Redesigning the nursing home system: health & design experts study COVID-19 spread, and how to stop it

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AUSTIN (KXAN) — It’s not a group you’d expect to find working together, but some of the state’s top health care professionals and visual designers are searching for solutions to the coronavirus crisis in nursing homes.

“Design is a very creative process that considers the human needs of whoever you are designing it for, first and foremost,” Design Institute for Health Executive Director Stacey Chang told KXAN in May.

Chang leads the partnership between Dell Medical School and the College of Fine Arts at The University of Texas at Austin, breaking ground at the intersection of health care and design.

After the Austin City Council approved a resolution dedicating resources to long-term care facilities, Chang said they would begin looking at the root problems contributing to the spread of the virus and how to redesign the system to prevent it.

MORE: ‘We’re not moving fast enough’: Austin City Council to consider nursing home resolution

Chang’s team from the Design Institute for Health has been working on the “Nursing Home System Study” alongside experts from the UT School of Nursing, the Steve Hicks School of Social Work, Austin Public Health and the Texas Health and Human Services Commission.

On Tuesday these researchers will present Phase 1 of their study to city council.

According to a city memo outlining their results so far, they identified ways to “simplify workflows and reduce staff burden, keep residents connected to their loved ones, ensure sustained financial viability for operators, and address employee retention.”

  • Read the full results here.

According to the study, around 3,000 people live in the 31 skilled nursing facilities in Travis County, but there are as many as 5,000 staff working inside. The researchers toured four different local nursing homes, interviewing management, certified nurse aides, social workers, and housekeeping staff on-site.

Much of their research focused on the pandemic’s effects on the workforce. The study concluded “staff workload (physically and mentally) is disproportionate to hourly wage.” They also noted that the competition is “fierce” for employees with the same skill set.

“They can make more at Buc-ee’s over the weekend, than they can here in a week,” one staffer reported.

A Director of Nursing at another facility reported to the researchers, “Why would you do this job for 13 dollars an hour? All that manual labor, and then you’re exposing yourself to COVID, when you could be working at HEB.”

They also noted that staff turnover rates were high — 85% for certified nurse aides.

One CNA told the researchers, their work often goes “unappreciated.”

Chang told council on Tuesday, he didn’t speak with a single CNA who could do their job from 6 feet away — one of the biggest challenges the industry is facing.

“There wasn’t a single facility we visited where there weren’t a half-dozen ‘hero’ stories,” he said.

They focused on skilled nursing facilities, but plan to expand their research to other long-term care options, like assisted living and state hospitals.

KXAN Investigators will have more on this research on KXAN News at 5 p.m.

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