Ladies and gentlemen thank you for joining the QAPI keeping staff and crowing quality conference. Your monitor for today will now begin.
Rank you very much. While we take a moment for everyone to join us and people to get through their operator, I would like to ask you to think about why you state your current job. And what is one thing that would make you happier with your current job?
Please put your answers in the chat box. For those of you who have not used a chat box before, on the right-hand side of the screen, if you're not in full-screen mode, there is a chat function. It says send to and you want to have it on all participants. Take a moment and write in the chat box what it is about your current job that you really like and what is the one thing that would make you happier with your job.
How is everyone today? Thank you for joining us.
We have some things that are happening in the chat. Today we will have Tiffany moderated chat for us. The other thing that I would like to ask you all to do as we go through this presentation, if you have questions, please put those questions in the chat and Tiffany will stop us and we will talk about[Inaudible - static] Let us get started.
Our topic for today is keeping staff and growing quality. This is a continuation of our Sears on -- series on QAPI. The previous webinars are recorded and on our website under the network healthcare acquired conditions in nursing homes. They are in that recorded section, so if you have not attended the webinars, take a few moments at your leisure and look at those recordings. They will help you on this journey for QAPI .
My name is Debi Majo and I am your monitor today . Let us move that picture quickly. Let me introduce our team. Susan is our director, Frank is a quality improvement consultant, Casey is our department manager, Tiffany is a quality improvement consultant and so is Melody Malone.
Minnie Malone is our resource consultant and Carlos Smith is a quality improvement consultant as well.
Our objectives for today -- we will understand the importance of staff retention. We will talk about the importance of selective hiring -- not just because they have a license and a pulse, believe me, I've done that. There are also three strategies we will review to increase staff retention.
So let us look at our plan for today. First we will review QAPI and root cause analysis. Then we have three speakers from three different nursing homes that will share with you how they are keeping staff. And then we will show you where you can find ideas to help you hire and retain quality team members.
First, we will review QAPI . Let me introduce Melody Malone.
Hello, everybody. I am so glad to be back with you today and going to QAPI with you. I am hoping at this point that everybody is pretty familiar or at least getting there, in case you are not, let us just review real quick the five elements of QAPI I know we have not seen the new regulation yet from CMS. We would are hopeful that we will see the soon. We encourage you to begin learning about each one of these elements. There is a document on our website on the QAPI resources that is called five elements of QAPI. It has all of the expectations for each one of these elements. Design and scope, governance and leadership, feedback, data systems of monitoring, or forms improvement projects, and systematic analysis and systemic action.
Just so you understand how all of this is going to start coming together, as you listen to our speakers today, I want you to be thinking about where does there, and fit into these five elements? What are some things that they were doing that you might decide to pick up and do in a performance improvement project? As you are thinking about that, think about your five star quality rating system.
I'm sure everybody would love to be at a five star facility. These are the quality measures that are utilized in the quality measure section of the five-star quality rating system. As you think about your staff turnover and you think about where you are in you quality measures and quality ratings, you might find that staff retention and growing quality come together in your quality measures.
As you are thinking about that, think about that root cause analysis. What is really causing your problems? And you get down to those root causes you can actually get to those identifiable prevention strategies that you can use for your quality improvement effort.
To remind you with root cause analysis, you will need to use some tools. We have several tools in our QAPI resources. And we have a QAPI webinar specifically on root cause analysis that explains how to use these tools. The five wise, brainstorming, both silent and out loud brainstorming, and use the Fishbone diagram.
Remember, once you have that root cause, you have the fundamental problem identified that is really causing your issues. Then you can move on to the model for improvement.
When you get to the model for improvement, this is when you really can do that while it you work that is done in quality improvement. In the model for improvement, you will identify what are we trying to accomplish? In the case today, retain staff and grow quality. How do we know a change is an improvement? You have to be tracking turnover over retention in order for that to work. What change can we make that would result in improvement? It depends on your root cause analysis. During today's webinar, hopefully you will be able to identify some opportunity that you can have a plan to -- you can plan, do study and act.
I will turn this back to Debi, I know this was a fast , quick run through but I think getting to our panel today will be very exciting. Debi, taken away.
