TheBigUneasy:Katrina’sUnsungHeroesFacilitator’sGuide
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TheBigUneasy:
Katrina’sUnsungHeroes
Facilitator’sGuide
ProducedbyCathieBrady&BarbaraFrank
B&FConsulting,Incand
SusanWehry,MD
June2009
FundingwasprovidedbyagrantfromtheLouisianaDepartmentofHealthandHospitals,usingcivilmoneypenaltiespaidintotheNursingHomeResidents’TrustFund.
ThegrantwasadministeredbytheGovernor’sOfficeofElderlyAffairs.
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ACKNOWLEDGEMENTSThisfilmisapartoftheNursingHomeStaffingProjectinitiatedafterHurricaneKatrinatoaddressstaffingneedsofNewOrleansareanursinghomes.TheprojectwasundertakenbytheWorkforceIssuesWorkgroup.TheWorkgroupwasavoluntarycollaborationamongorganizationsandindividualsconcernedaboutthewell‐beingofnursinghomes,staffandresidentsinthegreaterNewOrleansarea.ThegroupworkedtogetheronfindingsolutionstothenursinghomeworkforceissuesthatconfrontLouisiana.SponsoredbytheLouisianaHealthCareReview,theWorkgrouphadnolegislativemandate,formalstructure,orgovernmentalfunction.Stateagenciesandlong‐termcareorganizationsthatworkedtogethertohelpstabilizestaffinginnursinghomesafterKatrinathroughtheNewOrleansNursingHomeStaffingProjectinclude:
GulfStatesAssociationofHomesandServicesfortheAging
LouisianaDepartmentofHealthandHospitalsLouisianaHealthCareReview
LouisianaNursingHomeAssociationOfficeoftheStateLong‐TermCareOmbudsman,Governor’sOfficeofElderlyAffairs
ProjectFaculty:
CathieBradyandBarbaraFrank,B&FConsultingwww.BandFConsultingInc.com
SusanWehry,MDhttp://web.me.com/swehrymd
Allmaterialsfromthisprojectareavailableatwww.lhcr.org
Formoreinformation,contact:
LindaSadden,StateLong‐TermCareOmbudsmanGovernor’sOfficeofElderlyAffairs
412N.4thStreet,3rdFloorP.O.Box61
BatonRouge,LA70821Tel:(866)632‐0922Fax:(225)342‐7144
website:http://www.louisiana.gov/elderlyaffairs/LTCombudsman.html
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TheBigUneasy:Katrina’sUnsungHeroes
Facilitator’sGuide
TableofContents
Acknowledgements 2
Introduction 3
UsingtheFilm 5
DiscussionGuide 7
PriortoShowingtheFilm 7AfterShowingtheFilm 7
o GeneralDiscussion 7
o PsychologicalPreparedness 7
o GoodPracticesinanEmergency 9
o PersonalPreparedness 10
o LessonsinLeadership 10
o ThreeKeyResourcesonLeadership 11
Resources 14
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IntroductionWorsethanDesertStorm…Emergenciescanhappenanywhere.ThelessonslearnedfromKatrina,duringthestormanditsprotractedaftermath,haveuniversalapplicability.Theheroismofnursinghomestaffprovideslessonsinhumanityandcourage.Theleadershippracticesthatpreparedstafftorisetothechallengesexemplifythebestinleadership,inemergenciesandalsoindailyoperations.ThisfilmisapartofaprojectinitiatedafterHurricaneKatrinatoaddressthestaffingneedsofNewOrleansareanursinghomes.Theseneedsbecameparticularlyacuteinthemonthsthatfollowedthestormasresidentsandstaffbeganreturningtothedevastatedarea.Manyhomesevacuatedbeforethestorm;othersdidnotorcouldnotevacuateandstayeduntiltheywererescuedafterthecitywasmadeuninhabitable.Someneverstoppedoperations,despitethechaosaroundthem.Allfacedchallengesastheyworkedtoreturntofulloperation.Theirexperiencesvariedandyethadcommonthreads.Overthecourseofthreeyears,theprojectprovidedon‐siteassistanceandsharedlearningsessionstofacilitiesintheaffectedareas.Asthehomescomparedexperiences,theybecameawareofhowtheirowngoodpracticescontributedtopositiveresults.Togethertheysharedwaysofbuildingontheirexperiencesincrisisastheyworkedtoreturntonormaloperations.Sixofthehomesgraciouslyallowedustocapturetheirstoriesonfilmasawaytosharelessonslearned.Alltoldtheirstoriesinhopesofhelpingothers.Inthecourseoftheirtelling,bothextraordinarycharacterandexemplaryleadershiparerevealed.Whatemergedmostclearlyfromthestorieswasthatstrongleadershipandcommitmenttostaffbuiltbeforethestormservednursinghomeswellinatimeofcrisis.Wewitnessedcreativeandparticipatorydecision‐makingandthefosteringofrelationshipsthatallowedhomestobecomeemotionalhavensintimesofextremestress.Themostenduringtruthwelearnedisthis:Everynursinghomeisvulnerabletodisasters–bothnaturalandman‐made–andnoplanisinfallible.Thebestpreparation–andthebestresponse–istocareforstaff,becausepeopledobestinaclimateoftrustandteamwork,andwhentheyhavethesupporttheyneedtotakecareofresidents.ThisfilmisalsointendedasatributetothestaffofLouisiana’snursinghomeswhobroughtthousandsofresidentssafelythroughthestormandthedifficultiesthatfollowed.Oneofthestaffinthefilmsays,“disasterdoesn’tbuildcharacter,itrevealscharacter.”Whilethosestaffmembersinterviewedforthisfilmdisplayeddeepintegrityandcommitment,mostnursinghomesonmostdayshavethesamekindofpeoplefillingtheirranks.Mostnursinghomestafffindthattheworkofcaringforothersistrulyacallingthattheyrespondtoeveryday.
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UsingthisFilmThisfilmisintendedtopromotediscussion,generateideas,andserveasalearningtool.Thisguidehelpsyouextractlessonsfromthefilmaboutleadershippracticesandrelatedemergencypreparednesspractices.Itprovidesguidingquestions,highlightsgoodpractices,andidentifiesresources.MostpeopleheardsomestoriesaboutnursinghomesinNewOrleansduringKatrina.Almostallthecoveragefocusedontherareoccurrencesoftragedyandlostlives.Thisfilmtellsadifferentstory.Itisthestoryofnursinghomestaffwhokeptotherssafeandcaredfor,evenwhiletheirownsafetyandtheirownfamily’ssafetywasuncertain.Whataudiencesaresaying:
“Itshowedthecompassion”“Asareceivingfacilityitwasgoodtoseethewholepictureofwhatpeoplewentthroughtogettous–weknew‐butnotreally”“It’snotjustthetragedy–youshowedthepositives”
ThesearejustasamplingofcommentsheardwhenthefilmpremieredinLouisianainJune2009.Somenursinghomesplantousethefilmtohelpbuildteamwork;otherstoinspireempathy,compassionandunderstanding.Stillotherswilluseittohelptheirstaffhaverealisticexpectationsofwhatmaybeaskedoftheminanemergency,orwhenreceivingotherswho’vebeenthroughanemergencyevacuation.Thefilmcanbeusedinmanydifferentwaysbyanyoneaffiliatedwithnursinghomesandbythoseinterestedinarealstoryofhumanstrength,courageandcommitment.Usethefilmfor:
• Inspiration,Motivation,Appreciation–tosharewithstaff,asaninspirationalfilm,depictingthededicationofnursinghomestaff
• PreparationandEducation–tohelpstaffinnursinghomesandothercaresettingsthroughoutthecountrybeawareofwhatmaybecalledforintimesofdisasterorinbeingareceivingfacilitythattakespeopleinafteradisaster
• LeadershipDevelopment–toteachaboutanddevelopgoodleadershippractices• TeachingTeamwork–toarticulateconceptsandpracticesfor“beinginittogether”• Teachingwaystonurtureresilience–tosupportpsychologicalpreparedness;“steady
todaymeansreadytomorrow;”tobereadyforgoodleadershipandteamworkpracticesinacrisisbymakingthesepracticespartoftheday‐to‐day
• PlanningandCommunityAwareness–topromoteunderstandinginthecommunityaboutthesupportpeoplelivingandworkinginnursinghomesmayneedinadisaster
• SocialHistory–forknowledgeaboutahistoricalevent:howtheNewOrleansareanursinghomesrespondedduringKatrina
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Werecommendshowingthefilminitsentirety.TopicareasareeasilyaccessedsoyoucanreturntosectionsduringdiscussionusingthemenuprovidedontheCD.Theguidefocusesdiscussiononthethreeprimarythemes:
1. Preparation2. Nurturingresilience3. Practicinggoodleadership
Thefilmis49minuteslongandhasanintroductionandtwoparts:PartI:“Youcan’tjusthopeforthebest”
PartItellsthestoryofthesixnursinghomes’experiencesduringKatrinaanditsaftermath.Itdescribestheirpreparationfortheirstorm,gettingthroughthestormitself,andthenfacinganunprecedentedsetofchallengesasthecrisisgrewaroundthem.Thefilmcapturesbothindividualandorganizationalchallenges.Hearingdirectlyfromstaffastheytalkabouttheirexperienceshighlightstheseverityofthedifficultiespeoplefacedandhowtheysurvivedbyworkingtogether.Thissectionalsoillustratesthedegreeofplanning,preparation,andteamworkneededtosuccessfullyexecuteanevacuationofanursinghome.Ithelpsviewersthinkabouthowtheywouldpersonallyrespondtoasimilarsituation,andprovidesinformationabouteffectivepracticesindoingso.ItisthefoundationfordiscussionofwhatworkedinPartII.
