Anthony Cirillo
Healthcare policy and politics are again front page news. Yet, even after the President signed the new bills into law, the U.S. still ranks 37th in the World Health Organization and still be plagued with chronic conditions. In short, we will still need services across the aging continuum.
As much as people want to embrace aging in place the fact is we will need long-term care facilities. And boomers will not accept them as they are today when they need them later. And even as boomers make decisions for their parents they are starting to demand more. This brings us to person-centered care. In the hospital realm they call it patient centered care.
I have some theories as to why it has not caught on and will not until we think differently about leadership.
• Unless there is a clear correlation between pay for performance and the experience of employees, residents, patients and families, few will act. Carrot and stick.
• People are daunted by programs that seem to address experience management less from hearts and minds and more from hammers and nails. Renovations of facilities might be a by-product of culture change and experience management, but it does not have to be.
• Change. People are terrified to step out of their comfort zone.
• Command and Control. The hierarchy of healthcare lends itself to this and people have a hard time understanding that letting go of control within context and empowering staff actually benefits everyone.
But consider this even more systemic issue: Healthcare workers are like firefighters. They do dirty jobs, look death in the eye every day and celebrate the joys of life, too. So why does the firefighter culture thrive with low attrition and people clamoring to get in? Firefighters face their mortality every day and they have created a culture where they can talk about it, release it, joke about it and move on. The firehouse is their community, their home.
Healthcare workers do their job and take it home with them. When they are burned out, they leave. Firefighters are treated like heroes; healthcare workers, not so much. So part of it, in my opinion, is building cultures that recognize this and help people release the fear and anxiety. That is not part of any rewards and recognition system. It goes fundamentally deeper. It points to more fundamental issues about how our culture looks at healing and aging.
Is healthcare reform going to aid this? No. With an eye toward squeezing dollars from the system, bottom line-motivated people will hunker down and continue business as usual.
Enlightened and visionary leadership will change the industry, however.
They recognize that educating the public about health and aging issues is not just the right thing to do but also builds relationships.
Enlightened and visionary leadership knows that changing the employee experience will change the resident and patient experience and people will talk about it.
Enlightened and visionary leadership realize that empowering staff with tools allows them to collaboratively solve problems. It helps creates context. That sets off light bulbs in people’s heads so that they figure out how to make the experiences better for everyone.
Enlightened and visionary leadership recognizes that culture change is not the program of the day, driven by more rules and regulations.
Enlightened and visionary leadership use times like these not to hunker down but to press the “reset” button, changing the rules of the game, redefining the work, changing the organization.
So don’t look to healthcare reform to solve systemic cultural issues in long-term care. Look inside yourself.
