the learning organization--becoming a highly effective agency

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C. Sam SmithBusiness Development Advisor

7 Secrets to Becoming a Highly Effective Home Health Agency

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--- presenting contemporary examples of the pre-eminence of organizational culture, and how a culture based on values can strengthen an organization’s strategic initiatives, team spirit, learning ability --- and profit-ability ---


Ford Motor Company was an organization marked by layoffs, bitterness, disgust with the market competition and with management…enter Mark Fields… the newly selected President for the Americas…who introduced the phrase:

- Peter Drucker

FLASHBACK TO 2006

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Creativity

Innovation

Confidence, Hope

Six years later, the results are tangible!

FORD’S CULTURE SHIFT AFTER 2006


….is reflected in its product line for 2013

FORD’S CULTURAL CHANGE –VISIBLE OUTCOMES


TODAY’S LEARNING GOALS

I. Develop ideas about how to go about aligning your culture with your values, vision and strategic goals in the journey towards becoming a Highly Effective Home Health Agency

II. Apply the learning organization principles to every facet of operations in the agency

III. Understand how to translate the measures into action items which can be taken and replicated in order to optimize workflow in the agency


THE “SECRETS” OR VALUES

Secret #1 – Aspire to Be a “Learning Organization”Secret #2 – Value ProficiencySecret #3 – Value ComplianceSecret #4 – Value Expenditure ManagementSecret #5 – Value Ideology & VisionSecret #6 – Value Careful RecruitmentSecret #7 – Value Servant Leadership


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What are some specific characteristics of Learning Organizations?


A. Systems Thinking / Bounded Objects B. A Shared Vision C. Understanding Mental ModelsD. Team LearningE. Personal Mastery

CHARACTERISTICS OF LEARNING ORGANIZATIONS

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The idea of the learning organization developed from a body of work called SYSTEMS THINKING.

Learning organizations have information systems that measure the performance of the organization as a whole and of its various components (metrics)

Systems Thinking involves all the characteristics that must be appear in an organization for it to be a learning organization. If some of these characteristics are missing, then the organization will fall short of its goal of being fully effective.

This is a conceptual framework that allows people to study businesses (home health agencies are businesses) as bounded objects, like cellular organisms.

SYSTEMS THINKING


LEARNING ORGANIZATIONS ARE “BOUNDED OBJECTS”

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- - - like cellular organisms


ORGANISMS

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Tribes – The original organism for human endeavor- banded together for a common purpose

Imagine: “have you thought of your HHA being in business in the current or a different form 700 years from now”?

…in 2712…

‘STORA’ : This is an example of a living organism-an ongoing tribe, a living company. Founded in 1302!

Organic businesses - have a spirit, they are “alive”!


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In some agencies the agreed upon shared vision is often to succeed against a competitor; however, these are transitory goals.

The shared vision should reflect a long term goal that is intrinsic within the company, such as the vision of excellent patient care.

It is important in motivating the TEAM to understand the shared vision of excellent, quality patient care as being the overriding cultural value can energize the organization.

SHARED VISION


SHARED VISION

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The effective learning culture must be guided and disciplined by its shared vision and its collaboration

Each member is expected to seek Personal Mastery of his or her role in the tribal organism—to become a Subject Matter Expert

Knowledge is encouraged to be shared, not hoarded for personal advantage


A SHARED VISION – ARE YOU UP TO IT?

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It is incumbent upon owners & managers to dispense constant praise and encouragement towards:

Personal Mastery for staff / both administrative and clinical Team learning practices so all staff members can benefit. Benefits will manifest in:

Quality patient care Repeated improved processes Procedural understanding Positive, productive inter-personal standards Mutually beneficial work objectives


WHY DO WE DO WHAT WE DO?

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An example of a shared vision…

“an authentic desire to make a difference, to care for patients, and to serve patient families, to dignify employee/contractor stakeholders…”

…can you think of others?


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The assumptions held by individuals and organizations are called Mental Models.

To become an effective agency which is growing as a learning organization, these models must be challenged.

UNDERSTANDING MENTAL MODELS


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In creating a learning environment, it is important to replace confrontational attitudes with an open culture that promotes inquiry and trust.

Unwanted assumptions, norms and misaligned values need to be discarded in a process called ‘unlearning’.

It is the responsibility of each agency to identify the flawed mental models of its members.

These should be dealt with discretion and in a considerate, humble manner.

UNDERSTANDING MENTAL MODELS


VIGNETTE #1

Nurse Judy Understanding Mental Models


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Benefits staff members grow more quickly

the problem solving capacity and agility of the organization is improved through better access to knowledge and expertise.

TEAM LEARNING


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An individual’s commitment to the process of learning and professional proficiency is known as Personal Mastery.

An agency whose workforce learns and implements quicker than the workforce of other organizations creates a ‘competitive advantage’ for that agency

.

