A Long-Term Care Leader's Guide to High Performance

From the authors of the award-winning Meeting the Leadership Challenge in Long-Term Care, this book provides a blueprint for success in today’s performance-based healthcare system. It presents a tested approach to delivering optimal care to each resident using a proven, coordinated bundle of key practices that include: Leadership that brings out the best in staff; a communication infrastructure to support teamwork throughout an organization; and a high-involvement performance improvement process that delivers quality person-centered care and prevents avoidable declines. This practical resource takes long-term care leaders through the critical steps to achieve staff stability, strengthen coordination of care, and maintain the highest practicable well-being for each resident. It demonstrates how engaging staff in continuous quality improvement produces consistently high-quality care. Whether care communities are excelling or struggling, leaders can benefit from these performance-improving practices. Filled with candid, impactful personal accounts about implementing quality improvement in nursing homes, A Long-Term Care Leader’s Guide reveals precisely how leaders and their staff can do better, together. Accompanying downloadable, how-to guides include: Three Steps to Transforming the Medication Pass: Individualizing Care and Managing Workflow; Rethinking the use of Position-Change Alarms; Eliminating Off-Label Use of Antipsychotics: A 10-Step Guide for Nursing Homes; MUSIC & MEMORY: Implementation Steps to Maximize Benefits: A Nursing Home Leader’s Guide; Common Infrastructure Self-Assessment

Cathie Brady, M.S., is co-owner of B&F Consulting, Inc., which facilitates nursing home improvements by developing leadersâ?? abilities to nurture their staff and help people work better together. Brady has more than 30 years of experience providing services and advocating for older adults in a variety of settings, including serving as Executive Director of the Department of Aging Services for the city of Bristol, Connecticut, and for 10 years as the Regional LTC Ombudsman for eastern Connecticut. Brady has an M.S. in Organizational Management from Eastern Connecticut State University. She served as faculty for a national 22-state pilot with Quality Partners of Rhode Island on Improving the Nursing Home Culture and co-produced a four-part Webcast series for the Center for Medicare and Medicaid Services entitled â??From Institutional to Individualized Care.â? Brady has directed several initiatives in Connecticut, Massachusetts, and Maine to support workplace learning and culture change and she co-developed a curriculum for Nurses as Mentors for a Robert Wood Johnsonâ??funded Jobs to Careers initiative in Connecticut. For 3 years, she worked with the New Orleans Nursing Home Staffing Project, which helped nursing homes recover from the aftermath of Hurricane Katrina, and co-produced a film with Louisiana Public Broadcasting called The Big Uneasy: Katrinaâ??s Unsung Heroes. A frequent speaker at state and national conferences, Brady specializes in working with leaders who have the right instincts but who are overwhelmed by the challenges of being in nursing homes in need, special-focus facilities, critical access nursing homes, or otherwise challenged care organizations.

David Farrell, M.S.W., L.N.H.A., is Director of Organizational Development and Regional Director of Operations for a private nursing home management firm in California. He has served as a licensed nursing home administrator in the long-term care profession for 25 years. As a nationally known leader in quality improvement and culture change, Farrell has documented the business case for providing a positive work environment and translated research about good leadership into daily practice. A published author and former board member of the Pioneer Network, he has delivered inspiring presentations to long-term care leaders at state conferences and corporate training events in nearly every state. While working for state Quality Improvement Organizations, he played a lead role in the National Nursing Home Quality Initiative. Farrell also served on the faculty team for the national Improving the Nursing Home Culture project involving QIOs and national nursing home corporations in 21 states. He has advised the Centers for Medicare and Medicaid Services on quality improvement and culture change.

Barbara Frank, M.P.A., is co-owner of B&F Consulting, Inc., a business that facilitates nursing home improvements by developing leadersâ?? abilities to nurture their staff and help people work better together. She worked for 16 years at the National Citizensâ?? Coalition for Nursing Home Reform in Washington, D.C., where she directed the landmark 1985 study â??A Consumer Perspective on Quality Care: The Residentsâ?? Point of Viewâ? and helped establish the national network of state and local ombudsman programs. She facilitated the Campaign for Quality, through which providers, consumers, practitioners, and regulators developed consensus on what became the OBRA 1987 legislation that refocused nursing home regulations on individualized care. Frank facilitated the first Pioneer Network gathering in 1997, and in 2005 she facilitated the St. Louis Accord, a national gathering of providers, consumers, regulators, and quality improvement organizations that came together to improve clinical outcomes through staff stability and culture change. Co-founder (with her colleague and co-author, Cathie Brady) of B&F Consulting, she works directly with individual nursing homes to improve their stability, care outcomes, and quality of life. As faculty to the Quality Partners of Rhode Island Improving the Nursing Home Culture pilot, she helped 254 nursing homes improve staff, resident, and organizational outcomes, and co-produced Quality Partnersâ?? Staff Stability Toolkit and the four-part CMS Web series â??From Institutional to Individualized Care.â? Frank also led a team in the New Orleans Nursing Home Staffing Project, which helped nursing homes recover from the aftermath of Hurricane Katrina. Frank co-produced a film with Louisiana Public Broadcasting called The Big Uneasy: Katrinaâ??s Unsung Heroes. She coauthored Nursing Homes: Getting Good Care There (1996). Frank serves on the board of the Pioneer Network and has a masterâ??s degree in public administration from the Kennedy School of Government.