PartII:“Sharingwhatworks”
PartIIcapturesreflectionsofstaffmembersfromthesamesixhomesastheysharewhatworked,anddescribesomeofthepracticesthatallowedthemtogetthroughthisdisasterandbackontheirfeet.Clearlyleadershipmadeadifferenceinhowthesesixhomesfared.Theirstoriesrevealleadershippracticesessentialtotheirsurvival,whichhadrootsintheireverydaywaysofleading.
FACILITATORTIPS:
• Asfacilitator,previewthefilmbeforeshowingittoagroup.• Allowparticipantsforreflectivetimepriortoandafterviewingthefilmtoabsorbits
emotionalimpact• Usepairedconversationand/orsmallgroupdiscussiontoallowspacefortheintimate
natureofthereflectionthefilmgenerates,inanysizegroup.• Theguideprovidessuggesteddiscussiontopics,andincludesresourcesonleadership.
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DiscussionGuidePriortoShowingtheFilmINTRODUCEFILM:
• Shareinformationabouthowandwhythefilmcameabout,usingthebackgroundfromtheAcknowledgementsandIntroductionsections.
• ShareanycurrentinformationyouhaveaboutrebuildingprogressinNewOrleans.DISCUSSION:AsktheaudiencetotalkinpairsaboutKatrina.Allowthisdiscussiontotaketime–itisapersonalreflectiontime.Possiblediscussionquestions:
1. WherewereyouwhenyoufirstheardofthedevastationinNewOrleans?Whatdoyourememberseeing?
2. WhatdoyourememberhearingaboutnursinghomesduringKatrina?
AfterShowingtheFilmGENERALDISCUSSIONAFTERVIEWING:Somepeoplemayhaveanemotionalreactiontothisfilm.Allowapauseafterthefilmends.Thenbeforeanyfocuseddiscussion,givetheaudienceafewminutestogathertheirthoughtsandshareinpairsorsmallgroupsbyinvitingpeopletodebriefonwhattheyjustviewed.Additionalgeneraldiscussion:asktheaudiencetoreflectbackonthediscussiontheyhadbeforeviewingthefilm.Askifafterviewingthefilm,theychangedwhattheyhadthoughtaboutthesituation.Havethemstartthisdiscussionintheiroriginalpairs,orinsmallgroups.
PSYCHOLOGICALPREPAREDNESSAskpeopletotalkinpairsforafewminutesabouthowtheymentallyprepareforsomethingstressfulorworrisome.ResourceInformation:Emergencypreparednessismultilayeredandeachlayeriscriticaltosuccess.Evacuationplans,shelteringplans,contingencyplansareallfornaughtifstaffandleaderslacktheemotionalreserveandfortitudetocarryoutthoseplans.Whenstaffsarepsychologicallyprepared,theyfeelconfident,competentandcaredabout,andnotonlycarryoutthoseplansbutdosoagainstallodds.Thiscapacityisoftencalledresilienceandisacapacitythatcanbedevelopedandnourished.AswithotherlessonsthatemergedfromKatrina,nurturingresilience‐whichwehavecalledpsychologicalpreparedness–beforethestorm,servednursinghomeswellinatimeofcrisis.Ifwearesteadytoday,wearereadytomorrow,nomatterwhattomorrowmaybring.
