Netsmart CareThreads
Netsmart CareThreads

Episode · 9 months ago

#Hospice How to retain hospice care providers during a pandemic - by CEO Ernesto Lopez, Hospice of Washington County


As hospice care services evolve because of COVID-19, how do providers adapt and pivot?

Equally important, how do organizations retain and engage care team members?

Ernesto Lopez, CEO at Hospice of Washington County, joined Netsmart to talk about to talk about prioritizing employee engagement and retention during a pandemic.

What we discussed with Ernesto:

- The role technology plays in engaging hospice care providers

- How to keep hospice care providers connected to your organization’s values

- The shift from facility based care to community-based care

If you want to hear more episodes like this one, look for the Netsmart CareThreads podcast on Apple Podcasts, Google Podcasts, Spotify or Stitcher.

Welcome to net smart care threads, apodcast were human services and postocute leaders across the healthcarecontinuum come together to discuss industry trends, challenges andopportunities. Listen is we uncover real stories about how to innovate andimprove the quality of care to the communities we serve? Let's get intothe show. Thank you for your time today. I wantedto. This: Is Jason Bank O' the Vice President of client developmentpostecte for netzsmark technologies, and with me I have Arnestolopez Ornestois the chief executive officer for hospice of Washington County and againTheyre Netesso. Thank you wanted to thank you for your time today. It iscan't imagine all that's on your plate with all going on in the country rightnow and and the work that you and your team do at Hospitil to WashingtonCounty and does every day, in behalf of your community patients at the end oflife and the families that care for them. How is how's your team? Doing? Hey Jason, thanks for having me onabsolutely the team is doing well, despite all the challenges, as youdescribe, that everyone's facis facing bow through this pandemic, our staff is,has really been resilient and throughout the storm, they'v remainedfocused on our mission and o'n, providing you know the best possibleand of life cadwor, patiens and families, and so that that's kind ofbeen the driver in their and this journey is ensuring you knowtheir passion for insuring that patients are getting the services thatthey need. In a time where you know those services have been restricted orthey've been modified because of covid nineteen. Well, thank you again. I think you knowone of the many things that is top of mine, for not just net smart, but formany throughout the country is on the teams that serve these endapplypatients and families are doing, and one of the major concerns ar a numberof hospiice inpitive care providers is not just you know the recruiting anonboarding new team members, but it's really the retention and the engagementof these superheroes that are providing this care on a daily basis. O, do yousee the priority of that process? Team member life cycle from recruiting toonboarding to retention and engagement as a leader in this industry? You knowJason, it's top. It's top priority for us, because engagement is the fuel thatpropels organizational culture, you know and that that organizationalculture is what really impacts, all those those pieces orthose phases of the cycle. You know you can retain good people if you don'tfeel if they don't feel connected, t the organization and some organizationsconfuse and employees, engagement or connection to to the mission or the orhospice in itself, as a sign that the employees highly engaged and what wevefound is that we have to you know continuously connect with our staffs,especially during this time. Communication is key because folks areworking remotely now more than before. Folks are having a hard time started,getting back to what we describe the mothership. You know, there's alwaysbeen that element of hospice. Where you know your staff is out in the fieldtaking care of patients and families, but they always have a place to comeback and land, and that was the bridge of you know maintaining connectioncollegiality with with with others, other staff members and with with theirsupervisors, and so that's changed significantly. So, as we'vemade this transitioning, you know connecting those fibers of engagementare really key to ensuring Y. U that you don't lose your high performersthat that you're able to recruit good...

