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Providence Mount St. Vincent

Organizational Systems Transformations

"There is a difference between training and education. Education is the classroom and literature. Training is the one-on-one teaching them 'what to do if'...... Both are important and we do both at The Mount." - Neighborhood Coordinator.

The below "overall" organizational and staff transformations are based on the Organizational Systems table (displayed on the Assessing Impact page) and are those that will most likely affect staff and organizational outcomes. Examples are listed below each strategy. 

1) Create an inclusive community for staff that is constantly communicating and reinforcing a resident-directed focus through formal and informal educational opportunities and relationship building.  

  • The Mount's inter-disciplinary leadership team participates in weekly meetings that focus on resident-directed concepts as part of the agenda For example, leadership team members completed a Resident Sensitivity Exercise (see the form below), compared differences and preferences and then contemplated a life based on someone else's schedule and preferences.  
  • The Mount maintains journal and publication subscriptions (examples from the case study include Assisted Living Consult, Modern Healthcare, Gerontological Nursing, RN, McKnights, and Long-term Care News). The Education Department scans publications and provides employees with summaries of relevant journal articles (employees can request the full copy for those articles of interest).
  • The Mount provides in-house training with a person-directed focus. For example, dementia training is provided to employees and The Mount works with all staff to create some standardization tools for regulatory issues.
  • Training includes "plugging" all levels of staff into available resources"What takes a lot of time for a Resident Assistant is not knowing what resources are available. When you have access to resources and know what's available, you have that extra 30 minutes to spend getting to know residents. I prioritize extra training with staff, one-on-one, so they understand where the resources are and resources are within an arm's reach." - Neighborhood Coordinator.   

2) Through a flat organizational structure, employees feel empowered to help control quality, waste, and problem-solve throughout the community. 

  • In case study interviews, staff use words like "organic" and "flexible" to describe problem-solving at The Mount. This means focusing on resident choice instead of working on maintaining hierarchical constructs. "We focus on resident choice instead of paper." - Neighborhood Coordinator.
  • Neighborhoods have their own budgets and receive monthly variance reports to help guide spending.
  • To achieve maximum outcomes, each staff member's "role" includes understanding multiple areas of focus and many are cross-trained. "Our staff are generalists and need to know many areas." - Mount staff member.    

3) Leverage the value-added potential of inter-disciplinary, cross-trained teams throughout the organizational structure to take advantage of synergies in the organization.  

  • The Mount leadership encourages inter-disciplinary teams to problem-solve among and between themselves. According to one staff member, "We typically don't use work requests or paper bureaucracy. Everyone can just call each other, and you can get things done pretty quickly with a phone call."
  • The Mount takes advantage of organizational synergies. For example, The Mount's Occupational Therapist also educates employees on injury and preventive wellness. In another example, the intergenerational childcare center is used by employees for daycare (providing a convenient and cost affordable option). 
  • Staff engage in regular communication within and between teams to explore best practices and lessons learned. For example, neighborhoods meet regularly to discuss team needs, but neighborhood coordinators also schedule breakfast with each other to share experiences and best practices. One staff member commented, "People are free of judgment or repercussions across teams." 
  • Staff report that the Medical Director and Nurse Practitioner are extremely accessible and supportive of person-directed care in clinical issues.  

4) Leadership actively pursues engagement and supportive strategies with staff. 

  • After 5 months with The Mount, new employees meet with the administrator. The purpose of this interview is for leadership to ask-"What can we do for you? How do you like the job?" According to Charlene, "After the first few minutes, employees realize that it is about them and getting their opinion and feedback. We really want to know about their experiences and how we can help."
  • The Mount helps to support education and scholarship for employees (tuition reimbursement and scholarships for CNA's and LPN's).
  • There are numerous examples of The Mount engaging with employees on a personal level including providing Christmas bags with toys for the children of staff. "The Mount is a family and great support system. I'm able to feel safe and provide for my family. I wouldn't move and wouldn't leave. I take care of people here and feel like they take care of me. Charlene and Tom help me, care about the residents and care about employees... they are good people." - Mount staff member.  

5) The Mount utilizes data, process-maps and problem-solving approaches to support staff and resident-focused transformation. 

  • During the case study visit, the Administrator, Tom Mitchell, was utilizing process maps and analysis to reduce wait times at the "Cafe" for residents. Residents enjoy the tray line and picking out their own food; however, this was causing a queue. By utilizing data (# of meals served) and observation (where dietary staff can help residents), The Mount identified approaches to ameliorate the problem. 
  • "Leaders are accountable for social interactions, budget and clinical responsibilities, so we use toolboxes [data and process maps] to get things done." - Neighborhood Coordinator. 

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The Below Example is of a Resident Sensitivity Exercise Used in Leadership Meeting