Thank you, Melody . First of all we have the director of nursing, Jamie Boulton from SPJST restroom number one. Say that really quickly. How many times can you say that?
SPJST is a nonprofit organization whose goal is to provide outstanding health care and customer service to its guests. This surrounds all that they do. They have interactions with their desk, in respectful and loving relationships that they have with their guests families and employees. Jamie, tell us about your facility.
Enqueue. I hope everyone is having a wonderful afternoon. I little bit about SPJST . Do not ask me to actually say with that is, that if you e-mail me a -- if you e-mail me all, I can do that you later. It is a 74 bed facility and built in 1957 by the SPJST , which is a Czechoslovakian organization. They set it up for the drawing community and the need for nursing homes.
Since then, we have expanded in any essential living and nursing home. Very important to us, we are very focused on the community and the family. I think that is very important structure was when you are setting up an organization, setting up a nursing home, and talking to retention, which is what I will talk about in a moment, in order to bring in their detention, you have to have that sense and feel of community and family.
We are run by a board of direction -- Board of Directors of SPJST . Our profits go back into the organization. What we do for retention -- first of all, I would just like to throw some numbers that there. Historically, our retention has been high. We have multiple employees that have been with us 35 years plus. I myself have been here for three and half years. I would just like to point out that even though that is not that long, I'm sure many of your bird the nightmare statistics that they have a half-life of about nine months to a year as a director missing.
My administrator has been the administrator for SPJST for 23+ years . My business office manager/assistant administrator has been here 33 years. My maintenance manager, 33 years. My assistant director of nursing has been here 16 years. And I have multiple CNA's -- I carry 40 CNA's and I have eight of them that have been here 20 years. I have one CNA that is been with me for 38 years, which is staggering. That is just some of the numbers.
The reason I point that out is because when you have these numbers -- I use these as a tool during my interview process. If you can boast the kind of retention that we have in management and you are showing that starting at the top, you have stability. In order to have stability with your staff, your nurses and you CNA's, you have to have stability with your management. We can show that. And I use that as a tool.
It starts with the interview process. It was mentioned earlier. It is not about filling a hole. It is about finding the right person, the right personality that fits in with your employees.
The biggest thing I look for in the interview process is compassion. You have to have that compassion for others. You can look in somebody's eyes and you can see whether or not they are there to just do a run-of-the-mill interview or if they really have compassion for what they're doing. Unless they are really good at faking an interview, which is always a problem.
The majority of the time, if you spend some time with someone and get them -- get to know them little bit during the interview process. Not ask them not just an open-ended question such as tummy but yourself, see what they speak to. If they are speaking about things about compassion and caring for others when you are asking them to tell you a little bit about themselves, that is telling where their focus and centers on the life.
Another important thing, of course, that I think is overlooked and I remember telling myself multiple times, reference checks are a waste of time. Why do we even have to do these? They cannot tell you anything, everything is done by fax. That is true but there are still places that will -- where you can talk to an HR person or director of nursing, especially if it is someone locally that you know. I would like to point out, I know a lot of places have practice where the HR person will do the reference checks for use. -- For your. I do my own personal reference checks because I want to speak to that person that knew the person that I am interviewing. Even if they will not tell me anything, sometimes you can get an idea from them by their tone what that employee is about.
You have to pay attention to those sort of things. It is very important, it starts with the interview. They are a couple of other things I will touch on.
That one thing is there will always be employees that you bring in that of other things going on in their lives. You know you're being successful in your interview process of bringing and good employees if they leave for short amount of time and they want to come back. I have a lot of employees that after they leave, they want to come back.
Incentives are always important. I know that you can bat around a bunch of different ideas about incentives let me just start some of the things that SPJST does for our employees.
Number one, we give 30 min. paid lunches. I know there are a lot of facilities out there that either make you clock out for lunch or automatically Dr. from the paycheck. We give up a lunch and we also offer a free meal for the day shift and evening shift.
You can do that with very little cost out-of-pocket considering the amount of food that most of us throw away everyday. It is a great idea. You can look into that.
