AHCA/NCAL opening session: Team leadership, quality improvement needed in changing times

Teamwork, including members of all staff departments, served as the focus of the opening general session at the 66th American Health Care Association/National Center for Assisted Living (AHCA/NCAL) Annual Convention and Expo in San Antonio, Texas.
Perhaps no one knows the impact of successful teams–and the dangerous consequences of failed ones–than Gen. Stanley McChrystal, the retired four-star general and special forces leader whose command is credited with the 2003 capture of Saddam Hussein.
Hierarchical, one-leader-of-all leadership isn't always the best strategy anymore, McChrystal said, stressing the need for nimble "teams of teams" and cooperative leadership in quality care delivery. The best individuals don't always make the best teams, especially when the team leadership structure doesn't adjust to changing times, he said.
Today's new teamwork includes cooperation across departments and plenty of analysis, he said. Teams need to do root-cause analysis to determine why things go wrong, and to never personify problems. "This is the new reality," McChrystal told attendees. "We need new communication and new ways to communicate the information we have. Siloes can be effective, but they also can end up being culturally independent."
AHCA/NCAL leadership has had a busy and productive year in terms of policy and advocacy, including the organization's policy wins in the permanent doc fix and its vehement positioning against the Center for Medicare & Medicaid Services' (CMS) proposed changes in participation requirements, noted Len Russ, AHCA chair. "We've flooded CMS with thousands of comments," Russ said of the latter effort. "We've told them it's too much too soon, and it's too expensive. And CMS is listening."
New quality initiatives are underway for the membership, with specific targets of improving overall organizational success, improving discharges and readmission rates within post-acute/short-stay settings, and to reduce staff turnover inappropriate antipsychotic use in assisted living. Another goal for assisted living: keep customer satisfaction at 90 percent of higher. "When you put ideas before ambition and people before politics, there's no limit to what you can accomplish," Russ said.
Pat Giorgio, NCAL chair, noted the challenge to the assisted living industry amid fast-changing resident demographics and desires. but she's also concerned about the ratio of caregivers entering the workforce compared to the number of baby boomers arriving at assisted living's doors. "We need to invest in the leaders of tomorrow," she said, encouraging attendees to cultivate leadership, especially among female coworkers. "Find two people who could replace you and mentor them."
Although embracing the quality initiatives will prepare providers for pay-for-quality payment models, the most important part of quality care delivery is more transparent, said AHCA President and CEO Mark Parkinson. "It's about everything that happens in our buildings every day that can't be measured," he said, "it's about you and your staffs."
The 2015 Mary K. Ousley Champion of Quality Award goes to…. Alice Bonner, PhD, RN.

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