Assisted Living Christmas

The reports are not yet compiled for the holiday sales figures, but I’m guessing they’ll be awful. Snow and bad weather has kept many, many people out of the stores; hopefully safe and warm at home.

It’s been nice at our home to focus more on family and friends than on the great consumer adventure – what to buy for our loved ones who, truth be known, have everything they need and most of what they want. What they really need we can’t get them at the mall anyway – a happy relationship for one; a solid job for another; a secure home for yet another.

The business of caring for our country’s most frail, elderly adults continues day after day, even through the holidays. Yet we experience financial challenges and census drops that feel like a fall from a cliff. We know our staff are suffering, and we’re about to cut their hours.

It’s a difficult time for many businesses and individuals today. It can feel so overwhelming that we may feel hopeless; helpless.

And yet at the holidays our thoughts are turned to a bigger screen than the one our own difficulties are played out upon. Themes of peace, joy and love; memories and tradition nudge us out of our own inward focus.

So we turn off CNN and tune into the Yule logs with their flickering image of a warm, cozy fireplace. We put on old melodies we can sing along to (if the kids are out of the room). We wrap the simple gifts that represent our heart’s longing for the true happiness of those we love.

And we take just a minute to say to friends and strangers alike, “Merry Christmas! Have a wonderful New Year.”

Assisted Living Challenges: making the most of high unemployment

Two sectors of our economy seem to be thriving: education and health care. My company (Institute for Senior Living Education) happens to be nicely poised in the intersection of these two sectors; yours is likely more in the health care/senior care sector.

Unless your census has suffered significantly with the economic downturn, you’re likely in the hiring mode, not the lay-off mode.

Applicants may be, for the first time, plentiful and qualified.

If you’re lucky, you may have this edge in hiring for the next several months.

Taking advantage of it, however, it not a slam-dunk. It may take a little more thought and consideration to be able to hire the best and keep them into the economic recovery.

What can you do? Here are some thoughts taken from a wide range of studies and industries that seem to apply to this environment:

1. Spend some extra time thinking about the kind of person you’d love to hire for each opening you have. Look at current employees who are your stars in similar roles. What makes them so great? Consider personality, character and other factors that may be independent of experience and training. You may have the opportunity to hire individuals with similar personality traits and train them to become equally valuable members of your team.
2. Get plugged into technology to help you with the hiring process – now. Never used Craig’s list before? Give it a shot now. Look for other online job boards you can use. Consider utilizing an online application option to allow those interested in your positions to apply online, without needing to develop a resume or fax/mail/drop off an application. Many tools are available, including one developed by my own team that is currently available at no charge to senior care employers (see www.apply2care.com). Link your job postings or want ads to the application website and gain the advantage of being the first employer to see the application, delivered directly to your email inbox, looking tech-saavy and current to your prospective employees at the same time.
3. Select carefully. You may have the opportunity to interview several candidates for a position – a delightfully new situation for many providers. Involve individuals who will be working with the new hire in the interview process and don’t hesitate to take your time to interview twice, check references, and slow down the process. Hiring carefully now can save you time and money in turnover later.
4. Think about career advancement opportunities you can offer in-house. If you hire individuals who may be somewhat overqualified for their new position, offer these employees extra training to be ready to advance as opening occur in your own internal career ladder. Perhaps you don’t foresee any management openings; offer training anyway to keep the motivated hire interested and engaged.
5. Consider additional training opportunities all the way through your team. This is a proven strategy to reduce turnover and increase employee engagement; now may be the perfect time for you to implement enhanced training programs for all your staff members.

While other companies are laying off employees, most of us are still hiring. Take advantage of this change of pace, and build up your team to become the very best it can be.

Senior Care companies can face the economic downturn with boldness and action

Look outside your window today. In most parts of the country you’ll see bare tree branches, leaves on the ground, and other signs that Mother Nature has gone into hibernation.

Turn on the TV and you’ll see the stock market and other economic indicators looking much the same: they’re heading toward a dormant state, if not a near death moment.

"There is a tendency for companies to simply cut costs and then hibernate to ride out economic recessions," said Alan Black, CEO of Intelliden , in a recent press release containing five strategies for navigating the downturn.

Black goes on to say, "However, as history has shown, by taking smart, pro-active steps during a downturn, technology managers can help their companies be much better placed when the upturn arrives. The current economic downturn will undoubtedly end at some point and those companies that are leaner, fitter and more innovative will likely have the most to gain from the upturn."

While Intelliden is an IT and networking company, some of the strategies are useful for all business managers:

1. Control costs without compromising the business. In the senior care world payroll costs are the biggest cost center. Can you control your overtime or other costs without compromising the service you deliver? Look at areas of employee cost that can be reduced like those related to turnover and training. Don’t skimp on new employee or current employee compliance training, but do look for ways to reduce cost of that training, for example by reducing the need for overtime or higher cost instructors. Do you use agency staff to fill in gaps? If so, you know this is a significant cost center that does nothing to improve your service. Make it a point during this period of economic downturn to eliminate agency staffing and turn that money to improved training and retention programs that have proven effectiveness for quality outcome.

2. Simplify your technology environment. This is an excellent time to look at all of the ways you use technology. Most senior care providers use a mixture of paper and pen record-keeping along with technological solutions. Now is an excellent time to look at all the systems you use. Find overlap and eliminate it. Seek off-the-shelf packages that meet your needs in a more robust, complete manner. A small investment in electronic records now, for example, may save you millions in labor costs over the coming years.

3. Don’t stop innovating. Downturns are times when we may be forced into creative solutions to problems that, in the past, we just kept pushing off to a future date. Don’t shy away from looking at your key problems or challenges as well as your core strengths and objectives. Look for new ways to improve outcomes, increase customer satisfaction and bring in new revenue. Seek solutions – technological or otherwise – to become more efficient at the same time you’re increasing effectiveness. Are you spending too much time on things that aren’t your core business? Contract them out or change the way you manage them.

In nature, the period of a winter “downturn” leads to a vigorous growth phase in the spring. That seems like a pretty great business model to follow.

