Hindsight is 20/20
by Kent Brooks
“I wish I knew then what I know now”, “I wonder what might have happened if…?” These are phrases that have come out of my mouth over the past six months. After a 12-year career in Hospice Administration (Exec Director/CEO/COO), where I employed many MVI tactics at NFP Hospices with fairly respectable success, I jumped at the opportunity to become part of the MVI Team about six months ago helping Hospices directly implement their Models through Magic!. What I have witnessed has blown me away…
For 12 years I dabbled with the Model, using a piece here and a piece there, usually when it was convenient and with relatively good results. At first, I simply followed the MVI suggested standards for things like caseloads and visit length. Those methods combined with benchmarking against the suggested MVI Model for cost categories were HUGE tools in taking a struggling, no, failing Hospice, from a -26% loss to 10% profit. (Yes, a 36% turn-around!). We didn’t pay bills with community dollars either – we invested them in the future. We tripled the balance sheet, built nine months of cash or near-cash reserves, and acquired administrative offices, with no debt in two locations. Even better, we increased the number of patients served each year by over 50% and experienced quality scores in the 90th percentile. We made a difference! Another program that I worked with for a couple of years, just prior to coming to MVI, adopted many of the practices mentioned above and was on its way to similar results. That program also implemented a Compensation System that I had created as a result of attending the Compensation & the Model Tough Training.
THE RESULT: In addition to rewarding staff for good performance, we saw problems disappear that had haunted managers and supervisors for years. Staff liked the idea of making more based on quality/performance and self-regulated in order to obtain it. Problems like lateness to meetings, incomplete in-service education and late documentation just went away! This allowed managers to focus on more important things and the system weeded out bad actors.
But I never put the entire machine together! The Hospices that I was involved with were certainly in better shape when I left than when I arrived using these methods. But what if? What if I had implemented the Model at Magic! level intensity? Having now seen firsthand how all the pieces of complete implementation work together to create a result that is exponential has been a real eye-opener! From the Perfect Visit to People Development, from Creative Compensation Systems to practices that lead to increased quality, census and profitability, it is truly amazing to see it at work and to experience how the multiple facets of full Model Implementation work together like cogs in a machine to accomplish something far bigger than they could ever do on their own. For example: Creation of Perfect Visits with Perfect Documentation, taught in a synthetic learning lab instead of on our patients. On the surface, this simply looks like a training and orientation move, and it is. But it is so much more. It is a marketing tool that allows us to communicate to referral sources that we are consistent, competent and caring. It increases quality scores because it builds the CAHPS categories right into the visit ensuring that important elements are addressed correctly and consistently. It builds confidence with patients and families. Combined with a Compensation System, it creates efficiency, rewards effort, and sets managers free to guide, teach and coach. And together, the Perfect Visit and the Compensation System allows a Hospice to identify opportunities staff have for improvement earlier. Using practices like Self-Learning Modules and System7, those staff can be given the tools to flourish and excel, again leading to incredible quality scores and reduced staff turnover. If I had put the whole machine together at my prior Hospices, the successes that I outlined above would have been multiplied beyond belief.
As you move into the uncertain future of Hospice, I would urge you to strongly consider full Model Implementation at your program. Don’t fall into the trap of being happy with the mediocre success that comes from just using a piece here and a piece there – put the entire machine together and make it work for you! Don’t appease yourself with all the reasons why you can’t do it: “I can’t afford the time-money-effort to implement the Model right now.” The real truth is you can’t afford NOT to do it. Avail yourself to the unlimited resources at MVI, participate in the great Tough Training Programs, commit to Model Implementation on your own or consider letting us help you via Magic!. It will take effort, it will mean change, but it won’t really cost you money if you look at the economic result, as you’re virtually guaranteed to come out with 10-14% margins. The result will be worth it, and as a bonus, you won’t find yourself saying “Hindsight is 20/20”, “I wish I knew then what I know now”, “I wonder what might have happened if…?”