Ok - so I need your suggestions.
There are times in all of our lives, work and personal, where the weight of it all, meaning the things we need to manage, just seem overwhelming. In health care, it has been especially difficult because we know our reimbursement is going to remain flat or even go down, when every other cost we have is going up - including wanting to increase salaries.
There is so much to be excited about - the great work we do, the friends and family we have, that we live in a great state where you can be in the mountains or at the beach in an hour or less but I have to be honest, there are days I just want to pull the covers over my head and make it all go away.
I have told you before that I go running to clear my head, but sometimes that isn't enough. Unfortunately I usually end up in DSW buying some really high heel that is going to make my feet bleed, but look really pretty on. That is the price we pay for fashion and a little retail therapy. My rock of course are my parents, who are never seem to tired of giving me that hug and that reassurance that this too shall pass. In the end, I know they’re right, but hearing it from them always seems to make it better.
So what do you do when you are trying to shake it all off and refocus on the good?
Any tricks can you share?
Friday, May 14, 2010
Wednesday, April 21, 2010
The Art of Negotiation
Next month I will be doing a panel discussion at the Governor's Council on Women and the topic is the art of negotiation. I started my career as a social worker and negotiation is at the core of what we often do with and for the people that we serve. Trying to negotiate services, trying to negotiate with clients to identify their needs and create plans that they will actually follow to improve their lives. Most people think about negotiations like a lawyer around one specific issue. I would argue that we all should think about negotiations in terms of our daily life - work and personal.
Some of you may have heard me say, in a tongue and cheek way, that I think life is all about the accumulation of points. There are some days that you are doing good deeds or favors for others and you are ringing up "good will points” - not that you need something right now, but you know there will be a time when you need something and you can pull on those points, or favors, to be able to get you through a tough time. See, most of us do really well in times of crisis. We can rally and step up and show our best. Sometimes we don't always do well on the day to day.
This week a long time employee was telling me she finds herself on the receiving end of what can only be described as verbal abuse from her colleagues about how they have had enough of "her" demands and they aren't going to do it anymore. When I push to identify who these people are so we can give coaching about our values and culture of caring, she says she isn't comfortable because she has to work with them every day and doesn't want to be seen as "ratting" them out.
This conversation made me so sad at so many levels. Sad that she did not feel like she could tell her colleague to stop yelling. Sad that her colleague was so frustrated that her only tool to manage the stress was to yell. Sad that even after all the discussions about creating a non punitive workplace where we hold each other accountable, we still are uncomfortable doing it, And last but not least, most sad that the child who needed our care was being delayed by our internal issues.
So I will continue to "negotiate" with each of you about creating an environment that allows you to hold each other accountable for the behaviors that we all signed up to uphold when we joined Children's and we will live to fight another day.
Our kids need us.
We must.
Some of you may have heard me say, in a tongue and cheek way, that I think life is all about the accumulation of points. There are some days that you are doing good deeds or favors for others and you are ringing up "good will points” - not that you need something right now, but you know there will be a time when you need something and you can pull on those points, or favors, to be able to get you through a tough time. See, most of us do really well in times of crisis. We can rally and step up and show our best. Sometimes we don't always do well on the day to day.
This week a long time employee was telling me she finds herself on the receiving end of what can only be described as verbal abuse from her colleagues about how they have had enough of "her" demands and they aren't going to do it anymore. When I push to identify who these people are so we can give coaching about our values and culture of caring, she says she isn't comfortable because she has to work with them every day and doesn't want to be seen as "ratting" them out.
This conversation made me so sad at so many levels. Sad that she did not feel like she could tell her colleague to stop yelling. Sad that her colleague was so frustrated that her only tool to manage the stress was to yell. Sad that even after all the discussions about creating a non punitive workplace where we hold each other accountable, we still are uncomfortable doing it, And last but not least, most sad that the child who needed our care was being delayed by our internal issues.
So I will continue to "negotiate" with each of you about creating an environment that allows you to hold each other accountable for the behaviors that we all signed up to uphold when we joined Children's and we will live to fight another day.
Our kids need us.
We must.
Tuesday, March 30, 2010
The Big Pink Elephant
As you know we did not make the Top 25 Best employers in the State this year. We have received the actual survey results and comments.
In most companies feedback like this would normally be the “big pink elephant” in the room that no one wants to talk about. But the only way things get better is to put them out in the open and have a plan to make it better.