A Thanksgiving Story

Three Thanksgivings ago we sat down at the extended table with our extended family and felt so incredibly blessed we could barely speak. My father had survived a small stroke; my husband’s father had survived a heart attack and bypass surgery. We didn’t expect to all be together that year, but we were.

A year later, my father was dead and my mother in the hospital, unable to join us for Thanksgiving dinner. We rushed, somewhat numbly, through dinner, avoiding the traditional recitation of blessings.

This year feels a little like that particular Thanksgiving, on a global scale. It’s hard to find things to be thankful for (if you actually open your investment reports). It can be frightening, as companies and individuals we have long looked up to for leadership are faltering – maybe even failing.

And yet. Today the sun shone through the piles of golden leaves. I walked to work the long way, savoring perhaps the last nice morning of the month, feeling healthy, alive and filled with thanks.

Today, we had a chance to help a whole group of individuals begin their journey to become caregivers and nursing assistants. We connected with business associates who are challenged but persevering; and several who are thriving.

My children are spread out all over the globe; one in India and one in Israel. They’re studying, volunteering, and traveling. They’re excited about their adventures and fully engaged in their work of growing into global citizens.

Our table will be a little lighter this year for Thanksgiving dinner. Our bank accounts and investment portfolios are certainly a lot lighter. But when I count my blessings this year – out loud – the list will be long.

Happy Thanksgiving.

Paddling Against the Current to Achieve True Culture Change

You’re on a raft in a swiftly moving river. Imagine that you’re not entirely happy with the direction this river is flowing – how do you change directions? Can you paddle the raft upstream against all the power of the rushing river by yourself?

If your community has been talking about “culture change” you may well be facing this same sort of challenge. Custom and habit are powerful forces, pushing against any effort you may be making to change direction.

Can you paddle that raft upstream by yourself? Not likely. But get your team involved, and you can push against even the swiftest moving currents.

How do you get your team involved? If you truly want to create a new culture of care in your community, you’ve got to get the entire team involved.

“Deep learning and cultural change are ALWAYS connected,” says Peter Senge, author of “The Fifth Discipline: the Art and Practice of the Learning Organization,” (Currency Publishing, 2006) and culture change consultant. According to Senge, culture change is “deep systemic change” – change that begins at the personal level of each employee in the community.

If you’re ready to make some changes, hand your team a paddle:

1) Start the discussion. To achieve culture change you’ve got to start talking about WHAT needs to change and WHY. It can’t be just your perspective – you’ve got to hear what everyone else has to say about this. Being clear about the WHY of change is every bit as important as the WHAT of change, too, so think it through carefully and make sure the WHY aligns with your mission and message.

2) Really listen. Sounds easy. It’s not. Really listening when you’ve begun the discussion means you may hear things that you think are working well may not be working at all out “on the floor.” Keep an open mind, while you’re keeping your ears open, too.

3) Create a culture of LEARNING. To change behaviors (culture), you’ve got to provide an atmosphere where learning is valued. “Learning is always about people knowing how to do something they couldn’t do before,” says Senge. Is your inservice training simply designed to meet compliance regulations? Are you repeating content month after month, year after year? Are you seeing employees learn to do something they couldn’t do before because of your inservices? If not, make a change in your approach to training to truly create a culture where learning and personal growth are valued. Furthermore, to make the transition from knowing to doing requires more than training; it requires leadership. You, as manager, must “buy in, role-model it and require it,” as Fred Lee (If Disney Ran Your Hospital) puts it, to see true culture change.

4) Keep it simple. Life is complex. Change is even more complex. To make change even more challenging, remember this rule: People always resist change. Especially if they don’t understand why they need to change.

5) Reward innovation. When your employees see that you’re serious about changing the way things have always been done, they may get excited about finding new ways to do things. Make sure you reward the excitement – give praise and public acknowledgment and watch other employees get on board. When staff sees innovation and change resulting in positive outcomes they will become advocates for even more change and innovation.

6) Have fun with it. Not surprisingly, the most effective change agents are ones that people enjoy. If you want to introduce a new approach or technology, you’ll be much more successful if it’s fun.

Changing your culture in any meaningful way is like paddling that raft against the current. It can be done, but only if everyone on the team is rowing together

How to break through the wall – creating success in times that feel impossible

On my daily walk to work I cross a bridge over the Willamette River. It’s not a wide river, but just upstream is a broad, powerful falls. The banks of the river are steep rock walls, dropping over 70 feet from the roadway to the water below. I’ve been walking over this bridge nearly every day for a year now. It’s my few minutes for reflection and planning; lately I’ve found myself thinking about the power of the water.

I see how the water, when it is focused into a narrow channel, can cut through what appears to be solid rock. The water that falls as a soft, blanketing mist much of the winter here in Oregon turns into a force that literally changes the landscape. It cuts its way cleanly through stone, over time.

As I consider that force, I think of two key concepts that I can apply to my work: focus and tenacity. It’s easy in any business to try something a time or two and then give up, looking for an easier way around an obstacle.

Obstacles like a poor economy, however, aren’t easy to get around. When the primary barrier to your success is money, from the client’s perspective, it can feel like a solid rock wall.

Whether you’re talking about a community that desperately needs census building to cover payroll and other costs, or, as in my business, a product that is needed but may not be considered essential to operations, the barriers can feel rock solid and impenetrable.

That’s when I start thinking about the river. It can’t break through a solid wall with a meandering stream. But when the force of the river is focused into a single, powerful jet of water, it can cut through almost anything – given enough time. That’s the second part of this principle – time and consistency. The Grand Canyon wasn’t forged in a single season, but it created a masterpiece over time with the focus and tenacity that is, itself a force of nature.

From my personal perspective, I’m encouraged by news articles like the one out of London that reports that 78% of human resources leaders are looking to online training to reduce their costs in accessing external trainers and resources and 57% are looking for ways to reduce the amount of time staff spend out of the office on training. This report shows a trend toward more companies looking at custom online training as a way to reduce their training expenses while still maintaining a competitive edge during tough times. Of course, this is exactly what our company has been promoting for the past two years, often feeling like we were running into that solid rock wall of resistance.