...people and that you have a stable andhighly engage organization and that's been a pretty significant shift formost most hospices as they're going through this Tho last seven plus monthsof dealing through through this pandamic. It's almost like you weresort of reading my mind. I just got done with a book. You went in thelocker room first, it was partially written by Mike Smith e used to coachthe Atlanta Falcons and- and I think you use pretty much everyword that he used to describe you know how do you engage with your team, whichis culture and communication and connection with them? I mean he talksabout the seven season and I think you, you almost said herbade him. You knowthe the one thing that we think about it: Net smart is: How can we play arole? Are there ways that Youve seen technology play a role and either thesatisfaction or dissatisfaction of the team and the engagement and theretention? And how do you see technology, helping hospice andpolative care providers in the mission to serve those that serve others? Itplays such a keyrole Jason because at the end of the day, the most important elemental factorisit's got to work. You know, you know if your technology isn't workingconsistently, then you're going to have people that are frustrated people thatare going to find workaround people that are going to be disengaged, and soso technology has to work consistently or if it does fail. For whatever reasonyou know, how do we quickly rebound and get a solution to them so that they cancontinue to do what's most important? But you know from a you know: From apandemic perspective, you know technology a has really been leveragedacross our entire industry, so you're hearing everywhere about telahealthbecoming you know this, this new key key tool or resource to be awbate toconnect with patients and families better. Well, it's been around for along time. Now it's really become more prominent and you know organizationsthat really never consider tella health as a viable tool ar starting to tounderstand the value nd, and I think that, as time goes on, the use of thesetools are going to be deeply integrated into into future workflow permanentfuture workflow, because healthcare providers have found tremendous value,time, savings efficiencies and even effectiveness around using these toolsand they're modifying the way that they they're providing care and connectingwith with you know, with patients and families, I would say the other, theother pieceis you know being able to to use technology to ensure that you'recommunicating to to your folks internally and so aside from insuring the technologiesworking and that you know that that it's functional you know how do youcommunicate effectively and timely with Wyour team internally, if you're, aemail, heavy user organization or if you're, using cell phones or telephonesprimarily to communicate? You know what other elements of technology can beused now you know texting. You know video, calling we started putting somesome different different we've been testing different methods with ourstaff internally to see what's effective, but in ultimately it's allcentered around communication, complete communication. How do we getinformation out to our people quickly so that they can respond wor? How canwe get information out to people so that they know what's happening in theorganization, so they're not worried about in stability? They're not worriedabout you know is my job. You know on the line. Is the organization going tobe viable? Are we going to be be able to serve our patients in the future? Soall those pieces are critical and ensuring that not only do you havegreat care and you're continuing your...

