Strategic Mapping

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Strategic Mapping Program Alignment

• Aligning Experiences Expectations Resources
  Outcomes

2
Session Objectives

1. Introduce Choice as a service culture dining
   experience
2. Review application of Choice in dining service
3. Present process for mapping from a strategic
   objective to a tactical initiative
4. Conduct the Mapping Exercise for a Current
   Project Initiative
5. Review Process, Q A

3
Changing Demographics

1. More Couples
2. More Choice Selection
3. More Control
4. More Flexibility
5. Experience Consumers
6. More Knowledgeable of CCRC Living
7. Healthier Wellness Important
8. Seamless Experience
9. Broader Constituencies

4
Evolution of Experience Economy

• Commodity Economy
• Whole bean
• Consumer Economy
• Ground Coffee
• Service Economy
• Dunkin Donuts
• Experience Economy
• Starbucks

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The Resident Value Of Positive ExperienceA
Memorable Feeling Created By You As A Result Of Us
Relative Resident Value EXPERIENCE SERVICE GOOD
RAW MATERIAL
Source Of Resident Satisfaction
Created Within The Resident
Created By A Provider
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Operational Culture

• Rhythms of Daily Living is an operational
  culture that aligns resources and expectations of
  service experiences. RDL facilitates initiatives
  of environmental culture change implemented
  within the community.
• The core service model for liberating residents
  and staff from an institutional paradigm is
  dining service. Dining is a catalyst and enabler
  of transformation across coordinated services.

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Rhythms of Daily Living

• The core of RDL is the opportunity to exercise
  choice residents for how they choose to live
  their day and staff choice for care delivery.
  This creates a collaborative coalition of
  residents and caregivers working together in a
  living environment. RDL facilitates the delivery
  of care, the experience of living and the dignity
  of self-determination.
• RDL is a management principle that aligns the
  natural rhythms of residents and the support they
  need. The organizing principle of RDL is that
  people should be able to make meaningful choices
  in their daily lives on their own or with
  assistance. RDL relies on caregivers to help
  define and achieve outcomes that balance
  individual choice and system efficiency.

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When Landing A Plane, What Is The Main Thing? 1
Left Of Runway Altitude Too High
Aligned
Altitude
Pitch
Air Speed
Cross Winds
Wind Speed
1. Concepts and Diagrams From The Power of
Alignment - How Great Companies Stay Centered
and Accomplish Extraordinary Things By G.
Labovitz/V. Rosansky
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The Main Thing
Choice
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Alignment

• The appropriate positioning of systems and
  resources to attain a defined goal, mission,
  outcome or culture

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Program AlignmentProcess Overview
PLAN DEVELOP
Evaluate
Organize
Define
Plan
Codify
Implement
Assess
Alter
Train
Improve
12
Process AlignmentPlan and Develop
Evaluate
Organize
Define
Plan
Codify
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STRATEGIC OBJECTIVES TACTICAL IMPLEMENTATION
PROJECT MAPPING

• As dining options and program enhancements are
  discussed, specific initiatives are defined and
  envisioned by department management and staff.
  These new dining experiences" require a specific
  definition process from concept to strategic
  alignment to tactical implementation.
• Executive and Board leadership must clearly
  identify specific strategic organizational
  considerations. Leadership must clearly define
  their expectation and measurement of a successful
  contribution to the community strategic vision.

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STRATEGIC OBJECTIVES TACTICAL IMPLEMENTATION
PROJECT MAPPING

• The following are the task requirements for this
  process
• Identify Service Initiatives
• Define Their Contribution To Strategic
  Objectives
• Define Appropriate Measurements Of Successful
  Experience Outcomes
• Identification Of Resource And Operational
  Intersects
• Identification Of Intersects And Roles Of Other
  Contributing Departments
• Structure Of The Process For Resource Allocation
  To Develop The Defined Initiative
• Sequencing Of The Tasks
• Implementation of the Initiative.