401(k)s are becoming more more scarce. We still have a 401(k) plan with messes $.50 to one dollar. That is something that will brighten someone's eyes. When you are interviewing them and they have a head on their shoulders to interview right back and ask you questions about a 401(k) plan and benefits. I like to hear those questions out of people that I'm interviewing.
Another big thing, you get them in the door, you are training them, you think they're doing a pretty good job, getting good feedback, but what they would like is to know that you care how they are doing as opposed to just asking those that are training them. I personally go out everyday when I have a new employee in the building and try to spend at least three or four or 5 min. with them and see how they are doing so for -- so far. What are they learned in one of the questions I have? They know you care, they need your interactive, then a you participant. I know we have jobs where stuck behind our desk lock but I tried it out there as much as possible.
Another huge one that I have found, you can have a very good employee that is a very good job for you and if they never know it or they bring your concerns and they do not feel like anything is ever done, then they get disenchanted with what they're doing and they actually -- that brings them down. You have to let them know how they're doing. Of course, one thing is annual feedback with each employee on how they're doing and a plan to improve.
Or, more important, is when they bring you concerns, you have to follow-up with those concerns. I am not saying you can go to them and say you told me this problem and I did something to so and so to make sure that doesn't happen. But they will no. If you follow-up on their problems, with their issues, they will know and they know that you care and they will keep that level of performance that there had to that point.
That is a big thing. It is one thing to bring a great employees, but you have to keep those great employees performing at that level. You can bring in a good employee and you can raise that good employee to a great level when they see how others are doing.
Another huge one for me personally is open-door policy. I have worked with many Abbas that is -- many a boss that is no are to be found and always behind closed doors. I am available to my employees, essentially 24/7. They know that and they are comfortable. I have never chewed out one of my employees for calling me and military when they need something. Even if it is something that I felt they should not have gone before, I still not get on them about that because I need to know that they can call me when they need to.
They can call you when they should not, but you want to make sure they will call you when they need to. If you get onto them when maybe they should not have called then maybe they will not when they need to.
On the bottom of my list, because I do not think it is the most important thing you will, but it is still important, and important enough to include, competitive salary. You have to at least be competitive in the community but we are not the greatest pain facility in the world because of where we are. You have to look at other areas in order to sell your facility to a good employee. The interview process works both ways.
I will and my notes on that.
Thank you, Jamie, very much. Does anyone have any questions for Jamie. If you do please feel free to put them in the chat. I will ask you an overall question and you can answer yes or no in the chat.
Do you plan to stay here current job for another year or more? If you think know and you do not want to put in there, I understand. You may not want to share that. But ask yourself what is your root cause for potentially leaving? And what did you hear that Jamie said that you might want to test even on yourself? Think about that.
We have a question from Tom. Jamie do you live in Taylor?
You could just answer it.
I live in [Name Indiscernible], which is 20 min. outside of Taylor.
Anybody else have a question for Jamie?
This is Tiffany, I may have mentioned it, when you were talking about providing lunches or dinner for your staff, how do you budget that in?
I did not mention how we budgeted in, I am actually not -- it is not part of my budget. However, I know the fundamental theory behind it and why Mr. Richards has supported that. That is there is always enough food when you are serving. Even if you have to budget just a little bit more to do that, it is worth it for the employees. It is a big incentive for them, to get that meal.
I agree. I have one nursing home I am working with that also provides -- there is always food in the refrigerator for their staff.
And there is a lot of throwaway. It will just be that way so if you have it available why not make that available to the employees? I'm not saying give them the food that is being during the way, just saying that we will have a surplus.
Right.
I have worked in a facility that this staff provided a meal and they ate with the residents.
That is a good point because that is something we are actually working on with a whole change in the dining room experience. We would like to work toward that. We already feel like this is our family, we would like to set up our meals where we are eating as a family.
That is a good opportunity. Okay, we now will move down to -- it seems to have a mind of its own the time, the slides. We will introduce Charles and seven and Jessica Ruiz, administrator and director of nursing at the Arbour in Westminster.
Good afternoon. The Arbor is a skilled nursing at Westminster. Westminster is a not-for-profit DCR see, continuing care retirement community. Is started in 1967. We have skilled nursing, assisted living and residential living or independent living. I will introduce my fantastic DON Jessica will give you 10 min. about our facility.
