Leading Home Care Report #118 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Home Health Care 2020Insights on Quality in the Agency Of The FutureAugust 29, 2007~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~In this issue...-- Insights on Quality in the Agency Of The Future-- Seven Perceptions of Quality in the Agency Of The Future-- The Key to Quality is Your Ability to Find and Keep Employees-- Certify Your Home Care Sales Professionals-- Leading Home Care is coming to YOUR Neighborhood-- Latest Postings on our Blog: Home Health Care Leadership Minute-- About the Author-- Permission to ReproduceWelcome,
to the second issue of our newsletter on the theme of the Home Health AGENCY OF THE FUTURE.
In our last issue, I discussed the the Oracle of Delphi, and how much value leaders place in having insights on the future. I shared with you the Six Pillars of the AOTF.
In this issue, we're going to look more closely at the first pillar - Quality. What role does quality play in your agency today? What role will it play in your agency in the future?
Insights on Quality in the Agency Of The Future~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Several months ago I was speaking at a home health care association conference on the topic of "Crafting Your Uniqueness: Creating Competitive Advantage in Home Health Care." The presentation is designed to stimulate the thinking of CEOs and executives about what makes their agency unique, and how they can create competitive advantage in the marketplace.We were talking about quality as a source of competitive advantage. I asked the audience to raise their hands if they believed that their agency gives better quality than their competitors. Nearly everyone raised their hands.
I had to disappoint them by saying that they were all living in delusion. When everyone in the room believes they give better quality than the next person, then we realize that quality has become a commodity. Everyone has it, so no one is unique.
Well, our industry has begun to move out of this delusional state by coming up with some quantifiable measures of quality. CMS has posted "Home Health Compare" on the Medicare.gov web site. Decision Health and Outcome Concept Systems have studied the data and identified the Home Health Care Elite 500... the top 500 companies in home health care.
Bob Fazzi and his team at Fazzi and Associates regularly publish a table of the Home Health Compare scores that identify agencies in the top 20%.
There is now some data out there to show who really is providing better quality care than the next agency.
So what does this mean for you and for the Agency Of The Future?
Here's What I Think It Means
To be a significant player in home health care in 2010, you'll need to be a top 20% provider of quality care just to be in the game. As consumers and referral sources become more familiar with outcomes data, you'll need to prove that you give good quality care just to be considered. It won't be a source of real competitive advantage. It will be the minimum requirement.
Look at the automobile industry. In the late 1970's, the Japanese car companies were cleaning our clocks in terms of perceived quality of their products. They were taking market share from Ford, GM and Chrysler.
Ford launched "Quality is Job 1!" Over the next few years they made significant advances in product quality and took back the role as the maker of the number one selling passenger car in the world... the Ford Taurus. Today, every car company builds high quality cars compared to 1979, but that's not good enough. Ford, GM and Chrysler are still losing market share. Last month for the first time in history, less than 50% of cars sold in the U.S. were built by American companies.
So the lesson is this. Quality by itself is not enough. But you have to have excellent quality just to play in the game.
The same thing is true in home health care. As consumers and referral sources become better informed and have more access to information, you'll have to provide higher and higher quality just to survive.
Seven Perceptions of Quality in the Agency Of The Future~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~As you get your agency ready for the future, there are seven perceptions of quality you need to consider.1. Patient Perception
Most patients and their families don't have the ability to assess the quality of clinical care. Their perceptions of quality are based on what they experience. Our research shows that most patients evaluate quality of care in terms of dependability of caregivers, continuity of caregivers, effectiveness of communication, and how they feel about the social interaction with caregivers and your agency. That means that you better be measuring patient satisfaction and understanding the factors that are more important to patients. Then you need to get close to your patients to find out what they really feel about your quality.
2. Physician Perception
When we survey physicians about the factors that determine which home health agency they will refer to, the number one factor is "clinical competence of staff." When we ask them to define clinical competence, it means, "The nurse takes care of my patients and doesn't bug me." In other words, the nurse is able to follow the doctor's orders without unnecessary interruptions. Again, the physician's assessment of clinical competence has more to do with communication and interaction with the field nurses than it does with measurable patient outcomes.
3. Referral Source Perception
Key referral sources, such as hospital discharge planners and nursing home social workers, have their own perceptions of quality. Again, it often goes back to "clinical competence of staff," but in this case it has more to do with reputation, education levels, certifications, and feedback from patients and families.
4. Payor Perception
Your fourth customer is the payor. Whether it's your Medicare fiscal intermediary, your state Medicaid program, or your favorite :-) insurance company, the people who pay the bills have a perception of the quality of your agency.
Again it may not have anything to do with the actual clinical quality of care, but more to do with how you handle documentation and communication. The ability of a nurse to do consistent OASIS assessments and write complete and accurate visit notes may be more important than the actual outcomes of the patients.
