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You Expected...what?!You Expected...what?!Alignment of Services, Alignment of Services, Expectations & Expectations & OutcomesOutcomes
Aligning Expectations – Resources – Outcomes
April 20, 2004 SCANPHA Annual Meeting 2
Agenda
Environmental View A Culture of Curing vs. a Culture of Caring Defining Alignment Current Process Presentation Process Management Dip Your Bucket Where You Lay Hit the Pool, Beach or Links
April 20, 2004 SCANPHA Annual Meeting 3
Must Rising Acuity Levels Mean Lower Dining Quality ?
©©
Independent Living Assisted Living Memory Enhanced Skilled Nursing
Nutrition Quality Food Quality Service Quality Life Quality
April 20, 2004 SCANPHA Annual Meeting 4
Rhythms of Daily LivingRhythms of Daily Living
The core of RDL is the opportunity to exercise choice – residents’ for how they choose to live their day and staff choice for care delivery. This creates a collaborative coalition of residents and caregivers working together in a living environment. RDL facilitates the delivery of care, the experience of living and the dignity of self-determination.
April 20, 2004 SCANPHA Annual Meeting 5
RDL is a management principle that aligns the natural rhythms of residents and the support they need. The organizing principle of RDL is that people should be able to make meaningful choices in their daily lives – on their own or with assistance. RDL relies on caregivers to help define and achieve outcomes that balance individual choice and system efficiency.
April 20, 2004 SCANPHA Annual Meeting 6
Alignment
The appropriate positioning of systems and resources to attain a defined goal, mission, outcome or culture
April 20, 2004 SCANPHA Annual Meeting 7
When Landing A Plane, What Is The Main Thing? 1
1. Concepts and Diagrams From The Power of Alignment - How Great Companies Stay Centered and Accomplish Extraordinary Things By G. Labovitz/V. Rosansky
Left Of RunwayAltitude Too High Aligned
Air Speed
Cross Winds
Altitude
Wind Speed
Pitch
April 20, 2004 SCANPHA Annual Meeting 8
Resident Services
Administration
EnvironmentalServices
Health&
WellnessDining
23+Departments
Quality Work
Quality Care
Resident Services
Administration
EnvironmentalServices
Health&
WellnessDining
23+Departments
??
Families
Residents
Staff
StandardsOrgs.
Owners
Lenders
Vendors
Insurers
Regulators
Consultants
Management
What Is The Main Thing We Must Achieve?
April 20, 2004 SCANPHA Annual Meeting 9
The Main Thing For Senior Care
Choice
April 20, 2004 SCANPHA Annual Meeting 10
“Some facilities studied, usually the lower turn-over ones, were in the process of thinking about how to increase individualized care. For example, the researcher asked, what are you doing if anything about resident choice. ‘We are looking at it. Ideally, we want them to eat when they want. We encourage them to tell us what care they want, a shower or bath, or to get up when they want.”
Page 5-49 Appropriate of Minimum Nurse Staffing Ratios in Nursing Homes, Phase II Final Report prepared by Abt Associates for the Centers for Medicare and Medicaid Services, December 2001.
April 20, 2004 SCANPHA Annual Meeting 11
PLAN & DEVELOP
Organize
Alter
Codify
Train
Improve
Choice AlignmentProcess Overview
Plan
Evaluate
Define
Assess
Implement
April 20, 2004 SCANPHA Annual Meeting 12
Servant Leadership
“I don’t necessarily have to like my players and associates, but as the leader I must love them. Love is loyalty, love is teamwork, love respects the dignity of the individual. This is the strength of any organization.”
