Transcript Rhythms of Daily Living

Strategic Mapping & Program
Alignment
Aligning Experiences – Expectations – Resources – Outcomes
Session Agenda
1.
2.
3.
4.
Introduce Sears
Introduce Project Initiative
Review application of Choice in dining service
Present process for mapping from a strategic
objective to a tactical initiative
5. Conduct the Mapping Exercise for Craig
6. Conduct the Mapping Exercise for the Corporate
Program
7. Review Process, Q & A
May 24, 2005
TAHSA Annual Meeting - 2005
2
Session Objectives
1. Discuss need for new service options
2. Introduce Choice as a service culture
3. Present process for mapping from a strategic
objective to a tactical initiative
4. Discuss outcome benefits and barriers
May 24, 2005
TAHSA Annual Meeting - 2005
3
SMRS Strategic Objectives
1.
2.
3.
4.
Community of Choice
Financial Enhancements
Quality of Living/Quality of Work
Operational Effectiveness
May 24, 2005
TAHSA Annual Meeting - 2005
4
The Customer Value Of Positive Experience
A Memorable Feeling Created By You As A Result Of Us
Relative Customer Value
Created Within
The Customer
EXPERIENCE
Source Of
Customer Loyalty
SERVICE
Created By
A Provider
GOOD
RAW MATERIAL
May 24, 2005
TAHSA Annual Meeting - 2005
5
Operational Culture
Rhythms of Daily Living is an operational culture
that aligns resources and expectations of service
experiences. RDL works in collaboration with
initiatives of environmental culture change
advocated by other organizations. The core
service model for liberating residents and staff
from an institutional paradigm is dining service.
Dining is a catalyst and enabler to initiate
change across coordinated services.
May 24, 2005
TAHSA Annual Meeting - 2005
6
Rhythms of Daily Living
The core of RDL is the opportunity to exercise choice residents’ for
how they choose to live their day and staff choice for care delivery.
This creates a collaborative coalition of residents and caregivers
working together in a living environment. RDL facilitates the
delivery of care, the experience of living and the dignity of selfdetermination.
RDL is a management principle that aligns the natural rhythms of
residents and the support they need. The organizing principle of
RDL is that people should be able to make meaningful choices in
their daily lives – on their own or with assistance. RDL relies on
caregivers to help define and achieve outcomes that balance
individual choice and system efficiency.
May 24, 2005
TAHSA Annual Meeting - 2005
7
“Some facilities studied, usually the lower turn-over
ones, were in the process of thinking about how
to increase individualized care. For example, the
researcher asked, what are you doing if anything
about resident choice. ‘We are looking at it.
Ideally, we want them to eat when they want.
We encourage them to tell us what care they
want, a shower or bath, or to get up when they
want.”
Page 5-49 Appropriate of Minimum Nurse Staffing Ratios in Nursing Homes, Phase II Final Report
prepared by Abt Associates for the Centers for Medicare and Medicaid Services, December 2001.
May 24, 2005
TAHSA Annual Meeting - 2005
8
Alignment
The appropriate positioning of systems
and resources to attain a defined
goal, mission, outcome or culture
May 24, 2005
TAHSA Annual Meeting - 2005
9
When Landing A Plane, What Is The Main
Thing? 1
Left Of Runway
Altitude Too High
Aligned
Pitch
Altitude
Air Speed
Cross Winds
Wind Speed
1. Concepts and Diagrams From The Power of Alignment - How Great Companies Stay Centered
and Accomplish Extraordinary Things By G. Labovitz/V. Rosansky
May 24, 2005
TAHSA Annual Meeting - 2005
10
The Main Thing For SMRS
Choice
May 24, 2005
TAHSA Annual Meeting - 2005
11
Choice Dining Alignment
Plan and Develop
Evaluate “Readiness” With Leadership, Managers & Residents/Families
Define Outcomes Baseline and Expectations
Evaluate
Organize
Organize For Culture Change
 Establish “Experience” Alignment Teams To Define/Implement Transition
Define
Plan
Codify
May 24, 2005
Define Service Functions and Outcomes For Each Experience
Identify Beneficiaries/Benefits and Diagram Service Functions
Plan Transition Process and Commit Resources
Write Program Transition Budget and Operating Narrative
Codify Policies/Procedures and Training By Function
Write & Task Procedures/Training Using RDL© Base
TAHSA Annual Meeting - 2005
12
STRATEGIC OBJECTIVES – TACTICAL
IMPLEMENTATION PROJECT MAPPING
As dining options and program enhancements are discussed,
specific initiatives are defined and envisioned by
department management and staff. These new “dining
experiences" require a specific definition process from
concept to strategic alignment to tactical
implementation.
