Re-Creative Resources
By Kimberly Grandal, BA, CTRS, ACC, Executive Director
Kimberly Grandal,

Kimberly Grandal, Founder
and Executive Director of Re-
Creative Resources, Inc., is a
strong advocate for the field
of Therapeutic Recreation
and Activities, with over fifteen
years of experience working
with the elderly in numerous
management and consultant
positions.  She is an Activity
Consultant Certified and a
Certified Therapeutic
Recreation Specialist. Kim is
a member of the New Jersey
Activity Professionals
Association and the New
Jersey/Eastern Pennsylvania
Therapeutic Recreation

In 1990, Kim graduated from
William Paterson University
with a BA in Sociology and
later studied gerontology
courses at Union County
College and Therapeutic
Recreation courses at Kean
University. Throughout her
career, Kim has been the
Director of Therapeutic
Recreation for several long-
term care facilities, including
one of NJ’s largest.

In 2006, Kim founded Re-
Creative Resources Inc. She
is a speaker for various state
and local activity associations
such as NJAPA, MOCAP, and
NJACA, as well as the Society
of Licensed Nursing Home
Administrators of NJ. She
also offers lectures for Re-
Creative Resources Inc.,
local colleges, and
community groups, and
provides consultation and
support to numerous
facilities in the state.

Kim is the editor and writer
for the “The Rec-Room", a
monthly newsletter published
by her company. In addition,
she writes monthly articles
for the Activity Directors Office
newsletter, and has
contributed articles to
Creative Forecasting
Magazine, and The
Continuing Care Insite

Kim is a recipient of the
Kessler Institute of
Rehabilitation 1997 Triumph
of the Human Spirit Award.  
Her passion is to promote
the field of Therapeutic
Recreation and Activities and
to unite Recreation
Therapists and Activity
Professionals. Kim currently
serves on the NJAPA board
as the Chairperson for the
Legislation Committee.
Providing Internet Resources
for Activity Professionals
in Long Term Care Settings

Copyright 2004-Present
The Activity Director's Office
All Rights Reserved

Resources Inc.

Re-Creative Resources, Inc.
is committed to enhancing
the lives of long-term care
residents through the use of
Therapeutic Recreation. We
provide a variety of services
such as Therapeutic
Recreation seminars,
in-services, resources, form
development, program
analysis and development,
consultation, and support for
activity professionals and
recreational therapists. A
selection of downloadable
training materials and forms
are available for your
convenience as well as a free
job posting site.
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The Activity Director
Community is a gathering
place for LTC
Activity Professionals.
Feel free to express yourself
and respond to submissions
from other AD's.
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and you need to be part of it.
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This site is moderated by
Robert & Linda Lucas, Owners of
The Activity Director website.
Quality Assured Activity Programming
By Kimberly Grandal, CTRS, ACC
Executive Director, Re-Creative Resources, Inc

Simply stated, Quality Assurance is a method of evaluating and monitoring services rendered within a
department.  The Activity Department should be an active participant in the facilities’ Quality Assurance program.  
Many Activity Directors dread QA time, and often leave the analysis and report writing for the last minute, when in
actuality, Quality Assurance should be occurring all of the time.  

The Activity Director should utilize standards, policies, and regulations to guide the Quality Assurance process
and set criteria.  Once the criteria have been set, it is important to utilize a variety of tools and systems to collect
data.  The creative Activity Director utilizes data collection tools that have multiple purposes.  For example: utilize
an “Activity Evaluation Audit” to evaluate the appropriateness and quality of group activities, but use that same
tool to evaluate the staff performance, which is useful information for the employee’s performance appraisal.
Another example is: utilize a “Sensory Program Record of Responses” to monitor resident responses to various
stimuli for care plan compliance and evaluation, but use the findings from that survey (if positive outcomes are
found) in a report to the Administrator demonstrating the need for additional multi-sensory equipment.  

Next, the Activity Director should establish timelines to ensure that all data is retrieved in a timely manner
throughout the course of the year. Data may be collected in a variety of ways such as audits, surveys, checklists,
etc. Often times, residents, family members and facility staff may participate in the data collection process as
well. Once the data is collected, the Activity Director must write a report to indicate the findings, by utilizing the
facility’s specific process, protocol, and format. Statistical information usually includes numbers, percentages,
and values, and is often best illustrated in a table, chart, or various types of graphs.

The next step in the Quality Assurance process includes analyzing the data.  Do the findings indicate need for
improvement in a certain area?  If there are issues, or concerns, provide further investigation to determine the
scope and severity of the problem.  At this point, the Activity Director should identify a plan of correction with
goals, timelines, and expected outcomes.  The plan should provide a detailed description as to what the Activity
Department, and/or other departments will do to improve or correct various issues.  

Once the recommendations have been made, all designated departments and individuals must follow through
with their responsibilities, otherwise there is no chance for improvements.  The issue at hand should be closely
monitored and re-evaluated as often as needed.  If there have been little or no improvements, further analysis
and recommendations will need to be made.   If there have been significant improvements, it should be proudly
noted in the next Quality Assurance report and the decision to monitor the identified area is up to the discretion of
the Activity Director.  It is, however, recommended that the Activity Director continue to monitor to ensure that the
problem is corrected.   

There are many different aspects of the Activity program that can be evaluated and monitored.  Sample
topics include:

  • Supplies/equipment
  • Environment
  • Budgeting
  • Programs
  • Activity Audits
  • Resident Satisfaction
  • Quality Indicators
  • Staffing
  • Resident Rights
  • Resident Council
  • Calendars/Calendar Analysis
  • Continuum of care
  • Quality of Life Surveys
  • Population Analysis
  • Documentation
  • Departmental Review

Activity Directors also play an important role in the Quality Assurance meeting.  It is the time to demonstrate
professionalism, knowledge, and purpose of the activity program.  The Activity Director may be asked to give an
overview of the area measured, report the findings, and state recommendations for further action, so it is
important to be well-versed on the subject and have copies available, including any graphs, charts, tables, etc.  

Activity program interventions should also be included in Quality Indicator monitoring.  There are many ways in
which the Activity Department can assist in improving or enhancing the services of another disciplines.  For

Residents who were physically restrained (remove restraints during activities; provide task-oriented activities for
diversion; encourage movement and physical activity to promote strengthening.)
Prevalence of falls (involve resident in specially designed fall-prevention program; provide manipulatives, pat
mats, activity aprons for diversion; encourage movement of lower extremities to promote strengthening)
Residents who had moderate to severe pain (encourage prayer or spiritual expression; provide aroma therapy
for relaxation such as lavender;  encourage resident to experience the multi-sensory room for pain relief and
Residents who have become more depressed or anxious (encourage resident to participate in discussion,
remotivation, and reminiscence groups; provide manicures and make-up session;  encourage physical activity
and exercise)
Incidence of cognitive impairment (evaluate the environment, involve residents in cognitively stimulating activities
such as word games, trivia, discussion groups, and educational programs)

When we take on the role of Activity Director, along comes with that the responsibility of ensuring the activity
program meets the needs and interests of the residents and follows standards of practice, regulations, and
policies.  Therefore, set criteria, chose the appropriate tools, gather statistical data, report the findings, analyze
the data, make recommendations, and follow-up, and when done with all of that, start again!

For great Quality Assurance Tools, purchase the Recreation Department Review Manual, by Re-Creative
Resources Inc.

Copyright Kimberly Grandal, 2006.  All rights reserved.
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