Guest Blog: Culture Change is Not About Fish and Birds
The following is a guest blog from Anthony Cirillo, FACHE, ABC:
Those are not my words but those of Barbara Frank speaking at the September AHCA conference in Las Vegas.
What her points boiled down to is that MDS 3.0 has many fine points, most of all, the resident interview.
Resident interviews reveal amazing things if you slow down, listen and respond. Combine that with consistent assignment, mid-shift huddles and empowered CNA’s and you have true culture change.
She made her point masterfully by putting us through an exercise in which we had to figure how a routine patient in a nursing home ended up dying in the facility through a series of missteps that could have been prevented.
I’ll give you a taste. This person was a night owl, yet with little to do at night, he was bored. So what does the staff do but give him sleeping pills. He falls the first night going to the bathroom.
Why? Because he was disoriented from pills he never took before. He is in a bed he not used to. No one bothered to observe him to watch his balance, gait and to make a safe passage to the bathroom.
Then comes incontinence. Then obstinence, not drinking before bed. Then a urinary track infection.
More meds. Agitation. Violence against staff.
And it all started with the sleeping pill and inattention to environment.
The resident interview is at the heart of the new MDS regulations and in many ways at the heart of person-centered care. But if we don’t listen and pay attention it is all for naught.
So how can we be better listeners? We started talking about this last month. Here’s more. According to my friend Loren Ekroth, you can start by:
• Showing interest in and be curious about those you talk with.
Being curious about another person helps to engage us and to validate that person as interesting. On the other hand, if we seem bored by or indifferent to the person, they feel invalidated, as if we are saying "You hold no interest for me. You are not interesting."
• Balance the talking and listening. Take turns.
For relationships, lots of talking and too much talking can be harmful to personal and business relationships. The scientific evidence suggests that balancing our conversation so that everyone gets a turn who wants a turn is supportive of social relations.
• Give genuine compliments and real praise when appropriate.
Some people have trouble giving compliments. Others have trouble receiving compliments graciously. Most of these troubles are caused by upbringing and culture. All of these old habits can be eliminated and replaced with kinder and more generous behavior that fosters better relations between people.
• Keep your positive energy up.
When we interact with others, we exchange not only words and bodily expressions. We also give off - exchange - our vital energy. If our energy is high and vibrant, we lift the conversation. If it's low and sluggish, we sap energy from the encounter.
• Ask better questions.
A routine question will evoke a routine response. However, if you'd prefer a more substantial conversation, you'll need to use a different question to evoke a different response. A deeper and more detailed conversation will certainly be less predictable and probably more interesting, and it will likely have the effect of enriching your relationship.
So while there may be specific resident interviewing techniques and “exact” questions to ask, it never hurts to learn the art of listening.
Anthony Cirillo is the about.com expert in assisted living.
A speaker, health care consultant, senior advocate and blogger, he
consults with long-term care facilities and is available for management
retreats and association keynotes. He is the author of "Who Moved My
Dentures?" His company, Fast Forward Consulting empowers organizations
to change the healthcare experience and leverage it in their marketing.
For more information go to More at www.4wardfast.com and www.anthonycirillo.com.