Executive and Board leadership must clearly identify
specific strategic organizational considerations.
Leadership must clearly define their expectation and
measurement of a successful contribution to the
community strategic vision. This must take place prior
to the initiation of Map 1.
May 24, 2005
TAHSA Annual Meeting - 2005
13
STRATEGIC OBJECTIVES – TACTICAL
IMPLEMENTATION PROJECT MAPPING
The following are the task requirements for this process:
1. Identify Service Initiatives
2. Define Their Contribution To Strategic Objectives
3. Define Appropriate Measurements Of Successful Experience
Outcomes
4. Identification Of Resource And Operational Intersects
5. Identification Of Intersects And Roles Of Other Contributing
Departments
6. Structure Of The Process For Resource Allocation To Develop The
Defined Initiative
7. Sequencing Of The Tasks
8. Implementation of the Initiative.
May 24, 2005
TAHSA Annual Meeting - 2005
14
Map Process #1, 2 ,3
Strategic
Objectives
Community of
Distinction
Financial
Enhancement
Quality of Living
Quality of Work
Operational
Effectiveness
Administration
Regulatory
Operations
Personnel
Map#1
Strategic Objective
Benefit
Map #2
Benefit Measure
Measurement Tool
Map #3
PP&E
Community
Operational
Resource
Requirements
Budget Impact
$/FTE’s
May 24, 2005
TAHSA Annual Meeting - 2005
15
Map Process #4, 5
Map #4
Collaborating
Departments
Nursing
Resident
Services
Therapies
Pastoral
Housekeeping
Maintenance
Activities
Nursing
Resident
Services
Therapies
Pastoral
Housekeeping
Maintenance
Activities
Task
Map #5
Task
Implementation
Procedure
Policy
Resource
Requirement
Inform/Train
Measure
May 24, 2005
TAHSA Annual Meeting - 2005
16
Project Management
May 24, 2005
TAHSA Annual Meeting - 2005
17
Craig Methodist
Windflower Dining Program
May 24, 2005
Aligning Experiences - Expectations – Resources – Outcomes
Discussion Topics
Current Operations Overview
Selection of the Initiative
Contribution to the Strategic Objective
Benefit Measure
Operating Resource Requirements
Collaborating Departments
Development and Sequencing of tasks
Implementation
Review of Project
May 24, 2005
TAHSA Annual Meeting - 2005
19
Current Operations
1.
2.
3.
4.
5.
6.
64 Cottage Homes
108 Apartments
40 Assisted Living Apartments
60 Bed Nursing Unit
60 Bed Alzheimer's Unit
109 Canyon’s Apartments (Lunch Only)
May 24, 2005
TAHSA Annual Meeting - 2005
20
Selection of the Initiative
1.
2.
3.
4.
Improve quality of meals
More resident choice
Faster response to resident needs
Positioned for additional possible future
initiatives
5. Maintain our position as a preferred service
provider
May 24, 2005
TAHSA Annual Meeting - 2005
21
Contribution to the Strategic Objective
1. Provide First Class Services
2. Enhance Residents Choice
3. Continue to Build Census
4. Develop “Seamless Service”
May 24, 2005
TAHSA Annual Meeting - 2005
22
Benefit Measure
1. Community: Best of Amarillo
2. Financial Enhancement: Record breaking
Census
3. Quality of Living: Improved Satisfaction
4. Quality of Work: Direct Interaction with Staff
5. Operational Effectiveness: Less Waste
May 24, 2005
TAHSA Annual Meeting - 2005
23
Operating Resource Requirements
1. Administration: Co-Develop Plan, Approve
finances
2. Regulatory: TDHS Involvement
3. Operations: Develop- Procedures and Operating
Plan
4. Personnel: Staffing Requirements /Training
5. PP &E: Design Facility and Spec. Equipment
6. Community: Resident Involvement
May 24, 2005
TAHSA Annual Meeting - 2005
24
Collaborating Departments
1.
2.
3.