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Psychologicalpreparednesshasthreekeyingredients:1. Asenseofteam: WeareinthistogetherLeadersreinforcethisbybeingadailyvisiblepresence.Bywalkingabout,sayinghello,learningandaddressingresidentsandstaffbyname,sayingthanks,leadersconveyasenseofbeinginittogether. LeadersreinforcethisbyensuringtheneedsofstaffandtheirfamiliesaretakenintoaccountwhendevelopingevacuationplansLeadersreinforcethisbyrollinguptheirsleevesandworkingsidebysidewithstaff.Inshort,practicinggoodleadershipskillsbuildsasenseofteam.2. Asenseofconfidence: WecandothisStaffneedtohaveconfidenceinleadershipaswellasinthemselvesandeachother.Leadersearnconfidencebyregularlyprovidingaccurateinformationaboutemergencyplans,communicatingclearlyandoften,andestablishingclearroles.Leadersbuildconfidencebybeingcrediblewhichincludesbeingfair,consistentandreliable.Staffdevelopconfidencewhenleadersnoticeandpraiseajobwelldone(“catchmedoin’somethinggood”)androutinelysolicitandutilizetheirideas.3.Emotionalreserves: Wevalueyourhealth Promotingwellness‐instaffaswellasinresidents‐isahottopicinhealthcareandiscrucialtopsychologicalpreparedness.Goodhealthincludesbothphysicalandmentalhealth.Goodhealthhabitsandstressmanagementskillsboostbrainpowerandhelppreventdepletionofcriticalbrainreservesduringacrisis.Leaderssupporthealthinavarietyofwaysrangingfromprovidinghealthbenefitstoprovidingnutritiousfoodandensuringadequatesuppliestodothejob(astraightforwardwaytoreducestress).Leaderssupporthealthbymodelinggoodself‐care(“youroxygenmaskgoesonfirst”)andmaintaininganattitudeofoptimism.Leaderssupporthealthbyincorporatingstressbustersintotheworkplace(deepbreathing,laughing,stretching,takingabreak).DISCUSSION:Embeddedinthefilmarestepsleaderstooktoensurepsychologicalpreparedness:Howmanycanyouspot?Whatdoesyourorganizationhaveinplaceforpsychologicallypreparedness?
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GOODPRACTICESINANEMERGENCYYoucan’tjusthopeforthebestEmbeddedthroughoutthefilmareexamplesofgoodpracticesforevacuationsinadisaster.Livingthesepracticeshelpedthehomestogetthroughtryingtimesandmaintaintheirabilitytoprovidegoodcareevenonagymnasiumfloor.Thesesamepracticeshelpedstaffdealwiththecrisesthatensuedwhentheirbestlaidplansfellthrough.Theimportanceofbeingpreparedrunsthroughthisfilm.Thisfilmisidealasanaidfordisasterplanningorwhenyoureviewyourfacility’splanwithstaff.Ifyouareusingthisfilmasatoolfordisasterpreparedness,asktheviewerstowatchwithapencilinhandandtojotdownexamplesofgoodpracticesastheyseethem.Hereareexamplesofgoodpracticesthatyoucanhighlightandusetopromptdiscussionamongparticipantsaboutbestpractices.Theyarelistedalongwithsubsectiontitlesinthefilmsoyoucanreplaythemifyouwanttofocusinonaparticularareafordiscussion.DISCUSSION:Encourageparticipantstosharetipsandbestpractices,tohelpeveryonebebetterprepared.
• Onthebus:[Firstsectionin“Youcan’tjusthopeforthebest”]o Loadingabus:Thisisphysicallydifficultandisanenormousorganizational
undertaking.Haveyoueverdoneadrillinloadingabus?o Staffingonthebus:“Wehadnurses,CNAsandadministratorsonthebus.”Not
knowinghowlongtheridetotheirevacuationsitewouldtake,theymadesurethatthebushadadequatestaff,nomatterhowlongthejourney.
o Suppliesonthebus:“Wetookthemedicineincasearesidenthadaseizure.”EventhoughtheridetoBatonRougewasusuallylessthananhour,thestaffknewthatinaneventlikethiswouldtakemuchlonger.Sohavingmedicine,water,food,coolers,andcare‐relatedsuppliesonthebuswasanecessity.
o Systemsofchecksandbalances:Asystemforcheckingresidents,medications,andsupplieswasadheredto—“Youbringtheresidentstothebus,pickupthemedsfromthemedcartandcheckoffthattheresidentisonboard.”Tomakesurenooneisleftbehind,everywhere,includingclosetsarecarefullychecked.
