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Good morning. One of the most significant challenges in skilled nursing and senior living leadership is avoiding the disconnect between decisions made in the boardroom and the realities of life on the floor. When leaders lose touch with frontline operations, they risk making decisions that hinder rather than help.
To combat this, it’s essential to “roll up your sleeves” and actively engage with your staff. Building trust and staying grounded in the day-to-day experiences of your team doesn’t happen overnight—but with intentionality, you can foster an environment where you stay closely connected to the pulse of your organization.
Be sure to check out our sponsor, TapestryHealth. They’re one of the few who are truly leveraging technology to save your direct care team time while simultaneously driving higher quality outcomes. Learn more about TapestryHealth HERE.
Elevate Your Leadership
Here are some practical and creative strategies to ensure you never lose sight of what's happening at the ground level:
1. Work the Dish Machine or Help Make Beds
One of the most effective ways to stay connected to your team is to routinely block out time in your schedule to complete frontline tasks. Two great examples are working the dish machine or helping make beds. This demonstrates humility and support and gives you firsthand insight into workflow issues, equipment inefficiencies, or even cultural dynamics within your team.
Actionable Tip: Schedule 30 minutes weekly in your calendar to do one of these tasks. Stick to it like any other critical meeting—show your team you're committed to understanding their work.
2. Share a Meal with New Hires After Their First Month
New hires bring fresh perspectives that seasoned staff may no longer see. After 3-4 weeks on the job, they've experienced enough to form initial impressions but haven't yet become accustomed to overlooking inefficiencies or challenges. By inviting new hires to a casual meal, you can tap into their valuable insights. This also lets you connect with them personally, laying a foundation of trust early on.
Actionable Tip: Create a standing lunch date for all new hires, and ask a few open-ended questions during the meal: What surprised you about your role? What's something we could improve? You'll be surprised by how much you learn.
3. Run Regular "What Would You Change?" Surveys
Feedback is the lifeblood of improvement. Every 2-3 months, run a quick and straightforward survey asking staff: "If you could change two things about your job, what would they be?" This survey can uncover operational inefficiencies, employee frustrations, and opportunities for meaningful change. Even if you can't act on every suggestion, sharing results and taking visible steps toward improvement fosters trust and engagement.
Actionable Tip: Combine online surveys with paper forms and place QR codes in high-traffic areas like the time clock or break room to make participation easy. The easier it is for staff to share feedback, the more responses you'll get.
4. "Coffee with Caregivers" Chats
Sometimes, the best insights come from informal, candid conversations. Hosting regular "Coffee with Caregivers" sessions in the break room can create a space for open dialogue without the pressure of formal meetings. Gather a small group of caregivers once a week and sit down over coffee to talk. This allows employees to share ideas, frustrations, or concerns in a casual, low-stakes environment.
Actionable Tip: Schedule these coffee chats on different days and times to accommodate different shifts. Keep the groups small to encourage honest conversation, and come prepared with a few open-ended questions to get the conversation flowing.
5. "Leadership Rounds" Podcast
Transparency builds trust; one way to foster that is by making leadership visible in real time. Consider creating an internal podcast where you interview staff during your rounds. This could be as simple as recording short conversations with team members about the challenges they're facing or innovative solutions they've found. Sharing these recordings with the broader team shows leadership listens and recognizes staff's contributions.
Actionable Tip: Start small with a simple voice recorder or smartphone app. Record a 10-15-minute episode each week where you check in with different departments. After recording, send the podcast link to all staff members to keep them informed and engaged.
6. "In Their Shoes" Training Rotation
Leaders need to experience frontline work firsthand to understand its nuances. Implement a training rotation where leadership spends time in different departments, such as dietary, housekeeping, or maintenance. This deepens your appreciation for your team's hard work and offers opportunities for process improvements that might otherwise go unnoticed.
Actionable Tip: Block out one half-day a month to work alongside a department you're less familiar with. Ask staff to walk you through their daily routines and note any challenges they mention. This cross-departmental exposure can lead to meaningful changes in efficiency or resource allocation.
