Transforming the Workplace in the COVID-19 Era...Transforming the Workplace in the COVID-19 Era...

Transforming the Workplace in the COVID-19 Era

Manny OcasioChief HR & Compliance Officer

Henry MoehringSenior Vice President, Health Care Services and Operations

Jennifer Hilliard, Of Counsel

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Presentation Notes

HOLD SLIDE PRIOR TO BEGINNING

Meet the panelists

Manny OcasioChief HR & Compliance OfficerAsbury Communities

Jennifer HilliardOf CounselArnall Golden Gregory, LLP

Henry MoehringSVP, Health Care Services and OperationsAsbury Communities

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Presentation Notes

BRIEF INTROS

What we’ll cover today

1. Key policies and practices to protect your workforce and clients

2. Creating a safe physical work environment and maximizing remote technologies

3. Top 3 lessons learned; Q&A

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What we’ll over today Key policies and practices to protect your workforce and clients Creating a safe physical work environment and maximizing remote technologies Top 3 lessons learned; Q&A

Long-term care policies & compliance


10 key themes

Coronavirus Commission for Safety and Quality in Nursing Homes – Final Report

1. Testing and Screening2. Equipment and PPE3. Cohorting4. Visitation5. Communications6. Workforce ecosystem: Stopgaps for resident safety7. Workforce system: Strategic reinforcement8. Technical assistance and quality improvement9. Facilities10. Nursing home data

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Coronavirus Commission for Safety and Quality in Nursing Homes – Final Report Commission - 25 members; diverse representation Final Report - 10 Themes; 27 principal recommendations; 100+ action items Testing and Screening Equipment and PPE Cohorting Visitation Communications Workforce ecosystem: Stopgaps for resident safety Workforce system: Strategic reinforcement Technical assistance and quality improvement Facilities Nursing home data

Overarching IssueCOVID-19 as a perfect storm whereby long-standing problems are exacerbated by crisis conditions

Workforce challengesTesting & screening recommendations

Testing and screeningEstablish a national strategy for testing with rapid turnaround of results

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Workforce Issues Generally; Testing and Screening Recommendations Overarching Issue: COVID-19 as a perfect storm whereby long-standing problems are exacerbated by crisis conditions Staffing shortages and high turnover rates Low pay and few benefits Lack of prioritization for resources Testing and screening – Establish a national strategy for testing with rapid turnaround of results Ensure availability of testing equipment and supplies Identify funding mechanisms Ensure accurate results Funding for technology-based screening

Problems identified: • Ensuring an adequate supply• Compliance with OSHA Respiratory Protection requirements• Proper use of PPE by staff

Equipment & PPE

Recommendations made:• Collaborative process for procuring, sustaining 3-month

supply of PPE (with CMS enforcement authority)• Guidance on use, decontamination and reuse of PPE• Training for facility staff

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Problems identified Ensuring an adequate supply Compliance with OSHA Respiratory Protection Program requirements Proper use of PPE by staff Recommendations made Collaborative process for procuring, sustaining 3-month supply of PPE CMS enforcement authority Guidance on use, decontamination and reuse of PPE Training for all facility staff having direct or indirect contact with residents

Problems identified: • Exacerbation of long-standing challenges• Multiple facility work• Insufficient RN presence• Part-time, minimally qualified infection preventionists• Lack of infection prevention workforce educators

Workforce ecosystem: Resident safety stopgaps

Recommendations made:• Resources for workforce; minimum care standards• Guidance on staffing strategies and coordination• 24/7 RN staffing in the event of a positive case• Increased attention to infection preventionist role

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Problems identified Exacerbation of long-standing challenges Multiple facility work Insufficient RN presence Part-time, minimally qualified infection preventionists Lack of infection prevention workforce educators Recommendations made Resources for workforce; establishment of minimum care standards Guidance on staffing strategies and coordination 24/7 RN staffing in the event of a positive case Increased attention to infection preventionist role

Problems identified: • Low wages and high turnover among CNAs• No nat’l training, licensing standards for infection preventionists• Delay in addressing general workforce challenges

Workforce ecosystem: Strategic reinforcement

Recommendations made:• Focus on CNA recruitment, OTJ training, national CNA registry• Professionalize infection prevention positions• Overhaul the workforce ecosystem• Convene LTC workforce commission

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Problems identified Low wages and high turnover among CNAs No national training or licensing standards for infection preventionists Delay in addressing general workforce challenges Recommendations Focus on CNA recruitment, on-the-job training and national CNA registry Professionalize infection prevention positions Overhaul the workforce ecosystem Convene a LTC workforce commission to assess, advise on, and provide independent oversight for modernization efforts

