Steven A. Brigance

2712 Market Trace Fort Smith, Arkansas

Not the top goal, but the only goal It’s the why that will get you through almost

any how This applies to everybody – no silos, no non-

connectivity, no opting out

“He who has a why to live can bear with almost any how.”

~Frederich Nietzsche

Great care and service to every resident and family member by skilled people dedicated to doing the right things in every community, everyday, in every situation will make us the most successful company in the industry – guaranteed.

~Darryl FisherApril 26, 2008In a prepared but undelivered speech

Compelled reorganizations Highly visible personnel changes Occupancy threats Extraordinary downsizing Media assaults

Uncertainty (there must be a stronger word) Imposed complexity Consultants who are legal & financial

experts, but… Unqualified people judging “success” Little if any internal control over events Important but dangerous industry

Increased focus on quality care & service Increased focus on doing the right things Focus on MVP’s Focus on fewer but more important metrics IQR (Independent Quality Review) Accountability & rewards

Communications from the top Management team in place & functioning at

highest level Suits/claims down Residents & Employee satisfaction surveys

up Occupancy up Training Community involvement

Executives/Home Office Leadership Home Office staff Regional Managers Administrators Community Care Givers Community Support Staff

Yours

-- Administrator Most important & most difficult Terrible title – worse than meaningless

ED, no better How about something with the word “Chief” in it

Skill sets Hiring standards Right models/different rewards Not everybody will make it Example 50% need to change 50% of those can change 50% of these in other jobs The rest have to go – do the math

Absolute commitment to quality care & service Absolute commitment to do the right thing in

every situation Advocate for the resident Team-oriented Goal-oriented Committed to accountability & rewards for all

employees Good hiring/training/re-training/retaining skills Recognition that this is a business & a calling

Owner/investor choices Architect choices

◦ Doors◦ Personnel choices

Construction Company◦ Supervision◦ Liquidated damages◦ Refusal to correct

Administrator◦ Credentials◦ Employment history◦ Cover-up◦ Retaliation◦ State regulators

Caregivers – nowhere to go

Dorothy &

Jack

Ignore the problem & underlying cause Blame things on a resident or family

member Delay contacting people who should be

involved Lie Hide Cover-up

Coach Try to fix things yourself Misstate Equivocate Never say you’re sorry Obfuscate & wait for things to blow over Assume the police are our friends

Screw up the records – before, during & after

Fail to appreciate we are in the elder care business

Have no appreciation of our MVP’s– no plan, strategy or vision for early resolution

“Diss” or cajole the state Assume your staff will cover for each other

-- and you Assume the family and/or resident will flag

To align your individual purpose/content-ment/why with the collective why of quality care and service

To become a trusted colleague To trust your colleagues To see the big picture and your role in it To become a trusted, “first-person” leader and

advocate To eliminate the “graffiti” Between stimulus & response to make the higher

choice with your “Whole New Life”

T – Team playerR – Respectful & responsiveU – UnderstatedS – SafeT – TalentedE – Executes well & consistentlyD – Dedicated & devoted

~Dr. David Wong, MD, MPHSeattle, Washington

Dependence◦ Requires almost nothing – its innate

Independence – requires 3 habits (knowledge, skills, desire)◦ Proactive (circle of influence)◦ Begin with the end in mind (vision)◦ First things first (management)

Interdependence◦ Win, Win◦ Seek first to understand….◦ Synergize (2 + 2 = 5)◦ Sharpen the saw – continuous renewal of yourself

and others

~Stephen R. CoveyThe 7 Habits of Highly Effective People

More comfortable More confident Adapted to the “New State” Sense of accomplishment More cooperative More successful Sense of some control

The stage where people are truly ready to identify with new goalsand are clearly focused on how to reach them.

Great accomplishments come when trusted, talented people appear “at the right time and the right place” with the right idea.

~Malcolm Gladwell Outliers, The Tipping Point, Blink

Between stimulus & response is a space of time – an opportunity to exercise one’s freedom, whatever the how (circumstances)

An opportunity to make the higher/better choice based on one’s why (purpose)

~Viktor E. FranklMan’s Search for Meaning (1945)

Steven A. Brigance

(479) 783-7070sbrigance@4OurElders.com