Program Evaluation

I. TR Process

a. Assessment

i. Name the assessment(s) used at your agency. If your agency does not use an assessment, identify an assessment that maybe appropriate for the agency. Include whether the assessment is standardized or an “in-house” tool.

Imperial Plaza uses the Life History Form, which is an in-house assessment tool. It starts out by asking basic information like name, age, move- in date, former occupation, veteran and religious preference. It then asks questions like tell us about your life story, a typical day for you and typical week, how do you like to spend your leisure time, interesting or unique facts about the individual, and lastly any significant life events that you would like to share with us. It then ask about hobbies and interest by categories. The categories are physical, emotional, purposeful, intellectual, spiritual, and social. It then ask three questions with each category. (Mesa. A, personal communication, June 19, 2020)

ii. Describe the on-boarding process- registration, admission, etc

During the on-boarding process, when the individual first arrives at the agency they have already been approved to live there and have done some of the work before hand. When they get to the agency they are given a tour of things and go through a brief orientation. This is usually done by the nurses, they explain the residents schedule like meal times, laundry days, shower days, and the other amenities the agency has. They are given calendar and flyer for family events that is also posted around the agency for when activities are. Once completed with that they would be given the assessment by the CTRS to find out more about them and what interests they have so to better know which activities may be geared toward the individual and which ones they may not attend. (Mesa. A, personal communication, June 19, 2020)

iii. Identify other documents or resources that assist in the assessment process (past records, families, other providers).

The other documents or resources they use at the agency are as mentioned above the printed note, calendar, and flyer for family events that will come up throughout the year. The printed note is sent to the residents family not to the resident themselves. The agency also reaches out to the family if needed but not often. That is usually in the case of the resident is not answering the questions or is not sure of the information they are being asked. They also use the social data information collected by the family like past employment and other details about them that would help spark up a conversation and get the assessment process rolling.(Mesa. A, personal communication , June 19, 2020)

iv. Other- list any other aspect of the assessment process or details you deem important to include here.

There are no other aspects to the assessment process that need to be listed here, all was covered in the questions above.

b. Plan

i. Describe the planning process at your agency. Be sure to identify the role of the assessment in planning.

The assessments are used as the basis for program ideas to be generated and turned into a program or a spin off of the activity. They keep some of the same programs each month but change some up depending on holidays or seasons or just to throw in something new for the residents so they don’t get so tired out of the usual activities. But mainly the programs are similar each month. Bingo, exercise, religious activities, and others are kept consistent and just happen to be the programs the older adults tend to lean toward for the most part. But the assessment is used to pick activities and those are used to generate ideas from the older adults and all the feedback is used to plan the calendar out for the month.(Mesa. A, personal communication, June 19, 2020)

ii. Identify any documents used in the planning process.

The documents used in the planning process are the initial assessments known as the Life History Form and resident surveys which they use to rate or discuss activities to discover whether to keep it or try something new.(Mesa. A, personal communication, June 19,2020)

iii. Describe other departments, sources, allied professionals that are involved in the planning process.

The others involved in the planning process are the assisted living supervisor, dining staff, transportation staff, hospice or therapy groups and rehab companies who come in sometimes to lead a group.(Mesa. A, personal communication, June 19, 2020)

iv. Describe how activities/interventions/programs are selected. Give examples.

The ideas generated for activities come from the combination of the residents assessments and the residents themselves. The assessments give an idea of interests and the residents add to that. They can use resident surveys to help pick programs or even to eliminate the ones that they do not find to be that interesting. They also have group discussions after an activity about that activity or just the activities in general and they collect the feedback of those who participate for those are who matter to the success of the programs and sessions. If not all residents go to a particular activity they can also voice their opinions in the resident council meetings as to what programs or activities they may like to try or see at the agency. For example with Bingo, as you know all residents like bingo and enjoy playing it but after a while just repeating the same old bingo over and over can get tiresome so they added some spins on bingo like one is $$ Bingo in which the resident(s) who win get to choose the next game and also win quarters so it adds a since of competition and spice to the regular bingo but still allows them to do an activity they enjoy.(Mesa. A, personal communication, June 19, 2020)

v. Provide a monthly and weekly schedule of programming/activities at the agency/setting.

June imperial plaza calendar

c. Implementation

i. Describe the implementation procedure. Give an example.

Activities implemented at Imperial Plaza are usually based on who is available or which floor is doing the activity on who will implement and now with the current state and this pandemic its a all hands on deck requirement for Bingo now takes two or three people instead of just one so they are working as a team to get the activities implemented. They must depending on the activity gather the supplies and make sure they have enough for everyone and bring a few extras in case some show up who may not usually. They make sure they get there early to set up for the activity and prepare the space for the arrangement that is needed for the activity. The individual who is implementing must also have a back up plan and some form of debrief with the activity to ensure evaluation and feedback. For example with Bingo, say Angela and one of the other CTRS is implementing since you need more than one right now to do it. They would need to gather the supplies before and have them ready to go and they do it based on the floor so they would take the stuff to the appropriate floor. Once it got close to time they would knock on the residents doors and see who all would like to participate in the Bingo and start passing out the cards and chips they would need to all who say yes to participating. After that they would explain the activity if it were a new spin off of regular bingo and then begin to play the activity. Once the hour and a half time frame was coming to an end, Angela would go into the discussion portion after and ask how they liked the activity and what they didn’t like, and gather feedback so they could change the activity up or keep it the same.(Mesa. A, personal communication, June 19, 2020)

ii. Identify how implementations are documented. Explain what information is required in this documentation.