7. Department Report-Backs
A great way to ensure frontline voices are heard is to have department leads report directly to leadership. Once a month, invite a representative from each department to present their team's biggest wins, challenges, and areas of concern at a leadership meeting. This creates a direct line of communication from the floor to the boardroom, ensuring that decisions are made with a complete understanding of the frontline realities.
Actionable Tip: Encourage department leads to gather team feedback before the report-back meetings. Focus on successes and challenges and create action items based on the issues they raise.
8. Monthly "Ask a Resident" Interviews
One of the most essential perspectives to consider is that of the residents themselves. Monthly resident interviews give you direct feedback on how your team's work impacts the people they care for. Involve frontline staff in these interviews to hear firsthand how residents perceive their care. This exercise not only provides valuable insights but also reminds staff that their work has a real impact on residents' quality of life.
Actionable Tip: Choose a few residents to interview each month and ask consistent questions to gauge their satisfaction and areas for improvement. Share the feedback with the staff, highlighting areas where they excel and growth opportunities.
9. Rotate in Leadership During Shift Changes
One of the most effective (and underutilized) times to connect with staff is during shift changes. Leadership often misses these critical moments because they're off-hours, but these transitions can be rich information. Rotating leadership presence during the morning or night shift change allows you to chat with employees coming in and going out—when they're most likely to be candid about what's working.
Actionable Tip: Set aside time every few weeks to cover shift changes. Ask how the previous shift went, what their challenges were, and if they need anything for the next shift. Even 10-15 minutes of presence can make a big difference.
10. Hold "Fix-it Friday" Open Forums
Implement a weekly "Fix-it Friday" initiative where staff can submit ideas for quick, minor improvements that could be implemented by the end of the week. These could be minor process changes, supply requests, or tweaks to routines that don't require a massive overhaul. By dedicating a day to making quick wins, you'll build momentum and show employees that you're willing to act on their input in real-time.
Actionable Tip: Encourage everyone to submit ideas in a suggestion box or via a quick digital form by Thursday afternoon. Review the suggestions and implement one or two fixes by the end of the day Friday, reporting back to the team what you've done.
Staying grounded in the realities of frontline work is essential for skilled nursing leaders. When leaders make decisions from a distance, without this valuable connection, they risk missing key details that directly impact the quality of care and employee satisfaction. By consistently rolling up your sleeves, engaging with new hires, and gathering feedback through creative and open channels, you can build a leadership style that is responsive, empathetic, and deeply trusted.
Takeaway for Today: Block 30 minutes this week to work alongside your team—making beds, working the dish machine, or participating in a shift change. Your presence will make all the difference.
Partners We Love
Together with TapestryHealth
I write a lot about TapestryHealth in this space because plain and simple, there are so many reasons to love this partner. Their technology is among the best I’ve seen – easy to use, incredible impact, and no cost to the facility. They understand everything SNFs have to deal with from P&L to HIPPA regulations, hospital outreach, the non-stop pressure to fill beds and maintain staff, all of it, because they come right out of this business. Tapestry is run by people who have worn every hat in a nursing home - medical director, DON, staff nurse, administrator, operations officer, you name it. And that’s why, regardless of how technologically advanced and bottom-line focused they may be, they never forget the all-important human side, the doctor-patient relationship, the connections made every day between patients and healers. Tapestry’s board-certified clinicians are trained in geriatrics and understand every challenge your nurses have to deal with, which is probably why so many nurses say they love working with their Tapestry partners.
You’ll love this partner, too.
You can check them out HERE or you can Call, Text, or WhatsApp 845.694.7288
Whenever you're ready, there are a couple of ways I can help you.
- Leverage our partnership with CEUSrEZ and purchase NAB-approved, online, self-paced, continuing education courses at a 20% discount here.
- Use our free AI-powered Chatbot trained on all 900 pages of CMS Nursing Home Regulations plus proprietary processes and information from decades of skilled nursing leadership experience. Click here.
- Coming soon in 2024. Stay tuned!
