Generally friends don’t sue friends. An empowered staff will be hundred times more effective than one more policy to fix a problem.

The other side of the coin to “Why Zero Tolerance in Senior Living is a Bad Idea” is this. Companies produce volumes of policies and procedures primarily to protect the best interests of the company, secondarily to protect the best interests of the residents and finally, if there is anything left, to protect the best interests of the employees. While it is clear both legally and practically that some policies and procedures are needed, the goal should be to create a culture of ownership rather than a culture of compliance.  A culture that says, let’s see what rules we can get rid of.  Here is what it might look like:

1.  From the very top of the organization there needs to be a constant stream of messaging that is focused in three specific areas:

  • The right thing for each resident is the most important thing.
  • No matter what your area of responsibility is, treat it as if you are the owner of that specific area and of the community as a whole.
  • Transparency makes all problems better – It should go without saying, but we are talking smart transparency.

2.  The truth is there are lots of ways to run a good senior community.  It depends on local marketplace, customs and cultures, the overall personality of the staff and the specific personality of the executive director.  There are some great executive directors who are laid back and others who are hard charging.  Executive directors need to have the freedom to exploit their strengths and their understanding of the local marketplace and to take advantage of the specific strengths of their team.

3.  When something goes wrong the response should not be a new policy, but rather a process that asks: What caused it to go wrong?  Was it lack of training; lack of big picture thinking; or, something that caused a person or group of people to act out of fear rather than empowerment?  And, finally, is this the wrong person for the job?

4. When things do go wrong, and they will,  having open and frank conversations with everyone about the challenges, the risks and the options will make everything better and, at least largely, protect you from legal action. Line staff are often able to identify potential changes in condition in residents before anyone else.  They need to know that, not only is it safe to provide that input, but that it is valued and they are a valued part of them team. A CNA who tires to report a possible change in condition of a resident is rebuffed by the charge nurse with, “When did you get a nursing license?” is not likely to try it again. No written policy will empower that aide, but open discussions will.

The Big Picture

Taking these steps will empower staff and give staff more time to interact with residents and their families.  They will be more invested in the success of the community.  From a legal risk perspective an empowered and engaged staff will have great relations with families as well as residents.  This becomes the closest thing to making yourself bulletproof to a lawsuit.  Generally friends don’t sue friends.  It will be a hundred times more effective than one more policy to fix a problem. Steve Moran

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