Introducing ‘Ask the Staffing Experts’

Editor’s note: With staffing levels, training, and retention one of the greatest day-to-day challenges for long-term care providers, Long-Term Living magazine has enlisted the help of two experts in staffing, Susan D. Gilster, Ph.D., FACHCA, NHA, Fellow and Jennifer L. Dalessandro, BS, NHA.

Susan D. Gilster, Ph.D., FACHCA, NHA, Fellow

Dr. Gilster is a leader in innovative healthcare project development and has been involved in creating organizations in the United States and abroad. As an educator, researcher, practitioner, and consultant, Dr. Gilster has published and presented nationally and internationally focusing on leadership, organizational development, staff retention and Alzheimer’s disease and dementia care programs. Dr. Gilster developed the Alois Alzheimer Center, Cincinnati, Ohio, which opened in 1987 as the first free-standing dementia facility in the U.S. Guided by her service-driven philosophy, she developed successful, transformational models and systems for leadership and person-centered care for residents, families, and staff. Dr. Gilster has published her innovative models and systems in two books: “Changing Culture, Changing Care: SERVICE First,” and “A Way of Life: Developing an Exemplary Alzheimer’s Disease and Dementia Program.”

Jennifer L. Dalessandro, BS, NHA

As an educator, researcher, and writer, Jennifer Dalessandro has been an innovator in long-term care for more than 19 years. She serves as the assistant administrator and research coordinator of the Alois Alzheimer Center. Ms. Dalessandro has helped the Alois Center evolve into a person-centered facility that continues to be service-driven. With her guidance, the facility has earned numerous deficiency-free surveys and the ACHA/NCAL Steps I and II Quality Improvement Awards. In 2006, the facility was one of the top 25 in Ohio for family satisfaction. In addition, through many international and national presentations and publications, Ms. Dalessandro has shared her knowledge about leadership, staff satisfaction and retention, and continuum-based Alzheimer’s care in a thought-provoking manner.

Visit the staffing experts’ personal Web site:

Every week Dr. Gilster and Ms. Dalessandro will answer your staffing questions and provide advice on how to keep, strengthen, and build a quality workforce. Have a staffing question for our experts? Simply e-mail it to We hope to hear from you.

Life is a lesson learned each day, if we choose. And for those who continue to learn, the growth, development, and satisfaction in their work and life simply continues.

This column is designed to provide a forum for learning and exploring mechanisms for enhancing staff satisfaction and retention in assisted living and long-term care. Employees dedicated to serving older adults are vital to the success of a community. Research indicates that happy staff yield satisfied residents and families, which promotes facility success and profit.

Yet happy, supported, and nurtured staff is not what is encountered in many assisted living and long-term care facilities across the country. All too often the experience is a revolving door of staff, moving in and out of a facility and from one location to the next in an effort to find a workplace that is meaningful, respectful, fulfilling, and fun. With turnover rates of 40% to 100% per year, it is a very costly quality concern.

To impact this dilemma, we will offer, discuss, and share successful practices for recruitment, selection, orientation, and ongoing programs with the goal of retention, decreased turnover, and enhanced joy in the workplace. We’ll introduce the importance of organizational collaboration and a shared vision, among other important factors necessary to provide a stable, satisfied workforce.

First, it is important to acknowledge that creating a successful workforce and culture takes an organizational approach. All staff, all shifts, all departments are important in achieving an exemplary workplace. No one person, no single department can carry the weight of the entire facility and every individual person is important in achieving success.

Effective leadership is critical in the development of a global approach to the recruitment and retention of staff. Change starts with the desire of a leader to create a work culture that meets the needs and desires of all people that they serve—residents, families, and staff. Leadership has the power and authority to initiate programs as well as support others in their quest to create an exemplary workplace. It starts with a leader’s vision but must be shared and embraced by the entire employee base, all departments all shifts to become a reality.

However, this column is not simply just for leadership, but for any person within an assisted living or long-term care community who chooses to be a leader and wants a more conducive, collaborative, and fun work environment. Effective change can, and often does, begin with one voice…but success will only come when many voices are heard.

We’ll be looking forward to discussing important staff-related themes with you, and we look forward to receiving your questions and suggestions for future topics. Keep checking back as we share valuable information to help you transform your facility into a more successful, profitable, and fun environment in which to live and work. We hope you find this week’s questions valuable.

(Editor’s note: The following teaser questions are meant to exemplify what types of queries Dr. Gilster and Ms. Dalessandro are prepared to advise on. Use them as inspiration.)

How can I prepare employees to succeed?

Employees do not come to a position in any facility fully prepared and capable of succeeding regardless of their years of experience. While they may have worked for decades in assisted living or long-term care, they have not worked in your facility. New employees do not know your residents or where the linen is kept. They are unfamiliar with your procedures, how you operate and most of all your expectations for their performance. If left to “figure it out” by themselves, they will most likely fail. And it is not their fault—it is yours.

New employees once carefully selected, need to be prepared and educated for their position, including organizational expectations for their performance. Facility and departmental orientation should be mandatory and ongoing education is essential.

Do you know all you will ever need to know?
Have you learned all that you will ever know? Why is it then that we think once a new employee has been through orientation (often too short and incomplete), that they no longer need to learn anything other than what is mandated by regulation. And even those often done in the fastest most efficient way are not real learning but a means of meeting a requirement.

In order for employees to be effective, grow, and remain interested in their jobs they need a routine, sustained system for enhancing knowledge and sharing valuable information with one another.

Are clinical ladders only for nursing?
Have you ever been in a facility with no dietary department or housekeeping? Have you visited a faculty with no one in maintenance or admissions? While the nursing department is essential in assisted living and long-term care, all departments are essential to community operations.

An organizational approach recognizes and values all employees in all departments and has a willingness to see every single employee grow, learn and achieve. It takes all staff, all departments, in all positions to work collectively and collaboratively to meet the needs of those we serve in assisted living and long-term care.

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