3 small changes promise big impact in motivating your LTC staff

The new year has just begun and even without an official resolution, January holds the promise of a fresh start. This could be the year to address perennial problems plaguing your organization. It can be a challenge, though, to know where to begin on the mountain of tasks needing attention. Perhaps you have neither the time nor the budget for major changes. The good news is that psychological research suggests small goals tend to be more successful than great ambitions. With that in mind, make use of the new year’s momentum by making minor adjustments in three areas for a big impact: appreciation, repair and organization.

1. APPRECIATION

Studies show that long-term care staff members aren’t in it for the money. Because workers tend to be more motivated by recognition of their efforts than by remuneration, showing appreciation will reap great rewards. 

• Start small by simply thanking the people around you for their efforts. Recognize triumphs, commitment to the team and attempts even if they don’t result in success. As leaders within the organization, your attention to appreciation can create a ripple effect as others model their behavior after you and start thanking their coworkers and subordinates. 
• Make it a habit to recognize one person, unit or action in each morning report or department head meeting. By calling attention to positive behaviors, you provide a roadmap for your employees or coworkers regarding the kind of work you’d like to see.  Ask coworkers to “tell on” their peers, and vary who receives acknowledgement so that the unsung heroes shine as much as the obvious go-getters. Use this powerful tool, for example, if you sense a new employee might be feeling anxious, commending their work in front of colleagues to generate a feeling of inclusion and welcome. 
• Take appreciation a step further by establishing an official recognition program such as “Employee of the Month.” Rewards can be as simple as a good parking spot, a plaque on the wall or a gift certificate to a local restaurant.

2. REPAIR

In any establishment there are things that break down. The New York City subway system, for example, is over 100 years old and in constant need of repair. The Metropolitan Transit Authority moves station to station with complete renovations that transform the location from dingy and crumbling to bright and freshly tiled. A recent sign in a subway car, however, announced a change in its repair program: instead of complete overhauls while most stations languished in disrepair, they’d now be attending to the most urgent needs of all stations. If the MTA can use this triage approach, so can long-term care.

• Ensure your system has accountability by using maintenance logs that leave a copy of staff requests rather than those where the maintenance staff takes the only copy of the notification. Accountable logs provide an opportunity to review whether or not repairs are being completed or being made repeatedly. A repeated request can indicate that the problem wasn’t fixed or that the fix isn’t holding. For example, maintenance staff may be doing their best to repair an item that actually needs replacing. Be aware that an end to repeated requests in the log may indicate not that the item has been repaired or replaced, but that the nursing staff has given up reporting it because nothing has been done.  Possible small changes for 2013:

1. Switch to an accountable maintenance log if you don’t already have one.
2. Review your current log to identify repeated problems.
3. Identify items that break frequently across units and use the information in purchasing decisions.
4. Reengage discouraged nursing staff in utilizing your revamped maintenance program by making announcements in staff meetings and by proving your commitment through timely repairs. 

• Take renovations one step at a time. Perhaps the staff dining room (conference room, lobby, etc.) needs a complete overhaul. With a little advance planning to ensure that the pieces will fit together, a renovation can come together in a manner that’s not a strain on your time or budget. Piggyback on larger projects by ordering enough supplies to get that extra room addressed or watch for sales in your area. Paint the walls in January, retile the floor in February, replace the furniture in March, display artwork in April, etc. By the end of the year your renovation will be complete. 

3. ORGANIZATION

Take this test: walk from floor to floor in your facility and see if you can locate essential and frequently used items such as consult forms, staplers and hand disinfectant. Are they in the same place on each floor? As any efficiency expert will tell you, things run more smoothly if your staff knows where their tools are and can get to them easily. 

• Start small by delegating someone to organize the file drawers with clearly marked folders containing essential and frequently used forms. Items that are used less often can be kept in a secondary but still accessible location. Create a system where all the weight books are blue on every floor, the attending physicians can find their paperwork in a color-coded binder on each unit, etc.
• Expand this concept by taking the time to organize your ideal nursing station (linen closet, supply room, etc.) Assemble a work group of staff members who use the area, keeping in mind that disciplines besides nursing use the nursing station and that the best person to reorganize the linens is not a 6-foot-tall man when most of the people who reach for them are 5’2”. Use feedback from the work group to rearrange the nursing station (linen closet, supply room) for maximum efficiency, and use this system on every floor so that floaters and others can find what they need right away.

A few simple tweaks to your system will show your staff that change has begun and that 2013 will be the year for progress.

Eleanor Feldman Barbera, PhD, author of The Savvy Resident's Guide, is a speaker and consultant on psychological issues in long-term care.  For more information, visit Dr. El's website, www.mybetternursinghome.com.