Vince Lombardi
April 20, 2004 SCANPHA Annual Meeting 13
Stakeholders
Community LeadershipResidentsFamily MembersStaffBoardRegulators
April 20, 2004 SCANPHA Annual Meeting 14
Leadership Roles
Board / CEO Executive Management Team Operational Management Team Staff Execution
April 20, 2004 SCANPHA Annual Meeting 15
Board & CEO
Define Mission and MinistryStrategic Outcomes & InitiativesListen For What Resources Are
RequiredReview Outcome Measurements
April 20, 2004 SCANPHA Annual Meeting 16
Strategic Intersect Grids
Anticipated Outcomes Measures Stakeholders Resources
April 20, 2004 SCANPHA Annual Meeting 17
Anticipated Outcomes
Clinical Cultural Experiences Staff & Resident Satisfaction Regulatory Financial Impact
April 20, 2004 SCANPHA Annual Meeting 18
Strategic Intersects – Anticipated Outcomes
PROJECT COMMUNITY OF
DISTINCTION
FINANCIAL ENHANCEMENT
QUALITY OF LIVING
OPERATIONAL EFFECITVENESS
POS System Improved management of production controls, improved tracking of billable supplies
Ability to implement DBP
MOW Increase presentation of community Brand into the community
Increased revenues and improved efficiencies of the existing resources
Improve QoL for MOW clients
Increased operational effectiveness for facilities
Campus Dining Program
Continuity of standards throughout the community
Increased cost efficiencies Improved QoL for all residents and work environment for staff
Increased effectiveness in all appropriate operational areas
April 20, 2004 SCANPHA Annual Meeting 19
Executive Management Team
Clarify “Main Thing” and Strategic Objectives Identify Preliminary Alignment Measures Begin to Frame Initial Service Alignment Team
(SAT) Approach Prepare Resident, Regulators and Stakeholders
Briefing and Education Process
April 20, 2004 SCANPHA Annual Meeting 20
Feasibility Analysis & Budget
High Level GAP Analysis of Community Capacities: Operational Cultural Environmental Fiscal Mission
April 20, 2004 SCANPHA Annual Meeting 21
Strategic Intersects – Measures
PROJECT CLINICAL CULTURAL STAFF & RESIDENT
QoL
OPERATIONAL EFFECITVENESS
POS System Ability to implement DBP
MOW Improved Increased revenues and improved efficiencies of the existing resources
Improve QoL for MOW clients
Increased operational effectiveness for facilities
Campus Dining Program
Continuity of standards throughout the community
Increased cost efficiencies Improved QoL for all residents and work environment for staff
Increased effectiveness in all appropriate operational areas
April 20, 2004 SCANPHA Annual Meeting 22
Outcome Measures
Clinical Cultural Experiences Staff & Resident Satisfaction Regulatory Financial Impact
April 20, 2004 SCANPHA Annual Meeting 23
Operational Management Team Conduct Operational Capacity Self-Assessment Using SAT’s Review, Edit and Validate Outcome
Targets Configure Process for Use of the SAT’s during
Process Implementation
April 20, 2004 SCANPHA Annual Meeting 24
Strategic Intersects – Stakeholders
PROJECT RESIDENTS FAMILIES REGULATORS PROSPECTIVE RESIDENTS
POS System EASE OF USE, INCREASED VALUE, EDUCATION
EDUCATION MINIMAL / NO IMPACT
MARKET DIFERENTIATION, SIGNATURE SERVICE
MOW NO IMPACT COMFORT OF NUTRTION AND VISITS
QUALITY & SAFETY
INTRODUCTION
Campus Dining Program
SEAMLESS EXPERIENCE
CONSISTENT PROGRAM OF EXPECTATIONS
CONSISTENT CLINICAL MEASURES
MARKET DIFERENTIATION, SIGNATURE SERVICE
April 20, 2004 SCANPHA Annual Meeting 25
1. Engagement Get All Stakeholders Involved
Ask For Opinions Allow Refuting Of Assumptions and Ideas
2. Explanation Enable Stakeholders To Understand Final Determination
3. Expectation Clarity Make Explicit All Roles, Responsibilities and Measurements
Confirm Cultural ReadinessThree Principles Of “Fair Process”
Fair Process: Managing In The Knowledge EconomyHarvard Business Review, 8/97, By W. Kim and R. Mauborgn
April 20, 2004 SCANPHA Annual Meeting 26
Strategic Intersects – Staff
PROJECT NURSING DINING MAINTENANCE HOUSEKEEPING
POS System Tracking of durable goods
Choice, DBP Billing Billing
MOW
Campus Dining
Program
April 20, 2004 SCANPHA Annual Meeting 27
Resources Intersects Administration: fiscal, management and leadership
considerations Regulatory: compliance criteria (grouped by clinical and
operational considerations) Systems: software programs, forms, policy & procedures,
protocols Personnel: staffing requirements, training, HR. The impact
on each care disciplines is identified by department PP&E: Property, Plant & Equipment necessary to perform
the tasks and functions
April 20, 2004 SCANPHA Annual Meeting 28
Strategic Intersects – ResourcesPROJECT ADMINISTARTION REGULATORY SYSTEMS PERSONNEL P,P & E
POS System Ability to implement DBP
Hardware & Software, Wiring
MOW Improved Increased revenues and improved efficiencies of the existing resources
Improve QoL for MOW clients
Increased operational effectiveness for facilities
Transport Equipment
Campus Dining Program
Continuity of standards throughout the community
Increased cost efficiencies
Improved QoL for all residents and work environment for staff
Increased effectiveness in all appropriate operational areas
April 20, 2004 SCANPHA Annual Meeting 29
Process Management
The detail of the Grids Onto the PM Tool Use of a Process Management system to:
Identify Project Tasks Define Time Required to Complete Detail Sequencing and Coordination of Tasks Assign Responsibility & Accountability for
Completion Ability to Efficiently Track Multiple Moving Teams Detailed Cost Assessment
April 20, 2004 SCANPHA Annual Meeting 30
Into the Pool
Identify the “Main Thing” Initiate the Alignment Process Use of Consulting Services Start in the Shallow End of the Pool