Mount Carmel A Bedtime Story Once upon a
Mount Carmel
A Bedtime Story… Once upon a time…
The Castle Facts n 258, 978 square feet on 23 ½ square acres n All on one floor n 457 beds n Over 575 villagers (employees) n 9 Nursing Units
The Floor Plan Of The Castle
The Castle n n n The castle is licensed for Medicare and Medicaid Mount Carmel accommodates both long-term and sub-acute residents. The castle averages 94% to 95% capacity at all times.
A History Of The Castle n n Established in 1958 Additions added in 1963, 1972, & 1986. Governed by a variety of different bodies over the years Currently managed by Benedictine Health System (BHS) of Duluth
Woods And Forest n n Greenfield is a small blue-collar working class community, where tradition and commitment flourish Newer smaller castles all jousting for the same employees
Trials And Tribulations In 1998 the castle was cited for 122 deficiencies, pushing Mount Carmel into a decertification
Benedictine Health System (BHS) Entered The Kingdom Through the collaborative efforts of BHS, Clement Manor, and the residents of Mount Carmel and their families, the doors were kept open…BHS continues to manage us today. With the drawbridge down and welcoming.
Benedictine Health System - History n Benedictine Sisters Benevolent Association establishes BHS in 1985 with three facilities n n Benedictine Health Center, Duluth, MN St. Joseph’s Medical Center, Brainerd, MN St. Mary’s Medical Center, Duluth, MN Bed complement in 1985 n n 445 Acute Care 120 Long Term Care
Benedictine Health System - Purpose n In 1985, the Benedictine Sisters of St. Scholastica Monastery established BHS to: n n n Further the Benedictine healthcare mission Efficiently and effectively manage the healthcare resources of the BSBA Increase the involvement and participation of the laity in the expanding Benedictine healthcare ministry.
Benedictine Health System - Today n n BHS owns and/or manages more than 60 health care facilities across 9 states Bed complement n n 818 Acute Care 4, 235 Long Term Care 584 Assisted Living 769 Independent Living
January 29, 1999 was the Drop Dead Pass/Fail Recertification Date… And we did it… The Kingdom stayed open!!
BHS Meetings With The Villagers Sharing the: Future Vision of Mount Carmel New administrative team was Knighted
BHS: Our White Knight The Royal Family then began improving quality systems throughout the land.
THE ROYAL FAMILY The King n n In January of 2002 a new king was crowned Administrator Mike Berry NHA Ruled other lands for over 33 years The Queen In January of 2002 a new queen was crowned Cheryl Waber RN, DON n Compassionate nurse who cares deeply for the people of her kingdom n
Storm Clouds On The Horizon
Trouble Is Brewing Over the years the kingdom went through a series of transitions following the trials and tribulations of 1998, which included: n n All departments were asked to review and reallocate their resources. Nursing was using an increase in the amount of agency staff.
THE DRAGON As the 2003 budget loomed near, the increasing cost of agency staff caused the fire breathing dragon to rear its head… It was obvious something had to be done.
THE DRAGON In 2002 the average cost of nursing temp. staff was $117, 000 month
KINGS ADVISORS AND COURT In February 2003 the King met with his advisors: n REDUCED POOL n n n Job Fairs Caribbean cruise drawing for successfully recruiting a nurse Increased amount of sign on bonus (still in place today) College recruiting ( Marquette and UWM) Adjusted nurse wages to be more competitive Contracted with agencies for reduced rates FIGHT THE DRAGON!
Preparing To Fight THE DRAGON
Fighting The Dragon Met with the agencies: n n n Limited the number of agencies from 15 to 5 Negotiated lower rates Notified the agencies that we were going agencyfree… and they laughed !!! n Then we recruited their staff, and… we laughed!!!
We Fought A Good Battle In 2003 the average cost of nursing temp. staff was $44, 592 month vs $117, 000 in 2002
We Wounded The Dragon! But he was not yet defeated….
What Should The King Do? The King knew that he would need MAGIC of some kind to slay this fierce dragon…
The Wizard He decided to consult a Wizard (Clint Maun) and his collaborator, the Sorceress (Cheryl Boldt)
Clint Maun
A Little About The Wizard n n Hails from the Kingdom of Omaha Well recommended and experienced in. . DRAGON SLAYING !!!
Privy Council n The Wizard had a Magical Plan to help the king slay the dragon. n n In order to execute the Magical Plan, the king needed to appoint a Privy Council. He gathered together some of the brightest and most talented villagers in the kingdom.
