Like most of you, we have attended a lot of conferences, workshops and seminars since entering the “Senior Living” sector. As repeat attendees of The Annual Memory Care Summit and representing a graduate of The Erickson School, we have one single expectation from the UMBC Aging brand and team – delivery of academic and person-centered content that can “excite and delight” business as usual. We use that phrase intentionally because our own team has just finished a group read (on Audible – our go to “employee training” app) of Joseph Coughlin’s “Longevity Economy.” Coughlin, introduces – among several other things – the concept of “transcendent” design where we focus on developing consumer products that will excite and delight all ages and not seniors alone. He encourages all of us to embrace what we would consider a “strengths-based” approach – where we design products for ability and inclusive opportunity rather than trying to solve problems that only highlight deficits in the targeted end-user. This kind of thinking should apply equally to our planned communities and programming.
“Our heritage and ideals, our code and standards – the things we live by and teach our children – are preserved or diminished by how freely we exchange ideas and feelings”
American entrepreneur,The Walt Disney Company
We are entering (or perhaps returning to) a new chapter in our Industry and culture where the curse of knowledge (in business and clinically) is being replaced by an emphasis on the fundamentals of imagination and relationship-building. What kind of future would we imagine, and then build, if we focused more exclusively on engaging across generations and sharing stories, experience and knowledge to that universal end?
Imagination vs Experience
If last year was about creating magical moments, and fine tuning company culture for sustained results, this year offered the charge to advance our Iconoclast Quotient (IQ) in recognition that while “Logic will take you from A to B, Imagination will take you anywhere.” Ideas and Interests are converging at an accelerated pace. If we want to offer health and wellness services to family, staff and residents, we will be required to meet our customers (all of them) wherever they are – and it will take the whole village to support their wants and needs effectively. In the past we have relied upon experience to light our path. In the immediate future we all need to be trailblazers of some degree.
Heroism and Incrementalism
In typical Erickson School fashion (this is the academic influence) a series of “pre-reading” materials were circulated via Dropbox to attendees – among these was a link from Bob Kramer of NIC to a recent New Yorker piece entitled “ The Heroism of Incremental Care” In the article, Atul Gawande shares an interesting metaphor surrounding the collapse of the Silver Bridge in 1967:
“The collapse signaled the need for a new strategy. Although much of the United States’ highway system was still relatively new, hundreds of bridges were more than forty years old and had been designed, like the Silver Bridge, for Model T traffic. Our system was entering middle age, and we didn’t have a plan for it.”
In this essay, emphasis was tied largely to the dichotomy of surgeons (heroes) and primary care physicians (incrementalists). For our purposes here, the relationship between outdated transportation infrastructure and our own bricks and mortar in Senior Living is key. We all know that we are developing products that are designed around realities/constraints and beliefs that are no longer relevant – like the Model T – and yet we still charge on without reconsidering the viability of our footings. It is worth emphasizing that EVERY time a guest speaker has joined the stage (we have been to four of the six events) they are emphatic about not wanting our “products or services.” We clearly need visionaries and iconoclasts to chart new courses for our Industry where we focus on engagement instead of behavior management alone.
5 Leadership Lessons from The Disney Institute
As leaders in the “Imagination” department, Mark Matheis offered the Disney Company’s’ perspective on how best to execute your plans once imagined:
Leaders establish, operationalize, and sustain the values and vision by which their organizations thrive.
Great leaders proactively establish values.
The more a vision can be expressed in a vivid, imaginative way, the more it will motivate people to action in the present.
Storytelling is an essential strategy for the communication of new ideas; people are more engaged and inspired by information presented through compelling narratives
The best legacy is not one that is fondly remembered, but one that is actively emulated
Value is created when Silos Break down
In “What the Smart Money Wants from You,” Robert Kramer, Founder & Strategic Advisor to The National Investment Center for Seniors Housing & Care, shared Industry Data and offered his own insight toward three drivers that are influencing our vision and narrative for the future:
The Longevity Revolution (Silver Tsunami)
Data, Robotics and Mass Customization
Healthcare Payment & Delivery Reform
“We always overestimate the change that will occur in the next two years…and underestimate the change that will occur in the next ten”
American business magnate,Microsoft Corporation
In his engaging presentation, Bob Kramer offered his invaluable insight (replete with data metrics of course!) into the future of aging, how it is being redefined by emerging trends and the anticipated impact of “new retirees”. The later will be represented by “transitions” to encore professions as opposed to traditional retirement. Bob’s own circumstances are illustrative of this occurrence. Having been recognized as the CEO leader breeding the remarkable success of NIC as the premier research, educational and data source for the Seniors Housing & Care Industry, Bob now transitions to Chief Strategist for NIC. Undoubtedly he, like numerous other industry veterans, including the likes of John Erickson and Dr, Judah Ronch representing the Summit, will continue to influence and shape the future of aging. These are not declinists but rather industry treasures to engage and leverage.