These statistics and comments help our senior leadership gauge how well we’re doing on employee satisfaction. There were many positive comments and negative as well. Our raw score dropped overall by 10 points and in each individual category by an equal or greater amount.
Your feedback was very telling about what you were unhappy about and what you would like to see addressed. It is also clear that there are some misunderstandings about all sorts of things from how we make money to how some of our benefits work. Here are a few noteworthy comments:
1. A few people didn’t understand why we are expanding our outpatient sites if we were having money problems.
Here is some clarity: Our Foundation raises money dedicated specifically for renovations of current or new locations, and then we hire staff to serve more patients. The only way we can make more money is to see more kids. There is no other way for us to be able to cover our increasing costs without continuing to grow.
2. Someone wrote that they were unhappy the tuition reimbursement was eliminated.
This one is just not true. We did not eliminate our tuition reimbursement program. We just put a cap on how much we will reimburse and that an employee must continue to work at CSH for a specific period of time after they complete their course. It’s unfortunate, but we had people get their degrees and resign after their graduation.
The examples above speak to a bigger issue of miscommunication and access to information. While we have the weekly wrap up, this blog, children's chatter and the intranet where a lot of information is posted, face to face interactions makes all the difference. This is an area where we can improve, and will!
I have asked Senior Leadership to start attending staff meetings to reinforce that you have access to have your questions answered at any time.
We will also be implementing “lunch and learns” given by Senior Leaders. We will advertise the topic and you can bring your lunch and learn more about all sorts of topics that were identified in your comments.
Many comments also referred for the need for more employee recognition and events we can do together. You ask, we provide.
We are going to have a get together during rehab week in September. We will also use this as the chance to recognize the employees who celebrated their milestone years this year and last (5, 10 15 years of service). In addition we will be pulling the stars that have been given out at each site and the person who has had the most Press, Ganey comments written about them by site and creating special recognition for them.
While I am disappointed that we did not get the recognition, not because of the award, but because it was your way of saying that you aren't happy.
While some will argue that it is not a surprise given that we aren't giving raises and we had to make a lot of hard choices about changing benefits in order to avoid layoffs, the bottom line is that your comments and scores tell us that you didn’t think we handled the changes in a way that was appropriate for you and I own that. No excuses.
You have given us feedback of the things you want changed. Some we can fix; some we can't. But through it all we will keep talking and using your feedback to make us a better organization and a better place to work.
Your ideas and comments are always welcome.
Amy
In most companies feedback like this would normally be the “big pink elephant” in the room that no one wants to talk about. But the only way things get better is to put them out in the open and have a plan to make it better.
These statistics and comments help our senior leadership gauge how well we’re doing on employee satisfaction. There were many positive comments and negative as well. Our raw score dropped overall by 10 points and in each individual category by an equal or greater amount.
Your feedback was very telling about what you were unhappy about and what you would like to see addressed. It is also clear that there are some misunderstandings about all sorts of things from how we make money to how some of our benefits work. Here are a few noteworthy comments:
1. A few people didn’t understand why we are expanding our outpatient sites if we were having money problems.
Here is some clarity: Our Foundation raises money dedicated specifically for renovations of current or new locations, and then we hire staff to serve more patients. The only way we can make more money is to see more kids. There is no other way for us to be able to cover our increasing costs without continuing to grow.
2. Someone wrote that they were unhappy the tuition reimbursement was eliminated.
This one is just not true. We did not eliminate our tuition reimbursement program. We just put a cap on how much we will reimburse and that an employee must continue to work at CSH for a specific period of time after they complete their course. It’s unfortunate, but we had people get their degrees and resign after their graduation.
The examples above speak to a bigger issue of miscommunication and access to information. While we have the weekly wrap up, this blog, children's chatter and the intranet where a lot of information is posted, face to face interactions makes all the difference. This is an area where we can improve, and will!
I have asked Senior Leadership to start attending staff meetings to reinforce that you have access to have your questions answered at any time.
We will also be implementing “lunch and learns” given by Senior Leaders. We will advertise the topic and you can bring your lunch and learn more about all sorts of topics that were identified in your comments.
Many comments also referred for the need for more employee recognition and events we can do together. You ask, we provide.
We are going to have a get together during rehab week in September. We will also use this as the chance to recognize the employees who celebrated their milestone years this year and last (5, 10 15 years of service). In addition we will be pulling the stars that have been given out at each site and the person who has had the most Press, Ganey comments written about them by site and creating special recognition for them.
