"You can't solve a problem on the same level it was created. You have to rise above it to see the solutions." ~Albert Einstein

Whoo hoo! Our Medicare survey is over - and we passed with flying colors! What a relief! I felt that, for the most part, I was finally able to do my job well during this survey - that being to coordinate the effort of responding to the surveyor. In previous surveys, most folks had that deer caught in a head light look and it was tough to get things in motion and I was on my own to get the job done. This time, there was a much better team effort. We had some opportunities to fix some problems before the surveyor got to them, and the surveyor gave us ample opportunity to explain a couple of concerns - which the team managers did very nicely.

I take this aspect of my job very seriously - the bottom line is that passing keeps our doors open. We have lots of folks who really need their jobs, folks with a true heart for the work, and patients that need them. Frankly, the requirements of both the State and Fed should be considered basic for the way we do business. People who whine about the unreasonable demands haven't read the regs. The requirements are what any one should expect as minimum standards.

When I first took this job, I was met with many of the typical complaints - "we don't have time to chart", "I care about the patient, you only care about the stupid paperwork" - one of my favorite examples was asking them if they would understand, when they went to pick up their car from the shop, the owner said "our mechanics care so much about cars, they just don't have time to make out an invoice - you'll just have to trust that the charge of $500 is correct!"

The answer is usually "but that's different!" - the truth is that it isn't different at all! But over the past 2 1/2 years, I've made a number of converts - we've worked on processes to make that paperwork more efficient, and more importantly, given them tools for how to fill in the blanks. One of the things I discovered is that the major reason for the papers not being completed is that they really didn't know how to articulate their plans and interventions. Nor did they really have a grasp of the basics of the cycle of planning - to set a goal, assess the situation, plan how to meet the goal, impliment the plan, and evaluate it. Coaching on these basics is helping tremendously.

One of the concepts I've learned and continue to see, is that resistance is based in fear - looking harder for the source of the fear and overcoming it moves the group forward. When folks are fearless, they know what to do and do it very well! The best part is getting people to contribute to the solutions. When we're part of a plan, we own it and want it to succeed.

Especially, since lots of folks would rather eat ground glass than be told what to do! LOL