Monthly Survey

Monthly Survey

May - Quality and the Board of Directors

March - Baby Boomers and Nursing Homes

February - What's Your Organization's Biggest Issue?

January - Organizational Resolutions for 2008.

October - Has healthcare quality improved in the last 15 years?

September - Use of the Baldrige Criteria.

August - Mission and mentoring in your organization.

July - How much do employees know about your organization's strategy?

MARCH 2008 SURVEY RESULTS
For a number of years there has been a great deal of talk about baby boomers aging. Even though it will be many years before boomers need nursing home care in big numbers, do you think members of the baby boom generation will allow themselves to be institutionalized in a nursing home setting?

Will boomers

Take advantage of the opportunity to receive skilled nursing services 10%

Try and find alternative ways to extend their independence. 54%

Insist on major changes in nursing homes. 27%

Absolutely refuse nursing home placement. 9%

COMMENTS:

 Most people will and are not taking the responsibility to fund their own needs and will demand the government (those who have money) to pay for it.
 Individualism will demand different solutions
 I believe they will invest their time to all three since how their parents and their grandparents have gone thru
 They will attempt to remain in control of their lives which means staying at home with assistance if required.\
 Think "The Golden Girls"
 At this point I think you are going to see an increase in the marketability of the CCRC concept with a broader spectrum of care.
 New models of incremental skilled nursing facilities from independent living to hospice on a single campus/community will be one feature of the future
 palliative care
 I think less institutional assisted living facilities will increase and expand what they can do.
 Boomers won't accept the traditional nursing home. They have seen their parents and grandparents loose dignity and enthusiasm for life

15 years from now, how will people pay for their long term care needs?

Medicare/Medicaid. 29%
Private long term care insurance. 35%
Personal savings. 22%
Other (mostly all of the above) 14%

COMMENTS:
 Most will never be able to afford the cost on a medium to long term basis and will fall back on the government to pay for it.
 All of the above - but more and more wealthy elders will select non institutional settings
 I do not believe most will have enough money for this type of care and think many are concerned about it.
 Overall I think personal savings won't be there for most of the population
 With the current trend Medicaid is for casted to go away sooner I wouldn't count on it.
 Long term care insurance is a rip off - check the stats and they do everything to keep from paying!

Many people feel that the US healthcare system is broken. If it is broken, will it be fixed in the next 10 years?

YES – 18%
NO – 82%

COMMENTS:
 We are not willing to pay the price of reduced service to actually reduce costs. It is a political football, and sadly will remain so.
 Not seen as a crisis yet
 I hope so. We will all need to work at making the changes.
 We 'almost Boomers' still don't want to think about growing 'old' and we are not addressing the issues that are going to affect us!
 "Fixed" is a strong word. With work it could be a lot better. Streamlining of services, more cost efficient solutions and preventative care.
 If by fixed you mean fully functional: NO. If you mean better than it is now: maybe. The potential for improvement is there but with the politicians?
 America wants the quality of care as we know it today with the gov't paying for it. I don't believe these thoughts are congruent.
 Too many people making too much money to change things.
 The politicians can't fix it and the interested parties (providers, insurance companies, drug companies, etc.) won't fix it.
 The type of overhaul and reform necessary seems to exceed what the legislature is capable of.
 I hope, but it is a dim hope, that the underlying US healthcare equation be addressed.
 I do not feel that it is broken. Most costs seem to increase due to Insurance. People are demanding that everything be covered at a low price.
 I fear it will be worse. Gov't shouldn't be in the health care industry. Medicare is an excellent example. Not the best system by any means.
 It has to crash, before change and we are near a tipping point. Cries for one payer can not occur without a reform
 Boomers won't accept the traditional nursing home. They have seen their parents and grandparents loose dignity and enthusiasm for life.

OCTOBER 2007 SURVEY RESULTS

Taking a "Big Picture" view, comparing healthcare in the United States now to 15 years ago, is it:

1) Much Worse: 6%

2) Worse: 17%

3) The Same: 17%

4) Better: 54%

5) Much Better: 6%

October Survey Comments:

The principle improvements have been in the advances in technology, medicine, etc. Patient relations has either stayed the same or gotten worse.

