Quality Insight

If I were in charge...

2012-01-26T08:41:00.000-08:00

I’ve had the privilege of reading thousands of comments during my time at Pinnacle. This comment I read last night is probably the highest compliment that can be paid to a provider.

“If I was in charge, that is the way I would do things.”

We encourage you to keep your customers perspective in mind as you consider the operation of your facility or agency.

Pinnacle Insights – The New and Improved Blog

2012-01-18T11:36:00.000-08:00

Each year Pinnacle conducts over 90,000 satisfaction interviews with individuals receiving health care. This is a work we are proud to be a part of because it is one of a very few professions that really can change people’s lives. People want to tell us about the care they are receiving or about the care of a loved one. We hear great reports and sometimes the reports are not as great. When we share this feedback with caregivers they become better health care providers. There are very few things that impact lives more than this.

Going forward, we would like to focus our blog on these thoughtful comments shared by one individual and that are a benefit to all.

The entries will not be lengthy but we hope you will find them powerful. Our belief is that an awareness of others perspective is often the first step towards better care.

Our comment for today is,

“I value him being treated with dignity and not being ignored, or being thought of as unimportant.”

We welcome your feedback and suggestions.

Friendliness and Kindness of Staff

2012-01-10T12:54:00.000-08:00

Pinnacle has just completed an in depth study using the commentary from the 50,000 plus interviews we completed in 2011. The results of this project will be made public soon but we wanted to share a key element that we learned from this study.

Though many areas were studied, one item impacted the performance in several categories – the Friendliness and Kindness of Staff. This is the main contributor to the following vital areas of your company:

- If your customers are likely to recommend your facility to others

- If your customers are likely to recommend your facility to others despite a sub-par experience

- If your customers are unlikely to recommend your facility to others

With the economic challenges facing all of us today, focusing on the Friendliness and Kindness of Staff will pay huge dividends when it comes to customer satisfaction.

We would love to hear your thoughts on this subject.

Rich Goaslind

Pinnacle Quality Insight

www.pinnacleqi.com

Comments from recently discharged residents

2011-04-13T15:51:00.000-07:00

One of our First Impression calls yielded a very brief, but powerful comment from a recent discharge. I've removed the patient's name and the facility's name for privacy:

"Mrs. ______ wants to know if they have an outpatient therapy program. She would like _____ (facility) to call her."

All kinds of beneficial comments like these come up when we interview discharged residents. This example was about the outpatient therapy program--which was then forwarded on to the facility as an inquiry. We also frequently hear about residents being discharged prematurely, which we also promptly forward on to the facility so they can contact the resident about re-admission.

At Pinnacle, we are your Customer Satisfaction provider--but also do everything we can to help you grow your business.

Craig Christiansen
Pinnacle Quality Insight
www.pinnacleqi.com

A recent client testimonial

2011-04-05T15:36:00.000-07:00

We sent an email to all clients about an upcoming customer satisfaction survey we will be conducting to greater improve our product. We received the following reply to our email, and thought we'd share with you. BTW, our interview will take approximately 6 minutes--which explains the last line :)

I just want you to know how much I appreciate your service. It gives us immediate feedback. We can see both positive and negative trends and act upon them appropriately. We use the information as a part of our QA process and in response to staff/customer concerns. Our whole staff looks forward to the monthly feedback. It’s a terrific service and I look forward to the 6 minutes.

Best Wishes,

Mary

Press Release: Pinnacle Quality Insight Sponsors AHCA Quality Symposium

2011-02-16T17:22:00.000-08:00

RELEASE: Immediate

CONTACT: Roxanne Hutchens

801.293.0700

roxanne.hutchens@pinnacleqi.com

Pinnacle Quality Insight at AHCA Quality Symposium

Salt Lake City, Utah, February 8, 2011– Pinnacle Quality Insight (http://www.pinnacleqi.com/) is pleased to announce their sponsorship of the American Health Care Association’s 2011 Quality Symposium in San Antonio, Texas. The symposium has been named a “must attend” event for long term quality professionals, aimed at improving initiatives and management of health care facilities.

“There is definitely a culture change being felt among professionals in the long term health care industry, and it is one that Pinnacle is excited to be a part of,” said Craig Christiansen, Vice President of Sales and Marketing at Pinnacle. “We think it’s important to highlight events like the 2011 AHCA Quality Symposium, so that attendees will be inspired by excellence in long term care.”

###

About Pinnacle Quality Insight:

For long-term care providers who need to measure customer or employee satisfaction, Pinnacle Quality Insight offers phone-based interviews that deliver a balanced blend of scoring and commentary. Unlike mailed questionnaires, our offering produces a high volume of real-time results.

Piano Duet--A Couple Play the Mayo Clinic's Atrium Piano

2011-02-04T16:11:00.000-08:00

Take a look at what this charming couple, married 63 years can do with the Mayo Clinic's atrium piano. I hope you enjoy as much as I did. Have a great weekend!

Improving Food Scores in Customer Satisfaction, Part 3

2010-12-21T10:00:00.000-08:00

The third complaint that comes up most frequently is a lack of variety or choices.

It may seem more cost effective to buy items in bulk, don’t forget to consider the cost of having a poor reputation in the community—which can be substantially more.
Remember, most people appreciate good food. And even if your resident has lost their appetite or sense of taste, their visiting family members will see or hear about the food you are providing, and they are the more vocal advocates in the community for your facility.

“The food was typically the same, with little variety or fresh food.”
“They need to give her more choices in what type of foods she likes to eat, like peanut butter sandwiches. She loves those, but they will not give them to her."

I could list hundreds more comments just like these--but the point is made. Here are a few comments from some facilities who are doing a great job:

“The chef told me if there was anything I wanted that they didn't have, he would cook it for me.”
“I did eat some of moms grapes from one of her meals. They looked so good. Their food is very nutritious. They serve well balanced meals including meat and a variety of vegetables."

I toured a facility a few weeks ago that consistently performs at the highest level in overall Customer Satisfaction. They have consistently performed in the top 10% nationally across the board in all scoring. I asked the administrator, Bruce, about their meal program. "We've changed from 3 meals a day to 5 meals a day," he said, "And we've loaded the cupboards with snacks of all kinds, so any time they are craving something, residents can go have a snack--and the cupboards are open 24 hours a day." Little things like increasing snack choices and making them available have a tremendous impact on overall customer satisfaction. It's the little things like this that transform the "facility" into a "home". Bruce, has done a really effective job of seeing meal time through his resident's eyes.

