newsandupdates

Date: February 23, 2012

Does your agency team always work together as a team as they operate and compete in the marketplace?
When Home Health Agency (HHA) management encourages team participation to do the agency’s work, encourages the open exchange of knowledge and information- and also places its emphasis on becoming an adherent to this principle, it is thereby accepting the challenge of becoming one of the brightest and best–a Highly Effective Home Health Agency. This aim is to accept and continuously improve upon adoption of the positive virtues of ‘shared vision’, systems thinking’, ‘personal mastery’ and ‘team learning’, all principles of a “Learning Organization”, a concept first introduced by Dr. Peter Senge at MIT in 1991. ¹
Knowledge Sharing is a competitive advantage
By sharing knowledge, the home health team gets stronger and better decisions are made because there is a wealth of collective intelligence and experience on the team. Operating a HHA is a complex enterprise, requiring practical experience and specialized knowledge. There are many specialized bits of information that must be mastered in order to become a Highly Effective Home Health Agency. The areas and specialties of HHA knowledge are varied and have great depth and skill involved.
The knowledge and skills necessary to achieving mastery as a HHA MVP include:

The peculiarities of all variations of Medicare coding, requiring a thorough knowledge and understanding of HCPC and all other types of governmental specialized code
Skilled nurses and therapists charting—ICD 9-10 and all the skills of nurses
Scheduling for efficient work across the agency
Quality, caring patient relationship building and maintenance
Accurate and precise Medicare billing and the general regulatory and insurers framework
The ways that patient episodes can be documented and can completed so as to properly bill Medicare for the optimum billing and regulatory standard
Proper and compliant workflow methodology
Specialized and highly skilled mastery of the particular software platform being utilized to accomplish the work in the agency (yes, Axxess Agencycore is the best software platform in the US for the management of a HHA!)

Knowledge is your most valuable asset
Shared, facilitative learning helps promote the growth and business continuity of the organization, so when a team member is unavailable for any reason, other members can easily step in and function effectively and in the proper context. The shared knowledge of the varied disciplines represents expertise that can increase in value when shared among all members of the organization, members of all levels in the agency. Knowledge may be your most valuable asset to your HHA. In fact, technical and HHA specific knowledge in the minds of those who hold the greatest amount of knowledge in the agency, when openly and freely taught/shared with all the staff, is a great leap forward towards becoming highly effective as an agency in the competitive marketplace.
Axxess practices the principles and attests to their value
Axxess Healthcare Consult, as an organization believes that there is great wisdom in adoption of “Learning Organization” principles. A primary value of learning organizations—is that all its members actively pursue “Personal Mastery” in their field, whether it be as an administrator, a biller, an aide, a nurse or a therapist. It is a principle of “Continuous Improvement”. This is how we become ‘craftsmen’ or ‘artisans’ with mastery in our chosen profession. In fact, those who are intentional about training and guiding their staffers of all the disciplines to learn, learn and learn some more, with the goal of becoming Masters and promoting the achievement of Mastery for all employees in their fields of endeavor themselves, are actually taking positive steps toward achieving the worthy goal of becoming a Highly Effective Home Health Agency. This is why we at Axxess actively practice the standards of a “Learning Organization” and stress that our clients adapt this methodology of operation as well.
These agencies are compelling workplaces
The Highly Effective Home Health Agencies that are the winners in their marketplace are compelling places to work. Attrition is lowered. People want to grow and learn within a cohesive team—and thus will tend to be admired and respected in their communities and in their marketplace. These agencies are those that adopt and promote a shared vision and a standard operating model of repeated and systematic corporate learning, and over time they become a true “Learning Organization”. Our advice is to seek to eliminate withholding of valuable knowledge, and adopt the tenets of a “Learning Organization”.
The benefits are many and include the following:

Eventual reduction of the attrition –the dreaded high turnover of employees
Improvements in your agency’s profitability
The quality of its regulatory compliance
Excellence of care in all its services to its patients

Axxess will be sharing more information about becoming a Highly Effective Home Health Agency over the next few months as we move towards our upcoming Administrator Seminar Series, being offered in four locations across the country: in McAllen, Houston, and Dallas, TX. and Ontario,CA. Potentially, in early summer/late spring-we may be presenting the teaching series in the Chicago area. Go to http://axxessconsult.com/seminars for more information.
¹Citing: “The Fifth Discipline: The Art & Practice of The Learning Organization”, Dr. Peter Senge, 1991.

Wednesday, February 22, 2012

Home Health Agencies as Learning Organizations

According to Peter Senge, a learning organization exhibits five main characteristics: systems thinking, personal mastery, mental models, a shared vision, and team learning.