While I am disappointed that we did not get the recognition, not because of the award, but because it was your way of saying that you aren't happy.
While some will argue that it is not a surprise given that we aren't giving raises and we had to make a lot of hard choices about changing benefits in order to avoid layoffs, the bottom line is that your comments and scores tell us that you didn’t think we handled the changes in a way that was appropriate for you and I own that. No excuses.
You have given us feedback of the things you want changed. Some we can fix; some we can't. But through it all we will keep talking and using your feedback to make us a better organization and a better place to work.
Your ideas and comments are always welcome.
Amy
Monday, February 1, 2010
Defining Quality
One of the ongoing discussions in the health care industry is how do we define quality?
In acute care hospitals, the government has established report cards and uses those as a measure of quality. Most consumers/patients do not read these report cards before they go for services. They simply ask someone who they liked and whether they were "good" or not.
This is a sticking point between my parents and I. We continuously battle about which is the “right way” to choose a care provider. My father defines quality by whether or not he likes the doctor - meaning is he/she personable. My mother makes her decision based on whether or not the person will tolerate her eight million questions, give her all of the tests and prescriptions she wants and whether or not her office bills correctly so she doesn't have to fight with her insurance company.
We know that one of the ways people judge quality is based on our Press, Ganey surveys. How does the parent feel about the care we gave? Some would argue that like my Dad, the doctor may be really nice but is that really the way to judge the care given?
Our parents rely on Children's Specialized Hospital to do the screening for them. To find the highest qualified staff who will provide the best quality of care. We wouldn't hire people that weren't high quality and therefore that is something they don't worry about.
The question of how we define quality is often subjective. We observe practice patterns. We rely on supervisors to model and mentor and yes, we use Press, Ganey surveys to give us an indication if something is not going well.
The federal government has told us that they are going to pay hospitals more if they have good quality. Since we don't have a federally accepted report card, many of you are working on "proving" that our care is high quality. This is going to require us to delve more into research and partner with others in order to validate what we do. I know we can do it!
Another pressure we are facing is that quality is now tied to price. Can your hospital operate with what you are reimbursed? If you can't, there is an assumption that your hospital is not efficient and that signifies a problem. We can argue that as a pediatric rehabilitation provider there are a lot of nuances and differences for the cost issue. The State of New Jersey is looking at a $10 billion budget deficit, they aren't going to care about our differences. They are telling us the money has run out and we are going to have to do with less, unless we prove our worth and our outstanding of quality care.
So, we are looking at all of these aspects of quality. Looking at identifying things we can do differently, smarter, with more efficiency and to get better outcomes for our children and our employees.
The major reason we moved to an electronic medical record was to improve the quality of the care we delivered and to hopefully make all of our lives easier in using one system. We know in December that we had NO missed doses or medical errors with pharmacy. Some would contend that our new bar coding system is working. Outpatient therapists are telling me that there are definite improvements in being able to do evaluations and get their billing done.
So let me ask you - are there things that we can do to improve quality? Are there things we can do today to improve our efficiency?
These are conversations your directors are going to have with you over the coming weeks. They will look to you to give them great ideas and guidance so we can continue our move to excellence.
In acute care hospitals, the government has established report cards and uses those as a measure of quality. Most consumers/patients do not read these report cards before they go for services. They simply ask someone who they liked and whether they were "good" or not.
This is a sticking point between my parents and I. We continuously battle about which is the “right way” to choose a care provider. My father defines quality by whether or not he likes the doctor - meaning is he/she personable. My mother makes her decision based on whether or not the person will tolerate her eight million questions, give her all of the tests and prescriptions she wants and whether or not her office bills correctly so she doesn't have to fight with her insurance company.
We know that one of the ways people judge quality is based on our Press, Ganey surveys. How does the parent feel about the care we gave? Some would argue that like my Dad, the doctor may be really nice but is that really the way to judge the care given?
Our parents rely on Children's Specialized Hospital to do the screening for them. To find the highest qualified staff who will provide the best quality of care. We wouldn't hire people that weren't high quality and therefore that is something they don't worry about.
The question of how we define quality is often subjective. We observe practice patterns. We rely on supervisors to model and mentor and yes, we use Press, Ganey surveys to give us an indication if something is not going well.
The federal government has told us that they are going to pay hospitals more if they have good quality. Since we don't have a federally accepted report card, many of you are working on "proving" that our care is high quality. This is going to require us to delve more into research and partner with others in order to validate what we do. I know we can do it!