The expert quoted in the article concludes, "Now, more than ever, it is imperative to have a fully trained and knowledgeable workforce on hand to see you through these tough times but not at the expense of productivity. eLearning solutions such as virtual classrooms, web based training and mobile learning not only minimise the time employees spend out of the office, but they also allow employees to carry out training at flexible times, thereby reducing impact on their day-to-day work."

Ah, a little crack in the wall is suddenly appearing.

I believe I’ll focus and continue to be tenacious, and see if we can create a channel right through this barrier.

What’s your barrier? Take a lesson from the river, and break through it this winter!

Holiday Gift Ideas from my team to yours

Election is over: What’s next for senior care providers?

Let me first say this: “Whew!”

It was a long campaign. It wasn’t always pretty or nice. There was mud slinging on every side of every issue. Often it seemed that the strength of some people’s passion overruled their sense of basic human decency, not to mention a sense of decorum desirable in a prominent elected official.

We have big issues ahead of us in the coming years. We’ll need to put aside our partisan passions and tap into our passion for quality care for seniors and for the strength of this industry.

We’ll need to advocate for decent pay, training and benefits for senior care workers throughout the US, because if we don’t someone else will (carrying a potentially big stick).

We’ll need to work hard to continue to improve the quality of care provided in senior living communities from the inside out, rather than wait for increased governmental oversight and regulation.

We’ll need to continue to demonstrate not only the social benefits of senior care in our care communities, but also the economic benefits to a society that will soon be staggering under the mounting pressure of an aging population.

We’ll need to embrace technology and clearly recognize a generation of younger people who have felt – perhaps for the first time – the power of their voice and the strength of their vote. These young people were involved in a strong wave of technology-based communication that has changed the face of our society, probably in ways we won’t even recognize until some time in the future.

It’s a new day in America. None of the old problems are gone, but perhaps we can face them with new energy and new resolve.

Elections and the Economy – scare tactics and employee performance

I got an email yesterday that still has me a little upset. It’s allegedly written by the CEO of a large company, containing a memo he sent out to all of his employees about the upcoming election. He’s encouraging recipients to send the same memo to their employees as well.

I admit, I was curious and read on. The lengthy memo went into great detail about why employees should be concerned about a tax policy that makes their bosses pay more – it could cost them their jobs. The content deteriorated from there – significantly.

After a few deep breaths to get my blood pressure back under control, I thought about the message we send to our staff when we use scare tactics to try to change their behavior – and there are plenty of scare tactics on any side of the election and the economic issues being debated today.

One study, reported in an article titled “Fear as a strategy: effects and impact within the organization,” (Journal of European Industrial Training, 1998), found that “the use of punishment and fear in the organizational setting has proved to be ineffective and undesirable. Managers must try to create an environment and climate where employees can express their full potential and respond to difficult challenges by letting go of fear of failure, fear of change, or fear of risk taking.”

What does work?

Creating an environment that recognizes the value of the individual employee to the organization, not just the leadership or top management.

Investing in employees by giving them tools to learn and grow, to achieve their potential or climb a career ladder within your organization.

MyInnerView, in collaboration with the University of Minnesota and others found five “interrelated and predictive domains” of focus for providers:

• Consumer (resident and family) satisfaction (do consumers receive from frontline employees the level of care and service they expect, or more?)
• Employee satisfaction (Do employees feel they are heard, respected and valued?)
• Workforce stability (Does the company have programs in place that foster the retention of the best and brightest employees?)
• Clinical outcomes (Are problems quickly identified and addressed appropriately? Do frontline staff know what to report, as well as when, how and to whom?)
• Regulatory performance (Is compliance in all areas of the program a key focus for all staff?)

Every successful company will have plans, approaches and programs in place in each of these five areas. And they won’t be based on using fear as a management technique.

Systems key to building sustainable training program

Several times each year I spend time thinking about where I envision my company a year from now; five years from now. I find that doing this exercise often makes me adjust, even slightly, my priorities today if I’m going to be aiming my company in the right direction to reach those goals tomorrow.

Over the years, I’ve come to realize what all good managers know: it’s the systems that you have in place that will take you on your desired path to growth, not just the people.

I have to admit that I stutter a little even while typing this. I profoundly believe that we must invest in our people, and that the quality of our people makes the difference in the quality of our service, and our company’s very survival.

At the same time, I know that if either Wendy or Wayne (very key people in my company) leaves or becomes injured and can’t work, I need systems in place to continue the growth and achieve my goals. I can’t afford to have my company’s success or failure dependent upon any one person on my team - including myself.

When we’re working with new or prospective clients we often hear owners say, “The administrator I have in one building loves to do all her own inservices. I think we won’t use the aQuire training system in that building.”

In my owner/operator days, I had administrators who were excellent teachers and administrators who were excellent marketing representatives. I had administrators who never had a single citation during survey, but weren’t ll that great at teaching.

I knew that, without systems to support the individuals, my communities would never move forward. We’d always be fighting the battle of dependency on the person, and worrying about trying to replace the person with someone with the exact same skill set should - heaven forbid - they leave.

David Finkel, (Investor Fast Track) whose advice I always read and appreciate, says that one of the most important distinguishers to move your business forward “is to build a systems-reliant company versus a people dependent business. 90% of small businesses stay that way because they choose the latter--building a people dependent business.”

Finkel goes on to describe a highly successful, growth-oriented business as one “where the key know how for the business has be captured in processes, procedures, and systems that allow that business to get consistently great results with consistently good people.”

Three benefits occur when you move from a people-dependent to a systems-reliant company:

1) Your business becomes much more scalable. You can replicate your business more easily, and more quickly. Imagine the ease of adding new services or new properties quickly and easily.

2) Your business becomes much more stable. If a key employee gets hurt, for example, you no longer are vulnerable to loss of forward momentum or quality service.

3) Your business becomes much more valuable. If another operator can continue your business, with little interruption, the value of that business increases should you wish to sell or leverage the business.

Clearly, these benefits require a commitment to looking at all aspects of operations. It requires looking at the ways “we’ve always done things” and being willing to shake them up.
It will require an investment in a system that will, in the long run, produce a higher return on that investment.