Good afternoon everyone. Some of our keys to reducing turnover here starts off with our environment that we created. Centering on residence in our care, having a hospitality environment that we hold staff to high standards on as well.
Just creating a culture in a community where we are devoted to taking care of our residents. And developing friendships and relationships, not only with the residents and their family, but with each other as well. Kind of what Jamie send as well, in our interview process, we are interviewing for the right fit for the community and for the location in which they staff member will be in.
Sometimes you interview a staff member who may be a perfect candidate for a memory support unit but may not feel fulfilled on skilled nursing unit. Because of that we may pass them for a full-time job offer if it is not a position that is being felt and try to offer them at least a PR and and keep them in mind for the future. I think having honesty and open communication in the beginning is very relevant as far as creating a relationship with that employ long-term.
The behavior process itself, we do a considerable amount of behavior interviewing, asking for responses. Putting them in situations that they may see and asking them to talk us through how they would respond to that situation as well. And just try to get to know them a little bit. See their personality and see if they fit in with the community as well. Oftentimes will take them to a tour at the time and introduce them to some residents and see how they interact. If we have any questions or holding out to see how they respond in that setting as well.
We also do an initial interview with our staffing coordinator. There is no less than that lease the second follow-up interview with our sister director -- our assistant director or myself. And bringing in staff to the interview and having them ask a couple of questions to get to know the potential employee as well.
Once the employee is selected, they will go through a thorough seven day on the job orientation with our mentors. We have mentors throughout the Medicaid and nurse aide on all units and all shifts. They have all been especially trained by our administrator. They go over leadership skills and training new employees. They have been with us and had a good record with us for at least six months before they can apply and join into the mentor program.
They spent seven days without designated person. There is also the first day before they even go out in the home, they spend a whole day with all of nurse management, about eight hours total, and we go over all of the clinical programs that we have at Westminster. Each nurse manager goes into [indiscernible] and that way they can begin to build a relationship and they can identify who to go to their questions or concerns. I think that has been extremely helpful.
We also go through some time with the therapy jam and transfer training, as well as all the clinical background as well. As far as what is expected in each program and how we are set up at Westminster.
Once the employee is on the floor, doing rounds, introducing yourself, checking in with them, seeing how they're doing, -- I think it is integral and building that relationship and fostering a. We continue to celebrate accomplishments and value each employee throughout their time. Making deposits in the days of every employee, giving them positive feedback, not going into the hall to ask questions or investigate situations but stopping and asking how their day is going. Asking if they know something is going on with the family, checking in on them, see how the family life is going as well and developing that relationship.
We have had situations where an employee had a mother portable personal experience of the time and we were able to intervene and move that person to and [indiscernible] position and bring her back to a full-time position when she was available because of our family life needs. I think being open to that and discussing that[Inaudible - static] Really helps that employee specifically. It is a reassurance to other staff as well that we are here for you and we will help you with your personal life troubles as well to make you successful.
We also have been [indiscernible] program and the stars program. Those are simply ways to write up people who up done well. It is posted throughout the unit. They get various gifts for them. If you did and [indiscernible], you will be -- a thank you from your assistant director. After you get so many star awards, the prizes build up for that. Just having the recognition. The [indiscernible] caring posting our throughout the community. We have them available for residents and that members to nominate each other as well.
We also do performance-based increases and evaluations. Each year, we will do a follow-up evaluation and feedback. Similar to Jamie, we have a low management turnover. We continue to give our boys continuous meaningful education. Giving an idea of what staff are struggling with and identifying the need and bringing education as needed. That way they have the resources they need to be successful.
We also try to empower direct care staff to follow their own problems and to recognize when they do and really give them all the tools that they need to be successful. Rather than as coming up with some sort of grand scheme of what we think would fall an issue that we are seeing, putting it in their hands and helping them to create a solution.
We have weekly standup where those items are discuss, we have mentor meetings. Our mentors are trained by our administrators. They meet monthly and put up services and how things are going on their respective units.
