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How candid feedback earned one facility an AHCA Gold Quality Award

For long-term care facilities, the American Health Care Association (AHCA) Gold Quality Award is a coveted prize.

It recognizes superior quality of care, and it’s a rare honor. Since the Award’s inception in 1996, no more than a handful of facilities have earned it in a given year.

This year, the Alverno Health Care Facility received it, making it the first facility in Iowa to do so.

We had a conversation with Deb Bergmann, Alverno’s Director of Marketing; Theresa Nielsen, Director of Nursing; and Libby Goodman, Administrator, to find out how Alverno achieved so much, and what they learned along the way.

A healthy feedback loop

To drive quality improvement, Alverno relies on resident surveys. This feedback is a crucial part of their process. It shows staff members where they should direct their energy in order to make the biggest possible impact.

But these surveys were not always so helpful. In the past, residents didn’t bring much enthusiasm, or candor, to the feedback process.

“It was a big ‘aha!’ moment for me,” Theresa said, “when I realized how important feedback could be, and how much education it would take for residents to understand it.”

Libby weighed in, too. “Sometimes residents can misunderstand the point of these surveys, or else have no faith that their feedback would be acted upon,” she said. “We assured them that we take their feedback to heart.”

To do this, in the month before the surveys open they embark on an educational campaign, spreading information about the value of resident feedback.

“We want them to know that these forms will make a difference,” Deb said, “and we want them to share their whole, unbiased opinions—both positive and negative.”

The month of education culminates in Survey Day, a special facility-wide event. Banners and decorations adorn the halls. Residents can find snacks near survey stations. They can also get prizes for filling out surveys that day.

This helps drum up enthusiasm for feedback. Even more important, it ensures that residents will be candid with their responses.

Showing where they shine

Some of the feedback is excellent.

“The surveys showed again and again that residents valued their bond with staff members,” Libby said. “That’s a big point of pride for us. We’re careful to cultivate strong relationships in our facility.”

Libby credits a few recent initiatives for this.

For one, a point-of-care staff-member works with every new resident on a “hospitality worksheet.” The sheet is used to explore the resident’s preferences, and it makes a powerful impression.

“It’s the first way that we show how much we value their choices,” Deb said.

Another important relationship-building initiative is the Do Good Club, held once every month. By having residents serve in a community-service project, the club instills a sense of usefulness in residents. Staff and residents work side-by-side, forming an important bond with each other.

Following through

Strong as these bonds can be, not all resident feedback is glowing. Alverno truly earned its Gold Quality Award by putting negative feedback to use.

First, the administration makes sure to meet with the Resident Council both before and after survey collection. This way, residents know that their voices have been heard.

“That transparency is very important,” Libby said. “It shows we’re acting in good faith.”

Once results have been shared, Alverno takes practical steps to resolve concerns. A recent incident is instructive.

“Surveys came back with all these negative comments about our food vendor,” Deb said. “They weren’t giving our residents the level of service they expected.”

To rectify this, Alverno’s administration took a radical step: they held an open Town Hall–style meeting with the residents and the vendor.

“I’m sure it was a little nerve-wracking,” Theresa said, “but it made a huge impact. The residents were impressed with how the vendor took responsibility, and the vendor made important changes for the better.”

This commitment to transparency and openness may seem extreme, but it drives extraordinary results for Alverno’s residents.

The most important lesson: improvement is continuous

 Like any meaningful achievement, Alverno’s Gold Award was no overnight success. It took a long, serious commitment. The facility first earned a Bronze Quality Award in 2003, then a Silver in 2010, before finally taking the Gold this year.

“This didn’t happen by accident,” Deb said. “It wasn’t easy for us—and we don’t think it could be easy for anyone.”

Alverno’s administrative staff agrees. The most important lesson they learned from this experience is not to rest on their laurels.

“We enjoy winning an award, obviously,” Deb said, “but the point is the process. It’s how we got here that’s important.”

Libby agrees. “Quality is an ongoing journey. We love being on it. We invite other facilities to join us if they feel the same way.”