In the area of staff training, a systems-reliant approach may result in a change in the status quo. It may require a financial investment. But your gain can be significant.

You can quickly and easily demonstrate full compliance with training requirements – for surveyors, investors, attorneys.

You can achieve consistency in training content and quality company-wide. Many people thought they’d achieved that with corporate training manuals, only to find that, once again, the use of the training manual was only as good as the person designated to use it.

You can set your company apart from the rest who only do traditional (read: “boring”) inservices, both in your hiring advantage and in your services delivery.

You can continue quality training uninterrupted, even with a change in key personnel.

Sustainability is a bit of a fad word today. But in the area of operational excellence, it's an element you can't afford to ignore.

Thriving in the Coming Workforce Crisis

You might not be currently experiencing a workforce crisis in your company or community. With the current economy many people are worried about job security. They’re not looking at the want ads so much as being thankful for the jobs they have.

But even today we have unfilled caregiving positions nationwide. And the gap between trained, prepared workers and the positions we need filled is only projected to widen in the coming years.

The Institute on Medicine recently released a report of their 2 year study into the affects of the aging of America on the health care and senior care workforce.

Their conclusions are pointed: “Unless action is taken immediately, the health care workforce will lack the capacity (in both size and ability) to meet the needs of older patients in the future,” says the Institute, in a report titled “Retooling for an Aging America: Building the Health Care Workforce.”

By 2030, the number of older adults will nearly double from the 2005 count, and will increase from 12 percent of the US population to nearly 20%.

Some of us are thinking – great! No more vacancies! We can even build more communities, and they will come!

But what about the staff? Who will be around to provide care in our very full communities?

It’s not like we have the problems of recruitment and retention solved in this field. In fact, many developers, owners and operators have been so focused on building and acquisitions it seems they’ve lost sight of the WHO: who is providing care; who is leading those who provide care, and who is caring for the people who provide care.

Focus on the WHO, and start positioning yourself NOW to become an employer of choice; a place where people will want to work, even when jobs are plentiful and hiring competitive. Here are some thoughts that can also help you position for success:

1) It’s all about training. Are you just skimming by with compliance training? Are you expecting your administrators, nurses, or others who are not educators by training or skills to train the people who will deliver your service? If you’re not investing in your front line folks, they’ll be looking for another employer who will. Provide the best training you possibly can, and then let current – and prospective - employees know that you’re willing to invest in their growth.

2) Who’s Leading the Team? One of the strongest reasons to stay in a job is having friends at the workplace. One of the top reasons to leave? A supervisor who doesn’t understand, support or lead. Look for leadership skills in people you’re hiring for supervisory positions; train for stronger leadership in existing employees.

3) Celebrate your Team. What do you do that is special for your employees? How do you celebrate their achievements, successes – how do you celebrate their birthdays and anniversaries? If you can’t list at least 5 things that you do that is unique and special, you’d better get busy. Your staff certainly will, with the want-ads in hand!

4) Invest in the Health of your Team. According to PHI, one significant factor to the upcoming worker shortage may be inadequate health care coverage for caregivers. It’s an incredibly expensive benefit, but the value may far exceed the cost of turnover for an employee group who recognizes the investment.

Watch this: the smartest companies in the field will be the ones who position NOW to become employers of choice. Then, when everyone else is advertising $1,000 hiring bonuses if you “come work for us!” they’ll be sitting pretty, with a strong, vibrant, well-trained staff.

Report from the Ground on CNA Training Online

This week the only online Nursing Assistant training program in the
state of Oregon hit the 50 student mark. While far short of the goal
of graduating 100 students each month, it is a significant measure of
the growth of this program, launched only a few months ago.

The Oregon Health Care Association (OHCA) in partnership with aQuire
Training Solutions launched the first-ever online nursing assistant
training program in Oregon in July of this year. The online training
program received approval from the Oregon State Board of Nursing
earlier in the year. This learner-lead training program provides 51
equivalent hours of didactic training online, 24 hours of lab and 75
hours of clinical training at one of more than 40 long term care
facilities around the state.

“I started out in the health care field as a CNA, and am well aware of
the ramifications of what is means to work short staffed,” says
Patrick Patterson, RN, CNA Program Director for Prestige Care, Inc.
Prestige Care, one of the largest nursing home operators in Oregon,
has been a leader in participating in this new online program.

“Working short staffed means that our residents lose out on quality
time, and our staff experience higher burnout and more turnover.”

Patterson says he was initially uncertain about replacing classroom
time with online learning. “I admit I was skeptical at first. I had to
step out of the box to take a good hard look at this approach.”

Just a few months into the program, however, Patterson is a believer.
“Once I saw the vision of what this can do for us I put my whole heart
and soul into making it a success,” he says. “We can offer more
classes with this program, as well as providing clinical training in
facilities where we have no classroom space.” In the end, more CNAs
will be trained and ready to fill the critical positions in nursing
facilities and other care settings.

“I’m proud to be a part of this cutting-edge program,” says Patterson.
“In this technological age, I truly believe that this is the way of
the future.”

Certified Nursing Assistants (CNAs) are the back bone of long-term
care. The aging of the baby boom generation, increased life expectancy
and increased staffing ratios in long term care, coupled with a
decline in the number of nursing assistants being trained by
traditional means, makes this online training program both timely and
essential to meet the growing demand for CNAs. Jim Carlson, Executive
Director of the OHCA, says, “Our online training program provides high
quality, cost effective, flexible and standardized training that will
enhance care in our facilities throughout the state.”

“This course’s curriculum really showcases some of the very best
practice in e-learning for adults,” says Sharon Brothers, President
and CEO of aQuire Training Solutions. “It not only allows the nursing
assistant student to learn at an individualized pace, without having
to attend classroom lectures, but it is also designed to train the
whole person. Students are actively involved in learning new skills
and gaining knowledge about aging and care, as they increase their
understanding of the importance of their work.”

Brothers adds, “We believe that the collaborative effort of this
course will help us train new nursing assistants to deliver the kind
of exceptional care that we all want for our loved ones.”

Those interested in learning more about the program can visit the
online application website, www.OregonCNAonline.com or contact
Brothers at Sharon@aQuireTraining.com.