The Declinist view of Retirement where seniors unplugged to enjoy their golden years is clearly outdated (like the Silver Bridge) and being replaced by a new emphasis on engagement where residents will want to be become integrated with the communities they choose in an intentional and productive way. As the “diaspora” of healthcare continues and senior services become “uberized,” it will become increasingly difficult to compete with the demand for full service and retail “life management” solutions. Lifestyle coupled with the presence of supportive care proving more intergenerational and “connected” will give rise to the trends of desire trumping needs. Where will we plug in to the new value equation as developers, operators, caregivers? Imagine a future of aging where business constituents are more “collaborative” than “competitive”. These trends are the leading indicators of integrative thinking (points from Dr. Ronch) and more integrated business models that emulate the real world.
Imagine a Cure for Alzheimer’s, Then What?
Scott Townsley’s session was centered around the assumption of a cure for Alzheimer’s. Whether or not a cure is on a horizon, this kind of open-ended / creative thinking enables us to focus on the survivable (or missing) attributes of our business and its offerings. Ironically, these attributes or amenities might actually define our core because they are likely “transcendent.”
“People don’t want to buy a quarter-inch drill, they want a quarter-inch hole”
American economist and professor ,Harvard Business School
The traps of quality and superiority were addressed where the former represents the sentiment that well established organizations don’t need to change (until it is too late) and the latter assumes that a premium offering will also maintain its hegemony – except that customers ultimately crave simpler, cheaper incumbents. The final ¼” drill trap presented echoed the detriments of Marketing Myopia where we forget that we are selling solutions not widgets. If we are struggling to identify our own value proposition as an organization, this exercise creates an opportunity to highlight (and work to close) the gap between what we think we are selling (i.e. memory care) and what the market wants to purchase for themselves or loved ones (valued relationships and engagement).
Awe – using art to create relationships
If you are not aware, The Erickson School strategically front-ends the program with business and academic content and reserves the final book-end for local guest speakers that can help to ground and synthesize our thinking (by tempering it) with the raw emotional reality of people and their own first-person caregiving stories. Just before these guests arrived, we were primed for the transition through Anne Basting and a re-telling of her incredible work. She relayed how her experience of introducing the transformational power of theatre to people with memory care issues enabled them to engage instead of being alone together.
“The arts are a way of being in relationship, of seeing and shaping the world. My work brings the tools of imagination and creative expression to care relationships and systems in order to foster healing through community building. We cannot heal without story”
Artist, Scholar, Teacher,UWM Center on Age & Community; Founder, TimeSlips
It should not be surprising that an entertainment giant like Disney would proffer the same insights garnered from improvisational arts. Storytelling creates a safe space for everyone through abstraction – when you create an open environment, expression naturally fills the vacuum. What does this look like in the built environment? Or is architecture just a shell if it is filled with genuinely human activities? In any case, the challenge is not just how do we create a better physical space for Memory Care but rather, how can we establish a broader network of engaging human activities? We need life centers where everyone can thrive.
To echo Atul Gawande’s essay once more, “Our ability to use information to understand and reshape the future is accelerating in multiple ways.” He continues to describe that “we have at least four major data inputs that reflect our health and wellness over time, (1) information about the state of your internal systems (from your imaging and lab-test results, your genome sequencing); (2) the state of your living conditions (your housing, community, economic, and environmental circumstances); (3) the state of the care you receive (what your practitioners have done and how well they did it, what medications and other treatments they have provided); and (4) the state of your behaviors (your patterns of sleep, exercise, stress, eating, sexual activity, adherence to treatments).”
When you consider the scope of these inputs, it becomes clear that we will need more bandwidth to capture all of this data and make use of it in a meaningful way. It is unlikely that a sole “hero” provider will venture off into the forest and return with a miracle solution for Alzheimer’s or any other dis-ease. Of course, if you have eyes to see and ears to hear, we might already be the miracle we are searching for.
“Remember, creative power will not operate itself. Knowing what to do is not enough. You, imagination’s operant power, must be willing to assume that things are as you desire them to be before they can ever come to pass.”
Author and Teacher
In this sixth year of the summit, we were all called to cultivate our iconoclastic quotient (IQ) so that the future we imagine is built on solid ground instead of crumbling foundations. We were also reminded that if engagement is the ultimate prescription, then we cannot succeed in isolation. Let’s take inventory of our respective strengths so that we can catalog and distribute the dimensional inputs of health and wellness together as due-diligence only. The shared moon-shot is to leverage the data and best practices to craft a new story about how we can age more actively and remain engaged together.
