Sophie Weider’s health was declining. She wasn’t talking, wasn’t eating, wasn’t able to get around on her own. When her granddaughter, Denise Boudreau-Scott, went to visit, the nursing assistant, Graciela, suggested they go for a ride to look at the houses. Only, Boudreau-Scott couldn’t get Weider into her car.
“Graciela said, ‘We’ll get her into the car,’ and she went and got another nursing assistant,” Boudreau-Scott says. “Graciela knew that was important to my grandmother. She knew it was important to me. They felt empowered, and the culture supported them.
“They didn’t ask their boss, or anybody else. They did it on their own. Actually, as they walked by the administrator’s office, they grabbed the administrator, too, so the three of them got her in my car.”
Boudreau-Scott, MHA, LNHA, shares her grandmother’s story to illustrate the larger importance – and impact – employee engagement can have for the company, residents and residents’ families. Her eponymous consulting company focuses specifically on healthcare staffing, engagement and workplace culture.
“Employee retention has an unbelievably important financial impact,” she says. “Often, we look at it as a soft skill and say ‘Yeah, yeah, happy employees. Who cares? But there’s a tremendous business case. If you have the ability to increase your productivity by 37 percent or profitability by 22 percent or reduce your turnover by up to half, that’s a huge financial impact.”
A study published in Seniors Housing & Care Journal found sustained culture change led to an additional three percent occupancy and $11.43 per bed per day resident revenue.
“We say we don’t have the money to do certain programs,” she says. “If you spent half the amount on turnover alone, you’d be able to use that money to do something for your staff or residents to help with their experience.”
Boudreau-Scott has identified four low cost, high yield ways to improving employee engagement.
Awaken to how and why things should be different
People need to be challenged to think beyond the status quo, Boudreau-Scott says. The goal is for people to think about doing their work in a different way – while also being respectful – whether they’re the leader, the middle manager or the direct care staff.
“I find tapping into that intrinsic motivation, what brought you into this field, getting to know your people on a different level, making those connections, helps them in turn make those connections with the resident,” Boudreau-Scott says. “It’s amazing to me sometimes that people work together for years but they don’t really know each other on a deeper level. It’s the same for residents.”
Assess where strengths and opportunities lay
The long-term care field collects a lot of information, such as patient satisfaction surveys, Minimum Data Sets and quality assessments. Boudreau-Scott says to ask questions that get to the why behind the information.
She recommends inviting staff, residents and family members to participate in focus groups. When conducting sessions, participants must be able to speak freely and without fear of judgment, so don’t put supervisors and direct staff in the same group, she suggests. Have someone who is neutral and welcoming moderate the group, perhaps a director of quality or someone external who is familiar to the facility, such as a social worker or chaplain.
But the most important thing is to listen to what participants say. “I was an administrator,” Boudreau-Scott says. “I know how hard I worked. It’s tough when someone says to you, ‘This is not good enough,’ because you’re thinking ‘But I’m giving it all I have!’ Be open to that process and don’t fight what they’re saying.”
Aligning goals to help reach those possibilities
Look at the themes, the most pressing problems from the data and personal testimonies. Then narrow it down to five, or at most six, goals. Choose goals based on greatest impact to the organization, staff and residents.
Boudreau-Scott says soliciting feedback is a way to get participation and input from others because big change won’t happen unless everyone buys in a little at a time. Establish guidelines, budgets, policies and procedures as necessary to make those goals feasible – and possible.
“It might be a goal that is year long, but you’re going to have little pieces along the way, so you’re constantly chipping at it,” she says. “It may even take two years to get there. That’s fine. But if you’re working in a way that you’re slowly building your culture to support that, then you can get things done.
“People can do a lot on their own. You can do a heck of a lot more, a lot faster, when your leadership is on board.”
Anchoring the changes into place so they sustain
Take stock of where you are, she says. Then start by starting.
Define how a goal will be measured and what constitutes success. Track a goal’s progress and anchor it to the data. Use the data to continue changing.
“It doesn’t mean things can’t change,” she says. “It doesn’t mean it always has to be that way. It actually, I think, helps figure out when things do need to be tweaked because chances are whatever you roll out with is not going to be perfect. If you have a process for going back and looking at it, you’re more likely to sustain and work towards the final outcome that you want.”