Sometimes we just need a reminder--that for our residents, our facility is their home--and Meal Time has been a significant part of their lives.

Craig Christiansen
Pinnacle Quality Insight
801-293-0700

Improving Food Scores in Customer Satisfaction, Part 2

2010-12-15T10:36:00.000-08:00

Monday's post covered being aware of and meeting your resident's dietary needs. The second complaint or praise I want to address has to do with a facilty's ability or inability to see the mealtime experience through their resident’s eyes. All too often in life, we see the world through our own perspective and fail to recognize the perspective of others. This can be an enormous fallacy as a caregiver, and can be the cause for many complaints.

You may not need help cutting meat, but some of your residents will. It may not make a big difference if you miss a meal, but it could be a significant challenge for some of your residents.

While mealtime may be just something on the schedule for some of your employees, it can be a significant break in the routine for residents. As with Monday's post, I've italicized the comments that illustrate a facility's need for improvement, and bolded the comments that illustrate a job well done.

“My food was not always hot. It would have been nice if they would have uncovered the meal and cut up the meat.”
“There have been a few times when he was in physical therapy or with a doctor and missed a meal. They need to follow up with meals, because it’s not good for an elderly person to go without especially if they are diabetic.”
“I didn't like the food. I suppose the bland food was good for the older people, but I don't consider myself older. I'm seventy-two.”
“They always brought me a try of food without even asking. I felt that was so thoughtful and caring.”
“They had a slip for you to put things you don't like and what you do like. They try to accommodate your wants.”
"I value a diet that will make him strong, so he can do his physical therapy.”
“He was on a pureed diet, but yet it was tasteful, and he never complained about it. When he had trouble, they went out of their way to find something for him to eat.”
“They were so good to my husband. When he was there at mealtime, they offered him a meal as well so he could eat with me.”
“The food was just great, and the quantity was very good. My wife's appetite has fallen off significantly and is just about non-existent. When I was there around dinnertime, there was always someone asking her if she could eat a little more.”

I recently toured one of our higher performing facilities who had transitioned from 3 meals a day to 5 meals a day, and had the cupboards stocked with plenty of snack choices. Their food scores are quite high, and their residents and family members are quite happy with the care they receive.

What is easy for some, is challenging for others. And in the world of caregiving, it is absolutely imperative that you look at the mealtime through the lenses of your residents--and make changes to accommodate.

Craig Christiansen
Pinnacle Quality Insight
www.pinnacleqi.com
info@pinnacleqi.com
(801) 293-0700

Improving Food Scores in Customer Satisfaction, Part 1

2010-12-13T10:46:00.000-08:00

Food consistently takes a hit in customer satisfaction scoring. No matter how hard you try, it’s difficult to compete with good old home cookin’. In addition, there are certain medications that affect taste buds, so even if you bring in a celebrity Executive Chef to serve up Fillet Mignon, it won't taste like it used to.

However, we’ve noticed that some facilities still receive high scores and very satisfactory commentary regarding their meals, so we know it can be done. It just requires some concerted effort, training of staff, and implementation of systems to allow for accommodation of specific needs.

After searching through several hundred comments from patients, I’ve identified 3 of the most consistent factors that seem to make the biggest difference for residents and family members, in their overall satisfaction with their facility’s meals. For this series, I’ve italicized comments that accompanied low scores, and bolded comments that accompanied high scores so you can read commentary from both ends of the satisfaction spectrum. I've broken this subject into three "Best Practices", and will be publishing them in a three-part series.

Best Practice #1: Be aware of health and dietary needs, and have systems in place to accommodate.

Concerns for residents with diabetes is one of the most frequent complaints. Make sure that those dietary needs are met, and there is a system in place to make sure there is an opportunity for individual needs to be met. While Diabetes is the most frequent need mentioned, there are other situations that need resident-centered treatment such as food allergies, lactose intolerance, gluten intolerance, and obesity.

“He is diabetic, and they are still giving him regular food. They aren't giving him the correct diet”
“One of our main issues when we arrived was that nobody was communicating. They knew his diet but the aides didn't know. Even the kitchen people were bringing him food that he wasn't supposed to have.”
“His roommate was a diabetic and I noticed that he was not fed the proper foods.”
“Their food and their menu need improvement. The other place had him on a diet because he is quite overweight. This place sends him pizza and spaghetti and stuff he doesn’t eat. They finally sent him a menu, but they send him things he doesn’t order. I have brought up some corn flakes, and he has been eating that for two of his three meals….”
“My mother needs to have a low fat and low sodium diet. They have a hard time accommodating her dietary needs.”
“He is on a very restricted diet, and his food must be finely chopped and his liquids thickened. They are very accommodating to these needs.”
“There are certain food she can't eat. They respect that and make sure they don't give her those foods.”

Respecting and accommodating dietary needs is the first step to changing your meal plan. If these comments are surfacing in your Pinnacle Reports, take the steps necessary to change. Improved scores go a long way to improving overall satisfaction.

Craig Christiansen
Pinnacle Quality Insight
www.pinnacleqi.com
info@pinnacleqi.com
(801) 293-0700

Article Review: Do's and Don'ts of Connecting, by Jim Gilmartin

2010-12-01T10:20:00.000-08:00

Though most people who follow this blog are caregivers, many are vendors of products intended for Seniors or Long-Term Care recipients.

I found an article yesterday by Jim Gilmartin from Coming of Age Inc, with some great tips for those "interested in securing a competitive edge for your product in baby boomer and older consumer markets (aging customers)". When marketing your product or service to an aging population--whether they be baby boomers, or senior citizens, keep the following do's and don'ts in mind:

Some of the Do's include:

1. Learn as much as you can about physical and behavioral changes caused by the aging process. Apply your knowledge to product design, marketing, advertising and sales communications and approaches.
2. Design your promotion or advertising to allow the consumer to define the service attributes using his/her imagination in terms of his/her needs and desires. Don't try to shove ten pounds of copy into a five-pound page. Less is more.
3. Design your product to meet functional, social reinforcement, and related experiences' expectations. 4. Promote and advertise your product as a gateway to desired experiences beyond the intrinsic value of your product. What additional value does you product provide?
4. Be authentic and give them the facts (reduce hyperbole).
5. Portray these populations as doing for others, as individuals, as smart, as active, as wise.
6. Use marketing and advertising firms with a demonstrated knowledge of your target markets (Check if people matching your targets age are on the creative team).
7. Use aging customers to assist in product, service and communications development.
8. Touch their hearts and they will allow you to enter their minds.

