Similar to fashion, where trends fizzle out and resurface later (we’re looking at you, fanny packs and high-waisted jeans), the “should we take photos” question is enjoying a revival in senior living communities. Let’s take a look from a risk management perspective at a few instances where your community might question the need for a photo.
Medication Administration Record (MAR)
Medication errors can have serious implications for residents in senior living and for the senior living communities themselves. There are several simple steps that can be taken to help prevent these errors, many of which focus on ensuring that staff administer medications to the correct residents. To that end, having a recent photograph of the resident’s face in the MAR can be an invaluable tool in helping staff properly identify residents, thereby preventing medication errors.
Consider adding the updating of resident MAR photos to a routine process. For example, if your community has quarterly care plans, facilitate a practice where photos are updated as part of that, or some other regularly occurring process. An old photo which bears little resemblance to the resident is of little benefit in accurate medication administration.
Are you missing photos because your staff have been unable to get consent from residents or responsible parties? If so, look at your process. Whereas a generic photography consent presented with a stack of other documents for signature at move-in may result in a blanket refusal, consider splitting consent for MAR photos out into its own separate process. Residents should understand that this is a step you take to prevent errors, that the photo needed to accomplish this is only a closeup of the face, and that the photo will not be used for any other purpose. If that still results in a refusal, don’t give up! Instead, revisit this conversation with the resident at a later date. This is a resident safety issue and obtaining consent from 100% of residents is the goal.
The prevalence of electronic health records (EHR) has led to a culture shift in documentation, which has made uploading photographs into the record almost effortless. Nowhere is this more evident than in the realm of skin conditions, most notably, skin breakdown. The pendulum between photographing wounds and not taking photos has swung, and some communities are now taking and uploading these photos.
From a risk management perspective, there is nothing that a photograph can do that a good narrative note cannot do. In fact, a photo can tell an incomplete story to an untrained eye; one which is not reflective of all information observed by trained staff at the time.
If, however, you still feel compelled to take photographs, take these tips into consideration.
- Make sure you have obtained consent from the resident/representative to take the photo.
- To foster consistency among photos, assign one person to take them.
- Use a company camera. Employees should not use personal cell phones to take photos.
- Develop a secure and compliant process for sending photos which outside healthcare professionals (such as doctors) have specifically requested. Texting a photo from one employee’s cell phone (i.e. a caregiver) to another (i.e. the wound care doctor) should not be permitted. Implementing a policy that photos will not be sent is another approach worth considering.
The popularity of smartphones has made taking photos and videos of interesting, funny, or unusual content a daily occurrence for many. It has become so normal that we rarely stop and ask ourselves if we should even be taking the photo or video in the first place.
Employees who photograph residents with their personal devices often do not have negative intentions. They’re taking a photo of a beautiful new haircut, a residents’ new outfit, or a visit from a distant relative. Regardless of the intention, these materials often end up on employees’ personal social media and invariably a coworker, someone who knows the resident personally, or the resident themselves views these materials and finds the fact that they have been made public objectionable.
Ensure that your staff understand that there are employees within the organization who have been authorized to photograph residents for work purposes (i.e., for use in the MAR). If they have not been specifically chosen as one of these people, there is never any reason to take photographs or videos at work.
Remind them often through formal education and discussions at staff meetings and review your internal policies to make certain that this is clearly communicated—especially any policies related to electronic device use while at work. A good focus is in preventing the photo or video from ever being taken in the first place so that social media posts do not become the issue.
A photo in your community might be worth a thousand words, but there are occasions when those words are better left unspoken. When taking photos, consider whether or not the photos are serving your needs in best running your community for the benefit of your residents. Remember the helpful risk management tips listed above when determining if your practices could be fine-tuned.