Another pressure we are facing is that quality is now tied to price. Can your hospital operate with what you are reimbursed? If you can't, there is an assumption that your hospital is not efficient and that signifies a problem. We can argue that as a pediatric rehabilitation provider there are a lot of nuances and differences for the cost issue. The State of New Jersey is looking at a $10 billion budget deficit, they aren't going to care about our differences. They are telling us the money has run out and we are going to have to do with less, unless we prove our worth and our outstanding of quality care.
So, we are looking at all of these aspects of quality. Looking at identifying things we can do differently, smarter, with more efficiency and to get better outcomes for our children and our employees.
The major reason we moved to an electronic medical record was to improve the quality of the care we delivered and to hopefully make all of our lives easier in using one system. We know in December that we had NO missed doses or medical errors with pharmacy. Some would contend that our new bar coding system is working. Outpatient therapists are telling me that there are definite improvements in being able to do evaluations and get their billing done.
So let me ask you - are there things that we can do to improve quality? Are there things we can do today to improve our efficiency?
These are conversations your directors are going to have with you over the coming weeks. They will look to you to give them great ideas and guidance so we can continue our move to excellence.
Friday, January 15, 2010
Finding Your Balance
Here it is 2010. New Year's resolutions are 2 weeks out and all I can feel is the weight of the world. This is more than you want to know about me, and probably will confirm your thoughts that I am crazy, but I have a morning routine like many of you. Mine happens to involve leaving my house at 4:15 am so my Dad and I can have some time together before we both head to the gym together. Dad turned 80 in July and we have been doing this little routine for 10 years. He is my touchstone. The voice of reason in an other wise storm of noise in my head thinking of all that I need to do and where I could have done better.
This morning he asked me how it was going and I said it just sucks. After I finished my run this morning I found a note from him on my car. It said " I hope you have a good day. You need to remember the balance - do your best and the rest will come. There are times your best won't be enough but it is all you have and you have to be proud of it".
It is hard to remember that balance. Many of you are balancing work, families, going to school and just getting through life. The one thing that I have learned with age is that a lot of my younger years were spent worrying about things that I couldn't really control anyway. I needed to give it up to God or whatever higher power you believe in but I didn't and just wasted a lot of time.
I wonder if there are strategies that you could share to help those of us who struggle with finding balance.
This morning he asked me how it was going and I said it just sucks. After I finished my run this morning I found a note from him on my car. It said " I hope you have a good day. You need to remember the balance - do your best and the rest will come. There are times your best won't be enough but it is all you have and you have to be proud of it".
It is hard to remember that balance. Many of you are balancing work, families, going to school and just getting through life. The one thing that I have learned with age is that a lot of my younger years were spent worrying about things that I couldn't really control anyway. I needed to give it up to God or whatever higher power you believe in but I didn't and just wasted a lot of time.
I wonder if there are strategies that you could share to help those of us who struggle with finding balance.
Friday, January 1, 2010
Reflections
So I have been spending a lot of time on vacation reflecting about the year that has passed and anticipating 2010. This isn't just the end of a year but the end of the decade.
I have personally reflected about the last ten years and realized there were some major changes: changed jobs 4 times - the last wonderful 6 years spent with you; experienced the loss of my 12 year marriage and am still standing; major health issues of loved ones, and the loss of my Grandmother. As I reflect on all this change I weigh all the blessings and honor the memories of the things and people lost.
Over the last 10 years, Children’s has grown from 4,000 children served, 500 employees, a 32 million budget to 17,000 children served and 1,000 employees and a 100 million budget. We built a brand new hospital, had the single most successful fundraising campaign topping 32 million dollars, with our first $5 million gift. We opened four new sites and renovated others. So much good and change has happened at a time when many hospitals have suffered closure and loss of services. We are positioned for continued success in the years to come.
I know this sounds sappy, but it's so true. One of the greatest things I cherish was the chance to work with each of you and the children we serve. I am constantly amazed at the lives we touch both our children and each other.
As I contemplate both my personal and professional hopes for 2010, I wonder if there are memories from this past decade, or any goals you have planned for 2010, that you would like to share?
I have personally reflected about the last ten years and realized there were some major changes: changed jobs 4 times - the last wonderful 6 years spent with you; experienced the loss of my 12 year marriage and am still standing; major health issues of loved ones, and the loss of my Grandmother. As I reflect on all this change I weigh all the blessings and honor the memories of the things and people lost.