What have we learned? Savvy business leaders are beginning to realize that much of the scaffolding for innovation has already been built by digital giants and the entrepreneurial community. Connectivity to these resources is lost absent more integrative thinking that rescues one from a siloed context. Mobile technologies in particular are seemingly ubiquitous and often designed for a broad array of user personas – not just boomers or seniors. There is an obvious silver lining here when we step outside of our aging services vertical – and allow ourselves to be informed by what we see in app stores, Kickstarter,Indiegogo and directories like Product Hunt. – we are reminded that many so-called industry-related problems are really just universal human problems in disguise. More importantly, many of these challenges are already being solved (or at least addressed) in adjacent spaces that are unencumbered by the concept of age cohorts.
How might we better connect the dots and foster more integrative solutions? Herein lies the opportunity contemplated by the Aging 2.0 Boston Reverse Pitch event where provider constituents in the field of Aging Services engaged in discussing how “new” repurposed tools and services might be responsive to distinct problems and challenges confronting the so-called Future of Aging. The Panel Participants were charged with identifying “passionate problems” in their own enterprise that are ripe for innovative solutions and offering them up to designers and entrepreneurs in the audience who might have an idea about how to accelerate a solution to market. Through the intersection of organizations like Aging 2.0, MeHI and Continuum Innovation, we now have a relatively captive audience for the most coveted resources of (1) designers that can create and/or reimagine tools, and (2) providers representing users that can test them.
The Reverse Pitches
The following presents “Passionate Problem” statements shared by each of the Provider panelists:
“People with dementia often don’t have the ability to communicate their physical and emotional needs. What if there were a way to make family and professional caregivers aware of those needs as they were happening?”
“We need technology that will liberate our workforce from managing information and deliver real time wearable data on a resident’s preferences, conditions and care plans as soon as they enter the resident’s home.”
Where do we go from here?
While topics of discussion were diverse, two broad elements of commonality seemed to emerge to constitute a “theme” of the event – or at least the “takeaway” challenge. First, connectivity inasmuch as technology is breeding a smaller world with real time access to one another and critical information. Second, the growing need for personalization of technologies that can be customized to individual needs and preferences. In the realm of Aging Services, opportunities abound where connectivity coupled with personalization will breed valued technology solutions. Beyond healthcare providers, primary family caregivers require better information access to monitor the well-being and needs of their loved ones – and to guide their own sense of oversight and intervention. As Christoper Sintros noted in his remarks, “we need to learn how to better leverage technology so that our cargivers are 100% focused on caregiving.” He added parenthetically that “our frontline caregivers – our front-line staff – have not benefitted from technology.”
In spite of all the accelerator groups that have emerged and are multiplying – and the c-suites that proudly wave the banner of innovation – our collective efforts are still somehow off the mark. In order to truly Change Aging, we should focus on the simple things first. The future is already here as they say – it is just not evenly distributed! Of course, we are not suggesting that all of the solutions we are seeking exist already or that they are in a turn-key state. Rather, our insight is just that there are so many parrallel activities present that our key actionable attention should be laser-focused on (1) awareness of what has been done already and (2) the desire to connect with the right people. We are all standing on the shoulders of giant. It would be a critical mistep to move forward in in our care business with blinders on.
Here is one example lead…
Sentio Solutions has created Feel, the first wristband to monitor emotional wellness, track feelings and manage stress. The integrated wristband sensors measure and track biosignals throughout the day, including galvanic skin response, blood volume pulse and skin temperature, to show individuals how their mood is affected by factors such as activity, the people they meet and environmental conditions. Through Bluetooth enabled communication, the Feel app visualizes the results and provides personalized recommendations to improve emotional health. Co-founded by George Eleftheriou and Haris Tsirbas, Feel is helping individuals manage their emotional health and improve their overall well-being. For more information visit www.myfeel.co.
Lets try to connect people, products and organizations actively together
This is an unprecedented time in our history because we are now often able to use the metaphor of an existing tool to describe modest innovations that established organizations are seeking. For example, in Veronica Barner’s pitch she expanded upon her problem statement by describing how caregivers could benefit from a Fitbit or Apple Watch type of device adapted to monitor mood variations and detecting the onset of depression or other behavioral indicators. Does the feel wearable represent a possible outlet for this problem/opportunity? You never now what the outcome of a chance encounter might be. Why not leverage our collective knowledge to broker these interactions?
Undoubtedly there are people and products waiting for a connection…
Please share any ideas that you have in the form below. People, Products, SDKs – all shareable information has potential value. We will make sure you get connected and follow-up with you.