4.
5.
Nursing:
Resident Services
Housekeeping
Maintenance
Activities
May 24, 2005
TAHSA Annual Meeting - 2005
25
Development & Sequence of Tasks
1.
2.
3.
4.
5.
6.
May 24, 2005
Dietary
Administration
Corporate
Nursing
Environmental Services
Activities
TAHSA Annual Meeting - 2005
26
Implementation
1.
2.
3.
4.
May 24, 2005
Construction /Equipment
Staff Training / Procedures
Opening Plan in Phases
Daily Review of Operations
TAHSA Annual Meeting - 2005
27
Sears Methodist
Corporate Dining Program
May 24, 2005
Aligning Experiences - Expectations – Resources – Outcomes
SMRS Operational Initiative
1.
2.
3.
4.
May 24, 2005
Resource Leveraging
Consistent Standards
Collaboration with Other Departments
Common tools & systems
TAHSA Annual Meeting - 2005
29
Sears Dining Mapping Program
Strategic
Objectives
Community of
Distinction
Financial
Enhancement
Quality of
Living
Quality of
Work
Operational
Effectiveness
Map#1
ESTABLISH
SEARS
STANDARDS
AND
MAINTAIN
MARKET
BRAND
ASSURE
HIGHEST
RETURN ON
RESOURCE
HIGH
LEVELS OF
SERVICE &
QUALITY
ARE
MAXIMUM
USE OF
AVAILABLE
RESOURCES
Strategic
Objective
Benefits
CORPORATE
STANDARDSSANITATION
May 24, 2005
INVESTMENT
EXPERIENCED
BY
RESIDENTS
DAILY
TAHSA Annual Meeting - 2005
30
Strategic
Objectives
Map #2
Outcome
Measure
Measurement
Tool
May 24, 2005
Community
Of
Distinction
- POSITIVE STATE
SURVEYS
FOR PUBLIC
REVIEW
- CLEANER
COMMUNITIES
- 0 DEFICIENCY
- HIGH LOCAL
BoH SCORES
Financial
Enhancement
- REDUCED LABOR
- IMPROVED
EQUIPMENT
MAINTENANCE
Quality of
Living
Quality of
Work
INCREASED
RESIDENT
SATISFACTION
Operational
Effectiveness
LESS TIME SPENT
MONITORING
SANITATION
IMPROVED
WORK
ENVIRONMENT
- LABOR COST
PER RESIDENT
DAY
- EQUIPMENT
REPAIR COST
QUARTERLY
RESIDENT
SURVEYS
MEALS PER
LABOR HOUR
STAFF
RETENTION
TAHSA Annual Meeting - 2005
31
Strategic
Objectives
Strategic
Objectives
Map #3
Operational
Resource
Requirements
May 24, 2005
Community of
Distinction
Financial
Enhancement
Quality of Living
Quality of Work
Administration
Regulatory
Operations
SANITATION
STANDARDS
SUPPORT
DIRECTORS WITH
SITE VISITS
STATE SURVEY
PROTOCOL
FEDERAL AND
STATE
REQULATORY
REQUIREMENTS
OPEN & CLOSE
CHECK LISTS
DAILY WALK
THROUGHS
WEEKLY
INSPECTIONS
CLEANING
PROGRAM
Budget Impact
$/FTE’s
$100 PER
CAMPUS FOR
TRAINING COST
TAHSA Annual Meeting - 2005
Operational
Effectiveness
Personnel
DIRECTOR TRAINING
ON PROCEDURES
AND FORMS
STAFF TRAING ON
CLEANING
TECHUICHNES
REDUCTION OF .35
DISHWASHER FTE
32
Map #4
Collaborating
Departments
Nursing
Resident
Services
Therapies
Pastoral
Housekeeping
Maintenance
Activities
Nursing
Resident
Services
Therapies
Pastoral
Housekeeping
Maintenance
Activities
Task
Map #5
Task Implementation
Procedure
Policy
Resource
Requirement
Inform/Train
Measure
May 24, 2005
TAHSA Annual Meeting - 2005
33
Contact
Dan Look – 770-565-4006
Dining Management Resources, Inc.
3605 Sandy plains Road
Suite 240-269
Marietta, GA 30066
[email protected]
www.dm-resources.com
May 24, 2005
TAHSA Annual Meeting - 2005
34