Read the article: \"The Changing Landscape\", which is found in the \"Short Term

Question

Read the article: "The Changing Landscape", which is found in the "Short Term Stay" attachment.  Post to the discussion board your opinion of what you read in the "Short Term Stay".

In the past 10 years, this nation has
seen a much greater range of options
for seniors in need of care and services.
As a result, the number of shortstay
admissions—those staying 30
days or less—is growing at a rapid rate.
There are, at any one time, about 1.5 million
residents and patients in nursing facilities
across the country. The majority (80%)
of these are the traditional long term care
resident with an average length of stay of
approximately one year. At the same time,
however, there are 2.5 million short-term
stays of fewer than 30 days in skilled nursing
facilities in a year. This illustrates the shifting
balance toward the short-term patient and
should highlight the importance of this population
to the senior care profession.
WHAT IS THE SHORT-STAY PATIENT
LOOKING FOR? The short-stay patient comes to the
nursing home with very different
goals and much different expectations.
Perhaps she is looking for rehabilitation
in order to return to her independent,
productive life. Or she may simply need 24-
hour nursing care to recuperate from surgery
or an illness. Her experience during that physically and
emotionally challenging period will be the story she shares
with her family, friends, and neighbors.
It should be a story that the provider can be proud of. It
should be a story of loyalty. It should be a story that leaves
the listener feeling confident that, if the need arises, there
are caring, professional people ready and willing to provide
the care she deserves.
In “If Disney Ran Your Hospital,” author Fred Lee said,
“Patients judge their experience by the way they are treated
as a person, not by the way they are treated for their disease.”
Providers need to take a critical look at the consumer
experience. Are the services being provided consistent with
the treatment of the patient as a person, or is the focus
more on the processes of care? Providing a
level of service that will engender loyalty
implies understanding patient needs, acting
on them, and treating the patient as a person.While
providers must continue to listen to the long-term resident,
it is now critical that they listen clearly to the expectations
of the short-stay patient. As a profession, we have to take a
hard look at our service to these patients.We need a very
detailed understanding of the patient’s, and their family’s,
wants, needs, and expectations.We need to have a reliable,
valid way to measure our success in meeting them.
WHAT DO WE KNOW ABOUT THE
SHORT-STAY PATIENT? Acustomer satisfaction survey, designed by My
InnerView researchers, specifically measures the
needs of the short-stay patient. This instrument differs
from standard long term care surveys in
that it addresses the discharge and admission
process, setting and meeting rehabilitation
THE CHANGING LANDSCAPE
from long term care to short-term stay
What are your short-stay customers saying?
goals, and assistance with services and equipment needed
upon discharge.
In 2007,My InnerView used this survey to gather data
from more than 38,000 patients soon after their discharge
from a nursing facility. Ninety-one percent (91%) of the
respondents had stays of less than
three months.
The short-stay population differs
in important ways from longterm
residents. Short-stay patients
are significantly younger, only
46% are above the age of 80,
whereas 68% of long-stay patients
are over 80. The short-term
patient is much less likely to comparison
shop than other residents,
relying on recommendations from
others to make their selection.
Short-term patients are also visited
much more often than longterm
residents. Almost three-quarters
(73%) of them were visited
daily, as compared with 36% of
the long-term-stay residents.
By a significant majority, shortstay
patients are satisfied with
their experience with the nursing
facility. Seventy-seven percent
(77%) expressed overall satisfaction
with their stay, while 40%
would recommend their facility as
“Excellent” to others. Satisfaction
results were similar comparing
Quality of Life (82% Satisfied),
Quality of Care (80%), and
Quality of Service (79%) domains.
The area in which respondents
have the strongest “Excellent”
response is Quality of Care, at
43%. In the other domains,
respondents are more likely to rate
the service as “Good” than as
“Excellent.” This is consistent with
the patient’s focus on healing and
rehabilitation.
Global satisfaction with the
facility is actually lower for the short-stay patient than with
the long term care resident (77% vs. 82%). Possible explanations
for this include the very different expectations that
a short-term stay patient has when coming to the facility.
The difference underscores the importance of understanding
this population’s unique needs.
The short-stay survey evaluates
the perceived needs of the patients
using a correlation analysis. Every
item on the survey is correlated
with the extent to which the
patient would recommend the
facility to others as a place to
receive care. The items with the
highest correlations are considered
to be the most important to
the patient.
Items of importance to shortstay
patients include the concern
and competency of staff, the ability
of the facility to meet their
choices and preferences, the
responsiveness of management,
and the quality of both medical
and licensed nursing care. The
areas in which the patients are
most pleased include the quality
of rehabilitation therapy, the
respectfulness and care demonstrated
by staff to patients and visitors,