Some of the Don'ts include:
1. Don't underestimate the significance of these markets. They are the New Customer Majority. More than 110 million people in America are over the age of forty.
2. Don't consider age a determinant of consumer behavior (there is no evidence that a person's age is a major factor in determining buying habits). Age should be considered as a correlating factor only.
3. Don't design your service or advertisements to appeal to self-gratifying interests of the consumer.
4. Don't design or promote your services to appeal to the vulnerabilities associated with the aging process. At times they feel bad enough; you don't have to remind them.
5. Don't attempt to instill a "sense of urgency" during a purchase consideration (time is usually not of the essence in their decision making process).
6. Don't over-embellish product or service performance claims -- may be automatically perceived as misleading as would small print on product labels and advertising.
7. Don't stress self-indulgent of your product/service -- more effective in younger markets.
8. Don't stress images that are contrary to traditional basic values. Generally accepted universal or traditional values may include American flag, church or temple, home, traditional small town, etc.

The entire article can be read here.

Craig Christiansen
Pinnacle Quality Insight

Quote from a banquet conversation at CAHF

2010-11-18T15:52:00.000-08:00

Yesterday afternoon, we returned from CAHF convention in Palm Springs. CAHF stands for The California Association of Health Facilities.

We met some fantastic people. We interacted with vendors, consultants, attorneys, providers, and association members, and were able to get to know their stories, their passion, and their enthusiasm for this amazing industry.

During the banquet, I sat across from a successful attorney, who represents providers on regulatory issues. He asked what we do, I mentioned that we provide Customer Satisfaction Interviews for Senior and Long-term Care providers. His immediate response was, "I'm amazed when providers don't hire someone to do that!" I agreed with him, citing an example of a client of ours who was able to prevent a lawsuit from happening, because he was able to act upon knowledge gained through our interviews. He replied, "EXACTLY! Just acting on knowledge right away goes a long way in preventing tens, if not HUNDREDS of thousand dollars in litigation!"

He had raised a really important point. In a very litigation-heavy society, the old saying of "an ounce of prevention is worth a pound of cure" really goes a long way. Simply giving customers a chance to voice their opinion will turn up things that you wouldn't otherwise know about. By rooting them out EARLY, and addressing them RIGHT AWAY, they won't fester and become more of an issue than they need to be.

For information on our Customer Satisfaction products, contact one of our experts at 801-293-0700.

Craig Christiansen
Pinnacle Quality Insight
www.pinnacleqi.com

Video: Imagine The Future of Aging, by AAHSA

2010-11-18T15:31:00.000-08:00

View this video posted by AAHSA entitled "Imagine The Future of Aging". The technology featured in this video is both fascinating, and heart-warming as it provides a higher quality of life.

We are honored to be working in an industry where we have such a positive impact on the lives of others. To all others who have chosen this field of work, we commend you!

How Is Your Web Presence For Your Company?

2010-11-02T12:54:00.000-07:00

In talking with thousands of companies across the country, we are finding that a large percentage of them do not have much in the way of a web presence. Some of them have a basic webpage, but even more alarming, many don't have a website at all. We know budgets are tight, and many things like websites can be put off, but there are now countless inexpensive options to get your business online in an attractive, professional manner.

One of the most common misconceptions we hear is that their clientele isn't using the internet to find a Hospice or Home Health Agency, Skilled Nursing Facility, or Assisted Living Center. Nothing could be further from the truth. Not only are your RESIDENTS using the internet more and more, but their children are using it--and it is more often the family members who choose the facility/agency for the resident.

A few months ago, AARP published an interesting study on the increase in Internet usage among those that are 50 years or older.
For the entire article, click here.

What can we learn from this article? Put resources into a strong online presence--not only for residents, but for their children, their siblings, their friends to see your facility, and get to know you before they inquire. Be proactive, so that all of the positive things about your company can be publicized and available.

Perhaps one of the best examples of an excellent online presence, is from one of our clients, Kindred Healthcare. Their site, www.continuethecare.com

One of the first things you'll notice, is the visuably appealing circles, which point to each type of care Kindred provides: Long-Term Acute Care, Inpatient REhab, Skilled Nursing, Assisted Living, Outpatient Rehab, Home Health Care, and Hospice. Clicking on each circle gives you a description, pictures, and in 2 cases (Long-Term Acute Care and Skilled Nursing) gives you a short video.

Down at the bottom of their website, you'll see 4 tabs, "Subscribe to our Newsletter, Find a Facility, Refer a Patient, and Join the Team. I'm surprised at how few companies provide a place for referrals to be submitted.

Finally, you'll notice at the bottom of the page "Follow the Care" with a Facebook and Twitter logo. Their Facebook profile is rich with contact information, news, pictures, videos, shared articles, and job postings. This is one of the best Facebook pages we've seen in this industry, but it is very important to know that they didn't build this profile overnight--but through consistent contributions over a long period of time. So don't be intimidated--just commit today to starting and continuing to build your own.

Action items:

1. COMMIT TODAY to building and improving your online presence.
2. Start a facebook page for your facility or agency. Upload photos, news, anything you possibly can.
3. Join twitter, and try to follow as many Senior Care and Long Term Care Professionals as you can.
4. If you don't have a website, you can purchase a webdomain from resources like www.godaddy.com for as low as 15 dollars per year. They have great resources for tech support if you have any questions.
5. Hire a professional to build your website. Make sure there are easy ways to submit referrals, contact you, and easy ways to find your facebook pages.
6. If you don't have the resources to have a custom website built, you can go to resources like tumblr.com, wordpress.com, or blogger.com to put together a blog that can function as your website. You can add pictures to your blog, a list of links, contact info, etc. You can have your new domain name "point to" or "mask" your blog address--so that even though your blog address might be www.yourSNF.tumblr.com, you can have it "masked" by your new domain name, so all your customer would see is "www.yourSNF.com"

The point with your web presence is to build it up on a consistent basis. Write a blog entry every week to add fresh new content. Add to your Facebook as often as possible. We know you are busy, but even half an hour per week goes a long way to being fresh and current.