As technologies evolve, an emerging challenge is to source solutions that promote better aggregation of intelligence and eliminate redundancies of data collection and monitoring. Single source outlets are required that meet the customized needs and expectations of all constituents. Technologies need to be more fully integrated to provide real-time awareness of circumstances – providing timely detection of individual needs and preferences. Consequently, all constituents are aligned and informed such that healthcare providers and allied advocates present a seamless consortium of resources to foster the optimal support system for wellness and care.
Thanks to our Sponsors
We are proud to support and participate on the planning committee for the Local Boston Chapter of Aging 2.0. Events like these would not be possible without the support of our corporate sponsors. Thank you for your valued and recurring participation!
BOSTON – Local startups, Industry Professionals and Aging Services supporters converged last Thursday evening at the Boston office of Nixon Peabody. The focus of the event was to select winners from a series of 4 minute pitches that would go on to represent Boston in the 2017 Global Startup Search (GSS).
Capital Care Associates, LLC (CCA) was proud to be actively engaged in the planning and execution of the Boston Chapter Event while sourcing and securing event sponsors. Nearly twenty corporate sponsors representing a wide range of senior healthcare providers and service professionals participated in the program. “While emerging technologies prove disruptive to the future of aging, these new entrepreneurs amplify the opportunities represented by innovations surrounding person-centered care and quality outcomes.” cites Joe McCarron, Principal of CCA.
Allen Lynch, who hosted the event at his firm’s office, observed that, “the common denominator among the (participating) entrepreneurs was not just a passion for their product, but an often deeply personal reason for wanting to improve the lives of seniors.” Continued active support for the Boston Chapter from the existing professional and emerging entrepreneurial ecosystems prove that we are all invested in changing the way we age and how health care and wellness services are delivered in our homes and communities-at-large. Local events like these offer further proof that “Providers and ‘Enablers’ should come together in Senior Living.”
The Aging2.0 Global Startup Search is an annual program designed to search the world for the best aging-focused startups. The competition kicks off with a series of pitch events in Chapter cities around the world – hundreds of startups apply to compete and local teams carefully select participants and judges for each event. The winning startup from each local pitch event moves forward to an online voting round, where the general public and panel of expert judges evaluate and contribute to the selection of finalists.
In his opening remarks, Tom Grape, Chairman and CEO of Benchmark Senior Living relayed to newcomers that the Boston Chapter is an arm of the global Aging2.0 organization, and that “our mission is to accelerate innovation to improve the lives of older adults here in Boston and around the world”.
Tom, who has served as the Ambassador of the Boston Chapter since it was established in 2015 introduced a new Chapter Ambassador, Tim Driver to attendees. Tim founded his company Mature Caregivers in 2006 with the aim of helping families to get better in-home care for their loved ones and to help people over 50 to find jobs that they love. It is a sister business to RetirementJobs.com, that administers the ‘Certified Age Friendly Employer‘ program, recognized by AARP and Consumer Reports, and the U.S. Senate Committee on Aging.
Seven Pitches representing Boston
In preparing for this year’s event, the volunteer planning committee was charged with vetting applicants. The following seven were chosen to represent the City of Boston and surrounding New England cities and towns:
LifeJourney Books – LifeJourney Books’ innovative and simple-to-navigate system rescues and preserves each Lifestory, an engaging and enjoyable process which strengthens generational bonds, and creates a Lasting Legacy.
Nebula Industries – Nebula Industries is solving the problem of medical adhesive related injuries for those with fragile skin, particularly older people, using innovative approaches developed at MIT/Brigham and Women’s Hospital.
Senter – Senter combines the latest IoT & AI technologies with a heavy focus on thoughtful user experience to make the home healthier and safer for aging individuals.
CareNav – CareNav is a digital health solution offering patient navigation services. Their scalable platform matches patients with experienced nurses for 1:1 virtual consultations, pre and post doctor’s visit, to empower and facilitate their healthcare experience.
BeON – BeON Home light bulb system senses the health and safety of your loved ones without compromising their dignity.
GreyMatters – GreyMatters is an interactive life storybook app for the tablet that aims to improve quality of life for people with dementia and their caregivers.
SilverBills – Using technology, we receive, scrutinize and ensure that our clients’ bills are paid accurately and on-time. Our clients no longer need to write checks or remember due dates.
The pitch event was emceed by Alice Bonner, Secretary of the Executive Office of Elder Affairs in the Commonwealth and the following industry experts served as the Judging panel:
SAN DIEGO – In Messaging New Directions we relayed the general theme for the NIC 2016 National conference – that cost, value and messaging need data, analysis and connections if a clear narrative is to emerge for Senior Living. As expected, there was a newly crafted narrative shared at this year’s NIC 2017 Spring Forum and it was informed by the confluence of data, analysis and some new connections. NIC engaged Anne Tumlinson to research the Board inspired thesis of creating value by intentionally coordinating bricks and mortar with emerging soft resources coined as “Enablers.” These findings became the framework for the NIC 2017 Spring Forum entitled “Unlocking New Value Through Senior Care Collaboration.”