PERSONAL MASTERY


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The aim is a culture where personal mastery is encouraged and practiced in each member’s daily work-life.

The learning organization learns to employ agreed upon mechanisms to encourage individual learning to be transferred into organizational learning.

PERSONAL MASTERY


PERSONAL MASTERY

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For home health - ensure that staff members are achieving Personal Mastery in the areas of patient admissions, charting, case management, therapy deployment, regulatory/billing & compliance, coding and RN accreditation

Effective leaders have a constant eye on the proficiency levels maintained by the nursing staff


PROFICIENCY IS NON NEGOTIABLE

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Staff members are achieving Personal Mastery in the areas of patient admissions, charting, case management, therapy deployment, regulatory/billing & compliance, and RN accreditation Effective leaders have a constant eye on the proficiency

levels maintained by the nursing staff

SECRET #2 - PROFICIENCY


SECRET #3 - COMPLIANCE

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Agencies today must utilize Information Technology to provide the team with a methodology for regulatory and payment source compliance as they follow the doctor’s orders and perform the duties of skilled care of patients, and billing & reporting those patient episodes.


SECRET #4 – VALUING THESTRATEGIC MANAGEMENT OFEXPENDITURES


THERE IS A CORRELATION: AGENCY EXPENSES MUST DRIVE REVENUES & GROWTH

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Are the agency’s costs and expenditures aligned with the agency’s shared vision?

Each activity should be filtered by the question-“Am I saving the company money, time and resources, or am I adding to its assets and revenues?”

“Everything we do should be either making us more profitable - either increasing revenues or decreasing expenses”AXXESS TECHNOLOGY SOLUTIONS/CSS

Vignette #2- An Exemplary HEHHAOrganization Name: Bluebonnet Health Services, Inc.Size: 350-500 patientsPopulation served: McLennan County, Metro Waco, TXServices provided: Home Health services with varied reimbursement models

Exemplary in wisdom regarding expenditures: The market has two hospitals both with HHA subsidiaries.The HHA marketing challenge is to seek prospects’ TOMA (Top of Mind Awareness).Expensive advertising: As sponsor of the Lady Bears basketball team, radio, TV, and onsite game-time advertising

Results: Creates TOMA among the over 65 crowd who enthusiastically supports the Baylor women’s basketball team—average attendance over 9,500 per game. Bluebonnet’s census is regularly 50% higher than the hospital subsidiary HHA’s.


SECRET #5 – IDEOLOGY & VISION

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The effective tribal/organic agency is protective of its Unique, Productive Culture


THE LEARNING ORGANIZATION THRIVES ONIDEOLOGY & VISION

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The effective agency is protective of its Unique, Collaborative Productive Culture

Reinforces the shared vision/values regularly.


SECRET #6 – RECRUITMENT

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• Is there a probationary period whereby new hires must be

scrutinized by the team?

• It is vital to deploy skilled interviewing techniques that seek to

determine:

• Does this person possess a sharp tongue?

• Is this a person who sees himself/herself as a victim?

• Does this new person have any inherent traits that can cause

disharmony in the organization?


Exemplary in:Diversified income streams – A Shared Vision, Bounded Object,

Systems ThinkingNurse Mary Beth and her treadmill – Personal Mastery &

Understanding Mental Models

Vignette #3: An exemplary HEHHA

Organization Name: Mobile Personal Services, Inc. Size: 600+ patientsPopulation served: Pinellas, Hillsborough, and Pasco counties – Metro Tampa, FLServices provided: Home Health services with varied reimbursement models


SECRET #7 - SERVANT LEADERSHIP

Servant leaders –Assisting their staffs with Team Learning Translate & communicate the Present Reality to the Shared

Vision Value advice and truthful advisers Are slow to speak and eager to listen Value the aim of Personal Mastery in every work function Display emotional intelligence in Team Learning Understand the connection between giftedness and

responsibility


LEARNING ORGANIZATIONS“HUDDLE UP” REGULARLY

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Operate with a regularly scheduled “tribunal” - or “huddle”-

Personally embody the values to accomplish the vision

“Huddle up” every day, or once a week

Encourage open communication and provide example of humility and humor with the organization members

Make sure everyone is having fun!


The 7 “secrets” are simple wisdom.All of them are cultural standards--

Values that are vital to our aspirations in becoming a Highly Effective Home Health Agency.


“The state of the Long Term /Post Acute Care Segment of the Healthcare industry is

undergoing rapid change.Continuous improvement and team learning

are not optional—they have become imperatives.”

—C. Sam Smith

LEARNING ORGANIZATIONS WIN


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Interested in further reading?


the learning organization--becoming a highly effective agency

Documents

learning environment

learning organizationsecret

effective learning culture

todays learning goalsi

systems thinking

value compliancesecret

value proficiencysecret

overridingcultural value