by Michael Wasserman, MD, CMD

In his 1974 Cal Tech commencement address, Dr. Richard Feynman coined the term “Cargo Cult Science.”  It was based on the experience of the indigenous people of the South Sea Islands during WWII.  “In the South Seas there is a Cargo Cult of people.  During the war they saw airplanes land with lots of good materials, and they want the same thing to happen now.  So they’ve arranged to make things like runways, to put fires along the sides of the runways, to make a wooden hut for a man to sit in, with two wooden pieces on his head like headphones and bars of bamboo sticking out like antennas—he’s the controller—and they wait for the airplanes to land.  They’re doing everything right.  The form is perfect.  It looks exactly the way it looked before.  But it doesn’t work.  No airplanes land.  So I call these things Cargo Cult Science, because they follow all the apparent precepts and forms of scientific investigation, but they’re missing something essential, because the planes don’t land.”

What does this have to do with Long Term Care?  Or, CALTCM’s Annual Meeting?  A lot. 

The long-term care industry does what it thinks is necessary for skilled nursing facilities to function effectively. CMS has decided what they think is important from a regulatory perspective to achieve quality outcomes in nursing facilities.  Specific models of care have been proposed and tested and still the planes don’t come.  Those of us who have worked in the Long-Term Care profession for many years know what’s missing.  We share a body of knowledge and expertise in an interdisciplinary approach to improving quality.  We also share a collective frustration with the lack of progress the industry has made despite our expertise.

CALTCM’s 43rd Annual Meeting addresses these issues from a variety of levels.  Friday morning’s Best Practice competition will highlight cutting edge topics such as antibiotic stewardship, fall and injury reduction, and antipsychotic medication reduction.  By highlighting these best practices, we aim to share and disseminate successful approaches from fellow skilled nursing facilities.  The main program will focus on cutting edge approaches in key clinical areas ranging from diabetes to constipation.

This year, we are also endeavoring to bring the full interdisciplinary approach to a variety of problems, through the lens of just culture and patient safety.  Pain and depression are common issues for residents of long-term care facilities.  In the spirit of person-centered care, there are no practice guidelines that will cover every individual patient.  With polypharmacy already contributing to adverse events, the need to utilize the expertise of the entire team could not be more critical.  This years meeting will utilize case studies and interactive programs to enhance the learning experience.

Finally, our work in long-term care does not exist in a vacuum.  We are dealing with new Rules of Participation.  We will all be expected to work under the construct of MACRA, and it will be helpful to receive guidance in order to prepare for what’s ahead.  Join us at the 43rd Annual Meeting and let’s work together to improve quality in long-term care.