Craig Christiansen
Pinnacle Quality Insight
801-716-4161

Obtaining More Resident Referrals--in Today's Marketplace

2010-11-02T11:02:00.000-07:00

How are you seeking or obtaining resident referrals for your facility?

Most Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs) are still following outdated methods for obtaining resident referrals. They seek referrals simply by meeting with doctors, social workers, or discharge planners at local hospitals. If their census is near 100%, this may be all they need to maintain a full census. But when a facility is sitting at 60-80% occupancy, it is time to update the methodology for seeking and obtaining referrals.

In October's edition of Provider Magazine, Patrick Connole has done a fantastic job of listing multiple sources for resident referrals. As he says in his article:

"The new world of long term care marketing has expanded the boundaries of where and from whom skilled nursing facilities (SNFs) and assisted living facilities (ALFs) seek referrals, from the old days of working only with discharge planners and social workers at hospitals to the 2010 version, where marketing targets practically anyone influencing seniors' post-acute care decisions."
He goes on to write:

"In addition to senior centers, post acute providers promote their services among themselves "home care, hospice, rehabilitation, SNF, ALF) and to those influencing seniors: estate planners, clergy, ophthalmologists, Meals on Whelles volunteers, pharmacists, paramedics, and many more stakeholders, says Rhoda Weiss, an international consultant, writer, and educator based in Santa Monica, Calif. "As the numbers of people needing post-acute care moves from seniors to younger generations suffering heart attacks, strokes, orthopedic issues, uncontrolled diabetes, asthma, trauma, and more, the SNFs, rehab facilities, home care, and other providers are expanding their marketing and rethinking strategies, tactics, and techniques," she says, tapping into her experience as past national chair the American Hospital Association Society for Healthcare Strategy and Market Development and ex-chief executive officer of the Public Relations Society of America."

Read the entire article here:

Other points covered in this article that are low cost: Putting up a Facebook page for your facility, use twitter to connect with other HealthCare professionals, Blog about Senior and Long-term Care.

Action Items for your Marketing Team:

Continue visiting with Discharge Planners, Social Workers, and Doctors.
Find ways to meet with Clergy--they typically know the health needs of the elderly worshipers in their parish.
Get to know Estate Planners in your area.
Set up a Facebook page. Use it to show off your facility, highlight vendors you work with who are doing an exceptional job, and give praise to your nurses and other employees.
Get involved in the Senior Care Twitter Community. Currently, Pinnacleqi is following over 700 professionals across the country, who have shared countless insights, thoughts, articles, best practices, etc.

My next article will highlight how to use the Web in more innovative ways to reach out to potential residents, and make the decision making process easier for them.

Craig Christiansen
801-716-4161
info@pinnacleqi.com

A Haunted SNF??

2010-10-29T15:34:00.000-07:00

Could it be that this SNF is haunted? One inquiry seems to think so…or at least that the Halloween Décor was hauntingly scary.

Here are direct quotes from some of the questions asked in our First Impression interview:

Reason for choosing (or not choosing) this facility: “The Halloween decorations truly gave me nightmares.”

Recommended Improvements: “I would consider not using things that will cause the ill to hallucinate.

Tour Process: I could not get past the decorations

Facility Cleanliness: Again I could not get past the decorations

Facility Appearance: It was dark, gloomy and horrifying.

Who knows if the facility actually had really scary décor, or if possibly the resident just doesn’t like Halloween. I would guess the facility was just having some fun, and it was probably not a big deal. But no matter what, it’s important to receive insight into what your customer base thinks and feels.

We hope you enjoyed our “Halloween Edition” of our Pinnacle Blog, and we wish you a very happy Halloween!

Craig Christiansen

Pinnacle Quality Insight

AARP Study Examines Social Media Usage For 50+ Adults

2010-06-07T14:05:00.001-07:00

We often speak with Home Health Agencies, Skilled Nursing Facilities, and Assisted Living Centers who are not on Facebook, or do not have a website. Reasons we hear are that they have not "gotten around to" putting up a website, or perhaps they do not see the benefit of having their facility or agency listed on Facebook.

In a recent study conducted by AARP, Social Media usage was examined among adults over the age of 50 that may change some opinions about how useful websites and Social Networking sites can be within our industry. Some interesting statistics were discovered. For example:

Two out of five (40%) adults age 50 and over consider themselves extremely (17%) or very (23%) comfortable using the Internet. One out of five (21%) Hispanic adults age 50 and over consider themselves extremely (6%) or very (15%) comfortable using the Internet.

Approximately one-quarter of all those 50+ use social media websites (27%) with Facebook being by far the most popular (23%). Among those who say they access the Internet, almost two-fifths (37%) use social networking sites, with almost one-third (31%) using Facebook. Approximately one-fifth of all Hispanics 50+ use social media websites (21%) with Facebook being the most popular (13%).

Among adults 50+ who use social media websites, three-quarters (73%) are connected to relatives other than children and grandchildren, three-fifths are connected to their children (62%), and one-third (36%) are connected to grandchildren. Among those introduced by a family member, three-fifths (63%) said it was their child.

For the entire study results, click on the following link:

http://assets.aarp.org/rgcenter/general/socmedia.pdf

We highly recommend you post your agency in Facebook. Post pictures of your staff, your facility, anything you can to give it a more personal touch. DEFINITELY put up a website—as more and more potential customers are googling your company's name.

Craig Christiansen
Pinnacle Quality Insight

Renault’s New Swivel Seat Could Help Senior Drivers and Passengers

2010-04-26T09:31:00.000-07:00

I saw this new innovation on the blog elderguru.com. I'll quote part of his blog here, with a reference to the entire article below:

"Here is a “Why didn’t I think of that?” idea for car manufacturers. The Renault Clio car has a newly designed swivel seat. Seriously – why hasn’t this been thought of before, especially for cars built with elder drivers in mind?"