• Many recommendations implemented/being implemented

• Regulatory process required for other recommendations

• Funding challenges• Increased cost and regulatory burden on

providers• Staffing and supply chain challenges • Wild cards:

• Scientific advancements• Politics

Impact of Commission Report

Final Action

Stakeholder Input

Politics

Science

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Many recommendations implemented/being implemented Regulatory process required for other recommendations Funding challenges Increased cost and regulatory burden on providers Staffing and supply chain challenges Wild cards: Scientific advancements Politics

Compliance & major challenges – an operator’s experience



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Henry to speak about: Ops/Clinical: operationalizing the multiplicity of and contradictory regulations Manny to speak out: Workforce: screening/calls-outs/keeping morale up/associates feeling safe

Command Center

Asbury Command Center @ the ASCC

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HENRY Command Center process; gleaning info from multiple sources – each state had regulatory direction – we have challenged leaders to keep abreast of CDC and state websites and provide clinical education for consistent info across system

Move fast; breakdown silos

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HENRY Quicker way to respond to change, as an industry that was not our strength, direct, transparent comms, direct conversation between leaders, breakdown of silos between dept heads, EDs, and other leaders. Collaboration within states.�

Values-based decision making

Our valuesAsbury holds strong to a set of Core Values that drives our mission and reinforces our commitment to serving seniors.• Commitment to residents, associates, volunteers

and partners• Stewardship and financial strength• Quality and innovation• Integrity

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MANNY living wage – started 3+ years ago and how it was the right thing to do then and helped us during the pandemic with the frontline workforce How do we apply Values-based decision making to our policies? Policies revised or new to deal with the fluid pandemic situation.

• Systems Engineering• Human Factors• Behavioral Psychology

• The Model Penal Code• Contract Law• The Common Law/Equity

Science Law

The Goals

Maximize system performance (justice as a secondary value)

Justice (a primary value)

The basis of Just Culture

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MANNY assuming goodness of intentions/Just Culture, we will interpret every reality in the associate’s favor. This boosted morale, supported associates, continued family feel. Language matters – built supportive language – look at HR comms in TM and language/blame game/etc. We never had a walk-out Just Culture Integration It will take at least 1 year, but typically 2 to 3 years, to complete all these steps. At which point you want to put a system in place to find out from your employees if they believe they are being treated in accordance with the Just Culture principles they are being taught. It’s not so much counting how many risk reports you receive, although that is a good indicator of a Just Culture health, but its finding a way of hearing back from your employees if they think that you’re not just talking about Just Culture, but actually practicing it. We have a standardized survey you might choose to use or perhaps you’ve got something that already fits and gives you this information, so whatever methodology works best for you, make sure to revisit every six months to a year, because culture is always evolving and so you’ll want to find a way to make sure that as your organization’s culture evolves that Just Culture principles remain a part of it. �Basis of the tool for Just Culture

Leveraging technology

Streamlined screening process; centralized call-out system

Online learning tool for expanded PPE & COVID-19 related training

Utilized associate app to quickly reach non-desk workforce and provide additional tools

Use of system-wide e-communications system; promoted our emails and grew resident & family distribution lists

Quickly embraced additional platforms like Zoom & FaceTime to help residents connect with loved ones

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MANNY & HENRY Rapid deployment of call-out process, 98.6, Relias training, Sharelink expanded use of remote tech, framework in place with App, TailoredMail, COVID Comms Hub (transparency in data) Early screening process and streamlining through technology – 98.6 Clinical processes to keep associates/residents safe – expanding use of Relias and Asbury Associate App for PPE training Being willing to quickly embrace non-system remote technologies like Zoom/FaceTime Communication: Having platforms in place to effectively reach/communicate with all key stakeholders

COVID-19

Lessons learned 1. Having tech framework and applications in place; be willing to quickly bring in new technologies

2. Having living wage in place was vital

3. Committed to listening to those closest to those we serve

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What we learned COVID-19: Spreads fast demands equally speedy, calibrated, focused, and sustainable response. Here are the top 3 things we learned: Having tech framework and applications in place and bringing new technology in – investment can be tough but ROI is huge, committing time and resources to making technology stick Having living wage was vital and paid off Committed to listening to those closest to the outbreaks – focused on listening and support, listening with open mind, not taking a defensive posture

Questions?

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Q&A

Thank You!




Transforming the Workplace in the COVID-19 Era...Transforming the Workplace in the COVID-19 Era...

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Transcript of Transforming the Workplace in the COVID-19 Era...Transforming the Workplace in the COVID-19 Era...