Let’s demand leadership in 2010
Editor’s note: This article was written by guest blogger Anthony Cirillo, FACHE, ABC, a healthcare marketing and experience management expert and elder advocate. For more information about the author, please see our About page.
Healthcare reform has a lot to do with access to care. In terms of healthcare delivery, the need will not change. It will only increase and we will need services across the aging continuum. As much as people want to embrace aging in place (hey, I want to live at home too) the fact is we will need long-term care facilities. And baby boomers will not accept facilities as they are today when they need them later. Even as baby boomers make decisions for their parents they are starting to demand more.
This brings us to person-centered care, culture change, experience management—whatever you want to call it. I have some theories as to why it has not caught on. Here are some of the obvious ones:
- The bottom line is unless there is a clear correlation between pay-for-performance and the experience of employees, residents, and families, few will act. Will new F-tags dealing with dignity change anything? I am skeptical.
- People are daunted by programs that seem to address experience management less from hearts and minds and more from hammers and nails. Renovations of facilities might be a by-product of culture change and experienced management but it does not have to be.
- Command and control. The hierarchy of nursing facilities lends itself to this and people have a hard time understanding that letting go of control within context and empowering staff actually benefits everyone.
But consider this even more systemic issue: Healthcare workers are like firefighters. They do dirty jobs, look death in the eye every day, and celebrate the joys of life too—rescuing a kitten or celebrating a centenarian’s birthday. So why does the firefighter culture thrive with low attrition and people clamoring to get in? Firefighters face their mortality every day and they have created a culture where they can talk about it, release it, joke about it, and move on. Firefighters are treated like heroes; healthcare workers, not so much. So part of it, in my opinion, is building cultures that recognize this and help people release their fear and anxiety. That is not part of any rewards and recognition system; it goes fundamentally deeper. It contributes to the notion that for many, long-term care is a job, not a career, calling, or passion.
Enlightened and visionary leadership can help expand the reach and benefits of culture change by improving the employee experience and work environment. To do so, facility and industry leaders should:
- Recognize that educating the public about aging issues is not just the right thing to do but also builds relationships.
- Know that changing the employee experience will change the resident experience and people will talk about it.
- Recognize that culture change is not the program of the day, driven by more rules and regulations.
- Use times like these not to hunker down but to press the reset button, changing the rules of the game, redefining the work, and changing the organization.
- Understand that empathy will assist in cultivating loyalty and an understanding that employees are not following the organization down a blind path.
- Realize that empowering staff with tools allows them to collaboratively solve problems. It helps creates context.
The bottom line is that trusted leadership recognizes the fragile life-and-death nature of long-term care and allows staff to celebrate, grieve, and become empowered to change it, to make it better.
But maybe we need to face the facts that some organizations do not have this type of leadership.
Perhaps we need to start looking at the boards of directors for our healthcare institutions. After all, doesn’t the buck really stop there? For many leading our healthcare institutions, the simple fact is that they may not want to change and will not do so unless a higher authority mandates it. So maybe we resolve in 2010 to build better boards. And maybe this all starts with a better vision for your organization, an organization that looks to be of service to the community, wants to contribute to the better health of all, and wants to educate people about aging issues and choices.
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MacKenzie Kimball
MacKenzie Kimball is a Managing Editor in HCPro's long-term care division. She is the editor of the monthly newsletter PPS Alert for Long-Term Care and the MDS 3.0 Update e-newsletter.
MacKenzie has written 224 posts.
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Comments
You are so right on so many counts. As healthcare WORKERS today, we have the opportunity to make significant culture changes to LTC BEFORE we become LTC RESIDENTS. We can ALL participate in this exciting transformation.
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