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Telling Our Story:From Nursing Home in
Need to Nursing Home in the Lead
Alden Princeton
Call-offs
Tardiness
New employee retention
Decreasing facility acquired pressure ulcers
During the calendar year 2010, 10 complaint surveys with a total of 8 findings, last complaint 12/2010 yielded 5 tags
Policies and procedures not being consistently followed by facility staff
History of negative survey outcomes, including F314
Poor customer service attitudes among some staff
No formal daily communication process
Where we started:◦ Chaotic, very loud!! ◦ Limited professionalism-Including Dress Code!
misunderstanding of “grace” period-being late Questionable reasons for call-offs or no reason
provided at all Issues with nursing scheduler
◦ Increase in overtime (both scheduled and utilized)
◦ First tracking period 800 tardies in two week period/ All Departments Average of 7-9 times per employee per pay period 35 call-offs per month (nursing department only)
Daily stand-up and stand-down meetings initiated immediately
Administrator initiated Call In Log and reviewed all call-offs and tardy data for trending and root cause◦ Staff were creating overtime for one another◦ Why were people calling off-Have to call Laura◦ Re-Interviewed current staff, placed on 30 day
corrective action plan if needed.
Clarified language in union contract
Lots and Lots of in-servicing and education
Clearly communicated expectations, with discipline as necessary.
Reviewed AMS code of conduct, labor laws
Answered all staff questions, “That’s the way we've always done it!!…Doesn’t make it right!
Following extensive education, facility administrative and management staff strictly enforced policies and held staff accountable
The pay period ending 9/17/2011◦ Yielded only 26 tardies for all facility staff!!
As of 9/23/2011:◦ Average call-offs for the month of September
were six!!
Overall retention was historically good, however, new hires were leaving at a very high rate, due to the attitudes of long standing staff:◦ Lack of Team Work from Seasoned Employees◦ “Bullying” of new hires◦ Staff attitudes- “I’ve seen Administrators and
DON’s come and go”◦ “You’ll never make it”
Changes to orientation◦ Initiated a day-long core orientation day with refreshments
and lunch In addition to orientation shadowing staff
◦ During daily stand-up meetings, managers are informed of all new hires Managers make it a point to go meet and greet new hires and
discuss how their orientation is progressing/ Get to know them!◦ During daily stand-down meetings, managers provide an
updated report on the new hires◦ This change has generated a tremendous amount of positive
feedback! New employees feel valued~◦ New hires given a survey at the end of their orientation
asking for suggestions for improvement
Where we were:
Facility Acquired in 2010 was 80 YIKES!!!
January of 2011, we had 11 facility acquired in just one month!
Then along came Advancing Excellence!!!
Instituted ‘Rock and Roll Rounds’◦ Every 2 hours 8 a.m. to 8 p.m.◦ Manager involvement/QA Environment tools◦ Beyond “turning and repositioning”
Continence checks Exercising Ambulating Off Loading AAROM/PROM Splint Quality Assurance
◦ Non-punitive approach
Pressure Ulcers: February: 6 March: 1 Staff now running to Clinical
Support April: 0 Supervisor for more Zinc Oxide!!!! May: 2 June: 1 Staff reporting every little skin
issue!!! July: 3 August: O Sept. 1 Total of 25- All Healing, non necrotic
Regulatory Compliance:◦ As of today, only 3 complaint surveys with NO findings◦ Princeton’s Annual survey resulted in only 5 minor tags requiring
only desk review by IDPH- nothing in skin!!!
Interview process based on corporate core values and mission statement.
Administrator involvement in all interviews Exit interviews-data analysis Staff development-staff satisfaction survey Continuous efforts to develop meaningful staff
recognition:◦ Thank you goodie basket◦ Dessert with the managers◦ Public praise/Lunch with “Laura”◦ Certificates of Recognition◦ Personalized cards with scratch off lottery tickets
Absolute importance of a ‘collaborative partnership’/ Unified front from all managers
Consistency and fairness
Don’t let things fall through the cracks
Follow the process and it will result in continued positive clinical outcomes
Dear Alden Management Services…..
Advancing Excellence: www.nhqualitycampaign.org
LANE: [email protected]
Alden Princeton: Laura Kelly [email protected]
