CARF Survey Report 2010

On With Life, Inc. is proud to announce our recent re-accreditation by CARF, the Rehabilitation Accreditation Commission. A letter from the President of CARF noted:

"It is my pleasure to inform you that On With Life, Inc., has been accredited by CARF for a period of three years for the following programs:

• Home-and Community-Base Rehabilitation Programs: Brain Injury Program (Adults)
  
• Inpatient Rehabilitation Programs – Skilled Nursing: Brain Injury Program (Adults)
  
• Inpatient Rehabilitation Programs – Skilled Nursing: Brain Injury Program (Children and Adolescents)
  
• Governance Standards Applied

This accreditation will extend through March 2013. This achievement is an indication of your organization’s dedication and commitment to improving the quality of the lives of the persons served. Services, personnel, and documentation clearly indicate an established pattern of practice excellence.

Your organization should take pride in achieving this high level of accreditation."

HIGHLIGHTS OF OUR SURVEY REPORT

• On With Life has been a specialty brain injury rehabilitation program since 1994. There is a very strong and committed board of directors, interacting and involved with the executive leadership, that represents a cross section of local and state community leaders. Board members are active, dedicated, and committed to improving the lives of persons served at On With Life, and most have served for many years, including the family members who founded On With Life. The governing board, working closely with the executive leadership, has resulted in long-term stability for the program.

• The staff members are outstanding and dedicated to positive outcomes for persons served. They live the mission and vision of On With Life. They are compassionate, patient, and extremely competent. On With Life is to be commended for its use of licensed and certified personnel and for its commitment to a high staff-to-person served ration.

• On With Life is committed to training, education, and mentoring of new staff members so training and in-services are ongoing and comprehensive. The redesigned staff competency checklists, especially for nursing positions, are comprehensive and outstanding. On With Life encourages and supports staff members in obtaining status as certified brain injury specialists (CBIS) through the Brain Injury Association of America.

• Medical direction is provided to staff members and persons served. Both medical directors have visionary ideas to develop the program in the future.

• Persons served, including family members, and referral and funding sources feel that communication is excellent and their input is listened to and care plans modified based on the needs of the persons served. If any issues arise, resolution is rapid. All staff members are positive and well trained and meet the expectations of the persons served.

• There are comprehensive strategic and financial planning efforts in evidence, involving a variety of experienced leadership members. Fiscal management and strategic planning are integrated and are conducted to ensure long-term solvency. The strategic planning goals include four focus areas: clinical services, operations, corporate compliance/financial issues, and corporate development.

• There is also a thorough risk management plan in place and a comprehensive insurance program. This process benefits from the active involvement of several board members who are also attorneys.

• The accessibility plan is thorough and promotes accessibility for the persons served. On With Life is dedicated to ensuring that persons served have access to the local community. The accessibility plan is monitored regularly, and changes or updates are made as needed.

• The physical facility is spacious and decorated to be as non-institutional as possible. Artwork has been donated and covers the walls. Colors are bright and cheery, and signage is extensive but user-friendly. The cafeteria serves healthy, nutritious meals to persons served, staff members, and visitors for a nominal cost.

• A new bulletin board outlining the outcomes results from the previous year is easy to understand and is posted at wheelchair height in an area for persons served and family members.

• The design of the facility lends itself to a high level of safety in all aspects of the program. There is a culture of safety for all staff members at On With Life, who complete a daily safety checklist to keep safe practices for persons served and staff members in the forefront at all times.

• The On With Life programs employ dedicated staff members who communicate with each other often and help mentor new employees. They also share resources and problem solve to provide the best services for their consumers. In the skilled nursing facility, therapy staff members recently moved into shared office space by teams instead of by discipline, which allows for more informal communication. The quality care coordinators send out daily updates based on nursing reports. These updates are kept in a book for staff members who do not have immediate access to e-mail.

• The program identifies and supports the preferences of the persons served by completing the comprehensive lifestyle survey and then celebrating community events such as Ankeny SummerFest and Festival of Trees and cultural events such as St. Patrick’s Day Festival and the Iowa State Fair.

• The facility has many strengths in its design, primarily the spaciousness of the therapy gym and recreation room, which are colorful with ample windows to the outside, and the single rooms for the persons served.

• Quality process action teams have developed interdisciplinary initial assessments and discharge summaries. A team also improved the scheduling system with real-time therapy updates.

• The Community Services program has a comprehensive safety plan for its clients that is reviewed with them. The neuropsychologist and nurse manager also provide annual brain injury behavior management classes.

• The organization has a user-friendly website with interactive videos.

• Team conferences reporting is done by topic rather than discipline, which demonstrates an interdisciplinary approach. The language is at the level of the person served.

In the following areas On With Life demonstrates exemplary conformance to the standards.

• On With Life is to be commended as an organization for its commitment and dedication to brain injury education and prevention and for advocating for appropriate services for individuals with brain injury. The executive director and neuropsychologist are members of the Governor’s Advisory Council on Brain Injuries. Staff members speak regularly within the state and local region regarding advocacy and education, and On With Life has sponsored its own brain injury education conference for many years. Staff participated in the Day on the Hill at the state capitol to advocate for services for individuals with brain injury. The executive director and other staff members have served as president of the Brain Injury Association of Iowa (BIA-IA) for many years, and On With Life is a major corporate sponsor of the state association.

• On With Life encourages and supports continuing education opportunities for staff to enable them to remain current in the field. Staff members are given membership in the BIA-IA after hire. They are encouraged to obtain CBIS certification and proudly display this designation and others on their identification badges.

• The newly developed Pediatric Team Resources Book is outstanding and comprehensive, containing the latest and most current articles, research and information concerning the pediatric population and adolescents with brain injuries. The resources book includes appropriate assessment tools and specific, comprehensive pediatric competencies.

• The organization is commended for the usability of the new computerized scheduling board that is prominent in both the therapy area and the nursing area of the facility.

• Currently three studies involving assessment instruments for persons in a minimally responsive state are in various stages of development. One, which is federally sponsored, focuses on the use of a specific coma scale. Another is used to explore "awakening” effects of a common sleep drug on vegetative state, and the other is a National Institutes on Health (NIH) study the use of Zoloft.

• The organization is commended for involving persons served annually in the legislative process by taking them to the Day on the Hill. Their presence is noted by wearing black and yellow. Staff and persons served are also involved as speakers and advocates in the BIA-IA, the Governor’s Advisory Council on Brain Injuries, the Hospital Association, and the International Association of Cognitive Psychotherapy, to name just a few organizations.