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Map Process 1, 2 ,3
Strategic Objectives Community of Distinction Financial Enhancement Quality of Living Quality of Work Operational Effectiveness
Map1 Strategic Objective Benefit
Map 2 Benefit Measure
Measurement Tool
Map 3 Administration Regulatory Operations Personnel PPE Community
Operational Resource Requirements
Budget Impact /FTEs
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Map Process 4, 5
Map 4 Collaborating Departments Nursing Resident Services Therapies Pastoral Housekeeping Maintenance Activities
Task
Map 5 Task Implementation Nursing Resident Services Therapies Pastoral Housekeeping Maintenance Activities
Procedure
Policy
Resource Requirement
Inform/Train
Measure
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Project Management
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Choice Dining Continuous Alignment
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Comparison of CulturePioneer Network

• Institution-Directed Culture
• Staff provide standard treatments based on
  clinical
• Institutional defined schedule and routines
  resident comply
• Work is task oriented and staff rotates
  assignments interchangeable residents
• Centralized decision making
• Hospital environment
• Structured activities
• There is a sense of isolation and loneliness

• Choice Directed Culture
• Staff enters into a care giving relationship
  based upon individualized care resident desire
• Residents and staff design the schedules
• Care is relationship-centered, consistent
  assignments
• Frontline decision making
• Environment reflects the comforts of home
• Spontaneous activities
• Sense of community and belonging

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Workmanship of Riskvs. Workmanship of Certainty

• The distinction between workmanship of risk and
  workmanship of certainty turns on the question
  "Is the result predetermined and unalterable once
  production begins?"

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Culture of Curing

• There is a significant difference between these
  two cultures. A culture of curing, the medical
  model, requires workmanship of certainty
  specific, objective, regimented procedures to
  achieve a specific outcome.

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Workmanship of Certainty Leadership Attributes

• Workmanship of certainty requires a traditional
  hierarchical leadership style.
• Expectations are defined by the leadership
• Outcomes are measured against static benchmarks
• The process is predetermined and always replicated

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Culture of Caring

• A culture of caring, the LTC model, requires
  workmanship of risk the collaborative
  relationship to create a quality of living
  experience that is subjective and defined by the
  resident and care provider at the moment of
  service.

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Workmanship of Risk Leadership Attributes

• Workmanship of risk is best developed with a
  servant leadership model of direction.
• Leadership defines, through collaborative
  development, the expectations.
• The role of servant leadership is to then provide
  the community direction and then assure that
  staff have the necessary resources and
  environment for achieving the experiential
  outcomes.

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Servant Leadership

• a practical philosophy which supports people who
  choose to serve first, and then lead as a way of
  expanding service to individuals and
  institutions. Servant-leaders may or may not
  hold formal leadership positions.
  Servant-leadership encourages collaboration,
  trust, foresight, listening, and the ethical use
  of power and empowerment.

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Culture of Servant Leadership
Im here to see that you do your job -- and that
you do it right!
How may I help you successfully do your job?

• OR

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• Some facilities studied, usually the lower
  turn-over ones, were in the process of thinking
  about how to increase individualized care. For
  example, the researcher asked, what are you doing
  if anything about resident choice. We are
  looking at it. Ideally, we want them to eat when
  they want. We encourage them to tell us what
  care they want, a shower or bath, or to get up
  when they want.
• Page 5-49 Appropriate of Minimum Nurse Staffing
  Ratios in Nursing Homes, Phase II Final Report
  prepared by Abt Associates for the Centers for
  Medicare and Medicaid Services, December 2001.

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Quality of Living Considerations

• A large proportion of nursing home residents are
  malnourished and up to half are substandard in
  body weight, leading to serious consequences
  including infections, hip fractures, and even
  death. The environment in which residents eat
  and the degree to which residents may choose when
  and what to eat can affect residents health
  (malnutrition and dehydration) and quality of
  life (perceived safety, enjoyment, social
  relationships, individuality, autonomy, choice).
  i,ii,iii
• i Burger, S.G., Kayser-Jones, J., and Bell, J.
  P. Malnutrition and Dehydration in Nursing
  Homes Key Issues in Prevention and Treatment.
  National Coalition for Nursing Home Reform. June
  2000.
• ii Chou, S., Boldy, D., and Lee, A. Resident
  Satisfaction and Its Components in Residential
  Aged Care. The Gerontologist 42188-198, 2002.
• iii Kane, R. Long-Term Care and a Good Quality
  of Life The Gerontologist 41293-304, 2001.

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Session Objectives

1. Introduce Choice as a service culture
2. Review application of Choice in dining service
3. Present process for mapping from a strategic
   objective to a tactical initiative
4. Conduct the Mapping Exercise for a Current
   Project Initiative
5. Review Process, Q A

30
Contact

• Dan Look 770-565-4006
• Dining Management Resources, Inc.
• 3605 Sandy plains Road
• Suite 240-269
• Marietta, GA 30066
• dcl_at_dm-resources.com
• www.dm-resources.com