• Attheevacuationsite:[“settingupshop”]
o Creatingasafespace:Astheypreparedtosetupshoponagymfloor,thehousekeepingstaffdisinfectedthemattresses.Keepingtheareawherecareisprovidedcleanisimportant.Howelsedidstaffinthefilmmaintaincleanliness?
o Communityassistance:“Wefindthatiftherearevolunteersinthecommunityatthereceivingend,peoplefeelwelcome.It’sjustsuchanupliftingthinganditreallyhelpsalotandthenifwecan[have]policemen,nationalguardsmentheretohelpoffloadthepatientsitreallydoesrelievealotofstress.’Doyouhavethe
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communitycontactsinplacetomakethishappen?Howdoyoudevelopthesecontacts?
• Planning,andHavingPlanB:[bestlaidplansand“I’mnotleavinganybody”]o Whenplanschange:RememberhowPatrickandKathyhadtomakePlanBwhen
theirevacuationsitewaschangedtoonethatcouldn’tsupportthem.Doyouhaveaback‐upplan?
o Courageinthefaceoftheunexpected:StaffatSt.Margaret’sDaughtersHomemovedresidentswhenthestormblewofftheroofoftheirshelter.StaffatChateauLivingCenterreadiedtomovetheirresidentswhentheyheardfloodwaterswerecomingtheirway.
o EmergencySuppliesandContingencies:[“itwashot”]Doyouhavethecapacitytocareforpeopleinapoweroutage?Doyouhaveworkingrelationshipswithrescuerswhocanbackyouupifyouneedit?
• CommunicationandStaffSupport:o Staff’sfamilies:[“Icouldn’tfindmyson”]Askstaffiftheyandtheirfamilieshave
createdanemergencyplan.Thisfilmcanbeusedasaspringboardfordiscussionabouthowyouplantosupportthosewhoevacuatewithyou.
o Backupcommunicationsystems:Howwouldyougetintouchwithpeopleandhowwouldtheygetintouchwithyou,intheeventofaregionaldisaster?
PERSONALPREPAREDNESSIfyouwouldliketoaskpeopletofocusontheirpersonalpreparednessandtothinkaboutwhatnursinghomestaffwentthroughasindividuals,herearesomesamplediscussionquestions:
1. Haveyouthoughtaboutwhatmighthappeninyournursinghomeifyouwereeverforcedtoevacuate?
2. Wouldyouchoosetoevacuatewiththehome,ortostaywithyourownfamily?3. Ifyoucould,wouldyoubringyourownfamilywiththehomeinanevacuation?4. Ifyouelectedtogowiththehome,whatwouldyoutake?5. Whatwouldthehomeneedtodotomakeitsoyouwouldchoosetogo?6. Couldyouliveinawingofanursinghome?Howmightyouseethingsdifferentlyifyou
livedwhereyouwork?7. Isyourfamilypreparedforadisaster?Doyouhaveplansforrelocationand
communication?8. Howdoyoukeepyourspiritsupwhenthingsarenotgoingwell?9. Doyouidentifywithanyoneinthefilm,andwhy?
LESSONSINLEADERSHIPTheleadershippracticesexemplifiedinthisfilmarerelevantnotonlytoemergencypreparednessbutalsotoeverydayleadership.Thesepracticescreateworkplaceswhere
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individualworkersthrive,andworkwellwitheachother.Workingwelltogetheriscrucialtobeingabletoprepareforandrespondtoanemergency.Itisalsocrucialforstaffretention.Goodleadershipisaskill,andlikeanyotherskill,themorewepracticeit,thebetterwegetatit.Katrinagavepeoplemanyopportunitiestoexerciseleadershipskills.MostofthetimelifedoesnotcomeatusquiteasfastasitdidforthosewholivedthroughKatrinaanditsaftermath.AdisastersuchasKatrinachallengespeoplecaughtinittobehaveinwaysthatordinarylifedoesnotcallforustodo.Clearlyleadershipmadeadifferenceinhowthesesixhomesfared.Theirstoriesrevealleadershippracticesessentialtotheirsurvival,whichhadrootsintheireverydaywaysofleading.Theirpracticesechothe“Level5leaders”JimCollinsdescribesinGoodtoGreat,JimCollinsasseeminglyordinarypeoplequietlyproducingextraordinaryresults.
