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

1. Advancing Excellence Initiativewith the Illinois LANE Preserving Critical Access Nursing Homes Telling Our Story:From Nursing Home in Need to Nursing Home in the LeadRenaissance South Shore

2. Key Areas of Action • Reduced Volume of Call Offs from Direct Care Staff by 75% • Reduced Overtime Rate 0% • Created & Implemented Consistent Staffing • Created a culture for our employees to be heard and have a voice in change. • Improved Employee Morale and Patient Care

3. High Volume of Call Offs • As the new Administrator of the building I analyzed and took over doing the schedule for the CNA’s in an effort to identify the contributing factors to the high volume of call offs. • I wanted to identify if call offs were due to a system problem or staff were not happy. • After meeting with staff over a 2 week period Here’s what I found very quickly….

4. Contributing factors to call offs • It was not a System Problem. We had more than enough staff to fill our shifts. • Several staff members were primary care givers for parents or sick children. • Staff were frustrated with floating all over the building • There was no accountability for call offs.

5. Facing the Challenge • As a symbolic measure we threw out the old handwritten schedule and created a new computerized schedule that would help us track our progress. • We created a staffing schedule that met the needs of the facility not the needs of the staff. • We worked with the staff who were primary caretakers for their loved ones to create “flex schedules” to reduce their call offs

6. The Turning Point • We asked staff where they would like to work. • We felt it was important to hear where our staff where most comfortable working and create a schedule that would meet their preference and offer consistency. • This gave the staff a voice and active participation in a facility wide change. We Empowered our Employees

7. Reducing High OT Rate • By working with the staff and creating a Balanced and Consistent Schedule we were able improve our call off rate which directly impacted our OT Rate. • We also began keeping the staff accountable for their call offs. • Since January costs associated with OT dropped by 71.6% which was a $84,362 costs savings.

8. OT Decline

9. A Little Change Adds Up to Savings!

10. Low Employee Morale • We opened up the Administrative Doors that were once closed and began to hear our employees. Here is what they had to say… • They were tired of their co-workers calling in and having to shift or wait for a replacement to come in. • They didn’t feel appreciated or had a voice in facility changes.

11. Improving Employee Morale • We reestablished internal accountability for call offs and set a clear system for all call offs. You Call Off…You Call Off to the Administrator! • We made the staff hold each other accountable as well.

14. Overall Results • Call Offs were cut by 80% since the beginning of this project. • OT was reduced to 0 with a 71% cost savings over 3 quarters • Employee Morale was improved with continued participation in facility decision making • The implementation of Consistent Staffing has reduced re-hospitalizations, within 30 days, to less than 11%

15. Overall Results • The implementation of Consistent Staffing has: • Created a staff force that is knowledgeable of their patients • Increased Patient/Family satisfaction • Reduced re-hospitalizations to less than 11% • Reduced falls by 60% over the year

16. Lessons Learned • Communication is Key! • A Comprehensive Orientation Program is a valuable investment • Use challenges or mistakes as learning experiences. • Address issues immediately, even if you don’t have a solution.

17. Importance of Corporate Support • Corporate team was present from the beginning and supportive of the changes and “out of box” ideas that were brought to the table. • Trusted the Administration Team to make the changes independently. • Were always available with guidance and resources when needed.

18. The Future • We are very excited about our work and success to this point. We have recently reached a milestone within our facility with 0% OT, which was celebrated amongst all staff. • We plan to use this momentum to continue empowering our staff, helping them grow professionally, and continue to strive for clinical excellence!

19. For More Information: • Advancing Excellence: www.nhqualitycampaign.org • LANE:  LBridwell@ilqio.sdps.org • Renaissance Park South: Connie Ortega COrtega@nucareonline.com • NuCare: Michelle Stuercke, • 847-977-8590; • mstuercke@nucareonline.com