Innovating Senior Care
The following NIC webinar provides a comprehensive introduction to many of the talking points that were expanded upon at the NIC Spring Conference:
Of note, Bob Kramer, CEO of NIC summarizes that, “Healthcare providers and payers are beginning to realize that if you are serious about delivering better health outcomes and controlling costs, housing as well as socialization matters, and in fact, without them you won’t achieve good outcomes.” There is a symbiotic opportunity represented by coupling asset-based providers with the care capabilities of so-called “enablers” and the captive customers they already represent – and can share strategically – in order to scale together. Kramer noted a remark from CEO of Kaiser, Bernard Tyson at the J.P. Morgan healthcare conference, that “40% of an individual’s health is driven by personal behaviors outside of the healthcare environment”. Recognizing the influence that non-real estate based providers of technology and services will have on the Senior Living sector is the first step toward breaking down silos of care.
Enabling by Example
Kelsey Mellard represented Honor at the event where they were the unofficial poster children for the disruptive (enabling) innovation our industry is being charged to embrace. Co-founder Sandy Jen’s brief TEDMED talk below captures their view on the impact non-medical caregiving can have on the cost and value of healthcare:
Jen describes how “unskilled home-care has always orbited outside of the traditional healthcare system of nurses doctors and hospitals and more and more, people are realizing that the home part of hospital to home is crucial.” She adds that it (home-care) can (1) reduce readmission rates, (2) increase quality of life for patients after discharge and (3) reduce the cost of provider health care to an aging population estimated to reach 84 million by 2050. In a recent Argentum post titled, “7 Innovations Changing the Aging Experience” Aging 2.0 Co-founder Stephen Johnston relayed that, “Emerging technologies have the potential to disrupt the senior healthcare market and thereby nudge service providers to improve their offerings.” If advice from NIC and their expert panels take root, it is likely that we will start to see a groundswell in active partnerships and collaborations.
The New World of Senior Care Collaboration
The Value Based Care (VBC) Revolution
The shift from volume to value in Post-Acute Care (PAC) is not going to be possible outside the broader framework that is mandating a transition from treatment of sickness to promotion of health. It is no longer sufficient to care for someone only when they are under your roof! When you recognize this, it becomes clear why an active focus on population health and wellness is critical. As tools and services that exist in the community become more sophisticated (and even ubiquitous) to consumers of all ages, it is imperative that senior living providers not fall behind. In the Forum’s opening session, leadership from Jupiter Communities, naviHEALTH and Optum relayed the following three key takeaways for success in seniors housing:
Provide evidence-based care and show strong outcomes
Educate both payers and traditional clinical providers that they (you) are a meaningful part of the solution
Collaborate rather than compete with other providers
Referring to the “right” PAC setting will be a critical strategy for VBC since “43% of Medicare patients utilize post-acute care after discharge and there is wide variation in costs across each setting.” As stated previously, 84 million people will be 65 years old or older in the United States alone by 2050. Beth Mace, NIC Chief Economist and Director of Outreach, contextualizes that datapoint further by reminding us that today’s 82 year old resident was born in 1934 and is part of the Silent Generation. With all of the age wave and silver tsunami buzz continuing over the past few years, we are still years shy of the crest that boomers will represent for providers of housing, care and tech-enabled services. Now is the time to begin preparing for that certain demographic future.
Tweeting advice to the Industry
Thursday’s luncheon featured a panel discussion with Senators Tom Daschle and Bill Frist, M.D.
As the clip above reflects, we need to engage in a more active national conversation about our social contracts and the role our government should play in health care. Interestingly, Sen Bill Frist made multiple passive references to the role quality food and nutrition has to play in improving health and reducing the cost of care. Did anyone else hear this? Or was it just wishful thinking on our part? If we want to prove that we believe in breaking down silos, we might consider a 2018 NIC Spring Forum focused on the economic development and health impacts of advancing and deploying local food systems!
Takeaway from a Taxi ride…
Providence offered a clear metaphor for reinforcing the value of collaboration in the experience of my brief taxi ride to the San Diego International Airport. As I stepped onto the Bayfront Hotel porte cochere, I could see that there was a single taxi waiting. The attendant escorted a woman into the back seat and then quickly turned to me and summoned the next car in line. Asking if I was headed to the airport, I confirmed that we both were. Our two, four-door, five passenger taxi sedans began to travel down Harbor Drive on parallel tracks together yet alone. We arrived at the same gate, at the same time, and we both presumably paid the same twenty-dollar fare.