THREEKEYRESOURCESONLEADERSHIPJimCollins,inhisbookGoodtoGreat,foundLevel5leadershiptobethemainingredientincompaniesthatwereabletomaketheleapfromgoodtogreat.SomeofthecharacteristicsofLevel5maybesurprising.Hetalksabouttheleadersbeinghumble,shy,gracious,self‐effacingandunderstated,yetfanaticallydriventopositiveoutcomesfortheirorganizations.CollinsnotedthatLevel5leaderschanneltheiregoneedsfromthemselvesandintothelargergoalofbuildingagreatcompany.HeespeciallyhighlightedthewayLevel5leaders“createaclimatewherethetruthcanbeheard,”usingfourkeypractices:
• Leadwithquestions,notanswers• Engageindialogueanddebate,notcoercion• Conductautopsieswithoutblame• Build“redflag”mechanisms
InTheLeadershipChallenge,apopularevidencebasedmanualonleadership,KouzesandPosnerfoundfivefundamentalpracticesthatenabledleaderstogetextraordinarythingsdone:
• Modeltheway• Inspireasharedvision• Challengetheprocess• Enableotherstoact• Encouragetheheart
SusanEaton,inher2002CMS‐fundedstudy,Whatadifferencemanagementmakes!,appliedleadershipconceptstonursinghomes,comparinghighandlowturnoverhomes.Sheidentifiedthefollowingkeymanagementpracticesatnursinghomeswithhighretentionandhighperformance:
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SeeResourceSectionformoreinformationabouthowtoobtaintheseresources.DISCUSSION:YoucanintroduceKouzesandPosner,andEatonpriortoshowingthefilmandaskviewerstowatchforexamplesoftheseleadershippractices,oryoucansharethisleadershipinformationafterthefilmisviewed.Askpeopleaboutleadershippracticestheysawinthefilm,and/ortosharebestpracticesinleadershiptheyareawareofintheirownworkplaces.LinktothepracticesdescribedinthesectiononPsychologicalPreparedness,aseverydaygoodleadershippractices.Youcanreplaysectionsthathighlightcertainpractices(asnotedbelow).Useanycombinationofthesepracticesasaspringboardforfurtherprobing.Otherpossiblediscussionquestions,withreferencestosubsectionsoftheguide,include:
• GoodLeadership:Whatmakesagoodleader?Selectquotesfromfilmthatspeaktothisissue“intheirownwords.”
• Goodleadershippriortoanevent/Goodpreparation:[“What’sthestory?What’stheplan?”]Askviewerstorespondtothefollowingquotefromthefilm:“Ifyoueverhavetohaveanevacuationoryouhavetogothroughsomethingtothisextent,Ihopethatyouhaveyourdailybusinessincheck.Becauseifyoudon’t,youwillprobablyfail.”Whatdotheythinkaboutthis?Whatisneededinthedailybusinessofleadershipinordertobesuccessfulinanevacuation?
• Communication:[“What’sthestory?What’stheplan?”]Communicationisessentialforanyorganization’ssuccess–whetherinsurvivingadisasterorretainingstaff.Identifyspecificexamplesofgoodcommunicationpracticesbysomeoftheleadersinthisfilm.
• ValuingStaff:[“Iknowwhatyou’regoingthrough”]Wouldyousaytheleadersinthisfilmvaluedtheirstaff?Respectedthem?Discovered–orre‐discovered–theircommonhumanity?Giveexamplesofeach.
Five Organizational/Management Practices Associated with High Retention, Attendance, and Performance From What a difference management makes! by Susan Eaton, 2002
“A Positive Chain” of high quality
leadership throughout the organization
Organizational practices that value staff in
policy and practice, in word
and deed
Human resource policies and
practices that invest in and support staff
Organization and work design to
reinforce intrinsic motivation of staff to
care for residents
Sufficient staffing and resources to provide humane
care
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• EnablingOtherstoAct:[“Ithinkwecanrunwiththis”]Onekeydimensionofgoodleadershipisenablingotherstoact.Discussexamplesinthefilmandthendiscussthewaysinyourorganizationthatyouenableotherstoact.