...content, you're continuously providingthat care, but that you're also ensuring that you have different waysof connecting with your staff so that they feel secure in what we're doingand where we're going so good. I know that you know sort oflike languages. somepopel prefer texting some people, prefor phone calls,others prefer email. So totally totally agree with that. You know it's funnywhen I was serving in a hospice. You know a couple of were talking aboutusing skite for business and boy was at revolutionary at the time an now youknow it's like everybody uses that or teams, so an hospice of Washingtoncounty. The mission is embracing individual needs with love, kindnessand compassionate care, while creating meaningful end of life. Experiences forour patients and families- and I know Arnesto- is a servant leader and ahumble leader, and so he wouldnt he would not mention on this, but I'mgoing to that. He himself is at one of their new locations waiting for thesurveyor, which just shows the type of leader that he is. But what are some ofthe creative things that you've done are seen that enable your team to be tofeel engaged to feel appreciated to stay connected to the mission andvision and the values of the organization. Sure Jey said you know, Iwould say the first thing that our team did was. Our leadership team is to lookat the things that we were doing before the pandemic. That were really workingwell for us from an engagement perspective and then try to ensure thatthose things continue to happen. Even though we've had we've got all thesenew restrictions and these constraints that are, you know that make it moredifficult to do it. So you know we wanted to take more time more moreenergy around the around around these things that have worked really wellfrom us one of the things that we've done and I'm sure many organizations dothis. You know we handwrit birthday and anniversary cards to each of ouremployees every month, so the Senor leadership team has done that for a fewyears and it's well appreciated. We usually include a a small nominal giftcard in there and just to thank you and a happy birthday. Well, we've continuedto do that. So each of our leaders takes the time, even though we'reworking remotely. They have to go in and hand, write these letters and thesecards and it goes they get circulated and they get sent mailed out and D, andyou would be surprised how many staff numbers, even though they've had thisNew Year's prior. They I get a huge thank you. I can't believe you guys arestill doing this. You know this is really neat. I appreciate it and justthe gesture in itself and the continued use of that gesture has been reallyimpactful. You know they're grateful that, despite these, you knowlogistical constraints and working rervotly that Wer we're able to do thisfor them. I would say other things like everyone, like everyone else, you knoweveryone's using zoom meetings or teams or whatever platform, to make sure thatthey're. You know that they're communicating with their staff, but youknow, we've had our townhall meetings with all our staff on the zoom on thezoom call, which is really fantastic. We do daily Operational Hutdles, we dodaily department, checkens and, and part of that is especially you know allthose elements that're important, because you know we have a cot. We havethe confidence, Ta, the staff and the management team that they're doing whatthey're supposed to be doing to make sure that their areas are being. Youknow, moving forward that that the cogs are moving. But you know we do thesecheckens, because not because we're trying to you know have s mesome, some level,accountability or trying to ensure that people thare working that we do thembecause it keeps US connected. You know it's those fibers of engagement that wetalked about with now with the management team. We also have to havethat, and so we make these these these sessions fun and creative. Youknow, for example, my team would killed... if I share this, but I'm want toscare it anyway. We're supposed to have our leadership meeting next week and-and so one of the leaders say well, let's make a challenge. I want everyleader to have a halloween costume on ther zoom call, and you know, and we'regoing to have a contest to see who's got the best best costume and you K Oit's. I things like that that you know they may seem insignificant. They mayseem like o that's kind of kind of kind of Dorky, but you know it's it's one ofthose things that people rally around it and they get excited, and you knowmost people probably wouldn't even think about you- know a costume, O ortrying to. But you know this is where you see engagement really come through,because folks folks are now out of their normal. You know sort of box ofday to day work now we're we're having to modify to to this new workenvironment. Well, why not make it fun? Why not make it engaging and so thatthat's one of the one of the things that we're doing about a month and ahalf ago we started video blogs, and this has been really successful for usso early in the year I had one of my leaders that suggested you know why?Don't we, why don't we do a video? We don't Tou, do a video and send it outto the staff. You know once every couple of weeks just to give up, youknow organizational updates in the past. You know I would send out. You know Isort of state of the union email and with a lot of communication just to letthem know where things were, and so you know we finally decided to go down that road and it'sbeen a really neat experience, because it's not just me sitting in front of acamera talking. You know we put a lot of humor and light heartedness behindit. We do you know we bring people on board, we make fun of things we make. IMake Fun of myself, you know it's just it's one of those things that peoplehave really connected with. They look forward to it. So we try to mix a bitof humor and and fun, but at the same time we're communicating, reallyimportant things. We're letting them know what's happening, what they needto do, what we're doing, and so it keeps them anchored into hey. This is,these are tough times, folks are struggling around the country andaround the world, and we've had to change a lot in our organization, thelast six eight months, but you know we still have you know the H, the passionto do this work and we still have a level of engagement to stay connectedand to be able to. You know relate to each other in different ways.So that's been a really neat. That's been a really NEAT program. The otherthing that I would share is we recently started an employee, giving programwhich, surprisingly, I know a lot of organizations do this already, butwe've never had one before we have a very successful development program. Wehave several different programs that we raise money for in our community. We'vewe've been very successful in our small community of raising significantdollars for for our resize population and we've never done something for ouremployees and so a few. A few weeks ago I went to our board of directors, and Isaid you know we have dollars that are allocated for you know through ourboard, for specific projects and- and I made the recommendation that we wouldput these dollars or some of these dollars into a fund, Tet staff thatwould be used for staff that are going through medical or financial hardships,and so, during this time you know, we've seen staff members have to be out of work because of ofhealth conditions unrelated to Covid or having you know, difficult challenges,because theie spouse lost their job. You know it's just it's been. It's beeninteresting for me to hear all these different stories and as an employernot be able to do something about it, because we don't have a policy, becausewe don't have a process, because we don't have a program. This new program,which we call hospice GIBS, allows employees to donate their unused ptotime, because we have a lot of people that you know that are not using theirPTO, because they've got nowhere to go,...

