Mark says value-based care and top-line revenue growth are the top two trends VHS is following, with multiple value-based care opportunities emerging in Virginia.
“Virginia has prioritized value-based care in skilled nursing facilities, which is the best way to reward high performing organizations and incentivize organizations to improve,” he says. “… These types of programs are vital to grow our top-line revenue as expense increases remain sticky and do not show any signs of improving in the short term. Our strategy of top-line revenue growth has significantly mitigated the expense increases and when our expense reduction strategies take hold, our top-line revenue will already be growing and healthy.”
Value-based care, the use of AI, veterans healthcare, staff recruitment and retention, and telehealth were other trends included in the piece.
Peter Murphy Lewis, the host of Experience Care’s LTC Heroes podcast, has long been interested in the innovative thinking of the leadership team at Virginia Health Services (VHS).
He asked VHS President and CEO Mark Klyczek and Vice President of Strategy and Business Development Eric Gommel to share the story of how they teamed up at VHS on his show:
Strategy and Growth
When Lewis asked Gommel why he wanted to “join forces” with Klyczek, Gommel shared that he admired Klyczek’s leadership style, which he experienced working with Klyczek at a previous health system.
“He’s great at executing on initiatives, but he also approaches his work with a sense of humor,” Gommel said. “And that sort of management style really attracted me.”
The discussion shifted to why Klyczek created the role Gommel would later fill.
“I knew we had to reposition Virginia Health Services,” Klyczek told Lewis. He needed someone with the specific skill set and experience in data and analytics, as well as facilitating and executing on strategy, that Gommel possesses.
“What Eric’s been able to do is accelerate our growth and our strategic initiatives,” Klyczek said. “I can only do so much, but Eric is really able to take the ideas and things that we come up with together, and run with them, making sure that they’re executed.”
Sprints: Focusing on Key Strategic Initiatives
The podcast host was familiar with Sprints but had not heard of them in the context of long-term care before the interview.
Gommel said he faced a challenge in introducing the VHS strategic plan and initiatives that went with it. He and Klyczek began to focus on a smaller, more achievable number of initiatives.
“The idea was to break the strategic plan into digestible pieces,” Gommel said. “We started with an eight-week cycle and have moved to a quarterly cycle. We then tried to narrow down to less than 10 specific initiatives with measurable deliverables.”
Gommel said the initial strategic plan was introduced during leadership meetings. He and Klyczek listened to feedback from executives, narrowed the focus and shortened the time horizon.
“This isn’t some fancy thing that we had to buy or pay for,” Klyczek said of how he and Gommel communicate the plan and track its progress. “We just leveraged Excel. Every time we meet as a senior leadership team, everybody has to report on their initiatives.”
Gommel continues to develop new, exciting ideas with the leadership team that will guarantee Virginia Health Services’ future success as well.
“What really excites me is our future projects,” Gommel said. “Those include initiatives focused on workforce development and extending programs Mark and the team have put in place over the past year.”
This blog was written and provided by the content team at LTC Heroes.
Virginia Health Services President and CEO Mark Klyczek found a way to improve nursing home and rehabilitation facilities through incremental change.
Those changes require sharing quality data, which is the key to raising a facility’s standard of care. Quality outcomes not only measure the care provided but also the satisfaction of Residents.
On average, most facilities in the industry receive their evaluations with a six-month delay.
Changing the system for the better
Klyczek decided he would not settle for a delay in providing the care Residents deserve.
So he changed the system.
“If we’re not going to spend the right time finding what the real issue is, then you’re just always going to have that conversation which I dread, which is, ‘that’s just the way things are, and we’ve never been able to change this’,” Klyczek said during his appearance on the LTC Heroes podcast. “And I’m not interested in that conversation.”
Thinking big may pose challenges, but VHS’s president said he will always continue to push himself and his team “beyond what a nursing home should be able to do.”
Klyczek decided to become more data-oriented and create his own system for checklists using Microsoft Excel. He created it while at Rochester Regional over the course of two-plus years. It’s a method he’s introducing and implementing now at Virginia Health Services. “I’m confident it can be replicated,” Klyczek shared on the podcast.
“I found myself saying, ‘I’ve got to get ahead of the way that quality is reported in nursing homes if I’m going to have an impact,’ ” he recalled. “And, as it turns out, when we got ahead of it, we actually had a bigger impact than I ever thought we could.”
Dedication to providing better care every day
The key to improving quality, according to Klyczek, is dedicating oneself to identifying the sources of error.
“If we’re not going to be honest with ourselves about what the root cause is, and we come to a conclusion too quickly, we’re probably not going to solve the problem completely,” he said.
He introduced a root-cause analysis tool developed by the Institute for Healthcare Improvement (IHI). This includes an action hierarchy tool that Klyczek and the team use to make actionable and meaningful changes. He now finds it easier to develop checklists and protocols that help the facilities make steady progress in the quality of care they provide.
Actionable change means taking things “bite by bite,” Klyczek said.
He begins by tackling the problems that are off by just a single percent or less. After he notices the trends, he will approach the staff and ask: “What are the barriers? How do I help you improve pressure ulcers, because we’re seeing it happens more often with this type of patient?” Klyczek makes sure to get as much information to the Certified Nursing Assistants (CNAs) and Licensed Practical Nurses (LPNs) as possible to enable them to make the best decisions.
“Because I can’t be there every day, and the nurse manager can’t be there every day, we depend on the CNAs and the LPNs to assume responsibility,” he said.
Klyczek also provides his team with a data analyst, who then gives the Director of Nursing or Assistant Director of Nursing at every facility the tools they need.
It’s a hard job, he says, but a rewarding job to work in long-term care. You have to support the team to be successful.
Guest blog provided by Cameron Zargar from the LTC Heroes team.
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