Category: Business Strategies
Posted by Dr. El - September 16, 2014 - Business Strategies, Communication, Customer service, Engaging with families, McKnight's Long-Term Care News
Here’s my latest article on McKnight’s Long-Term Care News:
I listened with great interest last week to McKnight’s Fall Expo talk on Pain relief: Dealing with difficult family and resident situations. Attorney Matthew J. Murer provided excellent information on how to work with families to prevent conflicts over treatment and other care issues.
Here, from a psychological perspective, are some additional ideas to prevent or reduce disagreements over care, thereby decreasing the likelihood that the situation will result in legal action.
1. Create systems that easily allow family members to be part of the treatment team.
We collect initial data from families upon admission, but there’s often more family members can and want to add to care.
Staff members may have difficulty adequately involving families because it’s not a fluid part of their workflow. Family members tend to visit in the evenings and weekends when the administrative and day shift workers are no longer in the facility, for example, and care plan meetings are held during working hours when many family members aren’t available.
Inviting relatives to meetings via secure video chat, establishing weekend or evening hours for key personnel such as social workers, and implementing a comprehensive communication system that transmits family information between shifts and departments can help.
In addition, staff members should be trained so that they’re genuinely receptive to information provided by loved ones rather than creating the impression that the family is a nuisance. (I’ve seen this!)
2. Educate families about the illnesses of their loved ones.
Many residents are given diagnoses just prior to or upon admission, but receive little information about their conditions. Similarly, family members often struggle to come to terms with new diagnoses and have many time-consuming questions to ask of staff.
They also may look for health information from less-than-reputable resources. Set up a magazine rack in the lobby with information and resources about common illnesses such as diabetes or stroke and/or add a page to your website with helpful links for families. This meets a genuine need, generates more knowledgeable conversations between families and staff, and helps to create more realistic expectations on the part of families regarding treatment and prognosis.
For the entire article, visit:
Posted by Dr. El - August 26, 2014 - Aunt Sylvia, Business Strategies, Communication, Motivating staff
Join Dr. El
Thursday, August 4th
at 2pm Eastern Time (1pm Central Time)
for a
FREE Webinar on
5 Ways to Encourage Teamwork in Your LTC Facility
sponsored by EmLogis
To register:
Aunt Sylvia at the nursing station, discussing teamwork: Click here or view below: http://youtu.be/7KTqBbjaJro
About the Webinar:
How much more could your facility accomplish in a day, week or month with more effective teamwork?
Are you building a culture of teamwork? Do you make it okay to ask for help? Can better teamwork be an affordable way for your facility to keep employees longer and make residents happier?
Join us for a live webinar on the 4th of September 2014 at 1pm CST to learn 5 (or more!) steps that you can take to encourage teamwork in your long-term care facility with expert Dr. Eleanor Barbera. Do you have very specific teamwork challenges? Dr. El will be available at the end of the webinar to answer your questions live!
Attend and you will learn:
Organizational strategies for fostering teamwork
Practical techniques for managers, department heads, supervisors, and charge nurses that enhance team relationships
Ways to address challenging staff behaviors
Who should attend this webinar:
Administrators and assistant administrators
DONs, ADONs, department heads, nursing supervisors, and charge nurses
Staff training coordinators
Human resource department staff
Posted by Dr. El - July 24, 2014 - Business Strategies, Common Nursing Home Problems and How Psychologists Can Solve Them, McKnight's Long-Term Care News
Here’s my latest article on McKnight’s Long-Term Care News:
In the medically focused setting of long-term care, psychologists are mindful of the emotional environment. While most psychologists almost exclusively address the mental health of the residents due to the current reimbursement system, we’re also aware of the interactions between staff members, families, the physical setting and the organizational culture.
Here are some of the important things psychologists might do to address the emotional climate of long-term care:
- Every resident would be evaluated by the psychologist upon admission (just like other disciplines), because entry into long-term care can be very stressful.
- Every staff member would have access to the counseling services of an Employee Assistance Program, because working in LTC can be very stressful.
- Family members would be able to join regular educational groups so that they better understand the illness(es) of their loved one, how the treatment team works, and how to best manage their important role on the team.
- Administrators, department heads, charge nurses and others in managerial roles would be given management training so that they’d have the skills they need to lead those on their teams, because chances are they didn’t learn management strategies in school.
- Treatment teams would learn communication skills that enhance collaboration between disciplines and improve interactions with residents and families.
