while improving their facility’s state survey 5-star rating process.
SureQuest Systems
Contact: Sue Cady
Phone: (972) 238-7200
e-mail: scady@surequest.com
Web: https://www.surequest.com
Nomination by: Diane Lindahl, RD, Armstrong Nutrition Management, Kittanning, Pennsylvania. SureAssess is remarkably innovative as it resolves two significant long-term care challenges: (1) efficiency and effectiveness of the RD nutrition assessment; and (2) linking resident-specific food intake and nutrition needs. With easy access data and calculations, SureAssess allows more time for true patient-centered care. In addition, SureAssess facilitates the Nutrition Care Process to position for evidence-based analysis with potential third-party reimbursement. SureAssess sets the gold standard for comprehensive LTC nutrition assessment.
What inspired you to invent/design this product?
Alma Sudderth: SureAssess was born when the consulting Dietitians at SureQuest Systems, Inc., realized there was a need for a system to automate and standardize their daily workflow. Dietitians needed a method to process and blend large amounts of data based on scientific formulas and subjective personal interaction with clients and produce client/patient information. This would include implementation of detailed assessments and individualized nutrition care plans. The process would allow dietitians to manage more clients, be more thorough, monitor more issues, and streamline results translating to increased productivity. A computerized system would be more reliable and repeatable than the manual process with more predictable results. It could be inclusive and intuitive allowing dietitians the ability to create task lists for managing short- and long-term assignments translating to decreased liability. The result has been the development of the most complete and efficient nutrition diagnostic assessment tool available today.
What were the main challenges you encountered in designing this product and how did you resolve them?
Sudderth: We had three challenges: (1) providing a user interface that is easy to use for a broad group of professionals with diverse computer skills; (2) while in development, the American Dietetic Association (ADA) began formulating the Nutrition Care Process (NCP) designed to improve the consistency and quality of client care and predictability of client outcomes. These two development projects were emerging at the same time and the challenge was to ensure that SureQuest incorporated the ADA process into SureAssess; (3) providing anytime, anywhere access to authorized users sharing core practice standards while maintaining patient privacy. This would allow a consultant RD to maintain his or her own data for multiple facilities. In addition, the data would be available to the facility even when the consultant is not on-site.
The result licenses SureAssess with the use of ADA’s “International Dietetics and Nutrition Terminology,” giving it the highest level of professional credibility. Standard formulas are included for all of the basic assessment calculations and the RD professional can select variations of formulas as preferred. Tiered security access protects patient privacy (HIPAA). Log-ins are assigned various levels of access giving permission to change or view core data and patient information.
GiftRAP Corporation
Contact: Michael Katri
Phone: (800) 619-4243
e-mail: sales@giftrapcorp.com
Web: https://www.giftrapcorp.com
Nomination by: Guy Cowart, Consonus Rehabilitation Services, Milwaukie, Oregon. Rehab Optima possesses an amazing ability to tailor documentation to our unique standards—it conforms to us! It enables therapists to efficiently document at the point of care. Rehab Optima’s intelligence ensures an objective, functional, and patient-centered plan of treatment by guiding clinicians in goal development and treatment approach selection. It is a dynamic product that does it all: enhances patient care, ensures regulatory compliance, and increases therapist efficiency. These are a few highlights of the Advanced Clinical module, but there is so much more to the product.
What inspired you to invent/design this product?
Michael Katri: When Rehab Optima Classic, our first generation product, caught on as a solution of choice, we were not prepared for the volume of unique ways in which our different customers ran their businesses, operationally and clinically. As we grew, the feasibility of responding to every request became impossible, but we never lost our passion for exceeding customer expectations. When we set out to design Rehab Optima-Web Edition, we wanted to make sure it was designed to be tailored to each customer’s unique requirements. Rather than making our customers fit their business into Rehab Optima, we wanted to make sure Rehab Optima would fit into our customers’ businesses. We also wanted to provide features that our customers could use to guide their clinicians down clinical pathways that would result in optimal patient care and clinical compliance while also optimizing staff efficiency, so therapists could be free to treat their patients.
What were the main challenges you encountered in designing this product and how did you resolve them?