We just try our best to build leadership skills and every employee. We have got to some supervisor training with our charge nurses. And with our mentors, leadership training, provided by [Inaudible - static] As well. We also have consistent assignment meaning that each employee is going to be on the designated unit on a designated shift. They get to know the residence and the residents get to know them. And they get to know the people that they're working with everyday and they get to build those relationships and pull together as a team to see how they work best together.
We allow each of them the flexibility to have some -- where West may operatively then east, our memory care operates differently than those other areas, we allow that kind of atonomy in there does -- in the daily decision-making.
I think another thing is setting clear goals, helping them own the solution as well like I mentioned earlier, and reducing redundancy and creating efficiency is much as possible. I think one of the hardest things to do in this position is to manage all of the concurrent things that are going on throughout the day and trying to meet the needs of all of the residents. Making a decision workflow is integral to their success as well. We always welcome the feedback of what we can do to make the environment better for them to do their job to the best of their ability.
So more things that we have recently started, I will wrap it up after this, we celebrate employees birthdays. If they have a birthday, they get a card from management and we give them -- they have a little raffle ticket. Just a way to say thank you and recognize them and to celebrate their birthday with them.
We also like to grow our staff. So we have a really great tuition. We also have flexible scheduling for staff. We do have some staff allocate changes in staff that come to us because of their schedule work/life balance and with their team, we have developed a self scheduling on various areas of the community.
Back to growing people as well, we celebrate their successes. We have quite a few CNA's who are also [indiscernible] as well. We do give them the fall reimbursement and pay for their hourly wage as a [indiscernible] as well as CNA because of the knowledge they've had from that additional training and education.
I think the other big thing as well as we have quite a few employees who have moved from becoming CNA's to becoming mad aides and we congratulate that and when able we try to fill them into a position and grow them. We just had a CNA who graduated in a who is our admission and discharge nurse and he got his RN license. That is prevalent throughout the community. CNA's our activity directors, medical records -- administrative executives and receptionists as well. We like to grow our staff and foster their growth as much as possible.
The only thing I would add to the growing people think, I used to -- when I first started out the business, I thought that I should hire people that did not have ambition so they did not leave make. I found out over a couple of years that the more you grow people, the better your reputation grows and you start to get people applying to positions with your organization that may be did not apply before because you have that ability. You just create this really positive word-of-mouth in the community. You do not have to advertise much when you do need assistance. Our turnover rate back in 2007 was almost 100% and it is 7% today. Much improved.
I think there are a couple of questions from participants on the line.
Is there a pay increase for the mentors?
Yes. $.75 an hour and like Jessica said, that mentor class is actually -- it is an eight hour class that we created internally. Basically, it teaches mentors or CNA's and medication aides communication techniques, different types of learners, how to be a good coach or mentor. That is what -- we are growing those folks in creating a ladder system within our CNA so there is something attractive to reach for right in the door.
Out of those mentors, they become our go to people in the halls and the units. When we have questions are answers,, those are our go to people. They will help get feedback from everyone else and help create a solution to an issue as well. They enjoy that. For them, that is self-fulfilling.
Another question you have someone answered. Have you seen an increase in retention when you started consistent assignments accept you have answered that, you have a 7% turnover today. Did you have -- what was your retention rate when you began this consistent assignment?
I will say that the first year I got here in 2008, we implemented consistent assignment about six months into 2008. Actually, the turnover rate that year decreased by 50%.
Wow.
I guess -- it is hard to say though because there were two major changes. That was the consistent assignment introducing residents and their care. The other change was that three day orientation where they did an orientation on three different halls. One day on each call. -- Hall. I change that to a seven day orientation so it is very structured. Somebody described, they were just hiring to fill a spot and they were just thrown on the floor whether they were ready or not. I think that was a lot of why there was so much turnover back then. Those two changes reduced it by about 50%.
That is awesome. You do have some great comments as far as parties and chat box for you all.
Thank you.
Okay, thank you both very much. It sounds like the Arbour at Westminster is doing a great job with retention and low turnover. That is very impressive.
I will ask another question. Feel free to put this in the chat. You to hear and IDF on the first two facility speakers that you will go test in your nursing home? As you think about answering this question, if you're not comfortable putting in the check, that is okay as well, do not forget the model for improvement as a tool when you are looking at your staffing practices.
