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by Debbie Hommel, BA, ACC, CTRS, Executive Director of DH Special Services
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Executive Director
DH Special Services
About Debbie

Debbie Hommel, BA, ACC,
CTRS, is the Executive
Director of DH Special
Services. She is a Certified
Activity Consultant on State
and National level, with over
twenty-seven years of
experience in providing direct
care and consultation to long
term care, medical day care,
assisted living, and ICF/MR
facilities throughout New
Jersey, New York, Maryland,
and Pennsylvania. She is an
experienced trainer and
workshop presenter,
conducting a variety of
seminars throughout the
Tri-State area for the Activity
Professional, Administrator,
and allied healthcare
professional. Debbie Hommel
is an active member of Activity
Professional Associations on
State and National levels. She
is ACC certified through the
NCCAP. She is a founding
member of the New Jersey
Activity Professionals'
Association, serving terms as
Vice President and President.
She received the Weidner
Lifetime Achievement Award
in 1994 and the Monmouth &
Ocean County Activity
Professionals Life
Achievement Award in 1999.
Let Debbie answer your
Activity Questions
Providing Internet Resources
for Activity Professionals
in Long Term Care Settings

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Quality Assurance for the Activity Manager
By Debbie Hommel, ACC, CTRS

Many activity managers first introduction to the process of quality assurance is when
they are given a pile of forms and they are told to have them completed by the next QA
meeting (which is usually less then a few days away).   Upon review of the pile of forms,
the activity manager sees they involve taking surveys, observing activities or collecting
data about the calendar, the environment or charts.  It is too common and very
unfortunate that the true purpose of completing the forms is never really explained.  

Quality assurance is a management task which falls within the controlling function of
management.   In management, this process of “controlling” focuses on determining
the success or lack of success in meeting the initial goals and plans established for
the department.  Departmental philosophy statements, policies, procedures, protocols
and job descriptions are formal management tools which are developed during the
planning and organizing tasks of management.  These are the goals and plans for the
department. These documents or goals and plans are worthless if they are not
implemented.  Ensuring they are implemented as intended and with good outcome is
the emphasis of the controlling aspect of management

Not following through and not holding staff accountable is a common problem in
management.   New policies, new programs and new standards are often introduced,
and soon forgotten.  If this is the typical practice at your facility, it contributes to
inconsistent performance, poor morale and a lack of teamwork.  There is nothing more
frustrating than working on a project, creating systems to implement it and then
watching it fizzle out because it just was not followed through to fruition.  Standards
need to be established but they also need to be enforced or practiced to have any

The controlling function of management is the opportunity for the activity manager to
ensure plans are being implemented as originally established. Plans include staffing,
programming, documentation and financial.  The department should have a clear cut
system for comparing current outcomes to the previously written plans and goals for the
department.  It is the responsibility of the activity manager to identify gaps in the service.  
These gaps are when the outcome is not meeting the standard which was established
in the original plan (job descriptions, policies, and protocols).    Once the gap or area of
sub-standard or inconsistent service is identified, it is imperative to introduce a plan to
re-mediate or resolve the situation.    If the activity manager does not identify these gaps
or areas of weakness within the program or service, it could very well be noted as a
deficiency in the next state monitoring visit.  

Evaluating departmental services can be done formally and informally.  The formal
process involves following departmental systems to evaluate staff performance through
performance appraisals, quality assurance reviews of specific areas of facility service
and chart audits of required documentation and content.  Informally, the activity
manager should also adopt specific practices to consistently evaluate the services of
the department on a daily basis.  Each activity professional should become
knowledgeable and articulate in defining standards of good practice which are
supported by regulations, our profession, our facility policy, our personal experience
and the residents and clients served.  The activity manager should use these
standards when observing daily programming, staff interaction and resident/client
response to programming.  Being able to define and articulate standards of good
practice in clear and understandable terms will assist in training staff as well as
guiding all staff in understanding the department’s role in quality of life.   

If allowed by corporate/facility policy, the activity professional should view quality
assurance from a more flexible approach.  Rather than complete the same facility
forms over and over, with similar findings, the activity manager should be able to create
data collection tools (forms) based on clear cut standards and criteria defined by the
department.  This will allow more effective and individualized assessment of areas of
service needing review.  The true quality assurance process involves defining a specific
standard of service or criteria that should be met; collect data related to the standard;
compare data collected to original standard or criteria and make a value judgment.  

So, the next time you are handed a pile of forms to complete for your next QA meeting,
stop and think for a minute :  what part of your service do you truly want to evaluate and
create a plan to do just that!

Quality Assurance for the Activity Professional by Richelle N. Cunninghis, Elizabeth Best

Quality Assurance for Activity Professionals Independent Study Program 5.5 NCCAP
approved hours