CRI-Help: Where Compassion Meets Innovation

Dayna Dewitt, Director of Nursing at CRI-Help, did not downplay the risks that come with caring for the under-served population that is at the core of CRI-Help’s mission. Throughout our recent interview it became clear that the team's mission of caring for vulnerable individuals is the driving force behind CRI's 52-year history. In this piece, we'll explore how CRI-Help manages risk through innovation while never losing sight of individual patient needs. Patient Demographics: The Unique Challenge at CRI-Help

Overdose is my biggest fear. We have to be vigilant.

Dayna and her team serve a patient demographic that is both diverse and challenging, ranging from individuals dealing with severe mental health issues to those recovering from substance abuse. Catering to such an intricate range of healthcare needs could be overwhelming, but the team at CRI-Help is committed to providing highly individualized patient experiences. This is accomplished through a strong commitment to compassionate care, supported by the strategic use of technology.

“Many of our patients have not received medical care for a matter of years. If they are living on the street that's not something that they do regularly is see a doctor. Sometimes it takes multiple engagements just to get them to come into treatment so the fact that they came indoors is sometimes a first for them. That being said, they come with more risk, I guess you can say, because they are more medically vulnerable.”

Serving unique patients comes with unique risks:

Our number one safety risk is overdose. Because we have contracts with the jails and prisons, we get people that come in on ankle monitors, we get people that come in to avoid jail sentences, and we get people who come in just to get the heat off. These people will sometimes bring drugs on them and in places that you cannot find - so it's a big risk.

We take a harm reduction approach and meet them where they're at even if they're not fully in that stage of readiness to change. We will help them anyway. But we have to be vigilant and make sure that we are assessing all of the signs and symptoms that could come with intoxication. The fentanyl epidemic is at an all-time high, people are dying left and right. No one has died here, in large part because we train our team to look out for those signs.[...] I'd say overdose is my biggest fear.

3 ways CRI-Help reduces safety risks:

1. Training

Trainings. So many trainings. Overdose training. Narcan training for staff and clients. Frequent vital checks and protocols for early intervention, which safety rounds really help with.”

2. Searches (with dignity)

We do extensive property and body searches. We don't have an x-ray machine or anything like that. One option we’re looking into is possibly using a dog, a friendly little furball. I know one that is at another treatment center and he's just an adorable yellow lab that their clients love. We've tried to really improve contraband detection, but we really want to respect their privacy & dignity. This isn’t a jail. It’s a tough balance to strike.”

3. Q15 rounds

We need to be on target when it comes to the rounds because it's easy to get sucked into the day and think, “Oh, it's 20 minutes past when I was supposed to check on them, shoot I better go do that.” And in that 20 minutes who knows what could have happened in the bathroom.

The benefits of consistent safety rounds are:

Intervening with a safety issue. Medical issues, seizures, self harm, etc.

Interaction with the clients. Someone might be crying in their bed and rounds give the staff the opportunity to engage. You might find a patient in their bed depressed, crying, feeling hopeless. So we try to intervene with patients in that "pre-contemplation state" before they've relapsed in their mind. We want to have engagement with them, to have interaction and find out what's really going on and what we can do to intervene and reduce the likelihood that they AMA and relapse.

Change Management & Advice:

Change is hard. Progress is slow sometimes. Adapting to the digital age makes things a lot easier. Sometimes you have to take a leap, but our efficiency is at least 50% better now and we have really high compliance.

The digitization of healthcare operations at CRI-Help was not merely an update; it was a paradigm shift. Dayna remarked, "In the paper-based days, there were inefficiencies we couldn't measure. Now, digital tracking and real-time reporting have revolutionized our care delivery." The impact of this digital transformation is profound, affecting both operational efficiencies and patient outcomes.

Enhancing Efficiency Metrics: A Quantifiable Impact

Dayna estimates the increase in operational efficiency at around 50%. "When you transition from a 'faith-based' system of believing tasks are completed to knowing they are, you unlock a new level of organizational excellence," she stated. Moreover, this added efficiency enables the medical team to devote more time to their primary mission—providing exemplary patient care. "It works. I can take corrective action if it’s ever needed. Proximity verification gives me peace of mind that the rounds are happening. Sometimes it interrupts the staff when they’re doing something else, but that’s kind of the point - making sure rounds stay the priority and don’t get forgotten about. Because that’s when safety issues could occur. I think it’s way better to be proactive with safety items. Because if you’re reactive it’s already too late."

Future Directions: A Brief Glimpse

While unable to reveal specific details about ongoing projects, Dayna indicated that expansion and diversification are on the horizon for CRI-Help. "We're about to open a specialized center for women and children, which represents our broader commitment to evolving our care capabilities," she shared.

Conclusion

CRI-Help stands as a model for successfully navigating the delicate balance between personalized patient care and operational efficiency, achieved in part through their partnership with digital solutions. As healthcare moves increasingly towards digitization, the experience of Dayna and her team offers both inspiration and valuable lessons for organizations aiming to make a similar transition.

If you would like to learn more about CRI Help or Dayna’s experience, send her a message on LinkedIn.

If you would like to learn more about VisibleHand and which of their products might be a good fit for your safety and compliance goals, contact zach@visiblehand.io.