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Four Part CMS Satellite Broadcast From Institutional to Individualized Care

Four Part CMS Satellite Broadcast From Institutional to Individualized Care. Part 4 The How of Change: What a difference management makes!.

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Four Part CMS Satellite Broadcast From Institutional to Individualized Care

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  1. Four Part CMS Satellite BroadcastFrom Institutional to Individualized Care Part 4 The How of Change: What a difference management makes! This material was designed by Quality Partners, the Medicare Quality Improvement Organization for Rhode Island, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the US Department of Health and Human Services. Contents do not necessarily represent CMS policy. 8SOW-RI-NHQIOSC-072006

  2. Marguerite M. McLaughlin Manager of Educational Development, Quality Partners of Rhode Island

  3. CMS Satellite Broadcast Series: From Institutional to Individualized Care • Part 1, November 3, 2006: Integrating individualized Care with Quality Improvement • Part 2, May 4, 2007: Transforming Systems to Achieve Better Clinical Outcomes • Part 3, May 18, 2007: Clinical Case Studies in Culture Change Case Examples • Today: The How of Change: What a difference management makes!

  4. Cathie Brady Co-founder, B&F Consulting Consultant, Quality Partners of RI

  5. Barbara Frank Co-founder, B&F Consulting Consultant, Quality Partners of RI

  6. Thomas Hamilton Director, Survey & Certification Group Center For Medicaid and State Operations Centers For Medicare & Medicaid Services

  7. Goals: • Describe a change process • Explore the importance of inclusive leadership • Identify workplace practices to achieve staff stability • Demonstrate why of individualized care is better care

  8. Basic Premise Good care needs to be individualized That requires good relationships between residents and staff

  9. Sections • Section 1: The How of Change • Section 2: A Positive Chain of Leadership • Section 3: Achieving Staff Stability • Section 4: Individualized Care: The Path to OBRA

  10. Build this slide The How of Change • Personalize • See how it is for residents and staff • What’s working – keep it • Open dialogue to change what’s not working • Look at the data • Pilot test • Mid-course adjustments • Spread

  11. Bathing Without a Battle www.bathingwithoutabattle.unc.edu

  12. Ways to personalize the experience • sit in a shower chair • wear a chair alarm • lie in a resident’s bed • take a shower in the shower room • eat a meal

  13. Build Sources • The Leadership Challenge by Jim Kouzes and Barry Posner • What a difference management makes! by Susan Eaton

  14. What a difference management makes!Five Management Practices Associated withLow-Turnover, High Attendance and High Performance: High quality leadership at all levels of the organization Valuing staff day-to-day in policy and practice, word and deed High performance, high commitment HR policies Work systems aligned with and serving organizational goals Sufficiency of staff and resources to care humanely Eaton, 2002

  15. build A Positive Chain of Leadership • Encouragement and Valuing • Positive Presence • People Development • Personal Growth as a Leader

  16. Facilities with higher employee satisfaction have: • More residents without falls • More residents without pressure ulcers • More residents without acquired catheters • Less nurse turnover • Less CNA and nurse absenteeism • Higher occupancy My InnerView 2007

  17. build Encouragement: • Set clear standards • Expect the best • Pay attention and tune in to people • Personalized recognition

  18. Effective praise is: • Timely • Specific • Sincere • Proportional • Positive One Minute Manager Ken Blanchard

  19. build Achieving Staff Stability • Maximizing Financial Resources to Invest in Staff Stability • Attendance policies • Hiring practices • Consistent assignment

  20. Snapshot of Current SituationComposition of the current staff

  21. Financial Incentives:

  22. Terminations by Length of Service

  23. Incentives

  24. Turnover Costs:

  25. Instability vs. Stability

  26. Stage 2: Staff Stabilization Plan Goals: • more full-time positions • Improve attendance • Improve percent of new hires who stay

  27. New Wage Package

  28. As a result: Increase in FT Staff

  29. Increase in Percent of Nurses and CNAs Working Full-time

  30. Case Study and Tools Available from: • Better Jobs Better Care – www.bjbc.org • COVE – Coalition of Vermont Elders – 802-229-4731 • Quality Partners of Rhode Island – www.riqualitypartners.org

  31. http://cms.internetstreaming.com

  32. National Technical Information Services 5285 Port Royal Road Rm. 1008 Sills Bldg. Springfield VA 22161 (703) 605-6186

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