Tiina Lehtinen has worked as a RAI-planner in the City of Lahti since 2012.
– RAI came to Lahti in 2011 so I jumped on a moving train, Lehtinen says. In two and a half years the train has come very far with RAI-Tiina in the driver's seat!
– Even if I do other things too everyone still calls me RAI-Tiina at work, she laughs.
– I had a good basis for taking RAI forward since I have worked many years in different health care organizations in Lahti and have been educating myself along the way. I personally know the challenges of home care, housing services, hospital care and administration work.
As she takes RAI forward Lehtinen has cristal clear principles and goals that she works towards with great determination
– RAI must be a solid part on every level of the care work. A well-functioning, well internalized RAI is an important tool for the care takers, the ward, the unit and the management. My goal has always been that every time a new project begins or we adopt new procedures, RAI is immediately part of the process. Another important goal is that everyone using RAI in their work grasps the meaning and the possibilities of RAI for their own job. I want to break down our RAI strategy so that instead of it hovering above the staff as a vision implemented by the management, it becomes an objective that is part of a bigger entirety and is perceived by everyone as an important work for the greater good. Everybody understands that they are building a cathedral, not just quarrying rocks, Lehtinen says.
Lehtinen has achieved alot in the RAI sector in Lahti. Partly thanks to RAI, the care work in Lahti has received a great deal of acknowledgements lately.
– Our Siiri-project got the Innovation prize by the city of Lahti in the spring, and in May 2015 the Ikinä-project received a recognition by the National social and health sector. Siiri is a centralized counselling and service project for elderly people. The goal is to support living at home, improve the every day life and help find the right help at the right time. An important part of Siiri is the RAI Screener Oulu-survey that is done at the customer's home.
–The Ikinä-project focuses on preventing falling. A questionnaire to determine the risk factors for falling was immediately taken on board as part of RAI, Lehtinen describes.
Lehtinen says that alot has happened since 2012 and the initial challenges have been overcome but the RAI work is still in an early stage.
– The continuous RAI challenge is to do the assessments diligently and in a commensurate fashion so that the results can be utilized systematically. Implementing RAI requires some team spirit and a general notion that we are working together for the best of a person. When you are busy this is sometimes forgotten and the somewhat time-consuming assessments can cause a feeling of frustration. But once you invest the time doing the assessments properly it will pay itself back as you get more information to base the care work on and you can support and focus on the right issues. At the same time the managers and supervisors acquire important comparable information about the care work and its functionality. A comparison with other actors on a national level helps reveal our areas of development and also our strengths – we learn from one another.
Lehtinen says that by addressing the medical treatment part using RAI for institutional care, the costs for medications have dropped and the quality of life has improved for the customers.
– The assessment of medical treatment shows for instance the usage of anti-psychotic medications without psychotic symptoms, the regular usage of sleeping pills, the combination of usage of sleeping pills and sedatives and the total usage of medications. When you compare the assessment results on a national level you can quickly determine any possible aberrations. An important part of the process is to have a geriatrician committed to analyze the RAI assessment results and to determine the necessity of these medications. In six months the number of medications dropped drastically. At the same time we implemented softer methods to treat insomnia – sometimes a glass of warm milk and woolly socks are more efficient that pills and it's also to be accepted that some people simply sleep less than others.
Lehtinen shares an example on how some things can be solved in easy ways once you take the time to try and figure them out.
– The questionnaire of the Ikinä-project showed that one of the customers had a greater risk falling at night time because the light switch in the bath room was on "the wrong side" which made it difficult to turn on the light. The nurse suggested an inexpensive motion-sensored light to help with the problem. The family installed one the very same day and granny's risk of falling was diminished drastically.
Tiina Lehtinen summarizes the best parts of her job:
– When the RAI-light bulb lits on somebody's head. That is a really rewarding moment!