Katri: Major challenges included the industry’s propensity for sudden regulatory changes and the need for point-of-service (POS) documentation in facilities without a Wi-Fi infrastructure. We resolved the “changing regulations” challenge by allowing for system administrator-maintained versions of the clinical documentation module. In other words, customers can truly design their own documentation model including what data is collected and/or required on various clinical documents. When new CMS transmittals require modifications, our customers can simply create a new “version” of their documentation model with revised fields and/or requirements. CMS could release a transmittal indicating a requirement for a defined set of data points, and our customers could literally implement the changes within hours and be 100% compliant. We resolved the challenge of supporting POS documentation in facilities without wireless capabilities by leveraging technologies that support data collection in a Web-based application such as Rehab Optima even when temporarily disconnected from the Internet.
Dakim, Inc.
Contact: Dan Michel, CEO
Phone: (800) 853-7197
e-mail: info@dakim.com
Nomination by: Rodney B. Stoops, Jr., Providence Retirement Community, Chambersburg, Pennsylvania: We have been using [m] Power® as a cognitive therapy for our secure dementia residents and also in a newly created early Alzheimer’s program with amazing results. It is a well designed, simple to use, and friendly program which stimulates the brain. A female resident exhibiting signs of late-stage Alzheimer’s who could only mumble, was one of our first participants. After two weeks of using [m]Power®, she turned to the [m]Power coordinator and plainly spoke, “I wish I would have learned to play the piano when I was young!” First words in over a year! This is a phenomenal program that everyone needs to know about and use.
What inspired you to invent/design this product?
Dan Michel, CEO, Dakim: I was responsible for my father’s healthcare during his 13-year battle against Alzheimer’s disease. I observed that if I kept my Dad cognitively stimulated, his cognition, mood, and outlook all improved significantly. I learned from medical research studies that consistent, long-term participation in rigorous cognitive exercise can significantly reduce the risk of dementia. I committed myself to finding a practical, affordable way to provide this benefit to seniors and their families fighting to prevent or slow the development of dementia.
What were the main challenges you encountered in designing this product and how did you resolve them?
Michel: We faced three main challenges. (1) Making rigorous cognitive exercise so compelling and enjoyable that seniors would want to do them consistently. We solved this problem first by transforming standardized neurological tests and exercises into highly produced and truly fun games designed to appeal to seniors. And Dakim continuously downloads new exercises, via the Internet, on a regular basis to each [m]Power to keep the experience fresh and compelling for years to come. (2) Making the use of a computer simple, easy, and nonintimidating for seniors. The Dakim [m]Power uses a touch screen and a SeniorCentric™ interface. This eliminates the mouse and keyboard and enables most seniors to use [m]Power even if they’ve never used a computer. 3) Making it simple, easy, and affordable for senior living providers to offer their residents a dedicated brain fitness program. Dakim not only built-in features that make it possible for most seniors to use [m]Power without assistance—eliminating most of the labor and cost burden from [m]Power use—Dakim engineered the system to download and install new exercises and application updates automatically, without customer involvement.
Patapsco Woodworks, Inc. and JSR Associates, Inc.
Contact: Jane M. Rohde, AIA, FIIDA, ACHA, AAHID
Phone: (410) 461-7763
e-mail: jane@jsrassociates.net
Web: https://www.jsrassociates.net
Nomination by: Peter Brooks, AAHID: Showing an incredible act of compassion, Jane designed this table after observing how hard it was for people in wheelchairs to eat.
What inspired you to invent/design this product?
Jane Rohde, JSR Associates, Inc., principal; Patapsco Woodworks, Inc., president: The idea for the Access Table came about after interacting with senior residents living in a nursing home and observing the lack of a true dining experience. Instead of seeing an enjoyable event, I watched as my friend, Miriam, donned in an undignified full-length bib, struggle with her left hand to get soup from her bowl to her mouth as she sat in her wheelchair. It was time for a paradigm shift! For many years, the solution to adjustable table height was to raise and lower the base of a table. My experience told me otherwise. Staff often are not trained to change the height of tables to meet resident needs and often don’t have time to climb under the table to crank it to an appropriate height for someone seated in a wheelchair. The other human factor missing from this solution is the ability for someone sitting in a wheelchair to be seated at the same table as someone sitting in a chair. So if all of your friends are seated in chairs, you cannot sit with them, or if you do, it is very difficult to feed yourself.