Qualities Of The Privy Council Qualities included: n n n Movers and shakers Self-motivated Not afraid to jump right in up to their elbows Willing to take risks Global thinkers Truly committed to the residents and each other.
Privy Council Lady Catherine Brown Lady Anne Guetersohn Dedicated to the villagers providing human resources support using innovative thinking, and fairness to all of the villagers. An assistant to the king like no other, allowing compassion and kindness to shine in all of her interactions with the villagers.
Privy Council Lady Carrie Weber Lady of Darkness who, with her energy and zest for life, energized the Privy Council and kept them laughing, yet still focused on slaying the dragon. Lady Kari Schmidt Lady of Light who, with persistence and tenacity kept the Privy Council focused on the needs of the kingdom as a whole with an emphasis on equality.
Privy Council Lady Sandy Miller Lady Stephanie Rose Offers commitment and innovative thinking with experience from other lands. A visionary who jumps right in and gets the job done with exuberance and emphasis on detail.
Privy Council Lady Laure Zulkowski A soft-spoken leader, whom with intelligence and grace has led the kingdom to many successes. Sir Robert Radke An experienced leader with the ability to analyze a situation and provide solutions using critical thinking.
Privy Council Lady Dori Schell Lady Peg Napientek Offers critical thinking and new ideas A honest and kind teacher who can think globally Lady Mary Torrence Kindness and compassion allow her to staff the Village and keep the dragon at bay.
Privy Council These hand-picked villagers of the kingdom came together, under the direction of the Wizard and his Sorceress, to execute the strategic plan and aid the King and Queen in slaying the dragon.
We Needed To Prepare For Battle
The Magical Plan The Wizard had a Magical Plan entitled the… SUPER TEAM With a mission statement focusing on the elimination of agency staff (THE DRAGON)… while emphasizing quality systems of care throughout the kingdom.
Super Team But we knew that we had to “eat the elephant one bite at a time” (or in this case…THE DRAGON)
Privy Council Deliberates n n The Privy Council, in all of their infinite wisdom, knew they had to approach slaying the dragon from many different directions. They adopted the Mighty Wizard’s Super Team plan, but had to break it down into workable strategic phases.
Developing The Plan n They started by renaming themselves the mighty FOREST RANGERS …. therefore developing cohesiveness and strengthening the relationships within the Privy Council. This team then brought the Wizard’s Magical Plan into being on August 4, 2003
Forest Rangers They knew that measurable goals were needed thus… It was decided to adopt a 24 week plan to eliminate agency Hoping to rid the Kingdom of THE DRAGON once and for all!
The Magical Plan The Wizard knew the Magical Plan was only as good as the sum of its parts The Wizard emphasized MAGIC in each phase of the plan.
Breaking Down The Magical Plan The Forest Rangers knew that each of these phases had to be tackled one at a time. A proclamation went out to all of the Villages that the Magical Plan was coming.
The Villages In the kingdom the Villages exist in groupings known as Hub 1: Chestnut, Willow and Elm Hub 2: Spruce, Cedar, and Pine Hub 3: Hickory, Cypress, and Oak
The Floor Plan Of The Castle
A Method To Our Madness Phase I: 1. All of the Villages on NOC shift would be agency free by August 18, 2003 The fair Lady Carrie, Lady of Darkness, in charge of the villagers on NOC shift, proclaimed that they would be first to be free of THE DRAGON’s influence 2. Villages: Cypress, Cedar, and Willow would be Agency Free by October 31, 2003
A Method To Our Madness Phase II: n Villages: Oak, Elm, and Pine would be Agency Free by December 30, 2003 Phase III: n Villages: Hickory, Spruce, and Chestnut would be Agency Free by January 23, 2004
A Strategic Battle Plan The phases were chosen with great deliberation and thought from all the members of the Privy Council. n They chose to tackle the Villages that were using the least amount of agency first
Visionary Thinking n n n This forward thinking group of people knew that slaying THE DRAGON and getting rid of agency staff would not be enough to maintain quality systems in the kingdom. Recruitment and Retention was the key to remaining agency free The Magical Plan would also have to include ways in which to give the Villages more autonomy to fight their individual battles, therefore strengthening the kingdom as a whole.
One Great Unit n n At this time the Privy Council decided to enlist the help of the Wizard’s trusty Sorceress Cheryl Boldt She presented them with the mystical concept of turning each of the Villages into: ONE GREAT UNIT(S)
Cheryl Boldt
A Strategic Battle Plan The Sorceress knew that the kingdom had to have all of the Villages on the same page in order to best fight: THE DRAGON
A Strategic Battle Plan The SUPER TEAM plan was for all of the Villages…but each Village has very unique and individual qualities and are in different stages of governing themselves. Thus the Magical Plan was modified to capture the Village’s individual strengths, yet maintain equality throughout the kingdom.
