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Good morning.  Leading a senior living community or skilled nursing facility is a 24/7 job.  There is no doubt about that.  However, it doesn't mean that you and your team should settle for 3:00 AM phone calls and no work-life balance.  This morning we're focusing on a process you can begin working on today to better support your leadership team and your own sanity.

First, don't forget to check out the amazing and easy to use wireless listening systems offered by our friends at Eversound. 

Plus, we're really enjoying their founder, Matt Reiners, new podcast titled "All Ears- Senior Living Success with Matt Reiners."  You can check it out on Spotify here.

Eliminating those 3:00 AM phone calls

This article will explain how you can dramatically decrease the off-hour calls you’re receiving from your community.

Burnout and turnover among senior living leaders, especially clinical leaders, are high.  As an industry, we struggle to compete with remote working options and, in many cases, the salaries offered by agencies and competing industries.  The most direct positive impact we can have on recruitment, retention, and turnover is improving our leaders' environment and work-life balance.

Unfortunately, many Administrators and Executive Directors don’t take action to improve the work-life balance for their teams because

·         We don’t know how.  We’re responsible 24/7, right?

·         We’re afraid to let go.

·         There’s no time to get ahead of it.

·         We feel it’s our duty to be available.

·         We’re too short-staffed.

The truth is you can, and should, put systems and pathways in place to enable your onsite team to handle situations as they arise.

Step 1: Gather the data

Before we fix the problem, we need to identify what the problem is.

The 3:00 AM phone call comes in all different shapes and sizes.  It can be everything from “we have a resident with an unexpected change in condition” to “the toilet is leaking all over the floor.”

I recommend you craft a call log and have your leadership team keep track of the calls and texts they’re receiving for a 5-7 day timespan.  It’s essential to include weekends to truly understand the volume and types of calls you and your team receive.  Here is an example of a log I created and utilized earlier this year.  If you would like a copy of it, feel free to shoot me an email, and I will send it to you.

Step 2: Analyze the data and determine where your most significant area of opportunity is.

You will see from our log that we classified calls into four different categories.  You can follow these same categories or customize them to meet your needs. 

·         Category 1= Appropriate clinical call.  I.e., unexpected resident change in condition

·         Category 2= Inappropriate clinical call, I.e., resident on hospice passed away

·         Category 3= Staffing related, I.e., call out

·         Category 4= All other calls, I.e., maintenance-related, self-reports, equipment malfunction, etc.

Here is where we ended up after completing the exercise

As you can see, our most significant area of opportunity was in reducing the staffing-related calls that our leaders are answering.  We also noticed ample opportunity to eliminate the inappropriate clinical call category and reduce the appropriate clinical call pie slice through education and clinical pathways.

Step 3: Create pathways and decision trees

Now that we know where our low-hanging fruit is, it’s time to get to work.  We next sat down with the call receivers and had them list the steps they took after receiving the call or text.  Here is an example

DON called at 9:30 pm because an RN called out for the night shift.

Steps she took:

1.)    Called the on-call nurse leader

2.)    They each called the 7 PRN RNs on the payroll- no one willing to pick-up

3.)    Verified that there was an additional RN on the schedule for the upcoming night shift

4.)    Called the 6 PRN LPNs on the payroll

5.)    One of the PRNs agreed to pick up the shift

This is just one of many examples we went through.

We then created pathways for the charge nurse, MOD, or leader on duty to follow when there is a call out utilizing the above steps, including decision-making parameters and thresholds.  Now, the clinician on call is only notified if all steps are exhausted, and there is no other RN in the building for coverage.  By this time, all options would be exhausted.  In the 100 days since we implemented this pathway, the clinician on call has received zero off-hour calls related to RN staffing.

Rinse and repeat until you have pathways for the most common call types you’re receiving.

Please send me an email for an example of one of the pathways we created.

Step 4: Analyze and adjust

After three weeks of implementing our first handful of pathways, we successfully decreased off-hour notifications to our leadership team by over 90%.  In addition, our charge nurses and leaders now feel more empowered to handle situations and solve problems as they come up—a true win-win.

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Together with Eversound

In addition to improving the quality of life for your residents Eversound shows prospective residents and their family members that you will put their needs first.  Learn how Brightview Senior Living is leveraging Eversound to improve tour outcomes and conversions.

Grab your coffee and make it a great day.  We appreciate you and your dedication to your team and residents. -Thank you!