The over-consumption model that this story captures mirrors many of our contemporary business relationships and transactions. In this example, some outreach and collaboration would have created immediate value for the two of us. Moreover, who knows what we might have discussed and explored through the connection of common interests. Do we really choose to consume alone or have we been artfully conditioned to relinquish our collective buying power? We should not consider ourselves to be victims of a broken system – we are active players that can influence the rules of the game.
Interestingly, our industry predicament seemingly proves a microcosm of our world at large. Our communities, industries and nations need to honor a simpler mandate – we must always demand and promote more collective EFFICIENCY every-where and for every-one. These are habits that must be formed and refined if they are to take up permanent residence in our collective psyche. If we identify and optimize what is wrong in these daily details, the broader canvas just might correct itself. There is a clear opportunity attendant to the messages that NIC and others are developing for us. The challenge is to expand the scope of our inquiry and recognize through our actions not just that silos represent lost opportunities for added value creation – but that all of our silos are nested one inside of the other. When we celebrate acceptance of an expanded and more inclusive perspective, we must remind ourselves that their is an ever-widening circle to be informed by. As in our own business practice, “Combining Capital with Care” seems like the formulary for success.
We recently attended The Erickson School’s 5th Annual Memory Care Summit in Orlando, Florida. The Coronado Springs Resort at Disney World proved to be a symbolic venue represented by engaged staff who reminded us in real-time what the ideal customer experience feels like. What better way to explore the facets of Memory Care – and its growing significance for an evolving Senior Living Industry – than with the timeless nature of a Disney “theatre” as backdrop.
SETTING THE STAGE
Best practices proffered by the Walt Disney Company about employee training and brand management almost felt unrealistic. The competitive advantage of being part of a “magical kingdom” seemingly anchors them in a winner’s circle far removed from our own care industry. In the days that followed, it became clear that this apparent advantage just MIGHT be attainable for all. Is it possible that success is as simple as telling stories with lessons that can be shared, recalled and channeled – to inform the moments we create with residents, staff and families? It is our ideal nature to care and to be cared for. If we don’t seize opportunities to create meaningful relationships that extend beyond routine tasks; we are losing more than just a bottom line.
Employee Engagement is the key
The Program launched with a 90 minute presentation by Mark Matheis of the Disney Institute. Sponsored by Integrace and entitled “Disney’s Approach to Employee Engagement,” Mark portrayed Disney’s management excellence while sharing the underpinning of a customer service philosophy where everyone is special and everyone contributes.
Validated by his own 27 year career recall with Disney, his engaging stories exhibited the “real deal” that constitutes and carries the Disney culture. Like our own business, it’s the genuine caring for both employees and customers that fuels success. There is at lease one key attribute required of every Disney employee – you’ve got to be genuinely “nice” to join the team.
Green Side Up
Mark amplified one experience in the opening of Disney World’s Orlando Resort that captured the role storytelling can play in our education, training and engagement activities. Amidst the chaos surrounding opening day, it was the President of Disney who detected that a critical item had been overlooked. The Resort’s Grand Floridian Hotel did not have its grass sod laid – though it was neatly stacked on-site. He immediately dispatched a message to his entire team. All those not engaged in critical business were to report directly to the Floridian for priority assistance required. In the meantime, the President loosened his tie, rolled up his sleeves and began to unload and place squares of sod in front of the building. With beads of sweat emerging, a senior team member approached the President in response to his appeal. With some reservation, the executive, accompanied by others, expressed that he had never done this kind of work and questioned the skill-set required. The President offered a simple response, “It’s easy. Green Side Up.” And so it was that all joined in and the job was done. To this day, every employee knows the mantra of “Green Side Up”. It is a powerful metaphor that informs desired behavior. We work together toward the common goal of delivering a unique customer experience; irrespective of formal titles or job descriptions.
Overmanage for Sustained Results
Mark also relayed that “Disney’s consistent business results are driven by “overmanaging” certain things that most companies undermanage or ignore – and that is a key source of what differentiates us.” In simple terms, they “have learned to be intentional where others are unintentional.”
The example of an intentional act was captured by the deconstruction of a wave from a Disney Princess. The mechanical formulary of “wash the window, wash the window, missed a spot, missed a spot” captures the spirit of how designed experiences that have been broken up into meaningful elemental actions that can be easily shared and sustained as a desired behavior. It is not a huge leap for Animators to dissect micro-motions like this but that is the point of integrative thinking; to seek constantly to reframe problems and opportunities from alternative perspectives that capture every detail. If you do not create a script for your operation, how can you effectively train your team and deliver your brand’s promise?
