Nursing homes, overhead is bottleneck in quality framework

Major investments are being made in nursing homes. VWS is making EUR 2.1 billion available over the next three years, which we think is good news. As far as we are concerned, that should also be spent in the support departments according to Jan Kamp and Frank van den Bos

Most of the budget - 85 per cent - is earmarked for recruiting additional care staff, in line with the norm of ‘2 staff for every 8 elderly people’, thus ensuring more attention to residents. The remaining 15 per cent will be used to increase productivity or quality. The additional funds will allow nursing homes to employ about 25 per cent more staff over the next three years. However, the outflow to other sectors is high. If we include this outflow, at least 50 per cent of the size of the current workforce needs to be recruited. Both the demand for healthcare professionals and the pressure on the labour market are increasing enormously.

No doubt everyone immediately thinks of recruitment & selection processes and the quality of the P&O department. Are we distinctive enough in a very tight labour market? What does that mean for our recruitment strategy and associated processes? Many organisations undoubtedly include this in their quality plans. Don't forget to consider the dissatisfaction with the quality and customer focus of support services that many healthcare organisations are currently struggling with.

Overhead

A few weeks ago, we were at a meeting with representatives from 50 healthcare organisations. The main topic; how do we get our support departments more customer-oriented? Many care employees and managers experience support processes and departments as bureaucratic and not customer-oriented. In employee satisfaction surveys, support departments generally score very low.

In recent years, significant cuts have been made in support departments. A low overhead rate became a goal in itself. The key question is whether the quality of the current support services will be sufficient in the coming years to meet the ambitions and goals of the quality framework for nursing home care and the programme ‘At home in the nursing home’. However, getting and retaining good people in these departments is also complicated. As a result, location managers and team leaders spend more and more time managing support processes than motivating their own staff.

Systems that do not connect or whose data quality is poor. Locations that have no or poor wifi so that the IPad does not log into the client's room. Schedules that are not correct. Continuous alerts from clients wondering when someone will finally arrive. Phone calls from relatives directly to care teams because the reception desk is not staffed. Contacting finance regarding an incorrect salary payment. Being called on team productivity but not getting reliable information. Just a few examples that care workers face. Examples that all contribute to excessive workload.

Employee-oriented

Care workers focus on satisfied clients. Support services should focus on satisfied employees. Because how nice is it when, as a care employee, you feel supported, processes are correct, you know in time when and for/with whom you are working, there are enough staff, you can easily switch shifts, all information is up front where it is needed and your questions are solved quickly?

Nursing homes face a very big staffing challenge in the coming years. Prevent the support departments from becoming the bottleneck in implementing this. For this, you also need to know how the supporting processes are performing. To provide this insight, those processes need to be mapped, making visible the added value these processes have. It then becomes transparent, for instance, what the ICT landscape looks like and meets the requirements of the primary process, what the costs of the supporting processes are and how they are charged, where and how much (unnecessary) rework is done, and so on.

Once it is clear what the support processes must meet, you can determine their desired design. For this, create a roadmap and involve employees to increase the chances of successful change. A first step could be to ask your OR and care management for a top five improvement points they have regarding the support departments. Include these points in your 2019 annual and quality plan and budget.

This entry was posted on 30 October 2018 at skipr.co.uk