Challenges in Senior Care? Try the best solution: Training

It should come as no surprise to you that I passionately believe that better training is the answer to many of our senior care challenges.

Short on staff? Offer employer-paid training as a recruitment incentive.

Quality issues? Provide more consistent, quality oriented training to all staff.

Turnover breaking the budget? Offer genuine training opportunities to staff – this is one proven method to decrease staff turnover.

Need to distinguish your company from other care providers? Create your own in-house “University” and load it with required training content that will help your staff understand – and internalize – your company’s values and principles.

Let me take this one step farther: I passionately believe in online staff training. Not just because this happens to be my business, but also because I believe that it works.

Last week our RN course developer, a life-long educator, reviewed our most recent new course and said, “This course is better than a classroom course!”

This comment was a first for Judy. I think even she was surprised. Here’s why she said it:

• The content is written in an interesting, engaging way (not too many words; designed for a fast-food generation of learners);
• Images that illustrate the point and carry emotional weight are used throughout – more pictures than words, in most cases (we know today's learners are highly visual);
• Audio overlay allows the learner to hear as they read, making it not only more memorable but even a mini-ESL course for those who can understand English but not read it and vice versa (since many senior caregivers are not native English speakers);
• The course is interactive, requiring much more of the learner than just passive listening.
  

Judy went on to talk about her classroom experience, and her experience watching other inservice trainers and instructors.

“Even in the best of cases, much of the time you’re simply lecturing,” she said. “Giving the person the opportunity to interact with the content is simply more effective – and more fun!”

Thanks, Judy, for echoing my beliefs. Training does have incredible benefits, but training MUST be an active event, not passive video viewing or lecture snoozing.

But can they Learn Online? A look at generational differences and how they learn

A recent article in the eLearning Guild’s magazine, Learning Solutions, is titled “Understanding Today’s Learner.”

This article takes a look at today’s workforce comprising individuals from 4 different generations, all still active in the workforce.

Age isn’t the only thing that separates these four groups. How they learn, and how they have adapted to technology also varies dramatically from group to group.

Veterans (born 1925-1945): These are the oldest workers still in the workforce. Many of them work in senior care as caregivers, cooks, housekeepers or managers. They tend to be “loyal, hard-working and dedicated” and, as learners, prefer the traditional ways of learning. These individuals are commonly thought of as the folks who don’t know how to use technology and who will resist it if introduced. And yet…

In a recent support group composed primarily of spouses and children of people with dementia (average participant age at least 60), all but two participants indicated a daily use of email and the internet. Many asked repeatedly, “Is there a website I can go to to learn more about this?” (Note to senior care providers: Who’s manning your website?)

This age group will use technology to find answers to their own needs, especially as it relates to their health, and will be thorough in their reading of a website or other digitally presented content. Many of these learners are the most focused in their approach to learning online. While you may need to encourage employees in this age group to get started learning online, once they master the basics, you won’t have to continue to encourage, reward and motivate this learner. They’ll be hooked.

Baby Boomers (born 1946-1964): This generation, frequently called the “Me” generation, focuses on personal accomplishments and achievement. Many of us have balanced career and family our entire adult lives and believe that, with focus and hard work, we can “have it all.” Many of today’s mid and upper level managers are from this generation.

As learners, this population didn’t grow up with their hand on a mouse, but they have adopted technology and use it in their daily lives. They are the fastest growing segment of new Facebook users (the social networking site that started as a college networking tool), and, when the value of e-learning is presented to them, they rapidly adopt and use it.

Generation X (born 1965-1979) and Generation Y (Born 1980 – 1995): These learners grew up with technology, especially the younger Generation Y folks. They tend to be highly social, to multi-task easily and frequently and to assume that learning is their right – after all, they never knew a time when the internet wasn’t available for them to “google” a subject and quickly gain knowledge.

As learners, this generation, our largest employee group, wants to see several things, whether in a classroom setting or online:

• They like small bites of information, and they prefer to have freedom to quickly explore and learn, following their own paths rather than prescribed paths of discovery and learning.

• They are easily bored (that’s a news flash!) and prefer their information delivered with more visuals, sounds, video and images rather than lots of text to read and digest.

• They love to interact with others while they learn, casually throwing off ideas, thoughts, or reactions, blogger or instant message-style, to their friends or co-workers.

• They prefer to have learning available to them so that they can access the knowledge when they need it; a “just in time” approach to learning that online learning has made possible and accessible.

• They can learn new things without close guidance. These are the kids, after all, that not only programmed our VCRs but that learned to use their iPods, google and other technology without our help.

This learner wants to learn quickly, easily, and without being bored. They will be clear that even online learning can be boring, especially when presented with linear, simplistic content that doesn’t allow or encourage freedom to navigate and explore.

This is the employee, too, that will begin to demand options to mandatory training. They’ll assume that any large, sophisticated company will offer training options that fit their needs and their schedules. They’ll seek out information on topics when they need and want it, whether it is company provided or not. They may, in fact, choose an employer that offers more learning opportunities above one that does not.

Today’s workforce is the most complex in history. Knowing how your employees learn, and adapting your training programs accordingly, will help you build the strongest, most effective team possible to compete in today’s market.

Need to Save Money? Focus on Staff Training

The economy is pinching even the most robust company today. Certainly individuals are feeling it. Companies are seeking any place to cut even small amounts from the expense side of the ledger.

One area that simply can't be cut is basic staff training. Requirements are increasing; compliance is getting tougher; licensing is focusing on staff orientation and training; liability risks increases dramatically when training is slighted.

All this leads the smart senior care operators to ask this question, "How can I save money without sacrificing compliance and quality care?"

One answer many are finding is in technology. Use of distance learning is increasing quickly in every segment of society, from universities, where it now holds the same credibility as classroom education, to business, where time and money constraints have led to massive increases in this approach to training.

Brookdale Community College (New Jersey) notes that their distance learning courses - once considered a paltry substitution for classroom courses - have experienced a "'phenomenal' growth in popularity," according to a recent news article. Convenience is the primary reason for the growth, as more and more students (and employees) are pressed for time.

In private industry, online (distance) learning is experiencing explosive growth.