• ParticipatoryLeadership:[“Ithinkwecanrunwiththis”]o WhatdidyouthinkwhenBobsaid“I’llstealanyidea.Ifit’sworkingsomewhere,
I’llstealit,I’mnotproud.” Self‐check:Doyouseekoutgoodideasfromyourstaff?Ifso,whatis
yourmethodforgettinggoodideasfromstaff?Doyourewardgoodideas?
o DiscusswhatKellieandDenasaid,that,”Everyonehassomethingtoofferandyouvaluetheiropinion.Andwe’vecarriedthatforwardalotsincewe’vebeenback.Whenwe’remakingpolicychangeorbigdecisions,weinvitethepeopleinit’sgoingtoeffectandsayhowwillthisreallyaffectyoubecauseyoudothejobdaytoday.”Howdoyou/canyoumakethatoperationalwhereyouwork?
• TakingCareofStaff:Somenursinghomesdescribedprovidinghousingfortheirstaffafterthestorm.Whatdoyouthinkofthat?Howisitacomponentofgoodleadership?
• Ingenuity:[“Ithinkwecanrunwiththis”]Inthefilmtherewerenumerousexamplesofingenuity.[PortaJohns,cuttingupthetowels,themake‐shiftlaundry,buildingashower,contaminationsigns]
o Whatstruckyouasparticularlyingenious?o Self‐check:Areyourstaffabletotakeinitiative?Ifso,howdoyouencourage
them?Whathappensifagoodideadoesn’tworkoutaswellashoped?• DevelopingLeadershipinOthers:Howdidtheofficialleadersinthesehomesdevelop
theleadershipabilitiesofthosearoundthem?• BeinginCommunity:[“inittogether”and“eggsalad”]
o Whatdidstaffsayaboutteamworkandhowleaderspromotedit?o HowdidleadersModeltheWay?o Whatrelationshipsdoesyournursinghomehavewithothersinthecommunity
whoareresponsibleforcoordinatinglocalorregionaldisasters?
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ResourcesOtherresourcesthatyoumightfindhelpful:WhatYouDoMattersACurriculumforStaffStabilityThistrainingcurriculumistheculminationoftheLakeCharlesNursingHomeStaffingProject,ayear‐longlearningcollaborativedesignedtohelpnursinghomesintheLakeCharlesregionstabilizestaffingandresumetheirculturechangejourneyafterHurricaneRita.Themanualgivesparticipatinghomesawaytoreviewandrenewtheirworkandprovidesanopportunityfornon‐participatinghomestounderstandandusetheworktomakepositivechanges.Themanualincludesallofthematerialspresentedatthefourlearningsessionsalongwithinstructionsfortheiruse.ItisavailablebycontactingtheGovernor’sOfficeonElderAffairs,OfficeoftheStateLongTermCareOmbudsman,[email protected].
StaffStabilityToolKitbyB&FConsultingforQualityPartnersofRhodeIsland:Providespracticalguidanceforimprovingretentionandstabilizingday‐to‐daystaffing.Availableatwww.riqualitypartners.org.Clickon“HATChmodel”andthenon“Workforce.”GoodtoGreatbyJimCollinsarticulateswhatittakestogofromjustbeinggoodtobeinggreat.Itdescribesleadershipandorganizationalpracticesthathelpcompaniesexcel.TheLeadershipChallengebyJamesKouzesandBarryPosner:Writtenasafieldguidetoleadership,itidentifiesfivepracticesofexemplaryleadersanddescribeshowtoimplementthesepracticesineverydayleadership.Whatadifferencemanagementmakes!bySusanC.Eaton,commissionedin2002bytheCentersforMedicareandMedicaidServices(CMS):Comparesnursinghomeswithhighandlowturnovertoidentifymanagementpracticesthatcontributetoturnoverandpracticesthatcontributetostability.Availableonthewebat:www.BandFConsultingInc.comFromInstitutionaltoIndividualizedCarePartFour:The“How”ofChange:Whatadifferencemanagementmakes!aCentersforMedicareandMedicaidServices(CMS)SatelliteBroadcastandWebcastairedonFriday,September14,2007.Identifiespracticesthatsupportgoodleadershipintimesofchangeavailablethroughwww.Pioneernetwork.net
NewOrleansNursingHomeStaffingProject:ResourcesandmaterialsusedforlearningsessionsfromNovember2,2006throughJune30,2009,canbefoundat:http://www.lhcr.org.Clickon“NursingHomes”andthen“Workforce.”
Formoreinformationcontact:
B&FConsulting,Inc.‐‐www.BandFconsultinginc.com
SusanWehryMD‐‐http://web.me.com/swehrymd