...and so you know they've decided to stayhome and you know they want to continue to work well, they can donate into thisfund. They can, you know, paroll deduct. You know small increments of moneyevery month. If they want to do that n and then we will use this fund to beable to. You know, help those folks internally that are having thesedifficulties and- and the reason I went to the board was because I wanted thisthis program to to be here in perpotuity, so that you know, and inthe next ten fifteen twenty years our staff would sort of organically growand align to this program. But I wanted to be you know I wanted to be thestaffs program, the board, you know, allocated fiftyhousand dollars to thisprogram. I didn't share it with a staff, because I want the staff to really beengaged and feel like it's their program, but those dollars will bethere for inperpetuity to help support this and get us off the ground and- andI feel like these are the kind of things tha kind of programs that you doas an organization that really anchor staff to what they're doing, becausewhat it sens the messages. Hey Is this the organization cares. For me, theorganization is not just about to work, it's about my well being it's about myfamily. They care about me they're, willing to help bend and flex wheneverI'm going through challenges, and you know who doesn't want to work for aplace that does that, and so I'm really proud of that program andand we're excited to get it launched and start using it, because we've gotsome folks on our team that really need that help so good. So true, I know Ioften tell people if you do the type of individuals that provide this this careto folks at the end of life there they're really remarkable, but to havethem come together and support each other in this kind of way isextraordinary through the hospice gifs program. I you know the one thingyou're going to have to send out some outtakes of the video of locks now andyou're going to have send us send us some pictures of the Halloween costume,get together we're Goin to tat. You know on in all seriousness. I do thinkthat you know a lot of times, while the majority of the population is nowworking from home. What they don't realize is that you know you've gotthese selfless individuals that are out there in the community continuing on to service these, thesemost vulnorable in their time an need, and so so I think it really. You knowdoing things like that. Obviously you have a great supportsystem there with your own team, but it just sort of lets. Everybody see that it's a type ofindividuals that actually choose this as their career and their passion, so Ithink that just phenomenal love it finally wh. What do you see? Is that,as the outlook I know, yeah we'd all like to have a crystal ball right aboutnow. But what do you see is the outlook forhospice impoitive care over the next six to twelve months? You know, I thinkthe outlook is is good for us, because for a couple of different reasons, Imean we're seeing in healthcare the shift of acute you know, facility basedcare to post Ta q community base care has been talked about and debated fornow. I can't I can't even count the ears, but it's always it's always beenthe it's coming. It's going to happen. It has to happen because our currentprocess system from healthcare perspective is not sustainable. Well,you know, I think, covid has really forced us from a healthcare perspective,to see that and see the value of home home, based care and and the fact thatyou know N, when areas around the country, especially places that branout of hospital beds or or even in communities that basically close downtheir beds, because they wanted to make sure they would be available. For youknow an influx of covid cases, the...