Support From The Privy Council met: n Using suggestions from the Wizard and the Sorceress the council created support for the Villages to execute the Magical Plan. n They identified first that the culture of the kingdom would have to be changed… We had learned to live with the dragon!
Changing The Culture Of The Kingdom The Villagers had become comfortable with the dragon lurking about, but the Privy Council knew that the dragon had to be slain… n n n Multiple resources were needed Each Village would have to become stronger. The Villages needed to work together to conquer the dragon Thus Sub-Councils were formed
Sub-Councils n n n The Privy Council identified the weaknesses and strengths of the kingdom and created Sub -Councils. Each Sub-Council was led by a member of the Privy Council. Sub-Councils were specialized teams focusing on specific areas that needed to be addressed.
Convincing The Villagers These teams were needed to help the villagers execute the Magical Plan. n Some of the villagers do not believe the dragon can be slain… n n n They had heard it before and it never worked. Why would it work now? What does it mean for the villagers?
Would The Villagers Be Convinced? n n Even if they could slay the dragon, would there be enough villagers in the kingdom to take the place of the agency staff? Are the individual Villages ready to commit to the Sorceress’ plan and adopt the One Great Unit concept?
Could The Villagers Be Convinced? The Privy Council thought so… and the Wizard and the Sorceress were certain it could happen… but… Could they convince the villagers?
Everyone United Together n n The Sub-councils needed to consist of villagers who were prepared to fight the dragon… and the people who did not think the dragon could be slain. By keeping the dissenters close, the Privy Council felt there would be a better chance for success in their battle against… THE DRAGON!
Only by fighting THE DRAGON as a united front could the kingdom and its Village be free of this menace forever!!
Can The Kingdom Survive?
n n Would the villagers rise up? ? Will the dragon be slain? ? What other magic does the Wizard see in his crystal ball? ? Does the Royal Family get dethroned? ? Stay Tuned….
Questions? End of Chapter 1
Break between Chapters
Welcome back to our story… Chapter 2
THE DRAGON
Where we left off… n n THE DRAGON still lurks on the horizon, sucking the life’s blood out of the Villages. The villagers have gathered together to take on this menacing force of nature and are prepared for battle!
Magic In The Super Team Plan The Privy Council continues to consult with the Wizard and the Sorceress on executing the SUPER TEAM plan.
Sub-Councils Lead The Villagers n n Sub-Councils are organizing Some villagers continue to be skeptical, but THE DRAGON has to be slain.
Focus On Strengthening The Sub-councils The Wizard encouraged the Privy Council to continue with their endeavors, and focus on strengthening their Sub-Councils. He knew this was the route to success.
Magic At Each Stage Of Creation The Sub-Councils had to have the same MAGIC at each phase of their creation that the SUPER TEAM did. Quality had to be built in to each stage.
A Method To Our Madness Phase I: 1. All of the Villages on NOC shift would be agency free by August 18, 2003 The fair Lady Carrie, Lady of Darkness, in charge of the villagers on NOC shift, proclaimed that they would be first to be free of THE DRAGON. 2. Villages: Cypress, Cedar, and Willow would be Agency Free by October 31, 2003
A Method To Our Madness Phase II: n Villages: Oak, Elm, and Pine would be Agency Free by December 30, 2003 Phase III: n Villages: Hickory, Spruce, and Chestnut would be Agency Free by January 23, 2004
A Strategic Battle Plan n In conjunction with fighting THE DRAGON we were improving quality throughout the systems by concentrating on our strengths and weaknesses via our Sub. Councils.
The Battle Continues n n Units that were using the least amount of agency were chosen to be tackled in Phase I. The bigger hurdles were saved for later as the level of expertise increased in the Villages.
Magical Plan n n As mentioned earlier the plan to slay THE DRAGON was in place, now was the time for action. At the same time it was also time for action in addressing the weaknesses and strengths identified earlier by the Privy Council.
It was time to launch the Sub -Councils.
Talent Team Talent was a STRENGTH in all the lands: n n Talent team: This Sub-Council reviewed the talents currently available in the Villages, and how these attributes could be tapped. Therefore Lady Catherine and Lady Anne, with the help of their team placed an ad in Ye Olde Milwaukee Journal with the proclamation describing the talents and expertise of selected exemplary villagers.