So, after discussing this with Miriam and other residents, I realized that the table needed to come to the person, instead of the person coming to the table. After many months of researching gadgets and holding design meetings with my business partner, Chuck Beavan, manufacturers, and casework fabricators, it was clear that the simplest way to meet the need was to create an apron with a drawer that contained a bridge. This bridge sits on the drawer and extends between the arms of the wheelchair, creating a table surface close to the resident removing the need for the dreaded bib and the long distance for soup on a spoon in a shaky hand.
What were the main challenges you encountered in designing this product and how did you resolve them?
Rohde: The first challenge was the U.S. patent process, which was overcome and a patent obtained. The paradigm shift also created a need for design professionals to look at the dining layout differently. The table has been sized at 41″ x 45″ to maintain the social circle of the residents utilizing the table. During the creation of prototypes, it was clear that the standard 48″ x 48″ tabletop did not work well with the bridges, so the overall dimensions were changed. In the planning phase, the tables need to be reviewed in both their open position and closed position for proper spacing. Operationally, staff needs to be more cognitive of residents wishing to sit together and assisting them with their specific needs. Although the function of the table is patented, the aesthetics of the table still required a better residential styling and feel. After a lengthy search, Leisters stepped up to the plate to assist with further design, input, and manufacture of the table for the senior living market. Through further focus group sessions with Leisters, the finishing touches were added to address safety and cleaning issues to create a table that will promote independence and dignity of elders. Furthermore, a country kitchen style version is in the works that can be utilized to support culture change models of care.
NuStep, Inc.
Contact: Steve Sarns, Vice President, Sales and Marketing
Phone: (800)322-2209
e-mail: stevesarns@nustep.com
Nominations by: Connie Ozment, LPN, LMT, ADC, Glenbrooke at Palm Bay, Palm Bay, Florida; and Amy Klesse, United Presbyterian Home, Washington, Iowa, whose comments follow: Being in the industry for nine years, I’d say the NuStep TRS 4000 (of which we have five) is our most useful tool in creating active lifestyles for our residents. It’s a “great initiator” in attracting people to an exercise program due to the user-friendly design, the swivel chair that makes transfers easy, the variable resistance and height adjustments to suit residents of various sizes and functional levels. While the essential add-ons have led to success for residents with functional difficulties, the NuStep TRS 4000 also continues to challenge our fittest residents and creates active lifestyles for many.
What inspired you to invent/design this product?
Steve Sarns: I came up with the original concept of the NuStep in 1991 and further developed the idea with Mark Hildebrandt, vice president of research and development and key designer. We are exercise physiologists who earned our master’s degrees at The University of Michigan. My educational focus and passion is in the area of exercise and gerontology. At that time, fitness products were focused primarily on the young and fit population, even though the older individual and those experiencing chronic conditions had the most to gain from exercise. Mark’s expertise is in designing a product that is ergonomically correct, well designed, and meets the variety of needs of our customers. We were inspired by the challenge to design a product that would specifically enable those with chronic disease to safely and steadily improve their health, fitness, and mobility.
What were the main challenges in designing this product and how did you resolve them?
Sarns: One of the main challenges was to design a product that would be accepted and enjoyed by virtually all individuals regardless of age or function level, including athletically active individuals. Much time and energy was put into designing the NuStep so it looked stylish while being both versatile and effective. We believe this has been accomplished since we hear success stories from a range of individuals throughout the world who love the NuStep-young men and women going through sports medicine rehabilitation, as well as those recovering from stroke and battling Alzheimer’s disease. Even those who cannot walk due to spinal cord injuries or those with severe balance issues sit proudly on the NuStep exercising next to able-bodied individuals all NuStepping and appearing to be free of ambulation deficiencies. This raises individuals’ self esteem, confidence, spirit, and hope, which is the key to sticking with the NuStep program leading to positive gains. Again and again we have witnessed transformational stories of individuals progressing from wheelchairs to walkers to canes, and in many cases, to walking.
Stand Guard of Ohio, LLC
Contact: Larry Hodge
Phone:(419) 382-5978
e-mail: https://standguardofohio.bex.net
Web: https://www.standguardofohio.com
Nomination by: Audrey VanderHorst, RN, RAC-CT, Swan Creek Retirement Village, Toledo, Ohio. The Stand Guard system is a wonderful and helpful unit. What a blessing! This system works very well in long-term care facilities as well as in the hospital setting and at home when parents live with a caregiver. The sensor alarm alerts staff when residents are moving about in any and all settings before a fall occurs. The stand is portable and can go anywhere the resident is going. This product is also an excellent solution to keeping your facility and residents restraint-free. You can place the unit in other residents’ doorways to alert your staff of a wandering resident entering someone else’s room. This is a truly wonderful product and allows residents more flexibility while remaining as safe as possible.
