FELICIAN SERVICES
By JULIE MINDA
Prior to this year, when residents of Felician Village of Manitowoc, Wis., confronted staff members with concerns and complaints, staff didn't always have a good idea of just how to respond.
And, sometimes when residents felt their concerns were not addressed properly by the staff, "even small issues could escalate fast" and become serious conflicts necessitating administrators' intervention, said Raymond Weiss, director of mission services for Felician Village.
Felician Village administrators decided to establish a protocol for conflict resolution and train frontline employees and managers to use it with residents, their family members, colleagues — just about anyone employees encounter during their work. The grievances they hear may be large or small, but common complaints involve things like food quality and room comfort for patients and families and scheduling issues for staff.
The conflict resolution training is "about having a mind-set, an approach in which you're listening and fully present" to the aggrieved party, said Weiss.
The right disposition
The approach is encapsulated in the acronym HEAL A HEART.
Weiss developed HEAL A HEART with leaders' backing as part of a broader quality management program to establish a systematic approach to various aspects of operations at Felician Village. That campus includes independent living in apartments at "the Gardens," assisted living at both "the Court" apartments and "the Villa" group homes and long-term care at St. Mary's.
Weiss explained that HEAL A HEART "is a key part of the overall service excellence culture of the organization." To develop the approach, Weiss studied the literature on conflict resolution and learned about best practices in health care and other fields focused on customer service.
Weiss trained all Felician Village staff — nearly 300 employees — on the approach in January. Attendance at Weiss' hour and a half presentation was mandatory. He explained how service breakdowns and communications breakdowns occur, and why it's important to acknowledge and address concerns openly and compassionately. Training participants practiced the HEAL A HEART response techniques in role-playing exercises.
Expressing feelings
Felician Village's Katie Haese, manager of rehabilitation, and Dana Sirovatka, a housekeeper, said they use the approach regularly.
This summer, Haese encountered a resident who was frustrated because she had been left in her room when she wanted to go out; and she was frightened because the door was closed, and she couldn't see staff members to get their attention. Haese said she used the steps in HEAL A HEART — they include actions like active listening and apologizing — to understand the resident's concerns, empathize with her and find a solution, which involved updating her care plan. "You could tell at the start (of our conversation) she was anxious, but as we talked she relaxed," said Haese.
Sirovatka helped a resident newly relocated to an assisted living unit. The woman was uncomfortable sleeping in her bed and wanted to sleep on the couch instead — but the couch was not near her call button. Sirovatka used HEAL A HEART skills as she worked through a solution, which was to switch the position of the bed and couch. Remembering to empathize, as the approach asks employees to do, Sirovatka said she "pictured what it would be like if my grandma were here" and had this problem.
Transformed relationships
Weiss said that HEAL A HEART is not about assigning blame. "It is not about admission of guilt, but about an expression of compassion," he said. "It's not about being judgmental or negative, but about people having an opportunity to get to know other people better."
Weiss said the personal acknowledgment and caring the approach recommends can transform a relationship into something better than it was before.
There may not always be an easy answer to a problem. For instance, Haese said, many rehabilitation patients learn they cannot transition home as they had hoped, but may need to go into long-term care. While HEAL A HEART won't change that fact, it can help guide staff in a compassionate response to the patient's sense of loss and disappointment.
A process
Since the initial round of training, Weiss has been following up department by department to see how comfortable people are with the protocol, and individual units are talking in their regular meetings about how employees have used HEAL A HEART and what is working and what is not.
"Like any skill set, this must become natural" to staff, Weiss said, "but this is not a process that happens overnight.
"We're not robots — we're individuals. Some people may be unused to saying 'I'm sorry,' or some people's life experience may make them less warm than others. Those are the people who may need more follow-up conversations and encouragement" from Weiss and others.
In general, the rollout has gone very well, Weiss said. Staff surveys show greater awareness of the importance of using the approach. Felician Village plans to survey both staff and residents on the success of the protocol.
Brenda Georgenson, Felician Village director of quality management, thinks it's working. "Residents can sense a mood here, and when you have happy caregivers, you have happy residents, and when you have happy residents, you have happy family members. It seems simple but that makes a difference day to day."
She noted there is tight competition among long-term care providers to attract and retain residents; and residents and their families have very high expectations. "What sets us apart from others are things like HEAL A HEART," Georgenson said.
But, more important, she said, is that — in line with Franciscan values — staff know that residents feel valued and at home at Felician Village. "We'll hear (from residents) — it feels different here, there's a personal feel — it feels comfortable here."
Decoding HEAL A HEART
The acronym for HEAL A HEART stands for:
"HEAL" represents the disposition the employees should have:
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Humble
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Empathetic
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Aware
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Listener
"A" stands for "acknowledge," since staff are asked to recognize the person they're dealing with is an individual, made in the image of God — a person who deserves respect.
And, "HEART" stands for the steps staff should take:
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Hear
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Empathize
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Apologize
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Resolve
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Thank
Copyright © 2012 by the Catholic Health Association
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