See the entire blog here.

Stan Magleby
www.pinnacleqi.com

Using Voicemails For Your After-Hours Intake Process

2010-04-07T15:52:00.001-07:00

We are seeing concerning trend develop recently in our mystery shopper product. More and more often, as we call facilities after hours we are getting automated answering machines. These machines take the caller through a series of steps that are quite time-consuming and confusing. In many cases, the "admissions" option is not mentioned upfront or easily. I can only imagine the frustration of someone trying to call into a facility with something extremely important, including an after hours inquiry.

Imagine if you were calling into a facility with a question about admitting a family member and you had to go through a lengthy process just to get a recorded message. Most people in this situation will not go through this aggravation, many will stop the process and call the next facility on their list.

I realize automated phone systems are a convenience and save on staffing, but before using these systems you should seriously consider the frustration they create and the potential inquiries that are being lost.

Stan Magleby
www.pinnacleqi.com

Insightful Quote Of The Day: Being Stretched Too Thin

2010-03-17T10:21:00.000-07:00

Here is a comment we recently heard in one of our interviews:

"The nursing staff was stretched too thin, especially the evening shift. There were so many patients, and sometimes I got my medicine two hours late".

Comments like this are some of the most common we receive. This should be big concern to all facilities as they prepare for the QIS process. One of the questions that will be asked in the interview segment of QIS is, " Do you feel there is enough staff available to make sure you get the care and assistance you need without having to wait a long time?"

Please follow this blog to learn more about the QIS interview questions.

Stan Magleby

www.pinnacleqi.com

Insightful Quote Of The Day: Patients And Residents Appreciate The Calls

2010-02-24T15:05:00.001-08:00

Just yesterday, one of our callers was told the following:

"I appreciate the phone call and knowing they are interested in improving and hearing what their patients and their families have to say. That makes me feel good."

This is something we hear quite often. Patients and residents usually like these phone calls. It gives them a voice in the quality of their care, which is one of the more important things in their life.

Stan Magleby
www.pinnacleqi.com

News Update for Texas SNFs

2010-02-15T12:42:00.000-08:00

A recent modification to the Texas Department of Aging and Disability Services has been made. In an article posted February 14, 2010 by Vince Galloro:

The Texas Department of Aging and Disability Services said that it will add 35 investigators to speed its response to complaints about nursing homes.

The department has 316 investigators who spend all or part of their time inspecting nursing homes, and they respond within 24 hours to 99% of the most serious complaints, known as “priority one” cases, the department said.

With “priority two” complaints, however, investigators were able to respond to only one-third of the cases within the 14 days required by state guidelines, the department said. The department regulated nearly 1,200 nursing homes and investigated more than 16,000 complaints in fiscal year 2009. Fewer than a fifth of those complaints could be substantiated.

The department also is setting up several complaint investigation teams that include nurses, nutritionists, social workers and investigators.

Click here for the complete article.

Stan Magleby

www.pinnacleqi.com

Insightful Quote of the Day: Safety Concerns

2010-02-15T09:42:00.000-08:00

We had a quote that came through recently that serves as a reminder to constantly be on the alert for safety concerns.

"They should get rid of the wires hanging loosely outside, which could be obstacles if there was a fire. It's a safety hazard."

Sometimes we forget to try to see the world through the eyes of those we are caring for. In the case of vision or mobility difficulty, something as simple as loose wires can seem like quite an obstacle.

Stan Magleby
www.pinnacleqi.com

Quick Tip: Attitude

2010-01-18T14:23:00.000-08:00

I just came across this comment. This is such a great comment, I just wanted to share it with you:

"I like to see a happy face without an attitude. If you have a good attitude it helps everyone around you."

Our residents and patients have enough things to worry about, sometimes they just need our attitude to buoy them up and lift their spirits.

Stan Magleby
www.pinnacleqi.com

Insightful Quote Of The Day: Seeking Our Resident's Perspective

2010-01-18T14:19:00.000-08:00

Here are some insightful comments from this past week from our First Impression and Customer Satisfaction interviews. They don't need a whole lot of intro, other than each one gives greater insight into the experience our patients and residents are having. Each quote is from a separate individual:

"I was in bed one night. I woke up and looked around, and there was a guy sitting in my chair drinking my pop. I called the nurses, and it took them a while to respond. That man that was in my room could have been an ax killer."

"They made a big mistake and over exercised me. I'm ninety-two years old. They shouldn't have tried to get me back like I was at eighty-eight or eighty-nine."

"I (female) didn't like sharing the toilet with two men on the other side."

"I complained about one of the aides in morning care. All they did was ship her to the other side. They must not care what kind of care she is giving."

"They told me he was going home in one week, and it finally happened three weeks later. The communication was not very good."

Awareness of other's perspective is often the first step towards better care.

Stan Magleby
www.pinnacleqi.com

Today's Quote: Bedside Manner

2010-01-13T14:59:00.000-08:00

We hear comments like this more often than we'd like:

"The facility doctor had a terrible bedside manner and wasn't at all helpful."

I know this issue can be very frustrating. Somehow we need to work with our doctor's to assure they have an understanding of the individuals we work with and the importance of respect in our profession.

Stan Magleby

www.pinnacleqi.com

Insightful Quote Of The Day: Welcoming New Residents

2010-01-12T10:42:00.000-08:00

Here are two responses at opposite ends of the spectrum that emphasize the importance of properly welcoming new patients:

"I really appreciated that the administrator and a lot of the staff came to my room and welcomed me to the facility."
"I never met the administrator the whole time I was in the facility."

Of the two, you definitely want the first to be said about you. It's a good reminder that your facility is now someone's HOME. It's very important to properly welcome those we bring onto our services.

Stan Magleby
www.pinnacleqi.com

Quick Tip: Being Prepared For Unannounced Tours

2010-01-12T10:31:00.000-08:00

Here is a great comment from one of our First Impression interviews. This came from a family member who was interested in admitting her mother into this facility:

"I went in unannounced, and it was right in the middle of a Christmas party. I was so pleased with the admission person because she took the time to show me around and explain everything in detail and spent a lot of time asking about my mother's needs. I spent two hours with them. I was thoroughly impressed."