My mom is in the hospital now and if I wasn't there every day I shudder to think how her care would be.

The financial side of healthcare is difficult. I've been told that because I had successful heart valve surgery at age 56, I am not insurable privately again.

Healthcare is better only in some areas, flu shots for example, but 48 mil uninsured - horrible.

It's no worse, at least for middle class professionals.

Technology is better but access to primary care is worse. Hospitals do not understand the geriatric population.

There have been many advances especially in non invasive technology and pharmaceuticals. Not much progress in wellness which is mostly unreimbursed.

People may be living longer, but they are not healthier. The USA has the fattest people. Prescription drugs are ruining peoples' lives due to misuse.

Healthcare really is better than 15 years ago. We are able to do so much more, cure more things. But, the healthcare delivery system is the same or worse.

I believe we are doing some things better as far as care. My expertise is in the area of long term care. I know we are providing more acute care.

A few years ago, after learning that the company my daughter worked for was using Six Sigma, I asked her what she thought about it. She became really excited, turned on her laptop and showed me these "really neat" equations and files filled with data, then bragged about their quality improvement and cost reduction success stories. As an aerospace engineer she is accustomed to working with numbers and equations. After teaching financial management to health administration students and watching their eyes glaze over when they see numbers, I've decided that one of our biggest problems in improving quality is that healthcare people shy away from numbers and don't get excited about reviewing data. We can't solve our problems with guesswork; we've got to do the math.

AUGUST SURVEY RESULTS

How often does your management talk about mission?

25%
Always - every meeting and publication

69%
Sometimes - on special occasions

6%
Never

COMMENTS

-Missions are defined but people are seldom held accountable for their accomplishment.
-We try to judge or measure new ventures or investments by questioning whether it passes muster within our mission
-The "mission" of the pharmaceutical industry is focused mostly on profits--any patient-centered mission appears to be low on the list of priorities.

Does your organization measure mission effectiveness?

19%
Yes - we have well understood and communicated measures

50%
Yes - we have some measures

19%
I have no idea

6%
No - definitely not

6% Other

COMMENTS

-We measure the Wrong Things
-Measures are driven by conventional wisdom rather than an analysis of the relationship between different measures and desired outcomes.
-All communicated measures deal with "meeting our numbers" at every level. Employees lose their jobs when they do not continually exceed their numbers.

Does your organization have a mentoring program for managers?

17%
Yes - we have a formal process for every manager

50%
Yes - we have an informal approach

22%
No - we don't have a mentoring program

11% Other

COMMENTS

-Mentoring has become a required check box with the assumption that the next line supervisor is the mentor.
-I haven't been told of such a program if one exists.
-We can do much better. We have a tendency to select new managers based on departmental competency, relegating management skill to a lower priority
-Good point. I will have to raise this at the next board meeting.

July 2007 Survey Results...

Do your employees know your organization's strategy?

40% Yes, they're actively involved.

25% They don't have a clue.

5% We don't want them to know.

15% Other.

15% No Response(s)

COMMENTS
It is imperative they are involved in order to successfully drive the mission of the organization.

We're floundering around trying to keep up with business, sell new business, and manage what business we have ... we have no clear sense of strategy

UNFORTUNATELY I DON'T BELIEVE WE HAVE DONE ENOUGH TO HELP OUR STAFF UNDERSTAND WHAT WE ARE STRIVING TO ACCOMPLISH OR OUR STRATEGY TO GET THERE

MAY 2008 SURVEY RESULTS

Does your organization's Board of Directors have a Quality Committee?

35% YES

57% NO

8% DON'T KNOW

If your Board has a Quality Committee, how effective is it?

0% NOT EFFECTIVE

39% SOMEWHAT EFFECTIVE

33% VERY EFFECTIVE

28% DON'T KNOW

COMMENTS:

- It is being restructured. It had been a traditional model. Will be changed add relevant metrics and reporting.

- Brand new-too soon to determine effectiveness.

- Mostly has to do with gov"t compliance not quality in the true sense.

- Jusrt organized and having first meetings.

