The learning organization--becoming a Highly Effective Agency

7 Secrets to Becoming a
Highly Effective Home
Health Agency

C. Sam Smith
Business Development Advisor

AXXESS TECHNOLOGY SOLUTIONS/CSS 1

--- 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 ---


FLASHBACK TO 2006

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


FORD’S CULTURE SHIFT AFTER 2006

Confidence,
Hope

Innovation

Creativity

Six years later, the results are tangible!

FORD’S CULTURAL CHANGE –
VISIBLE OUTCOMES

….is reflected in its product line for 2013


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 Proficiency
Secret #3 – Value Compliance
Secret #4 – Value Expenditure Management
Secret #5 – Value Ideology & Vision
Secret #6 – Value Careful Recruitment
Secret #7 – Value Servant Leadership


What are some specific
characteristics of
Learning Organizations?


CHARACTERISTICS OF
LEARNING ORGANIZATIONS

A. Systems Thinking / Bounded Objects
B. A Shared Vision
C. Understanding Mental Models
D. Team Learning
E. Personal Mastery


SYSTEMS THINKING
 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.


LEARNING ORGANIZATIONS ARE “BOUNDED OBJECTS”

- - - like
cellular
organisms


ORGANISMS

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”!


SHARED VISION

 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

 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?

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?

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?


UNDERSTANDING MENTAL
MODELS

 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

 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.


VIGNETTE #1

Nurse Judy
Understanding Mental Models


TEAM LEARNING

Benefits
 staff members grow more quickly

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


PERSONAL MASTERY

 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

 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

 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


SECRET #2 - PROFICIENCY

PROFICIENCY IS NON NEGOTIABLE

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 #3 - COMPLIANCE

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 THE
STRATEGIC MANAGEMENT OF
EXPENDITURES


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

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”

Vignette #2- An Exemplary HEHHA
Organization Name: Bluebonnet Health Services, Inc.
Size: 350-500 patients
Population served: McLennan County, Metro Waco, TX
Services 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

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


THE LEARNING ORGANIZATION THRIVES ON
IDEOLOGY & VISION

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

 Reinforces the shared vision/values regularly.


SECRET #6 – RECRUITMENT
• 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?


Vignette #3: An exemplary HEHHA

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

Exemplary in:
Diversified income streams – A Shared Vision, Bounded Object,
Systems Thinking
Nurse Mary Beth and her treadmill – Personal Mastery &
Understanding Mental 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

 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.


LEARNING ORGANIZATIONS WIN

“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


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The learning organization--becoming a Highly Effective Agency

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