We should be prepared for an inquiry at ANY time. More and more, potential inquiries are being taught that an unannounced tour is the best way to truly see how a facility is running.

Stan Magleby
www.pinnacleqi.com

Insightful Quote Of The Day: Hand Sanitizer

2010-01-11T10:45:00.000-08:00

Here is a interview comment I came across today:

"The only thing that I thought was cheap on their part was not providing hand sanitizer. If nothing else, it makes people aware of keeping their hands clean and in that environment, that's important."

Stan Magleby
www.pinnacleqi.com

Recipients of Pinnacle Quality Insight Scholarship

2010-01-08T14:27:00.000-08:00

Congratulations to Heather Sowa and Haseena Vaswani, who were recently awarded Pinnacle Quality Insight Scholarships.

Heather has been in long term care for more than 5 years and is currently an LPN at Oregon City Health Care Center, Prestige Care, Inc. She is enrolled in the nursing program at Chemeketa Community College and plans to complete her Associate Degree in June 2010. Her short term goal is to become an RN in June and then she plans to begin a Bachelor of Science program in September 2010.

Haseena has been working in long term care for nearly 7 years and is currently the Social Services Director at Marquis Care at Hope Village, Marquis Companies. She plans to apply to the Masters in Social Work program at Portland State University in January 2010. Haseena is passionate about pursuing further education so she may provide greater social services to seniors in long term care. She believes more education about the resources available for mental health is necessary in providing better quality of life for the aging population.

Congratulations to both of you, we wish you continued success!

Stan Magleby

www.pinnacleqi.com

Insightful Quote Of The Day: Appropriate Attire

2010-01-06T15:31:00.001-08:00

I have to admit, I had a good laugh when I read this recent Home Health interview:

"The girls that came were 'slutty' and unprofessional. There was only one girl that wore scrubs one time. They had on very low cut shirts they were falling out of, and painted on pants. They made my husband so uncomfortable. When he asked them why they weren't wearing scrubs, they told him they were going out later."

Though this comment seems somewhat comical, the point is very serious. We need to ensure we are always showing the proper respect for those we care for, and appropriate dress is an important aspect of respect. We also need to be aware of how our employees are a reflection of our business and brand.

Stan Magleby

www.pinnacleqi.com

Today's Quote: Meal Time Staffing

2010-01-04T15:52:00.000-08:00

Here is a comment we hear on a regular basis:

"When it was meal time, all of the nursing staff went down to the lunch room. The patients that couldn't go down there couldn't get help when they pressed the call button because everybody was in the lunch room."

We all know that it is very important to fully staff the dining rooms during meal times. Yet it is also very important to evaluate the systems to assure the patients who choose to stay in their rooms are not neglected.

Stan Magleby
www.pinnacleqi.com

Discharge Reasons

2009-12-31T09:41:00.000-08:00

There are many reasons to truly understand the satisfaction levels of patients upon discharge.

How was their overall satisfaction with their service?
How well are they adjusting to their new surroundings?
Would they recommend your services to others?
Do they need any additional services?

A high quality feedback system must find out this very valuable information.

Another valuable tool in our discharge feedback system is what we call a 'Focus Interview'. More and more we are being asked to conduct 'Focus Interviews'. At times, facilities/agencies will have patients that leave service before their specific needs are met. This can leave some unanswered questions as to why the person left service so abruptly. Our 'Focus Interview' has proven to be a non threatening yet direct tool for our clients to obtain this very important discharge feedback.

Stan Magleby
www.pinnacleqi.com

Quick Tip: Knowing What Patients and Their Families Value Most

2009-12-31T09:39:00.000-08:00

Do you know what your patients and their family members value most when it comes to receiving or looking for services? We think this is very important to know. The statements we receive during our interviews are so very powerful. Here are just a few comments that we have recently received about what they value most:

"I value the staff-to-patient ratio and their ability to meet the patients' needs".

"I value the staff respecting each patient, listening to their every need, and then meeting those needs".
"I value a good staff that really enjoys what they do".

Stan Magleby
www.pinnacleqi.com

Quick Tip: Feeling Safe and Secure

2009-12-31T09:22:00.000-08:00

It is so important and such a basic need to feel safe and secure in your surroundings. This is one of the most powerful and ongoing points brought up by those we interview. Here are just a few comments we have recently received when interviewing customers of well run facilities:

"When it comes to the care I receive, good staff and safety are the most important to me."
"I can sleep well at night knowing that my Mother is safe and secure."
"I appreciate the facility keeping me informed about my loved one's safety."

Stan Magleby
www.pinnacleqi.com

Insightful Quote Of The Day

2009-12-30T10:24:00.000-08:00

Here's a quote that came up in one of our customer satisfaction interviews:

"I value the staff respecting each patient, listening to their needs, and then meeting those needs."

This is a great mini-testimonial, ideal for a brochure or facility website.

Stan Magleby

www.pinnacleqi.com

New Blog Category: Insightful Quote of the Day

2009-12-22T13:23:00.000-08:00

From time to time, we’ll be posting a “Insightful Quote of the Day”. This will be a direct quote from one of the conversations we have with those we interview, where we will cite something of particular value that we have recorded.

We’ll be quoting answers from two particular questions:

With the care that your loved one is receiving what do you appreciate the most?

Designed to inform you of what specific things families appreciate about the care being given.

What do you value most from any care provider?

Knowing what factors prompt people to buy is the holy grail of insight for any type of business. This question generates feedback about what they would be looking for in a facility, as well as what they most appreciate about the actual facility/agency.

Stan Magleby
www.pinnacleqi.com

Communicating With Upset Customers

2009-12-16T11:19:00.000-08:00

There are times that we all have to deal with upset customers. Avoiding these customers is the worst thing a health care provider can do. However unpleasant, communicating directly with disgruntled patients/family members must happen immediately. If handled correctly, you will have an opportunity to not only resolve the issue, you may create a more loyal customer in the process.

In our interview process, we send an immediate comment alert when a client or family member has a serious frustration with their service. Recently, one of our clients received an alert that one of their families was very upset over an issue. This family was very angry and ready to discharge their loved one. Our client was able to deal with the family’s issues immediately and appropriately, and the issue was resolved.

Our comment alert made the company aware of the issue, but through immediate communication they improved the relationship.