Our second day began with a presentation from James Hendrix, the Director of Global Science Initiatives at the Alzheimer’s Association, where we were reminded of their three-pronged mission to eliminate the disease through (1) the advancement of research; (2) enhanced care support and (3) the reduction of risk for all dementia sufferers through the promotion of “brain health.”
What is the scope of the problem? 5.4 million Americans of ALL ages will have Alzheimer’s in 2016 at total cost of care of $236 Billion according to the CDC! Interestingly, in a supplemental peer-reviewed journal entry, we learned that “…the Association also believes there is sufficiently strong evidence, from a population-based perspective, to conclude: (1) regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) have been shown to reduce the risk of cognitive decline and may reduce the risk of dementia; and (2) a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive
What’s the take-away? In spite of the millions of dollars (and human hours) spent yearly, we are not any closer to a meaningful cure BUT we have evolved considerably on the care front through the medium of Culture Change and Person-Centered Care (PCC) language and practice. Perhaps more importantly, a groundswell of professionals actively recognize that the “job” of Memory Care is not to heal or repair the disease; because we can’t (yet). Rather, our role as caregivers and family members is to relate and under-stand behavior so that we can be more supportive of individual needs as they struggle to mitigate the threat of a changing connection to self.
Ann Wyatt, Manager of Palliative and Residential Care at CaringKind relays that “Behavior is communication: it is not the dementia that causes the behavior, it is the dementia which prevents the person from expressing the cause of their distress.”
This change of perspective is transformative. It is conventional to bundle disease with symptoms in a cause and effect fashion but when you separate the two you become empowered to make a difference. In viewing behavior as form of communication, you are invited to listen more contextually and establish communication based on validation and empathy. This relational strategy is summarized by Validation Therapy’s founder Naomi Feil’s in her TEDx Talk at Amsterdam Women:
BRINGING IT HOME
Without question, the most moving part of this year’s program was the concluding morning presentations of day three. This segment is quickly becoming a promised experience delivered by the Erickson School’s Memory Care Summit; to conclude the series with human narratives that highlight the critical nature of the work we are all doing. Here we witnessed highly personal stories of two individuals confronted with life altering memory care circumstances. These interview presentations were moderated by Dr. Peter Rabins who consistently echoed the truism that our professional credentials do not fully prepare any of us to process the weight of memory loss among our peers and loved ones.
First, “Wearing Two Hats: Providing Care at Home and at Work”. This was the story of Teresa Robinson, VP, Clinical Services of Sagepoint Senior Living. Teresa is a caregiver in her organization as well as a caregiver at home as her husband was diagnosed with young onset Alzheimer’s before the age of 50. Second, “I’m Still Carol”. Carol Poole was diagnosed with Mild Cognitive Impairment (MCI) in 2013 and probable Alzheimer’s disease in 2014 at age 65. Remarkably, these two individuals continue to give beyond their personal burdens – sharing their experiences in hopes that it will advance a cause and help others.
To relay these stories further would not do justice to the love, compassion and caring commitment they represent. Suffice to say, these stories were heart wrenching and inspirational
– proving that Emotional Magic can fuel both the purpose and passion for evolving communities of practice around Memory Care. It certainly did for us.
SHARE YOUR STORY
In reflecting upon the Program Experience, the Disney backdrop certainly has relevance to our business models for Memory Care. We too can deliver those magical moments through intentional best management practices that are informed by our own narrative and brand identity. To be successful, we must support and sustain our own business culture that delivers on our promise of Person Centered Care – recognizing that Memory Care is indeed about validation and empathy. Our employees need to be genuinely engaged in a unified and integrated fashion with intentional purpose of enriching lives in the moment. Similarly, our service environments need to deliver the atmosphere and amenities conducive to comfort and care. Above all, our leadership needs to exercise the integrative thinking attributes that ideally empower, align and motivate our collective efforts by sharing stories that bind our thoughts and actions.
Data standards and integrity are arguably the two most critical ingredients when you consider achievement at either the (individual) human or (collective) global scale. There is no causation absent data (information) and there is no consequent execution unless it has been purposefully structured and validated for sharing. Healthcare Reform promises innovation in care delivery by increasing the transparency of data and quality metrics but how can you improve on something that doesn’t ideally exist yet?