So what does this mean for the Agency Of The Future (AOTF)? It means that you and your leadership team need to look closely at quality in every aspect of your business, and put in place people and processes to deliver exceptional quality.
Quality is an attitude more than anything. It's creating a culture in your organization where everything you do is at the highest levels of quality based on the perceptions of your customers and your employees.
To become a leading Home Health AOTF, you and your team will need to focus resources and talent on this first pillar of quality.
The Key to Quality is Your Ability to Find and Keep Employees~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Your ability to provide exceptional quality in the perception of your key customers is based on your ability to put in place people and processes. Finding and keeping the employees you need is a critical leadership competency.
Our work with home care agencies across the country suggests that the ability to attract and retain capable people can be a major source of competitive advantage in your marketplace. We are convinced that your ability to grow your business and get ready for the future will be based on your ability to recruit people and market your business. The key to your success will be to keep your recruiting and your marketing in balance.
To help your leadership team learn about the latest strategies for finding and keeping great people, you'll want to explore the downloadable eBook, Strategic Staffing: Finding and Keeping the Employees You Need in Home Care, by Stephen Tweed and Cathy Fyock.
The agencies that do the best job in recruiting and retention will become the model of the AOTF. Here's the tool to help you achieve that result.
Certify Your Home Care Sales Professionals~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~One of the biggest challenges facing rapidly growing home care companies is the ability to recruit, select, hire and train effective sales representatives. The need is great, and the supply of experienced home care sales pros is limited.
Get ready for a fresh approach to home care sales training that will take the guesswork out of predicting the success of your sales team. Join us for a program specifically for home care agencies that want to develop Certified Home Care Sales Professionals.
Stephen Tweed and Michael Giudicissi at Leading Home Care have teamed with Dr. Tray Dunaway to create an in-depth, focused sales training program and certification designed to give your sales people the knowledge, skills, and focus they need to reach even the most difficult referral source.
Then we teamed up with Decision Health, the publishers of... Home Health Line, and Success In Home Care... to create an exceptional workshop environment in which to provide this training. Join us in San Antonio, Texas on September 24, 25, and 26 for the 2007 Home Care Sales Professional workshop.
Don't Delay, Register Today!
Leading Home Care is coming to YOUR Neighborhood~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Stephen Tweed and Michael Giudicissi are constantly on the road working with home care companies that want to grow and with home care leaders who want to get ready for the future. When we're in your neighborhood, we'd be happy to meet with you to discuss how we can help you become a Home Health AOTF.
Here's where we'll be in the near future.
Stephen Tweed:
- September 11 - Novi, Michigan - Michigan Home Health Association
- September 12 - Chicago - Corporate Speech - Leadership
- September 13 & 14 - Lynchburg, VA - Strategic Planning
- September 24-26 - San Antonio, TX - 2007 Sales Professionals Workshop
- September 29 - Las Vegas - Corporate Speech - Private Duty Home Care
- October 7-10 - Denver - NAHC Conference
- November 16 - Phoenix - Leadership Conference
Michael Giudicissi:
- September 24-26 - San Antonio - 2007 Sales Professionals Workshop
- October 3 - Camp Hill, PA - PA Home Care Assn.
- October 18 - Chicago - Sales Boot Camp - Illinois Home Care Council
To explore the opportunity to bring Stephen or Michael into your agency, call Diane West at 502-339-0653.
Latest Postings on our Blog: Home Health Care Leadership Minute~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Here are the latest postings on our BLOG, Home Health Care Leadership Minute:
- NPDA defines three levels of caregivers for Private Duty Home Care
- Heroes in the Home
- PA Governor Signs Law Allowing Nurse Practitioners to Order Home Health Services
- Ohio Governor Signs Order Granting Collective Bargaining Rights to Independent Home Care Workers
- Mayo Clinic Offers Home Care Advice
About the Author~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Stephen Tweed, CSP, is Chairman and CEO of Leading Home Care ... a Tweed Jeffries company. For nearly 25 years he has been a recognized leader in strategy and leadership development for home care companies and associations. He is the author or co-author of five books, four of which were written specifically for the home care industry. He has served on the boards of directors of three not-for-profit home care agencies, and has served as interim President & CEO of a $25 million home care company.
Stephen is a past-President of the National Speakers Association, a 3500 member international society of experts who speak professionally. He is also the father of a 37 year-old son who is physically disabled and uses the services of home care on a daily basis.
Permission to Reproduce~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Permission is granted to healthcare publications, associations and companies to reproduce this article in your publication, or to distribute copies to your leaders, on the condition that you reproduce the credits and contact information as follows: "Reprinted with permission from Stephen Tweed's Leading Home Care Report. Copyright 2006 Stephen C. Tweed. To receive a FREE subscription to this newsletter, log on to www.leadinghomecare.com."
Contact Leading Home Care~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~email: stephen@leadinghomecare.comphone: 1-888-668-9333~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~