Case Studies
Engaging and Empowering Staff
The Client
A primary care practice in rural New Hampshire
The Need
The practice was experiencing high levels of nurse dissatisfaction. Nursing turnover had become an issue and was impacting practice productivity. Root cause analysis showed that nurses spent much of their time doing administrative work and had little opportunity to utilize their nursing skills and contribute to direct patient care.
The Solution
Using a solution-focused coaching model, the nurses identified opportunities to reduce administrative work burdens. This freed up time allowing them to conduct nurse-run, Annual Wellness visits for Medicare recipients. By doing so, patients received a comprehensive wellness exam, including preventative care and medical referrals as needed. The practice received an annual increase of $248,000.00 in Medicare payments. In addition, patients were highly satisfied with the care they received and nurses experience higher-job satisfaction as they were able to do what they loved – care for patients.
The Message
Using a solution-focused approach to problem solving and respecting the knowledge and wisdom of the team can turn problems into solutions and result in greater joy at work.
Using Data Effectively
The Client
A New Hampshire town police department
The Need
The police department launched a program aimed at reducing opioid overdose by helping individuals with substance use disorder (SUD). The program was demanding, requiring 24/7 coverage, and was being operated by one police officer. Data was being collected to track program results and effectiveness – but the volume of data was overwhelming, time consuming to manage, and most importantly it wasn’t providing the intended value of informing program results.
The Solution
The program data had to be simplified so that it could be collected and managed without huge demands on time. It also had to address the primary goal of the program – demonstrating program effectiveness in getting individuals into treatment and reducing overdose rates.
Working with the officer running the program, a more streamlined data management plan was created. Analytic functions and visual graphics were automated, which provided greater utility and greater efficiency. After the data was organized and simplified, it demonstrated that the program was making a significant, measurable impact on the community. The data was ultimately shared with policy makers and funders, resulting in additional funding, and has been a model for other similar programs across the state and the nation.
The Message
Data management is crucial to demonstrating success and informing stakeholders – and it doesn’t have to be complex to be effective. More often than not, a more simplified approach with succinct, user-friendly metrics is the best option.
Process Improvement
The Client
A New Hampshire based animal humane organization
The Need
The adoption counselors reported that the adoption application process was lengthy, time consuming for staff and had low approval rates. Staff were concerned that the inefficiency of the adoption process was frustrating for potential adopters and was taking time away from staff to socialize and train the animals in their care.
The Solution
Using a team coaching model, the staff was advised on process improvement methods. The process included data collection, setting improvement goals, and examining existing workflows for bottlenecks and other contributors to the process inefficiencies. Armed with this information, the team was able to redesign a more efficient and effective adoption application process. The new process resulted in an increase in adoption evaluations from 33% approval to 96% approval, a savings of 25 hours/week of counselor’s time, and high satisfaction among staff and customers.
The Message
Process inefficiency doesn’t have to be a reality. Short-term coaching in process improvement can result in long-term gains in organizational quality, value and satisfaction.
Coaching Leaders for Change
The Client
A mid-level nurse at a critical access hospital tasked with ensuring that hand hygiene methods were adopted by all care providers
The Need
Hand hygiene is accepted as a key component of good patient care, but using a method of reminders and reprimands was having no impact and was creating significant frustration for the nurse in charge of ensuring proper hand hygiene among care staff.
The Solution
Implemented a coaching relationship that addressed short-term project needs as well as change management skills based on literature and targeted to the needs and leadership style of the nurse. This resulted in a successful, quantifiable improvement to hand hygiene with support from staff and greater satisfaction for the nursing project leader.
The Message
Coaching support is a powerful method for accelerating professional development as it relates to organizational change. Coaching support is designed based on the unique needs of the individual, including strengths, challenges and leadership style.
Workshops and Training
The Client
A large primary care practice in Kentucky
The Need
The practice had multiple ongoing improvement initiatives; however, there was a lack of momentum and no measurable change despite ongoing efforts. Staff was feeling frustrated and leaders were concerned that important clinical improvements were not progressing as hoped.
The Solution
Interviews with staff and assessment of individual projects showed that staff had little to no training on managing complicated improvement initiatives. A customized training was designed to create a roadmap for improvement that addressed specific challenges and knowledge gaps. By allowing individuals to have a hands-on, collaborative learning experience built around their particular needs the improvement projects were able to realize significant gains and meet stated goals.
The Message
Investing in training is a sure way to “sharpen the saw” and facilitate meaningful change. Improvement skills training is a great investment in for an organization that is interested in transformational change.