All these characteristics are achievable in agencies that are seeking to become "Highly Effective". This is a process, not an immediate absolute. An agency needs to ascribe to the process, and adopt a patient attitude towards achieving the full benefits of the principles.

Systems thinking. The idea of the learning organization developed from a body of work called systems thinking. This is a conceptual framework that allows people to study businesses as bounded objects, such as as Home health agency. Learning organizations use this method of thinking when assessing their agency and have information systems that measure the performance of the organization as a whole and of its various components. Systems thinking states that all the characteristics must be apparent at once in an organization for it to be a learning organization. If some of these characteristics is missing then the organization will fall short of its goal. The characteristics of a learning organization are factors that are gradually acquired, rather than developed simultaneously.

Personal mastery. The commitment by an individual to the process of learning is known as personal mastery. There is a competitive advantage for an organization whose workforce can learn more quickly than the workforce of other organizations. Individual learning is acquired through staff training and development, however learning cannot be forced upon an individual who is not receptive to learning. Research shows that most learning in the workplace is incidental, rather than the product of formal training. therefore it is important to develop a culture where personal mastery is practiced in daily life.^. A learning organization has been described as the sum of individual learning, but there must be mechanisms for individual learning to be transferred into organizational learning.^[1]

Mental models. The assumptions held by individuals and organizations are called mental models.^[2] To become a learning organization, these models must be challenged. Individuals tend to espouse theories, which are what they intend to follow, and theories-in-use, which are what they actually do..Similarly, organisations tend to have ‘memories’ which preserve certain behaviours, norms and values. In creating a learning environment it is important to replace confrontational attitudes with an open culture that promotes inquiry and trust. To achieve this, the learning organization needs mechanisms for locating and assessing organizational theories of action. Unwanted values need to be discarded in a process called ‘unlearning’.

Shared vision. The development of a shared vision is important in motivating the staff to learn, as it creates a common identity that provides focus and energy for learning.^[3] The most successful visions build on the individual visions of the employees at all levels of the organization, thus the creation of a shared vision can be hindered by traditional structures where the company vision is imposed from above. Therefore, learning organizations tend to have flat, decentralized organizational structures. The shared vision is often to succeed against a competitor, however Senge^[3] states that these are transitory goals and suggests that there should also be long term goals that are intrinsic within the company.

Team learning. The accumulation of individual learning constitutes Team learning.^[2] The benefit of team or shared learning is that staff grow to mastery more quickly and the problem solving capacity of the organization is improved through better access to knowledge and expertise. Learning organizations have structures that facilitate team learning with features such as boundary crossing and openness. Team learning requires individuals to engage in dialogue and discussion; therefore team members must develop open communication, shared meaning, and shared understanding. Learning organizations typically have excellent knowledge management structures, allowing creation, acquisition, dissemination, and implementation of this knowledge in the organization.

Benefits to Home Health Agencies

The main benefits are;

Maintaining levels of innovation and remaining competitive
Being better placed to respond to external pressures
Having the knowledge to better link resources to patient needs
Improving quality of outputs at all levels
Improving Corporate image by becoming more people oriented
Increasing the pace of change within the organization

Barriers to progress as a Learning Organization

Even within a learning organization, problems can stall the process of learning or cause it to regress. Most of them arise from an organization not fully embracing all the necessary facets.

Once these problems can be identified, work can begin on improving them.

Some organizations find it hard to embrace personal mastery because as a concept it is intangible and the benefits cannot be quantified; personal mastery can even be seen as a threat to the organization. This threat can be real, as Senge points out, that “to empower people in an unaligned organization can be counterproductive”. In other words, if individuals do not engage with a shared vision, personal mastery could be used to advance their own personal visions. In some organisations a lack of a learning culture can be a barrier to learning. An environment must be created where individuals can share learning without it being devalued and ignored, so more people can benefit from their knowledge and the individuals becomes empowered.

A learning organization needs to fully accept the process needed for removal of traditional hierarchical structures.

Resistance to learning can occur within a learning organization if there is not sufficient buy-in at an individual level. This is often encountered with people who feel threatened by change or believe that they have the most to lose. They are likely to have closed mind sets, and are not willing to engage with positive mental models.

Unless implemented coherently across the organization, learning can be viewed as elitist and restricted to senior levels. In that case, learning will not be viewed as a shared vision. If training and development is compulsory, it can be viewed as a form of control, rather than as personal development. Learning and the pursuit of personal mastery needs to be an individual choice, therefore enforced take-up will not work.

Thanks goes out to the reference shown in the Wikipedia article shown under: http://en.wikipedia.org/wiki/Learning_organization.