Is it for you? Ask yourself these questions:

How much am I currently paying in overtime for staff training? Overtime is one of those hidden expenses that you may not count when you're considering how much your current training program costs. With online training, you can often reduce or eliminate this cost related to training - frequently more than paying for the cost of a new online program.

How much time (and money) is spent in preparing for training, presenting training and in follow-up documentation? If your community Administrator, Executive Director or other top level executive is responsible for staff training, consider the cost of this individual's time as well. Most managers aren't necessarily good teachers; their time is much better spent in managing and marketing your very valuable asset. Shifting this cost can actually save you significantly in terms of the bottom line.

Can I demonstrate, at any given moment in time, full compliance to all training requirements? At the end of the day, this is the most important question of all. Compliance is extremely hard to achieve with the standard inservice approach to staff training. Someone is always sick, on vacation, or simply forgets about the inservice. Make-up classes are time-consuming and costly. Full compliance is not met, in most cases, without focused, dedicated management attention. And that costs money - lots of money, especially if you're caught out of compliance.

Clearly, it's a good time for companies of all types to look closely at ways to cut costs, especially when they can do with without sacrificing quality and outcome.


aQuire Training Solutions - when it's TIME for truly effective staff training.

Interested in learning more? Contact us and we'll be happy to give you a tour!

Committing to Employee Engagement - Lessons from Community Colleges, Part 2

In Part 1, we looked at the five lessons the CCSSE (Community College Survey of Student Engagement) had learned in its five years of studying student engagement.

This week, let's look at their "Five Strategies That Work" to increase the level of engagement campus-wide.

#1: Set High Expectations and Clear Goals.

Once in a while I'll hear an Executive Director or top manager say something like, "I can barely get my staff to come into work on their scheduled days, let alone do something extra like take an online class." That same manager likely sets pretty low expectations in other areas of her team's performance. Likely, the expectations are pretty much about all staff can meet.

Interestingly, in the community colleges study the researchers found that you could tell, almost instantly, what the expectations and commitment of management is as soon as you walk onto a campus. The actions - and the focus of problems and solutions - clearly reflect the attitude of management. Is the focus on the team's skills or on their deficiencies? Is the discussion centered on challenging problems or difficult people?

Interestingly, "Institutions that expect students [employees] to perform well use language that communicates students' [employees'] value and potential. This language helps set high expectations for students [employees] - and it is contagious."

#2: Focus on the Front Door.

We're all concerned about turnover. In the college setting they refer to it as "attrition," but it's the exact same problem.

One solution that works: focus on people as they come in the front door. From the first moment of hire, look for ways to actively engage the person in his or her work and work environment. Make sure the job is both challenging and rewarding, and help the person make social connections as well. Getting through those first 90 days often spells success for the employee - or increases your turnover rate.

#3: Improve Early Education and Training.

Once again, the study found that the first semester of the person's work was the most important. This translates directly to our work too: employees who feel like the have not been given the initial training they need to do the jobs assigned to them typically are the first to leave or, if they stay, the least engaged.

Early, specific training - especially during the first 90 days - is crucial for building a stong, engaged team.

#4: Use Engaging Techniques in Training and Education.

Even in a college-based study, researchers found that the time that the individuals actually spent studying and learning was in high competition with their other life demands: work, family and friends.

In a caregiving setting, the time spent in training is even more thinly sliced. Making that training as engaging and effective as possible will help the employee gain maximum benefit from it. Certainly, doing just the minimum - consisting in some cases of the old "read and sign" approach to training - will likely create an environment where training is just one more element competing for limited time in the day of the employee. It will lose value - it will become a barrier, not a benefit.

This can be easily remedied by creating or utilizing training approaches that engage, challenge and interest the employee. Training of this sort has multiple positive outcomes for both the individual and the company.

In addition to engaging training, however, the study found that having the opportunity to discuss what the person has learned with a supervisor (or instructor) dramatically increases the person's engagement. When someone else is actively invested in the growth of the employee, benefits are considerable.

#5: Make Engagement Inescapable

In the college setting, this happens by making meetings with professors mandatory on a regular basis. It happens by making class discussions an integral part of every class. They can require collaborative projects, connecting students with other students.

In the work setting, engagement clearly needs to be just as intentional. Requiring goal-setting meeting with supervisors on a regular basis, for example, can facilitate those one-on-one meetings that are clearly valuable in building engagement.

Fostering team interaction through regularly scheduled pot-lucks, parties, note-exchanges or secret pals are examples of ways to make engagement virtually inescapable for every member of your team.

Employee engagement has clear benefits. Learning from these college experiences and applying them in our own work settings can help us find solutions to building highly engaged, successful teams.

EasyCEU.com: CEUs for senior care professionals · aQuireTraining.com: Staff training for caregivers · Apply2Care.com: Caregiver job applications right to your inbox

Committing to Employee Engagement - Lessons from Community Colleges, Part 1

You know all the benefits that an engaged workforce can produce: less turnover, happier clients and a much stronger bottom line.

You've probably been taking steps to look at ways to actively increase your own employees' engagements - we all have been.

So when an article came across my email box the other day titled "Committing to Student Engagement: Reflections on CCSSE's First Five Years" I opened it with interest. CCSSE is the Community College Survey of Student Engagement, and five years into their survey process here's what they have learned about engagement:

Lesson #1: Be intentional.

The study talks about students who are busy juggling school, family and work. These students don't have time to seek out study sessions or get excited about the school's bigger picture (sounds like our staff, doesn't it?). The conclusion: "Engagement doesn't happen by accident; it happens by design. Community colleges, therefore, must be deliberate and aggressively create opportunities to involve students so that engagement becomes central to every student's experience." Substitute the word "employees" in place of "student" and "company" in place of "colleges" and you get the idea. We've got to actively work to make engagement happen in the workplace, as well.


Lesson #2: Engagement matters more to some people than to others.

Some people need to be engaged to work at their best. Others work quietly, thoroughly and maintain a level of loyalty and engagement that seems to come naturally to them. The lesson here is not to look at your employee group as all one type, but to recognize that different people will have different needs for engagement, and will need different methods to effectively engage them in their work.