This could be the first place that you use your PDSA cycle or two that Melody showed you earlier for increasing staff satisfaction and decreasing staff turnover.
I will move on to our next speaker. Rockwall nursing care Center. Our DON is med Shelby. Before turn it over to DON -- med , I will turn it over to Melody as she has been working with them. Rockwall does have 192 beds and in Alzheimer's unit. Melody?
Thank you. I am really excited that med -- Valeria do see with you today to share her information because what I found just amazing, I met Valeria two years ago and she has 10% turnover in her nursing home.
I did not know you to get lower than that so Valeria, I think you're going to have to share . Valeria has been at her nursing home for 25 years as a DON. Her administrator was with her for many years as well . She has been a nurse for 40 years. She is just amazing. I will turn it over to her and let her tell you her success story. Valeria Thank you, Melody. Basically, I have been here for a long time. Most of my team has been here for a while as well. I have a lot of people that are been here even longer than I have, which is to say a lot. I've unit managers -- I had a unit managers that I lost this year because she retired. For the most part, it seems really funny but when my people retire, they usually retire by the way of going to the grave almost. That is hard to say but they work and then when it comes time to retire, they end up and it is just a short time.
Basically, we have always been a family here. Listening to Jamie and them all talk, it is like reiterating what we do here. I also have an open door policy. I encourage my staff to talk to me about the problems they're having with the patient's. If they do not feel they got satisfaction or the nurse, I encourage them to seek out and work with their problems. I offer them the tools to help them get ahead.
We are really a good facility in that we have a general psych unit, which a lot of facilities do not have. We feel that that is something that is really necessary in the community. Because of that, we have a lot of nurse aides that have a lot of psych experience.
We also feel like and we promote that each coworker be treated with respect. It does not matter which of they do or where they participate with care, whether it be our memory unit or psych unit or the regular geriatric site, they are treated with respect and know that they are an important part of our team.
I have, in my office, I always have snacks and water and drinks and things in here. They always know that they can always, when they feel low or whatever number that they can come in and they can get whatever they want.
I do not -- I keep that pretty well stocked all the time. We do rewards and recognize good work. We have several Laettner sides, they do an exceptional job of running the halls. They probably do a better job than the nurses sometimes.
I do believe that insistent assignment, we do have those. The lead aides are the ones that help them. If they have a problem or something develops on the call, they know they can go to the lead eight and they know that she will help them. If they cannot get satisfaction there, they can move up to the charge nurse and then to me.
I listen to them if they have problems. I feel like that is really important because a lot of times, they do not know who to go to if they have a problem. A lot of times, it stems them from doing something that might cause them to have to quit. Just let them vent and share with their concerns are just to help them out if they need help.
We are owned by senior care centers and senior care centers has a very exceptional foundation, it is called senior care foundation, basically, we have had to use it a time or two when we have one of our employees that would get sick. Or if one of our employees had a death in the family. They were there to help them with funeral expenses, help them with illnesses. That is really good. The nurse aides and nurses all know that that is something that can really help them.
I always like to welcome people back when have been on vacation or if they have been out on leave for having a baby or whatever. They know that we make a habit of -- usually we're always expecting something in a facility my site, we have a pretty generous staff so we always have someone that will have a baby, a wedding, graduation, or something. So we do try to enjoy that with all of the employees.
We are a really family orientated facility. We continue to -- sometimes it is thanking them for coming from work if they come in and help us out. Just thanking them. For the most part, I have worked at Rockwall for 20 something years and in that time, our facility started out as a hospital for Rockwall County, we are the oldest nursing home Rockwall County.
We have a good reputation in the community. Our employees are recognize. We have people that come in and they say is so-and-so still here? It is because we have a good reputation. I think the employees feel that they do a good job and we try to recognize for them -- we try to recognize them for that good job.
That is great. It sounds like you guys are doing all kinds of things that are making a difference and all of you, all of the speakers, are doing great things.
We will pause for a moment and see if there's anything in the chapter Valeria . We can let the operator open up the lunch the question.
I have a question. This is Tiffany. Valeria, you mentioned your foundation and that is provided by the company?
