IN THIS ISSUE:
Communication Corner--Creating innovative cultures
News You Can Use--Preventing falls in long-term care
The Leading Edge--Maximizing your time
Just for Fun--Signs you're getting old
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Building an Innovative Culture
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Many healthcare executives and managers seem to think that innovation requires a dramatic input of time, energy, and money. However, this is simply not so. You can build a creative, innovative culture in practical, low-cost ways. Whether you're trying to brainstorm on a new marketing plan, plan a company outing, or implement a new procedure, there are some simple steps you can follow to help open the door to innovation:

Build a temporary cocoon
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When you bring people together to innovate, make sure that the outside world is completely sealed off. Close the door and turn off all cell phones, pagers, etc. Also, make sure that employees leave all planners and paperwork behind, as these items can cause distraction and force people to lose focus. Use a whiteboard or Post-It notes to document ideas.

Stop thinking like an employee and start thinking like a customer
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Innovative ideas at your healthcare organization won't be worth much if they don't bring value to your patients/customers. Remember, customers' needs are what matters, not yours. To achieve true innovation, always remind your people to think like a customer.

Add variety
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While it may seem counterintuitive, include people who have little or no knowledge about the specific issue/topic you are meeting about. These individuals (perhaps employees from different departments) may be able to ask the questions you're overlooking or raise issues you've never contemplated. Their fresh perspective can prove invaluable.

Give it time
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It's unlikely that you'll produce the best, most innovative ideas in just one day. So, after the individuals have generated some ideas, give them some time away from the group to mull it over. In a few days, have the group meet again--invariably, new and better ideas will develop.

Remember that two is usually better than one
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Successful collaboration depends on merging two or more ideas together to generate even better ideas. Experiment and ask the group to look for combinations that are likely to achieve positive results.

Put it to the test
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Build a prototype of the idea and implement it on a small scale, before you fully roll it out to the entire organization. This way, you will be able to recognize any shortcomings, and correct them from there. Additionally, the feedback you receive from your focus group will help you predict what kind of reactions you're likely to receive from the rest of the company.

Execute, execute, execute
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Many groups move through the above steps only to lose their focus before full implementation. Avoid this by determining timelines, and more importantly, stick to them. Don't allow the test phase to drag on--quickly address and correct the issues you run into and move on. Remember, innovation is only complete when the idea is tested in a real market situation. So, make sure to follow through!

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"Don't worry about people stealing an idea. If it's original, you will have to ram it down their throats."
--Howard Aiken

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Preventing Falls in Long-Term Care

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Slips, trips, and falls are a big issue for long-term healthcare organizations. Not only do they pose a serious risk to patients, but also to the organization itself. In fact, an injurious fall increases nursing home costs by $5,325 a year. And experts suggest that if fall rates and treatments remain unchanged, there will be:

*An increase in the number of hospital beds needed to treat falls.
*An increase in nursing home beds to house fall survivors.
*A double increase in overall health system costs due to falls

Falls are more common among nursing homes for various reasons. For example, nursing home residents tend to be older, have more cognitive impairments, and have greater limitations in their activities. They also tend to have more chronic illnesses, be physically dependent, and have a higher prevalence of walking problems--all factors associated with falling.
Specifically, the most common causes of nursing home falls are as follows:
Weakness and walking problems are the most common causes of falls among nursing home residents.

Environmental hazards account for 16% to 27% of nursing home falls. Such hazards include wet floors, poor lighting, lack of bed rails, clutter, incorrect bed height, and improperly maintained or fitted wheelchairs.

Medications, especially psychoactive drugs such as sedatives and anti-anxiety drugs, can increase the risk of falls and fall-related injuries.
Other causes include difficulty in transferring (for example, moving from the bed to a chair), poor foot care, poorly fitting shoes, and inappropriate or incorrect use of walking aids.

Practicing Prevention
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Perhaps the best news about falls in long-term healthcare settings is that they are largely preventable. Effective fall prevention includes a combination of medical treatment, rehabilitation, and environmental modification. Interventions include:

*Assessment after a fall to identify and address risk factors and treat underlying medical conditions.
*Physical conditioning and/or rehabilitation using prescribed exercises to improve strength and endurance.
*Environmental assessments and modifications to improve mobility and safety such as installing grab bars, adding raised toilet seats, lowering bed heights, and installing handrails in the hallways.
*Review of prescribed medications to assess their potential risks and benefits and minimize use.
*Providing patients with hip pads that can effectively prevent most hip fractures if a fall occurs.
*Technological devices such as alarm systems that are activated when patients try to get out of bed or move unassisted.
*Incorporating these steps will certainly take time and resources. However, when you realize the benefits of fall prevention, it will all be worth the cost and effort.
Source: Centers for Disease Control and Prevention & Med Div Assoc. 4:95-97, 2003.

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Fast Facts on Falls

Each year, a typical 100-bed nursing home reports 100 to 200 falls. Many others go unreported.

As many as 75% of nursing home residents fall annually.

Patients often experience multiple falls--2.6 falls per person, per year on average.

About 35% of fall injuries occur among non-ambulatory residents.