Ye Olde Milwaukee Journal n n The goal of this was to personalize the ads to the specific needs of each One Great Unit (s). Therefore bringing new villagers into the kingdom who would have the talent to fill these needs.
Education Team Education was a WEAKNESS in all the lands: n n Education team: Initially this Sub-Council focused on improving the overall knowledge in the kingdom as well as teaching the villagers how to have fun at work. ( FISH video) The long range goal was expanding on the current Mentor Program which was not being consistently executed.
Education Team n Lady Peg and Sir Robert with their team led the kingdom to embrace new villagers, while promoting recruitment and retention.
Resource Team n n n Resource was a STRENGTH in all the lands: Resources Team: This Sub-Council was created to analyze and better allocate the wealth and monetary resources scattered throughout the kingdom. This team of analysts provided statistical input related to agency use and identified trends.
Resource Team n These identified trends allowed the team to better pinpoint vulnerable points of THE DRAGON. Hours of Agency Use By Units 9/9/03 – 9/14/03
Turf/Territory Team n n n Turf/Territory was a WEAKNESS in all the lands: Turf/Territory Team: This Sub-Council focused on the villagers having shift and departmental wars. Lady Dori and her team introduced the Problem=Solution Policy to all the Villages in hopes to bring a sense of unity throughout the kingdom.
Turf/Territory Team This team focused on unification of all the Villages in the kingdom using the P=S Policy
Publicity Team n n n Publicity was a WEAKNESS in all the lands: Publicity Team: This Sub-Council’s purpose was to publicize success while creating energy throughout the Villages. Therefore bringing spirit and a sense of anticipation throughout the kingdom
Publicity Team The Ladies, Carrie, Kari, and Laure along with their team created this sense of energy via posters, celebrations, song, festivities and dance. They created a buzz to get the villager’s attention.
Creating The BUZZ
The Song Prepare yourself for the live presentation of the famous “Forest Ranger Theme Song”
Selection Team n n n Selection was a WEAKNESS in all the lands: Selection Team: This Sub-Council’s purpose was to take old villagers and analyze why they stayed, what they liked, and how to attract more villagers from other lands with these same attributes. Lady Peg, Sir Robert and their team modified the way the kingdom recruited new villagers.
Selection Team n The interview process was modified: 1. 2. 3. Interview questions were created based on specific criteria that the villagers felt were key aspects of retention The villages interviewed their own recruits with the idea that “if you hired them, you would take care of them” The hiring process was streamlined
Selection Team Appreciating the current villagers was stressed through 1. 2. 3. Reevaluation of wages An annual Celebration of Appreciation with food and gifts for all. An additional Celebration of Longevity was held with gifts and feasting.
Trigger Team n n n Scheduling was a WEAKNESS in all the lands: Trigger Team: This Sub-Council’s purpose was to review the current scheduling of the villagers while analyzing the needs of all the Villages. The Ladies Carrie, Kari and the scheduling coordinators reviewed all the master schedules, including in-house pool schedules.
Trigger Team n n Revised criteria for in-house pool. Reviewed and modified the current bonus plan for nurses. Considered new shift differential for difficultto-fill positions. Encouraged Village leaders to be more involved in scheduling, with the goal of moving toward Unit-Based Scheduling.
Nursing Leadership Team n n Nursing Leadership was an UNTAPPED STRENGTH in all the lands: Nursing Leadership Team: This Sub-Council’s purpose was to take the individual strengths the Village leader’s already possessed and bring them together to form a unified front. n
Nursing Leadership Team This reform was needed both to slay THE DRAGON and move toward improving quality in all of the kingdom.
Overlapping Of The Sub-Councils n n These Sub-Councils were originally created as separate entities Overlapping soon occurred: n n Goals were similar Similar villagers on different Sub-Councils
Full Scale War The villagers, united under the direction of the Privy Council and the Sub-Councils, began their full-fledge onslaught against THE DRAGON
Conquering THE DRAGON n If they kept on track the plan was to conquer THE DRAGON in 24 weeks. Could they do it?
We Won Battle I n n NOCs went pool free on: August 15, 2003 The Proclamation made by the Lady of Darkness Carrie came true.
Continuing The War We had won the battle… but we had not yet won the WAR!
The Remaining Battles n DAYs went pool free on: August 19, 2003 They Won Battle II PMs fought the hardest battle, and casualties were high… but they were still able to conquer THE DRAGON October 7, 2003
The Proclamation n The King put out a Proclamation: THE DRAGON WAS SLAIN!! n This kingdom would never again be under the control of such a menacing beast!!