Yes, this.
If you want to give five dollars a month or is that something that strictly corporate-funded?
It is corporate-funded. And it is employee funded. I think it is a combination.
Oh, okay. That is a wonderful idea.
Ladies and gentlemen, at this time, if you would like to ask the question, lease press the number one key. Again, if you have any questions at this time, please press the number one key.
I will let you guys go ahead and call him for questions and keep going because we have some great things available for you as you move through this whole quality improvement process.
Stephanie is gathering at some of these great ideas, I think she will post them. That is one of the things available on our website. Is a view of our website. You want to make sure you are in the healthcare acquired conditions in nursing homes network. What you mean she would've joined the network. This is that orange button. And also manage notifications so that we know how often you want to get an e-mail.
The blue buttons down here that are on the nursing home homepage have all of the resources. We keep adding resources for the topic areas that we are covering. Earlier I mentioned 1010 so we have a button that is just for QAPI In the resources for QAPI, you will find one call the nursing home quality care collaborative. This is a national collaborative going on and they develop a change package. When you open up this change package, you will find that there are seven strategies. The strategy that focuses on today's work is the recruit and retain quality staff, strategy number two.
When you flip to that in the change package, you will see that under each one of the strategies there are multiple change concepts that you can use. For the strategies for recruit and retain quality staff, we heard some of those today. Hire only the best fit for your organization. Welcome new staff and make them part of the team. Set high expectations, support success. And give the staff a reason to stay.
With each one of these change concepts, there are multiple ideas for change ideas that you can use to test changes in your facility.
If you are wondering where we can start or follow-up to the conversation today of our three wonderful speakers -- for really I guess, if you are not really sure, here is another resource that you can go to that is on our website.
Remember some of the whole concept of the worksheet for testing changes is finding that idea that you think might result in an improvement. You heard many of those ideas today. And then developing your robust plan for testing the change, going and doing it, starting the results and then determining what we can act on. Is a something we could really use? Do we need to adapt it a little bit, adopted or abandon that idea? What did you learn from it?
And then test some more so that eventually you end up with a spreadable, sustainable quality improvement.
You will find resources for consistent assignment and staff turnover in our resources as well. I think I will turn this over to Debi Thank you, Melody . Let us ask. Today is Tuesday, what can you do by Thursday? What can you put in place in your facility that you learned today from our speakers that you can do by Thursday to make a difference in your staff and their retention and in increasing your hiring practices so you find people of quality rather than a live body to fill an open slot?
I will not ask you to put that in the chat, but think about it.
My next question for you is did we accomplish our objectives? Do you understand why it is really important for you to retain your staff, selective hiring, and do we discuss strategies for you to understand about employee retention?
Questions? Tiffany put in the chat, I think a very simple implementation is just saying thank you.
Thank you you miss an awful lot to CNA's that have had a really hard day and a combative resident and done everything they could to get the job done. Sometimes that is all it takes, and a smile and a pat on the back.
It is enough to get them through the next day.
This is Tiffany, I wanted to add to that. Valeria mention that during her presentation and so I just wanted to point that out .
I think that is excellent. Also Jamie said something about snacks and diet plans. I understand that as well but sometimes a little Twinkie or something to a staff member that is had a hard day means an awful lot.
Before you log off, please take a moment and fill out our polling questions. We would like to provide webinars and con two or -- to what our audience prefers. If you learned something today that you will use, please let us know. If you have any ideas of what you would like to see in the future, please let us know that as well.
As you finish the polling questions, I would just say a couple of things about TMF. We are the quality improvement organization in the state of Texas. We have been here for more than 40 years and we are helping healthcare providers and practitioners and a variety of settings and our focus is improving care for the patients.
The QIO program is a rapid, large-scale change in healthcare. Bolder goals, patients at the center, all improvers are welcome, everyone teaches and everyone learns.
If you have questions, this is how you can get in touch with us.
I want to thank everyone for joining us today. Please do not forget to fill out your polling questions. Thank you very much.
Goodbye everybody.
Goodbye.
Goodbye.
Ladies and gentlemen, this concludes your call. You may now all disconnect.