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Paul Willging Says...

December 1, 2005
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It's Time to Get Systematic

It's time to get systematic You've put together your budget and, on paper at least, you're running a profitable community. Now it's time to manage your finances and maintain control over what's actually happening in the community. That requires systems-systems that will help you understand what's going on, systems that will enhance community productivity, systems that will bring the latest in technology to your management environment.

Sounds good, doesn't it? But what does it all mean? Let's explore both the benefits and the challenges of ensuring that your community can take advantage of the best of what is available in information and management technology. Maintaining your competitive edge is critical to the success of your community. Important as it is at any point in the history of senior housing and care, it becomes even more so in a saturated market.

Being competitive requires much more than setting the right price. Price is important, but reducing price without enhancing productivity is likely, in the long run, to make you less, rather than more, competitive. Competition is, after all, based on value, and price is only one component of value, the other being quality. Consequently, your prices can be reduced without adversely impacting value only by increasing productivity. This is where technology comes into play.

Technology is more than equipment, machinery, and devices. It is just as much skills, expertise, and knowledge. While the former set cannot be overlooked, the latter-certainly in long-term care-are more likely to make the more appreciable difference over time. And, indeed, the former are only tools for the latter. One of the most critical tools, for example, is data. And in today's increasingly complex senior housing and care environment, data certainly need to be automated. But it is the application of data, not their generation, that will spell the difference in terms of community productivity.

The ability to gain easy access to information and to communicate that information to all involved stakeholders is indispensable to the provision of high-quality service. Data need to be accurate, timely, and readily communicated. But the machinery is less important to that process than the techniques for its dissemination and use.

There are any number of systems for improving productivity. The traditional view has focused on the department level, where the most basic tasks are performed. In this approach, responsibility for results rests primarily with supervisors and department heads. At that level, techniques to promote efficiency have been applied to controlling resources, monitoring output, changing work processes, and enhancing worker and group competencies and motivation.

While such processes bring benefits, there are also natural limits in terms of their ultimate value, at least in our profession. Senior care is, essentially, a task-oriented service based on a one-to-one relationship with the client. And while all of the above techniques can be beneficial, there comes a point where the number of minutes to perform a basic task cannot be further pared. Dressing Emma will take 15 minutes, regardless of technology.

That said, the number of programs has multiplied, and proposed organizational structures for enhancing productivity have become increasingly sophisticated and technically advanced. Planning and control processes now cut across all departments. Production technologies are now applied to the entire facility as a self-contained and complex system consisting in many interrelated subsystems. In this approach, managers are aided by functional specialists in areas such as human resources, information technology, and materials management.

The management gurus certainly emphasize the value of the company-wide system, as opposed to a piecemeal departmental approach. But, admittedly, the installation of system-wide techniques is also more challenging (and, the broader the application, the more critical the community's culture becomes in supporting this). Today, productivity enhancement is as dependent on "leadership" as it is on "administration." Which leads to a discussion of an entirely new approach to the application of technology, one less oriented toward production and more focused on direction. The installation and cultivation of strategic planning and quality improvement systems provide perhaps the best examples of a "management" as distinct from a "production" strategy.

Given the natural limits on task fulfillment in the senior care setting, a production strategy alone will be insufficient to enhance value in either the short or the long term. Capital and human resources are no longer as predictable as they once were. Competition and regulation are more intense. As a result, external forces (including economic and marketplace turbulence) create threatening conditions that require an organization to try to control its environment as much as its production.

Here there is less emphasis on control and more on strategic planning and quality improvement, as the volatility and complexity of the environment makes more traditional methods of control problematic. Here adaptation to a changing marketplace is the ultimate measure of productivity. Here responsibility shifts away from the department level to the most senior levels of management, including owners and boards of directors.