Over the last 10 years, Children’s has grown from 4,000 children served, 500 employees, a 32 million budget to 17,000 children served and 1,000 employees and a 100 million budget. We built a brand new hospital, had the single most successful fundraising campaign topping 32 million dollars, with our first $5 million gift. We opened four new sites and renovated others. So much good and change has happened at a time when many hospitals have suffered closure and loss of services. We are positioned for continued success in the years to come.
I know this sounds sappy, but it's so true. One of the greatest things I cherish was the chance to work with each of you and the children we serve. I am constantly amazed at the lives we touch both our children and each other.
As I contemplate both my personal and professional hopes for 2010, I wonder if there are memories from this past decade, or any goals you have planned for 2010, that you would like to share?
Tuesday, December 8, 2009
Yes Virginia...
Usually I’m very festive. My tree goes up right after Thanksgiving, I’m done holiday shopping weeks before Christmas, indulging in yummy holiday treats, smiling at little kids waiting in line to meet Santa – you know, the fun stuff!
So, for the first time ever in my life, I am not feeling the holiday. It’s probably a combination of personal and work. I don't want to do a tree - I just don't wanna...and then it happened as it always happens at Children's Specialized, I am reminded of the kindness and generosity that is extended by staff and strangers to our children and our hospital.
Remember the holiday cookie baking fun at Stevens Road? I think our staff deserves a medal for bringing out the sprinkles and cookie cutters, all to help bring a little holiday fun into therapy. That’s the spirit!
Just this morning, Vieno shared with me a wonderful story of holiday cheer.
With the holidays just around the corner, our staff in New Brunswick was getting a little worried because holiday donations had seriously dropped off from years past. Our annual holiday party for inpatients is just a few weeks away and staff was getting a little worried we wouldn’t have enough gifts for everyone! Just in the nick of time, we get a call from Diane Bonanno's office at Rutgers Recreation. The seventh annual Big Chill 5K is on Saturday, Dec.12 and instead of paying a fee, entrants are asked to bring an unwrapped toy for children in need across the garden state. With nearly 5,000 people signed up – we’re sure our patients, and many lucky kids around the state, will have a wonderful holiday with presents to spare. Since its inception, the race has provided over 20,000 presents to several NJ charities including the NJ Housing Authority and now PSE&G Children’s Specialized Hospital – New Brunswick. Yes, Virginia, there is a Santa Clause… and he’s running through New Brunswick on Saturday!
As expected, our staff and generous supporters have given me a dose of holiday spirit.
What is your favorite holiday memory or tradition? Here at Children’s or even at home with your family? What really gets you in the mood to break out the tinsel and eggnog?
Amy
So, for the first time ever in my life, I am not feeling the holiday. It’s probably a combination of personal and work. I don't want to do a tree - I just don't wanna...and then it happened as it always happens at Children's Specialized, I am reminded of the kindness and generosity that is extended by staff and strangers to our children and our hospital.
Remember the holiday cookie baking fun at Stevens Road? I think our staff deserves a medal for bringing out the sprinkles and cookie cutters, all to help bring a little holiday fun into therapy. That’s the spirit!
Just this morning, Vieno shared with me a wonderful story of holiday cheer.
With the holidays just around the corner, our staff in New Brunswick was getting a little worried because holiday donations had seriously dropped off from years past. Our annual holiday party for inpatients is just a few weeks away and staff was getting a little worried we wouldn’t have enough gifts for everyone! Just in the nick of time, we get a call from Diane Bonanno's office at Rutgers Recreation. The seventh annual Big Chill 5K is on Saturday, Dec.12 and instead of paying a fee, entrants are asked to bring an unwrapped toy for children in need across the garden state. With nearly 5,000 people signed up – we’re sure our patients, and many lucky kids around the state, will have a wonderful holiday with presents to spare. Since its inception, the race has provided over 20,000 presents to several NJ charities including the NJ Housing Authority and now PSE&G Children’s Specialized Hospital – New Brunswick. Yes, Virginia, there is a Santa Clause… and he’s running through New Brunswick on Saturday!
As expected, our staff and generous supporters have given me a dose of holiday spirit.
What is your favorite holiday memory or tradition? Here at Children’s or even at home with your family? What really gets you in the mood to break out the tinsel and eggnog?
Amy
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