Wednesday, October 29, 2008

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.

Tuesday, October 21, 2008

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.

Wednesday, October 15, 2008

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.

Wednesday, October 8, 2008

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, or contact
Brothers at