...value of of you know being able torefer patients out into the community for for postecte care became even morevaluable, so I do believe were the next. Six twelve months were going to start.Seeing more and more of this trend of you know, patientsthat you know are starting to come back to the hospital for noncovid relateditems, patients that we know need that kind of care and- and you know gettinggetting those those patients refer to the appropriate level of care, whetherit's hospice or Palative care or home care, or even you know, skilled nursing.There's definitely going to be a trend of an increase from the hospitals ofthese types of patients. Out to these these service providers, but you know,as far as what I see for for US internally, you know: We've got to beable to adapt and pivot and- and I think it's one of the things that we'vestruggled as an industry for a long time H, hospitce industry is, you know,sort of changing the way that we operate our businesses, the way that wedo things because were so accustomed to to sort of doing it within this boxthat you know that that was created when this wonderful benefit came tolight. You know back in the ES A lot of program struggle to change in pivot,and you know I think now we're going to be forced to to change and pivot,because we know that pay. You know, payer pair arrangements are starting tocome to light, there's going to be a shift. You know with Medicare advantageand that that's going to be a game changer for a lot of programs, butultimately the longer term view of how you know, hospices are reimversed andhow you know how we're we're, how we're engaged as a part of the the Continuoof care, I think, are going to come. moredalight and there's going to be agreater emphasisand focus for those of P for those providers. That can do thethings that the health care system needs. Manage. People at home safelyreduce the cost of care and reduce the you know. The consumption of expensivecare, which is, you know, has been the biggest challenge. You know we anhealth care for many years now. So I think the outlook is good for ourindustry, but we've got to be very flexible and we have to start takingmore accountability. For you know some of the some of these patients that thataren't getting to U Art, getting to Pallativ Care O'm getting to hospicebut are sort of floating around in that cycle of o acute post of cute care backand forth, and so this journey or this experience ofcovid nineteen has has forced us to look at that and see how prominent andhow valuable providers like like hospice and Palative care can be to thesystem. God I could agree more yeah. You know h the other thing that I wouldsay that's going to be important and going to be a challenge for us, an ourindustry as workforce health, and you know ensuring that our staff is stayinghealthy and protected from covid nineteen. I think a lot of people don'trealize that you know we focus on the hospitals, and you know the staff thatyou know it's well documented. You know the horrific outcomes that occuredearly on in the pandemic, where many many healthcare providers lost heirlives because of covid nineteen or became sick, and these are incontrolled environments, and so you think about hospice and Palative care.You know you have you have people that are going into someone's home goinginto into environments that aren't protected, that aren't confined. Youknow. You have an environment where you might have several family members,young Middle Age, older, and you don't know if someone's infected in that home,you Kno, our staff are going into those environments and, and they don't havethe types of protection hospital, Intensive Care Unit nurse may have, andso there's a tremendous amount of risk involved in in this kind of work. Soyou know, programs have to be very...

...diligent that they're screening thatthey're making sure that their staff is staying, healthy wit, they'r, reporting,symptoms back to you know the organization so that we can. We canhelp, manage and ensure that we're not sending someone, that's potentiallysick into into an environment whether it were their healthy patients andfamilies yeah. I couldn't agree more. I think I thinkthe you know the the industry is then in some aspects overlooked in terms ofprotecting the team members that are putting not only their health but quitefrankly, their family helt ih arms way in a daily basis. I think that you know, I know, we've all beenappreciative in an awe of what your team does, but I so appreciate now morethan ever what hostise and pocares I couldn't imagine, actually serving anin a hospiice now with sort of the the short durations, unfortunate and tragicdurations of the end of life with some of these covid nineteen patients. Andso you know it's it is you know we all know- and I know most of the listenersnow- that the the most intensive time for for hospice is when that patientfamily come on service and then, obviously, when that patient or family,the patient is deceased. So you know- and that is as had to put a tremendousamount of pressure on on you. Your team and the industry is a whole, and I justappreciate so much that's just to your time today, but but you and your teamand the rest of the HOSPITAC INDPALTYOFA organizations around thecountry serving those that are really truly the most vulnerable at this time.So, thank you again for your time and we look forward to connecting again myplece for Jason. It was a pleasure charing sharing our thoughts and thankyou F for your compliments and again I wish you your family as well safety and-and you know, Continue Tho key. What you're doing on your an with that smart,because we appreciate having having those resources so that we can takebetter care of our patients and families. So thank you. Thank you en Ug,so at net smart, we understand thechallenges facing provider organizations. Our team will help younavigate changing value, based care models with solutions and services thatmake person centered care or reality will equip you with technology andservices that provide holistic, real time. Views of Care Histories thatinform better decision making and better outcomes visit us today, anntstcom net smart serving you, so you can serve others thanks for listeningto the net smart carethreads podcast through collaboration and conversation,we can work together to make healthcare more connected than ever before andbetter support the communities we serve to ensure you never miss an episode.Please subscribe to the show in your favorite podcast player, if you useapple, podcast, we'd love for you to give us a quick rating for the show.Just have the number of stars that you think the podcast deserves until nexttime.

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