When the OIG released its report, The Medicare Payment System for Skilled Nursing Facilities Needs To Be Reevaluated, they noted a 29% margin (overpayment) for therapy service reimbursement. Further, Skilled Nursing Facilities (SNFs) increasingly billed for the highest level of therapy even though key beneficiary characteristics remained largely the same. Achieving information access and coordination throughout the “Continuum of Care” requires a call to action for better interoperability and data management practices if we want to be successful in the future value based / bundled payment systems. Common standards for (1) assessment/documentation, (2) secure exchange of EHR/PHI and (3) compliance/accountability across the Continuum of Care (Hospital to Skilled Nursing & Rehab to Home) need to be pioneered further before they can be adopted and enhanced. The Electronic Health Record (EHR) is arguably at the root of this opportunity but all business information has relevancy.
Introducing The 4th Industrial Revolution
As thought leaders on the world stage prepare us for the Fourth Industrial Revolution and Web 3.0 (The Semantic Web), we are reminded of the inequity gap that exists between enterprise level organizations, technologists and the remaining 99% of data users. That it to say that if best practices in knowledge management trickled down to Healthcare delivery the marketplace could be transformed very quickly. We get a glimpse of the future of work and mobile health when we watch a TED Talk or purchase a personal device with updated features but when will mainstreet be touched by technology that addresses productivity and information sharing in a more meaningful way?
Senior Living – as a subordinated subset of established industry classification(s) represents a now distinct and emerging asset sector, yet uniquely representing a blend of real estate; healthcare services; and hospitality. Everyone chatters about technology, disruption and innovation but we fail to emphasize two clear imperatives;
Simple, shareable language makes everything technically possible.
Business challenges have frequently been met and overcome in adjacent spaces (as the YouTube clip above intimates) if we only had the eyes to see them.
We must look to other industries to inform data initiatives that drive and define our evolving identity and moonshots. Of all the data we amass, what is more relevant to quality and compliance than the MDS? And how does that documentation relate to an EHR or related Protected Health Information (PHI)?
Stepping out of the Sandbox
There are too many languages in the medical community and they often represent overlapping or redundant concepts. Consider this post’s leading sub-title that suggests how innovation is intrinsically connected to interdisciplinary thinking. For example, IF we operate in a SNF setting and have a Medical Director as part of our Quality Assurance and Performance Improvement (QAPI) Committee but don’t understand either (1) the correlation between Quality Measures on Nursing Home Compare and the corresponding fields on each Minimum Data Set submission, or (2) the relationship between those measures and the 254 quality measures that CMS identified for the PQRS in 2015 (mapping to the U.S. National Quality Standard (NQS) health care quality domains), THEN, it is clear in this one trite example that we really need to rely on each other’s knowledge if we are going to make this work. Is it possible that there is a future scenario on the horizon where a more connected and semantic web will learn how to navigate and connect these complexities for us? The question becomes, how much accountability should we have for understanding and correlating all of these terms and frameworks? Leading from behind is not the sustainable solution.
The Need for Interoperability Standards
You are likely consuming this blog entry on a mobile device that is connected to the Web. The internet works because it operates upon open standards that have been established by the World Wide Web Consortium (W3C). If you are a designer or developer, you understand that you cannot create anything successfully without employing these interoperability standards in your own work product. On the other hand, we business consumers remain steeped online and in conferences with little emphasis on the need for knowledge to transfer.
The following clip references a government commissioned the JASON report that identifies what we have been getting wrong in our industry and prescribes an approach for fixing it:
It is clear that brilliant people endeavor to solve our problems beneath the surface-level chatter of our practice and headlines. They need our insight if the solutions they develop are to be (1) fast-tracked and (2) widely distributed. Our more active and collective engagement and collaboration will help make this happen.
The challenges we confront in our sector (and frankly the majority of business industries) are downstream of lacking interoperability standards; inadequate reporting capabilities; and too few safeguards to ensure data integrity. The commodity of business intelligence is the new currency
of sustainable business success.
The call to action is simple. We need to be alert to exhibiting trends and become better data managers. We offer the following recipe for ACTIONS:
A – ssess and appraise current information systems capabilities.
C – orrect conditions of inadequacy, inaccuracy and redundancy of data gathering.
T – ransition reporting capabilities to achieve full integration for all users.
I – nterpret data intelligence routinely to inform best practice management.
O – pen and share data with collaborative partners to promote new prospects.
N – urture systems reporting to foster data integrity and build business bridges.
S – eek outside resources to develop and maintain data integrity.
Providers in our sector who best capture, manage, share and act upon reliable business data will be the survivors and prosper. New standards like FHIR promise to transform the way we conduct business and deliver quality outcomes but they represent future solutions. Data integrity defines not only your business identity, but importantly, your performance history and ratings in the marketplace. The Five Star Rating system in the skilled nursing sector is a good example of how reported data defines a business brand. Take charge of this information flow; ensure its integrity; and manage it to your advantage now before it is too late. That constitutes leading from the front.
Need guidance with your ACTIONS? Contact us to learn how we can help.