Advancing Excellence Initiative with the Illinois LANE Preserving Critical Access Nursing Homes

1. Advancing Excellence Initiativewith the Illinois LANEPreserving Critical Access Nursing Homes Telling Our Story: From Nursing Home in Need to Nursing Home in the Lead Alden Wentworth Rehabilitation & Healthcare Center

2. In The Beginning… • An isolated incident occurred which caused us to be an IDPH “Special Focused Facility” • Subsequent survey results kept us in a 6 month survey cycle. • Inability to break this cycle • As a result, we were introduced to this project: The Advancing Excellence Initiative (AEI), by our management office.

3. How Did We Become A SFF? • Facility leadership was based on a “dual relationship” (i.e. Administrator & DON only) • Knowledge was kept between the two of them • Reaction vs. Education • Staff unaware of what was going on (i.e. POCs) • “Ignorance is bliss” • “Us vs. Them” mentality • Staff wouldn’t communicate with leadership

4. IDENTIFY THE PROBLEM COMMUNICATION (LACK THEREOF) • Because there was a breakdown in communication between management and the floor staff, resident care suffered.

5. The Cycle Began… • Continuous turnover in management (Administration, Nursing, etc.) • Unhappy Staff • Staff had no clue what was going on. • Staff were being reprimanded without knowing what was “wrong”. • Staff wouldn’t share information for fear of repercussions from Administration.

6. Implementation of AEI • This project made us sit down together and get creative on how to improve. • Attitude Change: we CAN/WILL do better. • Went into the project with our EARS wide open • Reflected on our strengths and weaknesses while listening to what others in the field had to say.

7. LET’S END THE CYCLE!!! In order to end the cycle of being a Special Focus Facility: • 1st: We had to get out of the semi-annual survey cycle (i.e. no tags above a G level for 2 consecutive surveys). • To do this, AMS coordinated a survey preparation plan that was implemented immediately. • 2nd: The facility management team had to be stabilized. • 3rd: The flow of communication between managers and floor staff had to open completely.

8. What Did We Do To Improve STOP, LOOK, & LISTEN • Evaluated ourselves (Management) • Evaluated our staff • Round table discussions • Stand Up Meetings • Morale boosting • Personalized scheduling • Improved interview process • Continuous Staff Education

9. Evaluate Ourselves… • REVERSE PERFORMANCE EVALUATIONS • Staff were given the opportunity to do performance evaluations on their supervisors • Managers learned that staff don’t necessarily see us the way we see ourselves. WE NEED TO ACCEPT WHAT STAFF SAYS ABOUT US

10. Evaluate Our Staff • A 3 Star system was utilized for every employee to establish what their strengths/weaknesses are. • Dependability/Reliability • Competence • Compassion • Results were discussed with each employee 1:1

11. Round Table Discussions • Nursing staff were gathered in randomly selected small groups for round table discussions with their supervisors. • Nurses decided the topics. • Had fun with it in order to help them feel comfortable with discussing ideas, concerns, etc. • Completely opened forum. No repercussions for topics discussed.

12. Stand Up Meetings • Each morning all staff (on each floor) meet to discuss what’s going on on the unit and assure everyone is working together to provide the necessary care/services to the residents. • Staff included: • Nurses, CNAs, Activities, Social Services, Housekeeping, and Management • Topics discussed are reported to the rest of the Department Managers at morning meeting and addressed asap.

13. Morale Boosting • Employee of the Month • An employee is honored each month for going above and beyond the care needs of the residents. • Monthly Attendance Incentives • A monthly raffle drawing is done for all employees that had perfect attendance during the month. • Wentworth Delighters Program • When family members, vendors, and/or other staff acknowledge an employee for doing an outstanding job, their compliment is posted for all to see. Recognition is celebrated by the entire building, not just that department.

14. Personalized Scheduling • Realized staff have lives outside of work. “Stuff” happens…so let’s talk about it and problem solve…TOGETHER! • Conveyed the importance of not calling off of work. If you need time off, ask. Don’t call off. If we show our staff we care about them, they’ll do a better job. In turn, our residents will get better care!

15. Improved Interview Process • Peer/Group Interviews • CNAs and Nurses are involved in the interview process. • Competency Exams • Interview questions changed to have more value • Formatting received at one of the AE training sessions.

16. Continuous Staff Education • Outside of the regulatory formal in-services conducted throughout the year, we also did the following: • 1:1 learning/training – when we saw staff doing something incorrectly, we taught them how to do it properly right away. • Informed staff on what managers’ jobs entail – Although they already knew who to go to for what, this helped them to know we are there to support them.

17. RESULTS: Hard Data Survey Remember we were a SFF??? …cleared in April 2011!!!!

18. RESULTS: Soft Data • Communication has improved! The more we share the more is shared by others • Leadership has improved; More approachable, open-minded, involved, and understanding. Staff Quotes • “You don’t even know that there is a better way to lead (or be led) until you lead (or are led) in a better way!” D.O.N. • “The message that’s been sent by our bosses is, ‘whatever works best for us, we should get to do’.” C.N.A.

19. Lessons Learned… • It doesn’t hurt to look at ourselves & own our behavior • Act on what needs attention • Listen to others: We don’t have to always come up with the solutions • Trust your staff: The floor staff really do know what they are doing. Allow them to participate in the decision-making. Administration can’t do it alone!!!

20. What The Project Did For Us? • Meetings proved to have valuable learning opportunities: • Learned from facilitators • Learned from each other • Broke corporate barriers and talked to each other! • Gave us the opportunity to open our eyes and see not only where we’re headed, but how far we’ve come.

21. Impact of Corporate Support • Attendance at meetings showed value to the project and to us as a team. • We were able to offer suggestions to corporate during the process: • Don’t just communicate with Administrator and/or DON when requesting a task from all of management. Meet with all department heads and explain purpose.

22. The Future • Round Table discussion opportunities for all departments (Actually requested by the CNAs- We’re listening! ) • Evolving Staff Satisfaction Program • Based upon survey results and staff needs • Employee Relations Committee • Expanding staff participation in on-going Advancing Excellence

23. The Future (cont.) A Corporate Position was developed to support Advancing Excellence in all Alden Facilities • Gives value to what we did • Helps our story to keep evolving • Provides opportunity for spread to our other homes

24. For More Information: • Advancing Excellence: www.nhqualitycampaign.org • LANE:  LBridwell@ilqio.sdps.org www.aldenwentworth.com • Niquitta D. Berry ww_asstadministrator@aldengroup.org (773) 487-1200

25. Special Thanks To… LANE Leaders: Lee and Enza The Alden Wentworth Advancing Excellence Team: Charlene Hill-Jeon, Administrator Niquitta D. Berry, Assistant Administrator Talia Thompson, DON Tracy Russell, ADON Lindia Ollie, Scheduling Coordinator Curtis Harmon, Wound Care Assistant Antonia Martinez, Environmental Services Director Jishell Lynch, CNA