Lesson #3: Part-time people are often not considered in plans to increase engagement.

We all have part-time workers who fill out our schedules and help us adjust to the varying needs of our clients. Do our engagement programs consider their needs? Do they effectively draw in those individuals as well as the full time folks?

Lesson #4: Information is our friend.

Sometimes transparency in data and information is vital to building an engaged group. Do your staff understand your goals and progress made to achieve those goals? It's pretty easy for staff to see large monthly rents or fees, do the quick math, and come to the conclusion that companies are making tons and tons of money, not considering the real costs of running a business. Sometimes a little transparency in this and other operational areas goes a long, long way to increasing employee engagement.

Lesson #5: Look behind the survey results.

You may do regular employee satisfaction surveys - if so, you are to be commended. But taking the time to look behind sheer aggregate numbers may yield rich veins of information that you can use to strengthen engagement.

Next time we'll look at what the same study presented as strategies for improving engagement - excellent ideas and plans that we can steal a little from as well.

EasyCEU.com: CEUs for senior care professionals · aQuireTraining.com: Staff training for caregivers · Apply2Care.com: Caregiver job applications right to your inbox

Corporate Training in State of Transformation

Corporate training is undergoing a transformation. Resources are getting a little tighter, and expectations are higher. The focus is on employee engagement, retention and building the dream team that will carry the company to success.

In the process, Corporate America has its eyes on training.

"Much of the daily chaos [in senior care] can be decreased when carefully selected staff receive proper orientation, training and ongoing education," notes culture change expert Susan Gilster in her recent article published (with Jennifer Dalessandro) in July/August Advance for Long Term Care Management. Gilster goes on to list some of the positive effects of focusing on training: better care, better decision-making, better family relations, improved feelings of job security.

As training starts to get increased emphasis, other transforming forces are changing the way employees are being trained:

Increased requirements for training and documentation. No longer is a "read and sign" inservice considered adequate. Most states are moving toward requiring "evidence of learning" (read "test") and a documentation of passing the test. Meeting these new, higher standards requires extra time, money and staffing on the part of many companies. Many companies are urgently looking to solutions that can help them meet 100% compliance, while not increasing their bottom line expenses.

Increased risk of lawsuits. Missing training documentation is a big red flag for lawyers. Sign-in sheets are worth a little; individual training records, complete with test scores and certificates are worth considerably more. With assisted living increasingly in the sights of wrongful death, elder abuse and similarly focused attorneys, evidence of staff training that meets and exceeds requirements is essential.

Increased OSHA inspections. How well is safety training being done? OSHA has begun targeting senior care facilities for inspections - and violations of standards come with hefty, mandatory fines.

Increased access to technology. Not only is e-training more affordable than ever, but internet connectivity is more accessible. New hires often come with skills in using computers, email and the internet; computer equipment is affordable to even the smallest provider. Suddenly, what seemed a technological barrier is now an approachable - and substantial - resource.

If it's time for a transformation in your company, take a close look at training. The benefits are significant and the access to quality resources is better than ever before.

Culture Change from the Inside Out

Yesterday I was talking with a colleague in a state office about staff training. Somehow we got onto the subject of culture change. It's a hot topic here in Oregon, as it is around the nation right now. It's a topic that's hot not just because it's an "in vogue" concept - it's hot because it's desperately needed. We're facing mammoth problems of staff turnover, lack of employee engagement, and a continued negative viewpoint within our society on senior care options - from retirement housing through nursing facility care.

We talked about how hard it is to change a culture of care, especially when business needs, not to mention regulatory compliance, seem sometimes to directly conflict with our goals of creating the ideal culture.

It's of increasing interest to me as the topic moves from the theoretical to the personal.

As a senior care professional with more years in the trenches than I care to count, it's an interesting experience convincing your own parents to move into senior care. My mom moved willingly after my dad passed away nearly 2 years ago. It's been the in-laws that have given the whole family fits.

My mother-in-law, dead-set against ever moving out of her home, has been growing increasingly forgetful, difficult to communicate with and depressed. My father-in-law, normally a socially outgoing person, has retreated so far into his home that it has begun to feel like a prison to him. Even his speech has become forced sounding, as he talks less and less throughout the day.

Shortening a long story into a brief summary, they're finally moving into a senior community next weekend. My mother-in-law called me the other day and said, "We've asked everyone we meet how they like it. Everyone has told us they love it there. I can't wait to be that happy again."

Meanwhile, she's exclaiming over and over about how many old people there are in this place. We began to gently point out that, at 90, she's right up there with them, when she stopped us and said, "I don't mean that they're old - I just mean that there are so many of them. I thought I was the only person my age still alive!"

Watching both parents smile more, talk more freely, and even walk with a little more spring in their steps is worth all the past years of convincing them to move.

What I find, in addition, is that this whole topic of culture change is now much more personal than it has ever been. It's me - my mom - my in-laws that need care. It's my family that is affected personally and directly.

And so the topic of how to truly effect culture change seems to come up more often, as I discuss it with colleagues and keep in on the board with my team all the time.

My colleague and I discussed how sometimes culture change happens best from the inside out - or from the bottom up, as it were.

Consider her example of teaching staff in nursing communities to use gait belts to assist heavy-care individuals in transferring and walking. Even though it had become "best practice," some communities didn't even have gait belts, let alone teach staff how to use them.

So she decided to add it to the new caregiver training curriculum mandated by the state. As new caregivers were trained to use gait belts during initial training, they began asking their supervisors to please provide them. Now, gait belts are common and available nearly everywhere in the state. It was definitely a more effective way to change that particular part of behavior than mandating that all staff shall use gait belts.

What if we teach principles of resident care and of working together in the same manner? As we turn out new staff, trained in new ways, we can change the culture from the inside out - from the bottom up.

It might just be the way culture change really has to happen.

Perspectives in Training - or Why Start Now?

We were into our second hour of listening to a speaker drone on about interpreting our facility’s electric bill. My mind was as glassed over as my eyes, when I happened to glance over at one of the four Administrators from our company who were with me at the seminar. She looked at me, and nodded in that way that told me she understood exactly how I felt – this was the single most boring moment of our lives. And, we’d done it to ourselves.

