ADVANCE Perspective: LTC : Leadership

Leadership Models

Liz Rosto — Mon, 05 Oct 2009 14:45:00 GMT

The following is a guest blog from Anthony Cirillo:

Recent Harvard articles have been consistent in their insistence that a different mode of leadership will be required in all businesses going forward. Business as usual got us into the predicament we are in so we can't simply go back to it when the economy recovers. New leadership will be about facilitating, collaborating and empowering. I write a lot about person-centered care. When readers write back, they pin a lot of the stagnation in implementing person-centered care on leadership. People change because they want to change. Leadership has to create that context. Albert Einstein said "No problem can be solved from the same level of consciousness that created it." With that in mind, here are some leadership qualities I believe are necessary to overcome the present stagnation.

Leaders must be committed to:
1. Creating exceptional experiences for everyone - staff, patients, residents, caregivers and family members.
2. Fostering a collaborative leadership style focused on empowering and energizing employees and adopting and acting on ideas that flow from bottom upwards.
3. Being an innovative thought leader, continuously exploring, experimenting, learning and sharing not afraid to have a point of view and take a stand on it.
4. Evolving into a change agent for Person Centered Care by walking the talk.
5. Educating the public about aging issues by sharing stories that in turn enhance their brand and contributes to operational success.

Is this you? Who do you know who exemplifies these qualities, and what has been your experience with them? Are you in? If so let's talk!

Anthony Cirillo, FACHE, ABC is a healthcare consultant, senior advocate and blogger for Wellsphere in the area of aging and senior health. 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. To read more, go to http://community.advanceweb.com/blogs/ltc_1/archive/2009/09/04/guest-blog-new-leadership-methods-needed-if-person-centered-care-to-blossom.aspx and http://community.advanceweb.com/blogs/ltc_1/archive/2009/08/05/guest-blog-putting-person-centered-care-in-perspective.aspx .

Is There Still a Shortage of Health Care Workers?

Liz Rosto — Thu, 26 Feb 2009 20:09:00 GMT

With record unemployment rates, you'd think the health care industry would be closer to filling the workforce shortages that have plagued the industry for years. While a few administrators I talked to told me their staffing levels are stabilizing and they are relying less on agencies, there are still nearly 110,000 caregiving vacancies in nursing facilities nationwide, according to AHCA/NCAL.

AHCA/NCAL recently established the Champion Nursing Coalition, a group of organizations representing consumers, insurers, businesses, health care providers and others committed to highlighting the nursing shortage and its impact on health care quality, access and cost.

"It is critical that this crisis be addressed immediately for those who need care now, and in the future,” said AHCA President and CEO Bruce Yarwood.

In a statement he gave at the Capitol Hill program launch, Yarwood outlined the need to address the long-term care workforce crisis: "Promoting and passing sound fiscal and public policies designed to strengthen our workforce and promote the continued improvement in seniors’ care quality deserves to be a top national priority – since many caregivers are retiring and are joining other retirees in need of care and services. While efforts to recruit and train new qualified long term caregivers are costly, our profession has continued to aggressively pursue potential nurses and caregivers. An unfortunate truth exists that nursing education programs are forced to turn away well-qualified applicants for the sole reason that there are not enough nurse faculty to educate these potential caregivers."

To read more about the program, go to AHCA's Web site. See also the Center to Champion Nursing in America.

I wonder how many job seekers out there might consider a career change to the world of health care? If health care is your second career, share you story with us.

The Value of an Apology

Maureen McAndrews — Fri, 01 Feb 2008 15:49:00 GMT

Over the summer I made a major purchase at a home improvement retailer. To make a long story short, the vendor: lost my order data due to a computer power failure, delayed product delivery, ordered the wrong size product, forgot to collect payment from me while I was in the store (which meant I had to make an extra trip to the store), allowed the product installer to cancel several appointments that I’d rearranged my schedule to accommodate and ultimately sent me a product that was drastically different from the one I’d seen in the store and ordered.

Throughout this entire process, which went on for several months, no one from the store ever once apologized. In fact, during one of my visits to the store, after I learned from the representative that the product measurements were inaccurate, I became very exasperated and said something to the effect of "This entire process has been such a hassle. I don’t know if I can keep going like this." The rep simply stared back at me and offered no apology. At that point, that store should’ve lost my business, but I elected to keep going because I didn’t want to forfeit my deposit and start all over again with another retailer.

But it would’ve made a difference if someone had said just once that they were sorry. Since my experience was with a retailer, it was simply a hassle. But when facility managers make mistakes, there are often far greater consequences. Even though the stakes are higher, an apology can still make a difference. As Loretta G. LeBar, JD, CHC, writes in her September/October 2007 article "Saying You're Sorry," "Today's culture discourages apologizing to victims and their families for fear of it being seen as an admission of guilt. We need to change this."

If you’re concerned about the legal ramifications of an apology, ask your attorney for more information on how you can effectively communicate when something goes wrong. If nothing else, at least start a conversation about the value of an apology. If the "carefully planned apology can prevent litigation, restore trust and build stronger employee infrastructure centered on quality of care for the residents," as Le Bar writes, wouldn’t it be well worth it?

More on "Water for Elephants" & Nursing Homes

Maureen McAndrews — Mon, 19 Nov 2007 22:25:00 GMT

In my last post on Sara Gruen's book "Water for Elephants," I discussed the book's main character, 93-year-old Jacob, who lives in a long-term care facility.

In the chapter where Jacob recounts his family's decision to send him to the facility, he says the dialogue between him and his children went like this: "It's not a nursing home, they said. It's assisted living-progressive, you see. You'll only have help for the things you need and then when you get older... they always trailed off there."

Jacob's reassurance from his children that "it's not a nursing home" raises some interesting questions about the public's perception of nursing homes. Does the public, in general, still regard nursing homes as cold and imposing institutions? By and large, do consumers assume that nursing home care is inadequate?

If they do, it's not surprising. A quick Yahoo! news search on the words "nursing home" yields some scary headlines about horrible things happening in nursing homes in different corners of the country. A nursing home operator in Hartford, Conn., is under investigation over reports of poor patient care. Moving further south, a former nursing home employee in Beaufort, S.C., is accused of tossing an 89-year-old woman out into the hallway. Then, out west, you have the state of New Mexico filing criminal charges against a nursing home operator in relation to a patient's death.

But there are plenty of nursing homes who are doing it right, and we've published volumes to prove it. We've written about the findings of programs like Better Jobs Better Care and we've told the stories of countless nursing homes who are taking many steps to deinstitutionalize and offer more person-centered care. So what can we do to better get the word out about the nursing home staff who are doing their best to enhance resident care? If you have suggestions, we're all ears.