- All staff members would be trained in non-pharmacological approaches to dementia care, because the porter needs to know what to do too.
For the entire article, visit:
Posted by Dr. El - July 10, 2014 - Business Strategies, McKnight's Long-Term Care News, Psychology Research Translated, Stress/Crisis management
Here’s my latest article on McKnight’s Long-Term Care News:
In my recent post, “Stuff I won’t do for residents and why your staff shouldn’t either,” I wrote about the need for individual workers to set appropriate boundaries around caregiving in order to retain the ability to give without burning out. In this article, I examine more closely the symptoms of burnout and ways facilities can reduce its likelihood — which is particularly important given the link between burnout and turnover.
Employers find burnout reflected in high levels of absenteeism and tardiness, extended sick leave, and an increase in worker’s compensation claims. Employees might notice symptoms such as stress-related medical conditions (for example, ulcers or headaches), reduced job satisfaction, feelings of depression, anxiety, cynicism, boredom, discouragement and loss of compassion.
One study found that burned out staff were more likely to be accepting of resident abuse (Shinan-Altman and Cohen, 2009).
What is burnout?
In my research, I came across a number of definitions of burnout. Some definitions, like this early description by psychologist Herbert Freudenberger, focus on the role of the individual:
Burnout is “a state of fatigue or frustration brought about by devotion to a cause, way of life, or relationship that has failed to produce the expected reward.” People most likely to burn out are those who are the most “dedicated and committed to their positions, have poor work boundaries and who have an over excessive need to give.”
Ouch.
Other explanations of burnout focus on the environment, such as this one by Pines and Aronson (1988): Burnout is “a state of physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding situations.”
It’s probable that most burnout is due to a combination of a stressful work environment and an individual’s difficulty balancing self-care with their commitment to their jobs.
Techniques to reduce burnout
The good news for management is that many of the causes of burnout can be addressed by the organization, whether they are due to the environment or rooted in the individual.
1. Training workers, including enhancing the initial orientation process and providing ongoing education programs that go beyond mandated courses, can address many factors that contribute to burnout. Studies suggest the following:
Orientation classes should provide clear job expectations and address ways to prioritize job tasks in order to reduce time pressures.
Managerial staff such as nurses and department heads would benefit from skills training to better help them supervise and manage their teams.
Team building efforts can improve relationships with coworkers and reduce professional isolation.
Training staff on how to manage aggressive behaviors reduces the stress of working with a verbally and physically aggressive population.
2. Scheduling issues are another area where management can make a significant impact on burnout through:
For the entire article, visit:
Posted by Dr. El - June 12, 2014 - Business Strategies, Communication, Customer service, Engaging with families, McKnight's Long-Term Care News, Motivating staff, Resident care
Here’s my latest article on McKnight’s Long-Term Care News:
At the front desk, the workers were having an argument. Some residents watched the proceedings with interest and others with expressions of alarm. A waiting family member shifted from one leg to another and began sighing with exasperation as the loud conversation wore on without her presence being acknowledged.
We may talk about the term “customer service” and ask our staff members to avoid public arguments like the one above, but nevertheless, similar situations happen every day. Why does it matter so much? Using the model of the family as a guide, I discuss the psychological importance of good customer service in all our interactions.
With other staff members – Just as the relationship between parents forms the foundation of a family, our relationships with our coworkers are the foundation of good customer service.
o As shown in the above example, the residents observe how we treat one another. If our conversations are respectful and collegial, residents feel comfortable discussing concerns because they perceive their caregivers to be levelheaded and understanding. Angry, shaming interactions between staff members create an unsafe environment, making residents less likely to share information — including details that may affect medical care.
o Difficult interactions with coworkers are frequently transmitted to resident care. This is known in psychological terms as displacement. In the classic case, the boss yells at the father, who comes home and yells at his wife, who yells at the kid, who kicks the dog. If the nursing supervisor publicly criticizes the nurse who then chastises the aide, the residents are likely to be on the receiving end of the aide’s aggravation. Alternatively, if the nursing supervisor compliments the nurse who in turn praises the aide, the residents are more like to be met with a cheerful, upbeat caregiver.
o How senior staff members talk to subordinates is passed along to the next level of subordinates, not just through displacement, but also through modeling. Senior staffers are showing through example “how we handle things here.” When an administrator uses “teachable moments” to calmly point out what aspects of a crisis were managed well and what could be done differently for mismanaged parts, this becomes its own teachable moment in terms of how to provide constructive feedback.