Stan Magleby

www.pinnacleqi.com

Quick Tip: Referral Sources

2009-12-15T11:38:00.000-08:00

Do you know what your local discharge planners are telling prospective clients about your facility or agency? From a marketing point of view, this is some of the most important feedback we should be aware of.

Over the years, we have been asked if we can conduct such feedback interviews. Quite honestly, conducting these interviews is just about impossible. We have found that discharge planners generally see it as a conflict of interest to give specific feedback regarding those they refer to.

So how do you get this feedback? Best practice is to make sure you ask each inquiry, referral, and admission the reason they chose to inquire about your specific facility/agency. Here are just a few of these powerful comments we have received by asking this question:

"We were told at the hospital that this was the best facility in the area for Physical Therapy."

"We were pleased and yet surprised with how good the care was, especially considering the negative information that we initially received from the hospital."

"We were so pleased with the care my mother received, I couldn't wait to go back to the social workers at the hospital and thank them for the recommendation."

Stan Magleby

www.pinnacleqi.com

Quick Tip: Cut Down Dining Room Wait Time

2009-12-11T14:15:00.000-08:00

Many of the interviews we conduct mention that "they experience a lot of frustration because they have to wait too long for their meals to be be served".

We see that waiting too long for a meal to be served increases the overall agitation in a facility. Waiting too long can also have a negative impact on one's perception of the quality of the food.

Stan Magleby

www.pinnacleqi.com

Quick Tip: Employee Retention

2009-12-11T14:02:00.000-08:00

One of the questions we ask in our employee retention interviews is, "What can be done to improve the work atmosphere?"

A comment that we hear quite often is, "I would appreciate more consistent feedback and communication from my supervisor regarding my job performance."

This comment comes up very often in our exit interviews also, the only difference is it is usually mentioned when asked, "What was the main reason for quitting your job?"

Stan Magleby

www.pinnacleqi.com

Quick Tip: Your After Hours Intake Process

2009-12-07T09:29:00.000-08:00

Do you really know what your staff is saying about your services during an after hours phone inquiry? Our research shows that many facilities and agencies are losing potential admissions due to improper intake procedures and training.

During a recent Mystery Shopper call, a weekend nurse told us that the care was "just okay". When asked about the food, her response was, "well it's not good at all".

Many companies train their weekday staff in intake processes, yet neglect this training for the weekend and evening staff.

It is very important to realize that many people start their inquiry efforts in the evenings and on the weekends.

For questions about how we assist companies with their after hours intake process, contact one of our Mystery Shopper experts at 801-293-0700.

Stan Magleby
www.pinnacleqi.com

Quick Tip: Recommendations

2009-12-03T14:05:00.000-08:00

In a recent First Impression interview, the person being interviewed commented that due to certain circumstances they were unable to admit their loved one into the facility. However, because the facility had done such a great job with the whole inquiry process, they have recommended this facility to many of their friends and know of at least three people who have admitted because of their recommendations.

This example illustrates the importance of positive experiences and the effect it can have on marketing. It also demonstrates the importance of following up with inquiries. This person had valuable feedback that would not have otherwise been heard.

Stan Magleby
www.pinnacleqi.com

Best Practice: Inquiries

2009-12-03T14:03:00.000-08:00

In a recent First Impression interview, the person being interviewed said, "We were very impressed and would have admitted our loved one to the facility, but no one has ever gotten back to us or returned our phone calls".

The intake process doesn’t end with the tour. Even if you are not using Census Development or any other inquiry-tracking software, it is imperative to have some system to track the progression of your inquiries.

Best practice is to have a list of all open inquiries and work with that list each day. An Inquiry is considered “open” until one of three things happens:

1. The prospect admits.
2. The prospect chooses not to admit.
3. The prospect is denied placement.

Chris Magleby
www.pinnacleqi.com

Quick Tip: Employee Recognition

2009-12-03T13:58:00.000-08:00

During a customer satisfaction interview, those being interviewed will often mention and compliment staff members by name.

Make sure that you use these opportunities to recognize/reward these specific staff members. This is a simple and effective way to build morale.

Stan Magleby
www.pinnacleqi.com

Quick Tip: Noisy Night Shifts

2009-12-02T15:36:00.000-08:00

For many years now we have seen a very frequent comment in our customer feedback interviews regarding excess staff noise on the graveyard shift.

One person recently said, " It got very noisy at night. The staff would get really loud and chatty, this made it very difficult to get any sleep".

I doubt if any of the staff were being loud or chatty on purpose. Sometimes becoming aware of the problem is the first step in fixing it.

Stan Magleby

www.pinnacleqi.com

Quick Tip: Cell Phone Usage

2009-12-02T15:07:00.000-08:00

In a recent customer feedback interview, it was stated that "many of the staff were paying more attention to their cell phones than to the patients". This is a trend that we are hearing more and more in our interviews.

We recommend that all companies take a good look their cell phone policy and recognize that this is a noticeable concern for those being cared for.

Stan Magleby
www.pinnacleqi.com

Anonymous vs. Onymous Surveys For Senior and Long-Term Care

2009-11-17T15:14:00.000-08:00

Onymous: Adj: “Bearing a name.”

Many Senior and Long-term care companies believe that for customer satisfaction interviews to be effective, they need to be done anonymously. Their logic is based on that idea that anonymity is the only way to provide an avenue where people can provide objective feedback about what they really think and feel without fear of retribution or punishment. This may work in some industries, but as you know, Senior and Long-term care is not like The Gap, it isn't like a Lexus dealership, and it is not like a restaurant. In fact, it is not like any other industry.

With 14 years experience providing services exclusively to Senior and Long-term care companies, we have found that not only do people give very candid feedback when providing their name in the survey, but they actually PREFER including their name with feedback. We give each resident and family member we interview the very clear, specific option of being anonymous. And after interviewing tens of thousands of individuals, ninety-eight percent choose willingly to provide their name to the interview, or to give their opinion "onymously".