There is no documentation as of right now unless it is a craft and they print off how to instructions. They have cheat sheet for exercise for if someone needs to fill in. There are no requirements in the documentation because it is not mandated at the agency. For cooking class they have the recipes with them. Having correct forms filled out with working with other departments like dining and transportation is one of the only documentations they have to do. Big family events have documentation on room set up or special diets for residents. But day to day no real procedure lay out or planned out for documentation purposes. (Mesa. A, personal communication, June 19, 2020)

d. Evaluation

i. Describe how the client’s progress is evaluated. Be sure to mention all documents used to evaluate client progress.

It is evaluated by noting if there is a change in the participation or refusal to join activities they used to always attend which is documented in the chart or to nursing.(Mesa. A, personal communication, June 19, 2020)

ii. Describe how the program’s progress is evaluated. Be sure to mention all documents used to evaluate programming and how programming improvement is made.

They used to have an attendance blog or chart that marked who was present and the participation which allowed them to observe the program and make notes or take mental notes. Now they do not have the attendance blog but do still observe and take notes on what went good and what could be improved or changed and suggestions on how to improve it. If a program does not work they adjust as they go as a CTRS is trained to do to think on the fly.(Mesa. A, personal communication, June 19, 2020)

iii. Describe how the therapist’s skills are evaluated. Be sure to mention all documents associated with this process. Describe how the therapist uses feedback to improve their skills.

They have annual reviews that have a self- review section and one for the supervisor to fill out. They come up with goals and easy ways to improve the skills they are already good at, but goals and outcomes are a big part of the review. Some are addressed on a case by case situation. If it becomes continuing it goes through HR process of course if the issue gets out of hand or is something they should not be doing and have been told numerous times not to do it.(Mesa. A, personal communication, June 19, 2020)

II. Program Outline

a. Programming-

Exercise
Music
art and crafts
Bingo
virtual travel
movies
family events
religious
community outings
cognitive stimulating
social

b. Interventions/activities-

$$ Bingo- They play it for 1 ½ hours. The objective is playing regular bingo and the winner wins quarters and gets to choose the next game. The outcomes of this activity is improving/maintaining number recognition for some as well as enjoyment and socialization.(Mesa. A, personal communication, June 19,2020)

Musical Memories- They play it for 1 hour. They play pre- recorded music that the residents choose. This leads to sing-along/ reminisce about certain artist/groups. The outcomes of this activity is enjoyment, socialization, and sometimes reminisce.(Mesa. A, personal communication, June 19, 2020)

Brain Teasers- They play this for 30 minutes. This is brain games/ trivia done collectively as a group. The outcomes of this activity are improve/maintain memory, executive functioning, critical thinking depending on the game.(Mesa. A, personal communication, June 19, 2020)

Sittercise & Pump-it-up- This is played for 30 minutes. The idea of this activity is exercising to music sitting down with and without weights. The outcomes of this activity are maintain/ improve ROM, strength, endurance, and socialization.(Mesa. A, personal communication, June 19, 2020)

Manicures- This is done for about 1 to 2 hours. They cut if the patient is not diabetic, file and paint residents nails based on their preference. The outcomes of this activity are enjoyment, relaxation, and socialization.(Mesa. A, personal communication, June 19, 2020)

Women’s Coffee Talk- This is done for about 1 hour. There is coffee and snacks served while a special guest presents/takes questions/ etc. The outcome of this activity is socialization.(Mesa. A, personal communication, June 19, 2020)

Movies- This is done by the length of the movie chosen. They come and watch a movie with friends. The outcomes of this activity are socialization and enjoyment.(Mesa. A, personal communication, June 19, 2020)

Chef’s Table- This is done for about 30-45 minutes. This is where a chef does a cooking demo and the residents then get to taste test the food. The outcomes are socialization and using senses like taste, smell, sight, and touch.(Mesa. A, personal communication, June 19, 2020)

Virtual Travels- This is done for about 30 minutes. They use the smart TV and youtube, they go on a tour of a city which they usually pick a state/country for each month and tour cities throughout them. The outcomes of this activity are reminisce, intellectual and socialization. These outcomes are for if a resident has been there, learning about a new place, and communicating about what they would want to do there and why.(Mesa. A, personal communication, June 19, 2020)

III. TR Process Delivery Flow Chart

IV. SWOT Analysis-

a. Strengths- The strengths of Imperial Plaza RT program is the variety of programs offered each week and especially each month which address physical, cognitive, social, spiritual, and intellectual needs of the participants. Another strength is the range of disabilities they are able to serve in just one population, older adults. They also have the strength of being able to think on the fly and change things as they go to better fit a goal or outcome they chose for the activity.

b. Weaknesses- One major weakness in the agency is the lack of documentation on the programs and the participants. This makes it difficult to know for sure which programs are working and which are not for individuals and as a whole the disability or population.

c. Opportunities- One opportunity would be to attend conferences maybe even present at a conference to expand and obtain knowledge that could be beneficial for your agency and your department. Another would be to advocate for your programs and the agency so you get more recognition. Have more community involvement could be a good way to branch out. Apply new strategies to the agency or the RT program in general.

d. Threats- The lack of funding or lack of money for programming or the RT program in general could be a threat for them. Right now with all that is going on and not knowing what the future holds they could have a loss of resources if things close down or get destroyed which could be astronomical to the community outings or the branching out of programs because they won’t have the support or the resources they need to go through with things.

 
References:
Lloyd, R. (2013, October 7). Whiteboard: Flowchart [Video]. Institute for Healthcare Improvement. Retrieved from https://www.youtube.com/watch?time_continue=258&v=tq7dQVaTbcc&feature=emb_logo

Mesa. A, personal communication, June 19, 2020

Whitely, K. & Lynch, S. (2018). Documentation flowchart Figure from Healthy innovations documentation process handbook In RECR 260 Children with Disabilities: Spring 2019. Retrieved from https://canvas.longwood.edu/courses/1291071/files/search?preview=54787353&search_term=handbook