For the entire article, visit:
Posted by Dr. El - June 3, 2014 - Business Strategies, Motivating staff, Talks/Radio shows
Join Dr. El
Wednesday, June 4th
at 2pm Eastern Time (1pm Central Time)
for a
FREE Webinar on
Creating a successful employee recognition program
sponsored by EmLogis
To register:
Posted by Dr. El - May 29, 2014 - Business Strategies, McKnight's Long-Term Care News, Motivating staff
Here’s my latest article on McKnight’s Long-Term Care News:
One of my recent posts, Employee recognition programs: What works, focused on the benefits of recognition and key points in choosing a recognition program. Now I’d like to address how to implement your chosen employee recognition program so that it becomes an energizing and integral part of your organization, rather than a short-lived promotion that fizzles after its initial burst of enthusiasm.
Here are some tips to ensure a long, useful life for your recognition program:
1. Establish a budget — Most companies spend between 0.5% and 3% of their payroll budget on employee recognition, with the average being 2%. Decide whether your distribution will be centralized, department-specific, or a combination of the two. Human resource personnel most frequently direct the programs (55% in a 2013 WorldatWork study, with a variety of staff taking responsibility at the other 45% of companies studied).
2. Determine how success will be measured — There are many ways to gauge the results of your efforts, including employee and resident satisfaction surveys, the level of participation in the program, and turnover rates. It also may be useful to have goal-specific measures, such as “number of infections” for a program designed to improve infection control procedures.
3. Train management staff on basics — It’s essential for the success of your program to have buy-in from senior staff members. Educate them on general recognition strategies such as when and how to acknowledge employees for best effect and the importance of their role in the project.
4. Design the program and get feedback — While you may have decided the broad focus of your program, now is the time to get specific. Exactly how will your program work? Who is eligible? What rewards will be offered? Who will be offering them? Try to create a simple program to provide meaningful, desirable rewards that are distributed fairly. Get feedback from your team to ensure the feasibility of the ideas and to increase their support for the enterprise.
For the entire article, visit:
Posted by Dr. El - May 5, 2014 - Business Strategies, Motivating staff, Talks/Radio shows
Join Dr. El
Thursday, May 8th
at 2pm Eastern Time (1pm Central Time)
for a
FREE Webinar on
Reducing Turnover in LTC
sponsored by EmLogis
To register:
Posted by Dr. El - April 21, 2014 - Business Strategies, Customer service, Depression/Mental illness/Substance Abuse, Resident care, Talks/Radio shows, Younger residents
Join Dr. El this Thursday in Connecticut!
The Connecticut Association of Health Care Facilities
is sponsoring a talk on
Meeting the Needs of Younger Residents
Thursday, April 24th, 2014 at 9am
at the Crowne Plaza Hotel in Cromwell, CT
For more information and to register: CAHCF.org
Posted by Dr. El - April 3, 2014 - Business Strategies, Common Nursing Home Problems and How Psychologists Can Solve Them, Dementia, McKnight's Long-Term Care News, Role of psychologists
Here’s my latest article on McKnight’s Long-Term Care News:
I watched with dismay as the nurse abruptly moved a table in front of a confused and agitated resident trying to leave the dining room. “Sit down!” she told him in a stern voice. “Dinner will be here in an hour!”
Those of us in long-term care have undoubtedly witnessed similar incidents where residents become agitated and staff members don’t have the tools to prevent or manage their distress. Psychologists — who could offer such tools — are largely limited in the current reimbursement model to providing individual services to cognitively intact residents.
Using mental health expertise
The Eldercare Method, developed by psychologist Kelly O’Shea Carney, PhD, CMC, executive director at the Phoebe Center for Excellence in Dementia Care in Pennsylvania, harnesses the training of mental health professionals to successfully address the gap between what’s known in the mental health world about how to handle challenging behaviors and how they’re often managed in long-term care.
The method uses interdisciplinary teams facilitated by mental health professionals (psychologists and licensed clinical social workers) to examine the causes of resident distress and to identify ways to prevent it. Team members include representatives from the nursing department and other direct care staff such as dietary, housekeeping, and aides.
Needs assessment
The first step in the Eldercare Method is to assess the overall behavioral health needs of the facility and to establish training programs and annual service goals. This dramatically increases the focus on behavioral health as compared to facilities that provide behavioral health training sporadically, often after an incident occurs, missing the opportunity to prevent problems on an ongoing basis.
For the entire article, visit:
Kelly O’Shea Carney, PhD, CMC