Falls can result in decreased physical functioning, disability, and reduced quality of life.

Loss of confidence and fear of falling can lead to further functional decline, depression, feelings of helplessness, and social isolation.

Source: Centers for Disease Control & Prevention
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Cheryl Boldt, a Maun-Lemke consultant presents an excellent program entitled "Falls: What you don't know hurts." This program teaches participants to:

*Understand concepts related to customary routine of residents
*Gain increased support from friends and family members as partners in fall prevention
*Assess your facility "routine" for toileting, meal service, snack pass, restorative and activity programs to determine if the services provided are conducive to fall prevention
*Assess your facility environment to assure it is conducive to fall prevention
*Assure staff competencies r/t fall prevention interventions they provide

If you are interested in this program, please contact Kathy Cain at 1-800-356-2233, she will be happy to answer any questions you may have. If you would like to read more about Cheryl Boldt and her programs please visit http://www.maunlemke.com.

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Are you managing your time, or maximizing it?
How to make the most out of your workday
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The top performers at your healthcare organization don't focus on managing their time. They concentrate on maximizing their time. Right now, you may be asking, "what's the difference?" And, in a nutshell, there's big difference.

Employees who just simply manage their time want to be told what to do. They seek clarity and direction in their work, and if something goes wrong, they can always say, "but I did exactly what you told me to do." While these types of employees are not necessarily undesirable, they tend to lack initiative as well as the desire to think proactively.

Conversely, employees who maximize their time are always thinking of the future. They quickly identify the desired end results and base their day around achieving those results. And if things happen not to work out, they usually say, "I focused on the wrong priorities. I need to evaluate what worked and what didn't, and try again."

Healthcare organizations that push their employees to maximize their time rather than manage it are more likely to succeed because individuals are expected to think for themselves. Promoting this kind of philosophy allows everyone to focus on accomplishing their own tasks; supervisors don't have to waste valuable time micro-managing, and making sure other employees are doing exactly as they are told.

Here are five steps to help you and your employees maximize the workday:

*Think of the end result first. While some of your daily tasks are most likely non-negotiable, there are probably a few that you have control over. In these situations, you need to think about the tasks that will produce the greatest positive impact on the organization. Before you do anything, think about the end result(s) you would like to see.
*Ask yourself who will benefit from these results? (Hint: if you're the only one who will benefit, you're on the wrong track.) In addition to looking at the benefits, it is important to identify the downside of each end result. If there are any downsides, identify any alternative ways to go about the task that would eliminate them. From this point, you can now begin to work backwards as to how you will achieve your goals.

*Prioritize and Itemize. Prioritizing is determining what needs to get done and in what order. So, once you have clarified the desired end result(s), you need to determine the three to four main priorities that are necessary to accomplish your task.

*Put it on paper. For each priority, write down the actions that need to be taken in order to successfully implement it. After you have written down all of the necessary activities, begin to organize them in chronological order. (Note: This step isn't intended to take a large amount of your time. The idea is to quickly get your agenda on paper, so you'll have something to refer to later.)

*Incorporate of the details. One very important, but often missed step to maximizing your time is scheduling for details. No matter what, you need to give yourself some time for the unexpected items that will inevitably pop up. Deciding how much time to schedule often times may be a guess, however, if you don't allot any time to tie up the loose ends, you won't get the task done right, or perhaps at all.

*Learn to say "no." Learning to say "no" can be difficult, but it is a necessary skill if you want to stay focused on maximizing your time. You shouldn't allow anything to interfere with your schedule designed to drive better results. This often means having the courage to say "no" to your co-workers and boss. Just remember to say "no" in a polite and professional manner. For example, you can say, "At the moment I'm working on this project. However, let's look at our calendars and set up a time to discuss your idea."

Ultimately, employees who maximize their time achieve meaningful results--for themselves as well as the organization. However, the best, most efficient things to do aren't always the easiest to do. So don't feel alarmed if you and/or your employees need some time and adjustment to incorporate these steps into the daily work routine.
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"There is still no cure for the common birthday."
--John Glenn

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Signs You're Getting Old
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Doesn't it seem like just yesterday that we were bringing in the New Year? And now we're already welcoming spring! As the saying goes, time flies. If time is quickly slipping through your fingers, you may certainly be able to relate to these "aging signs."

*Your back goes out more than you do.
*You quit trying to hold your stomach in, no matter who walks into the room.
*You are proud of your lawn mower.
*Your best friend is dating someone half their age, and isn't breaking any laws.
*Your arms are almost too short to read the newspaper.
*You sing along with the elevator music.
*You would rather go to work than stay home sick.
*You enjoy hearing about other people's operations.
*You no longer think of speed limits as a challenge.
*People call at 9:00 p.m. and ask, "Did I wake you?"
*You answer a question with, "Because I said so."
*You send money to PBS.
*You take a metal detector to the beach.
*You know what the word "equity" means.
*Your ears are hairier than your head.
*You got cable for The Weather Channel.
*You have a party and the neighbors don't even realize it.
*You're asleep, but others worry that you're dead.
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