What inspired you to invent/design this product?
Larry Hodge: I was working in the maintenance department of a retirement village, and was mounting motion detectors to the beds and walls in residents’ rooms. When the residents left, the alarms would have to be removed, leaving holes in the walls. When someone else moved into the same room needing an alarm, I would need to remount the alarms. The nursing staff asked if there was anything that could be done to make the alarms portable. I knew that there were safety issues when the residents were in their chairs watching TV, when using the toilet, or in other activities. My wife, Karen, has worked in hospitals and nursing homes, and had been involved in creating fall prevention programs with nursing, and we had both witnessed what catastrophic outcomes can result from a fall. All the caregivers involved were concerned with the safety of the residents, and wanted to be alerted of their movement as soon as possible.
What were the main challenges you encountered in designing this product and how did you resolve them?
Hodge: I wanted to make sure, through the processing of my design, that it would be stable. I had to consider size how big or how small should it be to be operational. It couldn’t be top heavy or too bulky because an alarm would still need to be mounted on it. I needed to decide what material to make it out of, and we wanted it to look pleasing to the eye so that it could be used in a healthcare environment or in home use. I needed to make it so that it was stable and would not tip over easily. Then I had to decide what type of motion alarm I would use with it. Once again, we looked at appearance and ease for the caregiver and chose an alarm with a choice of volume settings.
BeauLily, LLC
Contact: Margaret Light
Phone/Fax: (877)428-3321
e-mail: owner@beaulily.com
Nominations by: Karen Koch, Valley View Nursing Center, Montoursville, Pennsylvania; Barbara Friesner, AgeWise Living, New York, New York, whose comments follow: I got a Twiddle™Muff for my mother who has very advanced dementia and was pretty much the only thing that she connected to at that point in her illness. It did everything it said it would do it kept her hands occupied, it gave her something to focus her eyes on, and it gave her a “companion.” After seeing the wonderful response in my mother, I became a huge TwiddleMuff supporter! I recommend it to my generational coaching clients and spearheaded the drive to purchase TwiddleMuff for other residents of my mother’s nursing home. This is definitely an award winner!
What inspired you to invent/design this product?
Margaret Light: It broke my heart seeing my beloved grandmother, Lily, just sitting in a chair most of the day. By 90 years of age she was virtually blind and those once active and creative hands had become idle and chilled. I designed the TwiddleMuff as a unique way to keep her hands warm and happily occupied. It also reminded her of just how much she was loved even when I couldn’t be with her. Having worked in a care facility, I was well aware that any product used by the elderly had to be safe, easy to clean (industrial washer and dryer), and have a label for the resident’s name. Gleaning much advice from healthcare professionals, activity directors, and focus groups, my TwiddleMuffs have become the comforting, stimulating, and enjoyable products they are today! Grandmother Lily would be thrilled to know she was the impetus to improve the quality of life for so many!
What were the main challenges you encountered in designing this product and how did you resolve them?
Light: I had resolved that the TwiddleMuff would not only be soft and comforting, but also provide therapeutic benefits through tactile stimulation. It was necessary to experiment with a variety of textiles, testing them for the durability to stand up to repeated washings while maintaining their softness. The more challenging task was deciding what tactile elements would be incorporated. My life is filled with smart and talented family and friends so I didn’t hesitate to get their input. My sister-in-law is an occupational therapist and worked through various ‘gadget’ ideas with me. Local physical therapists in my hometown, reviewed the options and made suggestions. I ran focus groups with neighbors and colleagues to gather input on what they most appreciated for their elderly relatives. Area nursing homes allowed me to see how their residents responded. The final design was many months in the making but was similar to the first one I’d made for my grandmother several years earlier.
I Advance Senior Care is the industry-leading source for practical, in-depth, business-building, and resident care information for owners, executives, administrators, and directors of nursing at assisted living communities, skilled nursing facilities, post-acute facilities, and continuing care retirement communities. The I Advance Senior Care editorial team and industry experts provide market analysis, strategic direction, policy commentary, clinical best-practices, business management, and technology breakthroughs.
I Advance Senior Care is part of the Institute for the Advancement of Senior Care and published by Plain-English Health Care.
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