St. Catherine's Village Implements New Program at Siena Center

Teamwork, respect and communication are just three benefits of successful Stand Up Program

Every day at noon a female resident would go and look out the door rather than go to lunch.  This puzzled and then began to worry nurses and other staff members at Siena Center, the nursing home unit at St. Catherine's Village in Madison.

Thankfully, the mystery of this persistent behavior was quickly solved. Nursing Assistant Tawanna Elam, who spends a good deal of time tending to residents' daily needs, volunteered insightful information she learned from talking with the resident and her family. "We learned throughout her marriage, this lady had met her husband every day at the front door as he came home for lunch, said Cherie Polk, Siena Center Nursing Administrator. "This was valuable information that clearly illustrated the why of her actions and helped the staff assist her in the appropriate manner."

Today, Siena Center residents are benefitting from the coordinated efforts of administrators and supervisors, nurses, nursing assistants, housekeepers and maintenance workers, who meet twice daily to discuss residents' healthcare needs and other issues, both large and small that affect their care.

The Care Team meetings are part of St. Catherine's Stand Up Program, a collaborative effort that provides a voice for assistants like Elam who spend the most one-on-one time with residents, caring for their basic needs and assisting with daily living skills.

This type of coordinated care is intended to provide closer monitoring of residents' physical and mental conditions, increase communication among staff members, minimize interruptions in residents' daily schedules and allow for greater monitoring of all areas of Siena's operations.

Since initial implementation in May, 2009, the program has been embraced by all staff members, Polk said. This early acceptance of a program that changed their daily routine was a result of realizing the numerous benefits of learning about residents' needs from those who know them best.   

Polk said this type of inverted pyramid concept allows nursing assistants to inform and, in some cases, offer suggestions on resident care.  Even informing the team about small problems such as a malfunctioning air conditioning vent that is upsetting a resident is valuable information because it allows the problem to be fixed before it escalates.

The overriding idea is if those with the most in-depth knowledge of residents can pass information to others, quality of life is improved through early and regular intervention.

"Our nursing assistants are really on the front lines and know every trait, every habit of our residents," said Polk. "They spend the most time with residents and usually know before anyone else if they are upset about something like a special anniversary or if they are just not feeling well. Many times, our residents will tell the nursing assistants things they won't tell anyone else. Providing this information to all members of the Care Team allows us to take care of residents more efficiently, whether it relates to their medical care or offering additional support that day."

Polk said the first meeting of the day is held at 8:30 am.  Nursing assistants serve as team leaders and address each of the topics as needed with the interdepartmental team.  

Elam said having the opportunity to pass on information about those in her care makes her feel valued and appreciated. 'Before I started attending the meetings, I only knew about the duties I was expected to perform,' she said. "Now, I hear about many other things, such as medications, treatment plans and other things affecting my patients.  It gives me more information about what is going on with them. As a result, I can give them better care."

The process is also repeated in mid-afternoon for the 3 pm - 11 pm shift.  Plans call for a similar meeting to be held for the 11 pm - 7 am shift, which will ensure the successful Stand Up Program is in operation 24-hours a day.

"Anytime we can increase communication among staff members, it serves to benefit our patients," said Polk. "When we know more, we can do more for them. At the same time, giving our nursing assistants a voice illustrates to them how much we value them and the care they give our residents."

Another facet of the program involves caregivers communicating information to those who work on adjacent shifts. Recently, a day shift employee reported a problem involving a resident who awakened at an inappropriate time in the morning due to an extremely early bedtime. Letting night shift employees know this was affecting the residents' daytime activities and discussing the situation led to an agreed-upon solution, Polk said.

"In this case, the night shift agreed to work with the resident and strive to keep him from going to bed early in the evening," she said. "This helped him get into a more appropriate routine at night and the following morning. Overall, it benefited his socialization with others throughout the day. This is just one example of how the Stand Up Program is working for both residents and staff."

Continuity of care is important with residents at Siena Center, said Cindy Jayroe, RN, Nursing Director.  She feels the Stand Up Program allows for a seamless flow of care at all levels, guided by increased communication and teamwork. "Every piece of information coming from our care-giving team is utilized," Jayroe said.  

Sharon Sanders is another nursing assistant whose voice is now heard, courtesy of the Stand Up Program.  "I feel I learn something every day that allows me to take better care of my residents. That's what I enjoy the most."

"As our knowledge of our residents expands, so does our ability to improve their care," Holly Gage, RN, Health Services Director added. "Teamwork, respect and on-going communication are essential to providing service excellence. Our goal is to enhance and support the professional growth of all the staff.  It is gratifying to see this goal being met with the Stand Up Program."


Debra Lawyer, a Nursing Assistant at St. Catherine's Village Siena Center, prepares to replenish the laundry in a resident's room. Lawyer says the new Stand Up Program has broadened her knowledge of the center and residents' care.

Tewanna Elam is pictured electronically documenting her activities at the Siena Center. Elam is a member of the Care Team, an outgrowth of the new Stand Up Program that has benefitted her as well as those in her care.