Celebration Throughout The Kingdom Imagine to their surprise… not only were they able to slay THE DRAGON, but were able to do it In only 7 weeks!! There was rejoicing throughout the Kingdom!!!
Celebration Throughout The Kingdom
How Did The Villagers Do It? n n All of the other castles nearby were shocked. Some had been trying to slay their own dragons for years… How did Mount Carmel do it? All of the Villages were focused on the same result and worked together to achieve their goal. Teamwork and perseverance were the key.
Burning THE DRAGON
Celebration In The Castle
Moving Forward n Now that THE DRAGON was slain. . the villagers could concentrate their subcouncils on improving quality systems throughout the kingdom starting with, focusing on the concept of: ONE GREAT UNIT(S)
One Great Unit n n The Privy Council decided the order in which the villages would be declared ONE GREAT UNIT Initially the Villages were chosen by history of pool usage.
Planting The Vision n The individual Village leaders had a vision planted by the Wizard and the Privy Council to promote the ideas of individual autonomy for all the Villages. Each Village would start to become self operating.
Cultivating The Vision n A meeting with village staff was called by the Privy Council in which the vision was planted: n n Identify each strength and weakness specific to their Village. Emphasizing quality improvement and positives to be realized.
Could They Do It? n n Each Village was at a different level of independence. Some of the villagers were very skeptical of the ideas presented. Would they ever be able to do all the things the Privy Council suggested?
One Great Unit n n The Village leaders met with the villagers in order to set attainable goals for the unit that would start small and build from there. The villagers acceptance of the goals was important. The more they believed in the goal the more dedicated to reaching it.
Goal Setting n n The Village leaders helped their individual Villages identify weaknesses and strengths Tap into these areas to create goals that were measurable Move toward quality improvement.
Self Scheduling n n Each Village started with the basics to ensure consistent quality throughout the land. From there, self scheduling of the nurses on one shift began with the goal to move towards all shifts doing their own schedules.
Accepting The Goals n n The villagers acceptance of the goals was important. The more they accepted the goal the more dedicated to reaching that goal. The goals needed to be chosen by them, so that they would own it and not be dictated to them by the castle. The idea of autonomy was new and difficult to believe would ever be possible.
Celebrating Success n n Each Village set measurable goals for themselves, unique from other Villages. Each goal met was celebrated.
Becoming An Independent Village In summary: Each Village set its own measurable goals Each Village would become self operating (selfscheduling) Continue quality improvement Celebrate success …Thus declaring the Village independent…
Jousting Tournament One Great Units were up and running: n n Purpose: Create a team atmosphere while enhancing quality throughout all the departments and to encourage friendly competition between the shifts and the units. Taking the Goal-based objective of the One Great Unit(s) one step further.
Mount Carmel’s Major League Connection Decided on which quality goals would be part of the game. Picked issues that could impact quality care.
Choosing A Theme n n We chose the baseball theme because the physical structure of the land made it a natural. And it was Summer time! Each Hub became a division: n n n Hub 1: Eastern Division Hub 2: Central Division Hub 3: Western Division
The Competitors n n Each division was divided into three teams per Village per shift: Example: The Village of Chestnut Eastern division n Day shift team: Charmers n Pm shift team: Sparklers n Noc shift team: Summer Sluggers
Team Division n n The Nursing Staff was the focus of the competition. Fan support was encouraged from other departments living within the Village.
The Games Began n Each game was scheduled to last an entire week from Sunday to Saturday. Each team experienced one bye-week The teams competed within their own division first, with the winner moving on to a playoff round.
Name Of The Game First Game: n n n Target goal: Attendance/Tardy Score: the number of villagers that were late during that game (week) An example of a winning team was The Warriors beat the Wildcats 8 to 5.
Keeping Score
Creating The Spirit Of The Games
Team Players
Fan Appreciation n Kickoff Tailgate Luncheon: This was held for all the villagers to create a feeling of competition. Crackerjack was handed out to all villagers Things to come: n n Baseball Trivia with tokens awarded to the winners Complimentary tickets to local events
Commencement n Competition continued throughout the summer ending in a playoff tournament. Commencement celebrations followed the games ending in grand feasts. Awards were presented to the winners.
Moral Of The Story No one person can slay a dragon
Our Appreciations Go Out To: n n The entire nursing staff: without them The Dragon could never have been slain. All departments: for their support and sacrifices throughout the War Benedictine Health System: for coming to our aid when we most needed it. Administrative Team: For empowering the village leaders to have the autonomy to wage war.
Questions? We live happily ever after… THE END
- Slides: 137