Why are they so eager to attach their name to their feedback? There are several reasons:

The long-term care of the individual being interviewed, or that of their loved one, is one of the most important things they have ever dealt with in their lives. With something that important, they WANT to provide insight; they want their voice identified.
Enabling them to attach their name allows individual needs to be met. For example, if a resident has specific dietary needs following a needed surgery, attaching their name allows not only the patient specific care, but the chance for the resident to feel like they are being cared for as an individual. This increases loyalty, and fosters a better image in the community.
It provides a forum of dialog for the family and/or resident—which can diffuse any potential issues from arising, instead of allowing them to fester and become serious problems or complaints. It is far better to hear the issue out in the open directly from the resident or family than from an ombudsman or attorney. Open communication is always best.
It allows them to feel heard. The most frequent comment we receive is, “Thank you for giving me a chance to have a voice here.”

These reasons provide resident-side benefits to the feedback not being anonymous. There are also several facility-side benefits to onymous feedback:

It allows the administration to address any issues far more quickly and effectively. Every so often, our interviews uncover an isolated complaint within the 2% of those preferring to be anonymous. We send the reports to the administrator, who will inevitably turn to us and ask, “How can I correct this, if I don’t know who it is?” Having a specific complaint without a name attached slows down the correction of the issue, whereas having a name attached allows for immediate correction to the care provided.
It allows the facility to truly give individual-based care. The current movement in Skilled Nursing is to go through a culture change in the direction of “individual based care” or “resident based care.” When you are looking at a report with names of individuals attached, individual or resident-based care really can begin.

We provide high quality insight to health-care companies into all aspects of their care their patient or resident experience. Through "onymous" feedback, we give these Long-term and Senior Care companies a pure form of feedback and a direct communication link back to the important individuals they serve.

For more information on how to set up interviews for your facility, contact one of our customer satisfaction specialists at Pinnacle Quality Insight, at (801) 293-0700.

--Craig Christiansen
www.pinnacleqi.com

Phone vs Mailer Surveys

2009-11-16T22:14:00.000-08:00

Most every company realizes they have to survey their customers. Just last night I bought a few things at Radio Shack, and after ringing up my purchases the clerk said, “And if you want to save an additional $10 on your next purchase, just go online and fill out this survey on how we’re doing”. He circled the web address, and slid the receipt across the counter to me.

I get this type of survey request all the time. “For an additional 15% off your next visit, fill out this survey.” I typically get them when I’m just checking out, either on the back of the receipt or a separate piece of paper altogether. They all have basically the same premise: Go online, fill out a survey, and next time receive a discount. I’ve received them from auto-repair shops, hair stylists, restaurants, and as of last night, an electronics store. I think in principle, it’s sound: offer an incentive to fill out a survey, and make it ultra-convenient. But there’s only one problem:

I’ve never done one.

I’m tightening my budget like the next person, looking for good deals where I can find them, yet these receipts still sit crumbled next to my keys when I empty out my pockets at the end of the night. So even though I’m online, or have close access to the internet most of my working day, I’ve never filled out a single online survey. I’m almost ashamed at the fact. In truth, I can only remember going through one survey over the past 3 years—and it was over the phone about a car buying experience I’d had. It was done by a third party, and it took about 10 minutes. The surveyor was polite, friendly, and was clear he was calling on behalf of the dealership—who was using the surveys as a way to improve their service. He called while I was shopping at the grocery store, and once he had me on the line, I thought, “Why not?” and went through the survey. Oddly enough, it required more effort, and probably more time to go through a survey over the phone. But I was much more eager to do so than I have been to complete any online or written survey.

Here are some of the reasons why:

1. Procrastination: As human beings, we tend to procrastinate things we don’t HAVE to do. I don’t have any sort of natural deadline to do an online survey—just some time prior to my next visit…so what happens? I put it off. A phone survey is right now. There they are, on the phone, and it’ll only take a few minutes. It’s much easier to just think, “why not?” than it is to overcome the natural tendency to procrastinate.
2. It’s easier to speak your mind than to write it: It’s both mentally and physically easier to talk to someone about your opinion than it is to write it out. Oral surveys can produce much more data, and a free-flow of thought that written surveys won’t produce, even if you ask them the same question. When presented with an open field for feedback, people often look at it with the same anxiety they did with essay questions in school—wondering if they are going to say it perfectly, hoping they don’t make any mistakes. Furthermore, when dealing with Home Care patients, many times you are dealing with individuals with physical limitations such as joint pain or vision loss. Speaking bypasses these difficulties.
3. More Personable: Phone surveys convey a personable message about your company, which shows how service oriented you are. So much so, that you are reaching out to THEM—you value their opinion enough to take the effort to contact them. A written survey feels like a form letter and places the responsibility on them. I frequently tell clients, “The more impersonal the medium, the more impersonal the feedback.” If you distance yourself from your customers through the medium, you will get feedback that is also quite distant from what they are really thinking and feeling. If your favorite relative were to contact you, would you prefer they called you or sent you a form letter? Treat your patients in a personable nature and they will be loyal to you.
4. Easier Clarification: Being on the phone makes it easier to understand what really matters to the respondent. For example, if an area receives a low score, a phone interviewer can ask for clarification or an elaboration of the score. Through additional qualitative feedback, the respondent can clearly explain how important that particular area is. Mailer surveys typically don’t get as much qualitative feedback, and therefore each score is neutral in importance to the customer. So conceivably, you could get low scores in an area that really doesn’t matter much to the respondent.
5. The desire to help others have a better experience outweighs the prospect of gain: The surveyor I spoke with made his intentions quite clear. He was contracted by the company in question to see what could be done to improve their service. I felt a sense of duty, like I was helping other customers—as if by filling out this survey, it would help the next person have a much more pleasant experience. I don’t remember any incentive other than simply helping the dealership do things better, and thereby helping the next person have a better experience. This is exactly why if you ask someone to help you move as a favor, they will break their back helping you lug your heavy furniture around awkward corners. However, if you offer them money, they’ll weigh the prospect of giving up their Saturday for a few bucks.

To sum up, surveying by phone is valuable for increasing the loyalty of your patients and their families. It furthers your image as a service-oriented agency who cares about providing the optimal care. In addition, it provides valuable insight into how you can improve your agency to the point that you become, and remain, the only logical choice for homecare in your market.

For information on how you can have phone surveys done for your senior care or long-term care company, call Pinnacle Quality Insight at (801) 293-0700 and speak with one of our survey consultants.

--Craig Christiansen