Page 20 - Tale of Transformation

ATTRIBUTES STAGE 3
Decision-Making
• Learning circles and other group processes
encourage real input – it’s no longer symbolic
• Daily life decisions determined by group process
Staffing
• Staff are permanently assigned and rarely float across neighborhoods
• Work in self-directed teams lead by coordinator
• The administrator, DON and Dept. heads may work
evenings shifts and/or weekends
• Staffing schedules are more flexible
Physical Environment
• Decentralized dining offered without full kitchen • Some food prep is done closer to the residents • Nursing stations and med carts are still used but
often less intrusive and more home compatible
Organizational Structure
• Neighborhood coordinator position is formalized
and added to the worker’s primary duties on the
neighborhood team
• Org chart emphasis is resident-centered
• Neighborhoods are often named by the people
who live and work within to create identity and a sense of community
Leadership Practices
• Leadership becomes more decentralized
• Many decisions made by consensus in neighborhood teams
• Leaders develop skills in conflict management
19
How to Progress
From the Transformational to the Neighborhood Stage
in Staffing
Once you have consistent assignments you can begin to focus on some level of self-scheduling.
It is helpful to have block schedule (a repeating two-week pattern) because the schedule is the same each pay period.
Form a self-scheduling team working out a block schedule. There can be some variation in the block from pay period to pay period, giving the self-scheduling team some flexibility in meeting staff needs. It also works well to have two different blocks, rotating over 2 pay periods.
As self-scheduling becomes more sophisticated and successful in the life of the neighborhood, the neighborhood team can begin to talk about varying schedules for resident preferences and relaying these decisions to the self-scheduling team. The most obvious variation can be to adjust for neighborhoods where residents are sleeping in. This may be as simple as asking one CNA slot to start an hour later and work an hour later in the day. Any adjustments made need to be carefully thought through for all intended and unintended consequences, discussed beyond the neighborhood for implications, and evaluated against all regulatory issues. But consider the possibilities – if we can reasonably adjust an hour or two from the morning to a late afternoon or an evening hour, we may be able to focus more on the social experience at supper.
Each schedule should cover a specific group of residents. Staff on the schedule should have the opportunity to know each other and work together regularly.
A team of workers sit down on a regular basis. Staff will have knowledge of the membership of the team and a process to submit all the requests for time off and vacations. The team needs to have a commitment to fairness and equality, needs to know the parameters (wage and hour rules, union seniority agreements, overtime expectations, need for certain skills scheduled in any one time period
– i.e. medication aides and any other scheduling rules). The team also needs to have established rules of order for the self-scheduling process. Person previously responsible for this scheduling and Human Resources (or appropriate knowledge bearer) should provide all existing parameters and assist in establishing the initial rules, and perhaps sit with the team until it becomes skillful in the process.
As the team progresses in its own skills, it should also teach at the neighborhood team meetings. Gradually everyone will understand the process, and can work to drop their own hours into the schedule with the team meeting to work through the various conflicts of time and schedules according to the well-understood rules.