In our effort to meet licensing requirements for Administrator Continuing Education Units (CEUs), we’d signed up for a 2-day conference held in a nearby casino, thinking that even though the topics were horrid, we’d have some fun after hours gambling.

Instead, we’d spent the night wrestling with sheets that never quite stayed on the mattresses, followed by $10 breakfasts of soggy toast and dried out eggs. The casino was so smoky we couldn’t find each other across the room, and we’d all lost our gambling money. We were really having some fun now!

We came home from that conference determined to change our company’s approach to continuing education – once and for all! Never again would we attend a class just because we needed the credits. From now on, we were going to choose only classes that truly interested us, and that we believed would help us run better facilities, no matter what that took.

Since then, we’ve gone to all corners of the country seeking out the very best training opportunities we could find. Along the way, we started developing our own alternative to boring classes that allows us to complete those pesky required CEU hours without leaving our homes or offices (check it out on www.EasyCEU.com ).

But what else we gained from this decision has been staggering: we learned techniques to make teaching our own staff inservices fun and effective (really!); we improved our skills as managers, and we added features each year to our own facilities to make them continue to stand out from the competition.

We came home from these carefully chosen conferences fired up and excited. We had new things to try to motivate staff! We had new ideas for delivering services to our residents and families! And we knew a new marketing secret or two!

And guess what: our facilities prospered financially in ways we had not achieved before, when we were just trying to meet the requirements. We could afford to travel to these national conferences, and stay an extra few days to take in the sites of whatever part of the country we traveled to. These “retreats” helped our group of Administrators grow into a supportive team, willing to drop whatever they were doing to help each other out when needed – instead of competing for precious company resources like they’d done in the past.

We developed training games to use with our staff too, as our commitment to training in a meaningful way grew. For the first time, staff began to beg for even more inservice training, and our Administrators were able to provide that training (check it out on www.aQuireTraining.com).

Here’s what else we gained: a determination to see every employee in every one of our facilities, every day, come to work saying, “I love my job!”

We discovered that this love of the work of caring for our very special residents is more important that any other single employee qualification. With this attitude, we can easily teach skills and knowledge that each individual needs to do their job to the very best of his or her ability. Learning is fun, interesting, and helps them find even more satisfaction in their daily work of enriching our residents’ lives.

Every day we can “train” while walking through the building giving feedback, tips, encouragement and approaches to care. We can model a love of learning also, by coming home from our specially selected conferences excited about what we’ve learned, and eager to pass our new knowledge along to our team.

So I’m not surprised that every study about Assisted Living concludes, “We need more staff training.”

We do need training, but we need training that motivates, that stimulates, and that re-charges our batteries for this work we do. Just mandating more CEU or inservice hours is not the answer. We need individual facility and company commitments to making training meaningful, not just mandatory. Then, and only then, will we move this profession to a place where we’re not continually being threatened with ever increasing numbers of rules and regulations. We’ll start directing our own path toward a quality of service that will be welcomed by the public, instead of feared as “institutional.”

Opportunities for quality learning are out there – you simply have to look with an eye toward enriching your work, not just meeting your requirements. But you also have to be determined!

Counting your Blessings

We're heading into the last days of summer. I don't know about you, but global warming (or something) has given us one of the nicest summers we've had in years. I've taken less time off this summer than usual, but I think I've enjoyed it more. Work has been exciting and fun (and weirdly, it has been where I want to be this summer); and evenings have been spent with family and friends, enjoying the unusually balmy, long summer twilight.

I have focused this summer on counting my personal blessings, of which I have many. At the same time, I consider some of the other things I'm thankful for:

• People who come to work every day, excited about their jobs and invested in the outcome.
• Entrepreneurial operators willing to venture into the unknown to help them achieve big goals of being the best in senior care.
• Reminders that success comes in many forms, not just in the bottom line.

And finally, I'm thankful for the many people who work quietly and steadily, making this world a better place for my mom, for my in-laws, and for all the folks who are simply seeking a little comfort and joy in their waning years.

Blessings,

Sharon

Sharon K. Brothers, MSW

President and CEO

Sharon@aQuireTraining.com

Corporate Training in State of Transformation

Corporate training is undergoing a transformation. Resources are getting a little tighter, and expectations are higher. The focus is on employee engagement, retention and building the dream team that will carry the company to success. In the process, Corporate America has its eyes on training. "Much of the daily chaos [in senior care] can be decreased when carefully selected staff receive proper orientation, training and ongoing education," notes culture change expert Susan Gilster in her recent article published (with Jennifer Dalessandro) in July/August Advance for Long Term Care Management. Gilster goes on to list some of the positive effects of focusing on training: better care, better decision-making, better family relations, improved feelings of job security. As training starts to get increased emphasis, other transforming forces are changing the way employees are being trained: Increased requirements for training and documentation. No longer is a "read and sign" inservice considered adequate. Most states are moving toward requiring "evidence of learning" (read "test") and a documentation of passing the test. Meeting these new, higher standards requires extra time, money and staffing on the part of many companies. Many companies are urgently looking to solutions that can help them meet 100% compliance, while not increasing their bottom line expenses. Increased risk of lawsuits. Missing training documentation is a big red flag for lawyers. Sign-in sheets are worth a little; individual training records, complete with test scores and certificates are worth considerably more. With assisted living increasingly in the sights of wrongful death, elder abuse and similarly focused attorneys, evidence of staff training that meets and exceeds requirements is essential. Increased OSHA inspections. How well is safety training being done? OSHA has begun targeting senior care facilities for inspections - and violations of standards come with hefty, mandatory fines. Increased access to technology. Not only is e-training more affordable than ever, but internet connectivity is more accessible. New hires often come with skills in using computers, email and the internet; computer equipment is affordable to even the smallest provider. Suddenly, what seemed a technological barrier is now an approachable - and substantial - resource. If it's time for a transformation in your company, take a close look at training. The benefits are significant and the access to quality resources is better than ever before. aQuire Training Solutions - when it's TIME for truly effective staff training. Interested in seeing more? Contact us and we'll be happy to give you a tour!