and the quality of both
licensed nursing and certified
nurse assistant care.
WHAT WILL THE SHORTSTAY
PATIENT SAY TO
FRIENDS ABOUT HER
EXPERIENCE? Short-term stay patients
bring a unique perspective.
Unlike the family members
of long-term residents, these
patients have recently experienced
these services directly and will be
asked repeatedly to share the
experience. That is why the ques-
2 My InnerView Inc. • May 2008
‘Patients reserve their good word of mouth and loyalty
for hospitals where they feel their needs were anticipated
and met by a courteous, caring staff.’ —Fred Lee
< 60
6%
< 60
9%
60–79
26% 80+
68% 60–79
45%
80+
46%
3+
9%
Only 1
14%
None
36% Only 1
11%
None
67%
Two
13%
Two
24%
3+
26%
3%
Once week
or more
47%
Daily
36%
Daily
73%
Once
month or
more
9%
Once week
or more
23%
CHARACTERISTICS
OF SHORT-STAY PATIENT
CONSIDERABLY YOUNGER. Only 46% of short-stay
patients are over age 80, compared with 68% in
long term care.
LONG-TERM SHORT-STAY
LESS LIKELY TO COMPARISON SHOP. In short-stay,
only 33% visit at least one facility, compared to
64% in long term care.
VISITED MORE FREQUENTLY. In short-stay, 73%
of patients are visited daily, compared with 36%
in long term care.
Source: My InnerView Inc.
LONG-TERM SHORT-STAY
LONG-TERM SHORT-STAY
tion, “What is your recommendation of this facility to others?”
is a cornerstone of any good customer satisfaction
instrument.
The willingness to recommend is a measure of customer
loyalty.We have all heard it said that a satisfied customer
will tell three people, an unhappy customer will tell 10 people,
but a loyal customer will tell everyone who will listen.
One way to earn loyalty is to change the way we think
about the customer experience.With the 30-day length of
stay, what was once an annual admission has now become
12 different admissions per year.
The opportunity to develop a
relationship with the patient and
ability to create a loyal customer
has just gotten more complicated
by a significant factor. Not only is
there less time to interact with, get
to know, and earn the trust of the
short-stay patient, but a much
greater percentage of the time
spent with that patient is taken up
with the processes of care. At the
same time, it is important to consider
how the short-term patient’s
needs differ from those of the traditional
resident. The short-stay
patient is focused on healing and
returning to his or her prior place
of residence. So it is critically
important that we provide the
high-quality clinical and rehabilitative
care, but not at the expense
of the customer experience.
HOW CAN WE TURN THE
SHORT-STAY PATIENT INTO
A LOYAL CUSTOMER? For the provider interested
in earning the loyalty of
the customer, mere satisfaction
is not enough. The
provider must focus on providing
a level of service that their customers
will rate as “Excellent,”
which is a much more important
indicator of loyalty than “Good.”
The all-important question is,
“What is your recommendation of
this facility to others?” but that
recommendation is going to be
based on the elements of service
that are found throughout the
survey. Providers have to carefully
review their opportunities with all elements of service and
work to improve those in which patients rate them as less
than excellent.
Admitting 12 patients per year where, in the past,
providers admitted one, we see an environment where the
provider is focused on the admission
process and the discharge
process rather than the customer
experience. Providers who only
focus on the process will lose the
opportunity to have a personal
relationship with their patients.
Earning the loyalty of this
important group will pay dividends
to the skilled nursing
provider in the future in terms of
an enhanced reputation in the
community and an increased ability
to attract short-stay admissions.
As the trend to shorter stays, more
acute patients, and more admissions
and discharges continues to
grow, providers’ reliance on this
population for their success
becomes ever more important.
Word-of-mouth recommendations
can be your most powerful
form of advertising. According to
McKinsey & Co., more than twothirds
of economic activity is driven
by word-of-mouth recommendations
and shared opinions.
Your patients’ recommendations
are driven by satisfaction and loyalty.
Loyalty is earned by anticipating
and meeting the needs of the
customer.
My InnerView Inc. • May 2008 3
Loyalty
A loyal customer:
n Will give you the benefit of the doubt;
n Will use you again;
n Will recommend you to others; and
n Will enhance your reputation in the community.
31%
15% 3%
EXCELLENT GOOD FAIR POOR
51%
36%
13% 10%
EXCELLENT GOOD FAIR POOR
41%
34%
13%
5%
EXCELLENT GOOD FAIR POOR
48%
40%
11% 12%
EXCELLENT GOOD FAIR POOR
38%
39%
13%
6%
EXC GOOD FAIR POOR
43% 43%
13%
7%
EXC GOOD FAIR POOR
37% 39%
14%
8%
EXC GOOD FAIR POOR
40%
OVERALL SATISFACTION. Long-stay patients gave
more “Excellent” or “Good” ratings (82%), compared
with short-stay residents (77%).
GLOBAL SATISFACTION
RECOMMENDATION TO OTHERS. Short-stay patients’
willingness to recommend the facility to others
(78%) was lower than long-term residents (82%).
SATISFACTION OF SHORT-STAY
PATIENT BY DOMAIN
QUALITY
OF LIFE
QUALITY
OF CARE
QUALITY
OF SERVICE
Source: My InnerView Inc.
LONG-TERM SHORT-STAY
LONG-TERM SHORT-STAY
This article was written by BRAD
SHIVERICK, CPHQ, Chief Quality
Officer for My InnerView. For
more information, visit www.
myinnerview.com or

Explanation / Answer

Use the same generalized Hooke’s law expression to calculate the uniaxial stress expression. As it is given that the stress in y and z directions is zero, substitute 0 for and in Hooke’s law.

Now substitute 0 for and in , , and expression.

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