That’s one of the questions that Livio, an organisation specialising in nursing, care and home care, had been contemplating. “In recent years, we hadn’t changed our logistics very much. In fact, our rosters were still exactly the same as 10 years ago. When you’ve been working a certain way for that long, some actions become so engrained that you are no longer able to see whether your methods are still appropriate. You tend not to give such things much thought anymore,” says Nicole Dekkers, who is responsible for Livio’s nine residential care centres and its district nursing services.
A question that brings about change
This was reason enough to contact Accezz to discuss a change programme. Livio wanted first and foremost to create awareness among staff about their working practices and use of time. Accezz started with a pilot in a nursing home that houses clients with a residential care referral. At the same time, another programme was initiated at a residential care centre, which is also home to tenants without a residential care referral but who are receiving community care. “So many clients, so many care requirements. Moreover, the organisation of care has changed to help provide more individualised elderly care. Customised care is not only cheaper, but it is also more client-focussed. At Livio, for example, tenants used to receive the same care as clients with a residential care referral. For some clients, this meant more care than necessary, while for others it was the exact opposite,” explains Dekkers. She adds, “In short, it was important to look at where and how we could better attune our work processes to the needs of individual clients. And that began with a simple question for each client: when do you require help and at which moments?”
Spilled time is not the best time
Certain clients had been with Livio for many years and it was felt that these people would benefit most from the change process. “Clients who had come in a long time ago based on a certain care assessment were still receiving the exact same
care as when they arrived. Due to the changes, we are now able to better deliver care that is more suited to the client’s needs. For example, we have a client with a cleaning phobia who has greatly benefitted from additional household assistance. Good household help keeps this person mentally balanced. Prior to the ‘working efficiently’ programme with Accezz, the client primarily received a lot of physical help, which was not always necessary. This person is now much more satisfied because the assistance received is tailored to their current requirements,” says Dekkers. She continues, “Thanks to Accezz, we have also managed to improve our work processes in general. For example, we discovered that staff sometimes went back and forth three times to locate a patient lift because it had not been put back in the right place or had been used to put out waste: unnecessary actions that meant less time was being spent with clients. By simply agreeing on a fixed spot for the patient lift, the process has become more efficient and staff are accountable for their actions.
Without such agreements, it is more difficult to hold individuals to account on work-related matters and behaviour. Prior to this, everyone was primarily concerned with their own work. We are now able to address issues that could disrupt or delay processes, which is important if clients are to receive the care they are entitled to.”
How important is job satisfaction?
The programme with Accezz also made it clear that work transfers could be carried out more quickly and efficiently. An employee sometimes had to wait 45 minutes for a handover. In home care organisations, colleagues don’t meet each other physically for a work transfer, so a more streamlined process is indeed possible. Accezz has ensured that we no longer regard such things as ‘normal’; we now make more conscious choices, which is exactly what we wanted. To give another example, in the past, the roster was not even immediately changed after a resident had passed away. That’s something we really find unacceptable now,” explains Dekker. She states that staff had a ‘Trojan horse’ feeling at the start of the process: “They could not yet see what bringing in Accezz would mean for them. But, fortunately, it turned out that after we had changed the service patterns and shifts, there wasn’t too much resistance. In fact, job satisfaction has increased among our employees. By providing more clarity and structure, the work is less hectic and there’s more time for the client. In the end, however, the sting is in the tail with these types of processes; you don’t only need to implement but also secure results! In this respect, our coach/managers have become owners of the implementation, and, to secure results, they regularly conduct audits. Working efficiently and the method introduced by Accezz have thus become part of our DNA.”
The Leadership Law of the Lid
Dekker concludes by saying, “Changing mindsets was an im- portant spearhead in the ‘working efficiently’ programme with Accezz. But when you really want to change staff behaviour, you must first start with the management team and only then take it further with the employees. How management positions itself with regard to employees is fundamental to affecting staff behaviour.”
As leadership expert John Maxwell states in one of his 21 laws of leadership, it is a case of the Law of the Lid. This means that leadership determines the level of ownership, and per- sonal leadership ability determines how effective you are in your own team. If your leadership is six, your potential effec- tiveness can never be greater than a five. And if you as team leader score a six on leadership skills, your team will keep hit- ting your leadership lid and will never make it beyond a five. Good leadership is necessary to improve everyone’s potential within an organisation. After all, a good example tends to be followed. What’s next?”