Have any changes come about because of this committee?

65% YES

5% NO

30% DON'T KNOW

COMMENTS:

- New pracices developed on the in-patient side have been extended to the out-patients for added safety.

- Not yet, no changes.

- Major focus on patient safety and quality.

FEBRUARY 2008 SURVEY RESULTS

What's Your Organization's Biggest Issue?

#1 at 31% of the respondents: Finance & Budget

#2 at 21% of the respondents: Patient/Customer Service

#3 at 15% of the respondents: Quality & Safety

#4 at 13% of the respondents: Employee Turnover

#5 at 10% of the respondents: Competition

#6 Other, which included Physician Recruitment, Hiring Quality People and (the place I want to work for) Where to Play Golf!

COMMENTS:

The dynamics of this market are changing dramatically. One large competitor is aggressive and disruptive, especially with regard to building projects.

Maintaining the depth of talented knowledgeable staff members to provide consistent customer service.

Staff documenting to support care provided while following hospital policies and guidelines.

Senior management team issues balancing "mission v. margin" priorities & getting staff to understand that their "patient" is a "customer" with choices.

Surgery centers and critical access hospitals can compete for business, jeopardizing success of other institutions.

Getting the correct answers to the correct place at the proper time.

Budget, budget, budget!

There is a disconnect between the clincial staff and customer service. They have no idea how their behavior affects relations w/ the facilities we work with.

JANUARY 2008 SURVEY RESULTS

What resolutions should your organization make for 2008? Where are improvements needed?

Our organization needs to follow through with retention goals and holding everyone accountable for these goals. This is not a 1 or 2 person effort/goal.

Improved focus on the patient and satisfaction as the primary means of improving the success of the business units and entire organization.

To remain true to the Baldrige process in our strategic planning and carryout process improvements where they are needed.

Resolutions are to be prepared for MDH survey 365 days a year and begin integrating culture change. The physical structure of our facility makes a complete renovation i.e. moving walls almost impossible. Therefore, we will begin with resident choices regarding what time they get up in the morning and what time they go to bed at night. This also will create a change in how and when breakfast is served as well as the evening snack.

Our main improvement area is staff retention.

Personnel policies and procedures.

Get a tight handle on money spending, better policies for how and when to do routine procedures.

Our first and most important challenge for 2008 is to improve our employee satisfaction,

To make a concerted effort to institute a client satisfaction survey and utilize the data to implement necessary changes to improve the quality of service delivered.

Improvements are needed in our focus on client retention and staff development.

Need to balance high tech with high touch. The interpersonal relationships especially between patients, families, and the care staff appear to be declining. More time is spent with record keeping and other tasks which remove the human interaction. I feel strongly that the human relationships play a significant role in the outcomes and certainly are important in the patient/family assessment (perception) of their "experience".

1. To stay on top of current CMS new guidelines
2. To maximize our reimbursement in all areas of the organization - get credit for what we are doing.
3. To stay in line with our 5 year plan.
4. To create career paths for our employees - be the best possible place to work in long term care.
5. Plan for updating of our physical plant.
6. Set a strong Foundation initiative for improved fundraising.

Focus attention on a smaller number of objectives. Focus attention on patient and employee satisfaction opportunities. Resource where appropriate. Re-emphasize values & behaviors at all levels of the organization.

To continue to improve service at all levels.

To continue to standardize communication procedures and remove barriers to timely and compassionate patient follow up communication.

To continue the LEAN Health initiative and embed the processes in the organization life.

The organization needs to be consistent in its responses to every employee. This will have to start at the leadership level.

Leadership should focus the organization. It's a bit like packing correctly for a trip. First you stuff everything you need in the suitcase, then you take it all out and reduce it by half, then you look at the half you have left, and half it again. Voila....you are ready to travel.

SEPTEMBER SURVEY RESULTS

BALDRIGE, WHO KNOWS ABOUT IT IN YOUR ORGANIZATION?

1) Everyone from the board of directors to front line staff.
11%

2) Key management and select others.
22%

3) A few people have heard of it.
39%

4) As an organization we haven't done anything with Baldrige.
22%

5) Other.
6%