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Sailing to Success

September 1, 2007
by root
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By the staff of Ballard Healthcare, Des Plaines, Illinois

In the mid-1990s, 2000, and 2004, a series of decline points in the overall market share of guests needing rehabilitation services and, specifically, those requiring services related to orthopedic conditions served as a call to action for Ballard Healthcare, in Des Plaines, Illinois. In response, we developed new and distinctive clinical service lines in post-acute care for complex conditions while augmenting existing clinical services and exiting others. We also deinstitutionalized the physical environment to make it more comfortable and homelike. All of these efforts were made to continually improve outcomes and attract clients.

Yet, with the market's continued shift toward lifestyle-driven decisions, we desired a broader, holistic approach to address the needs of active adults requiring care. Our goal was to dispel the popular notion that skilled nursing facilities were only for the chronically ill or dying. A leadership conference in April 2005 presented the cruise ship “experience” as a method of delivering high-value, high-touch customer-focused service.

Immediately, this was seen as being adaptable as a clinical therapeutic intervention—one that focuses on mobility, activity, fitness, and well-being to improve the restoration/recovery of function and community reintegration, and/or minimize the rate of decline/loss of function (see figure on page 28). In incorporating all of these elements, the experience would address all of a guest's physical, social, cognitive, and emotional needs to enhance function, independence, and quality of life.

Consequently, in summer 2005, Ballard launched its initiative, Passage to Discovery, to enhance its guests' (patients') rehabilitation outcomes and quality of life by offering virtual land and sea cruises to destinations around the country and around the world.

Passengers and “Crew”

We designed this “travel” initiative with a twofold purpose: (1) to improve rehabilitation and quality of life for our guests and (2) to educate our staff about the “soft” non-clinical mechanism of the service culture.

Passengers. Cruises consistently average nearly 50 guests, starting with 45 guests aboard the maiden “voyage” down the Mississippi from St. Louis to Memphis and on to New Orleans, and peaking with 65 on a trip to the Congo seven months into the initiative. Participants are active adults (active in that they are generally ambulatory, although most are still in need of wheelchairs or other assistance) who are cared for on either a short- or long-stay basis. Short-stay (SS) guests are those who reside in the building for less than two consecutive quarters. Overall, the average length of stay for SS guests is 22 days, with more than 20% having less than 14-day stays. Long-stay (LS) guests have called Ballard home for an extended period. Throughout their stay, SS guests typically have fewer than 10 opportunities to take a cruise. Obviously, LS guests have more opportunities to “travel.”

Crew. Ballard staff at all levels and in all areas are involved with the Passage to Discovery program. We expect managers to participate regularly, along with a cross section of staff—51% of staff (representing approximately 125 staff members) have been involved with at least one cruise in the past year.

Each event is organized and coordinated by the “cruise director,” activity director, and their supervisor, the assistant administrator. The “captain” of every cruise is Ballard's executive director, who sets the tone by exemplifying how staff members are to serve guests at all times. To demonstrate that no one is too important to participate as an actor, all senior leaders don costumes as the ship's officers or act as servers, transporters, dining room hosts, or photographer assistants. No role is viewed as higher or lower in importance; achieving the desired guest experience is the focus. Other cruise roles include tour guide, photographer, server, bartender, and safety officer. Because this is such an enjoyable and rewarding program for both guests and staff, many staff members invite their families and friends to join the cast. When we featured Nigeria, for example, staff members and their friends replicated a tribal wedding, complete with a native village, traditional clothing, authentic ceremonial dances, and drumming and instrumentation.

Before Setting Sail

Our cruise experience is evocative of The Love Boat TV series, where guests have a fun, lighthearted, socially engaging vacation, shaped by the help of a friendly, attentive crew.

  • Guests and their family/friends board the ship every other Thursday. We chose this day so weekend visitors would not distract the staff's focus of providing our SS and LS guests a full cruise experience.

  • The days before the cruise are filled with a variety of activities reflecting the culture, cuisine, and customs of the featured destination. These include arts and crafts projects or, as when we went to Italy, a day sampling regional foods and listening to Italian operas.

  • Before beginning the adventure, cruise staff review all aspects of the day's activities and assignments, and are briefed on any necessary guest precautions.