Two continuous improvement winners share the key reasons behind their awards
People in the long-term care and nursing home industry have a special calling. That’s what Paul Richardson, president of Mississauga, Ont.-based Diversicare Canada Management Services, believes.
That’s what he attributes the company’s success to in its pursuit of continuous quality improvement. People on the front line are sold on the program because it’s about making the lives of residents better.
Diversicare, which recently won the National Quality Institute’s Order of Excellence, introduced its continuous improvement program 13 years ago. Diversicare manages 38 residences in Ontario and Western Canada, 10 of which it owns. In some of the homes, the staff are Diversicare’s employees. In others, they’re employed by other parties but managed by Diversicare.
Huge discrepancies in service
The company’s continuous quality improvement (CQI) program was introduced after managers began noticing huge discrepancies in the quality of service in different locations. Diversicare was operating in both the United States and Canada up until 2002, and at that time, in the U.S. especially, much of the problem was due to high turnover. In some homes in the U.S. turnover was as high as 80 per cent.
To strive for consistent quality, the company brought in a scorecard of 16 indicators. These were based on risk-based, negative factors such as falls and bedsores among patients and absenteeism or workplace injuries among employees. The company also looked at its recruitment, selection and retention processes.
“We said we had to reward the good staff, the staff who are with you through thick and thin,” said Richardson.
Talent teams
Each home put together a “talent team,” comprised of people who performed well and whom everybody else looked up to. The talent team takes part in staff selection, sits in on interviews and asks questions of candidates and mentors new recruits during orientation.
Over time, the talent teams have become “extremely skilled in the kinds of questions to ask (in interviews), the qualities to look for. Nobody knows how a job is done better than the people doing it, I think,” said Richardson, adding that their presence in interviews also helps candidates meet the people they will be working with.
As part of the continuous quality improvement program, management also adopted what Richardson calls a “cheerleading management” approach. This involved teaching managers to lead, coach and encourage employees to participate in improvement programs.
Early adopters recognized
The program didn’t take off right away. In the first two years, only a third of the administrators took to it from the outset, with another third taking a wait-and-see approach. The company then included continuous quality improvement objectives in the annual goals of all management and supervisory employees and gave recognition to the early adopters.
Diversicare also started an annual CQI conference to spread the message to successive ranks of employees. Front-line staff now make up 70 per cent of those attending the conference, which is focused on introducing new initiatives, sharing success stories and honouring achievements.
Richardson credits the success of the program to the front-line staff, who are the ones coming up with solutions such as how to sort laundry properly. They’re also the people sitting on the three regional CQI committees, which filter ideas and strategies upwards to the Canadian CQI committee for widespread adoption. In 1999, eight positive indicators were added to the scorecard, and the most popular of these was ways staff could fulfill the residents’ “key wish.”
“When you ask people what they would really like, a lot of them would answer, ‘Well I want to go home.’ Once we’ve gone beyond that, it might be ‘I’d like some wine every Thursday with my meal’ or ‘I want to go to Tim Hortons,’” said Richardson. One resident in Penticton, B.C., used to be a pilot, so the staff arranged for a pilot to fly her and a few staff members in a four-seater plane.
“The staff often get much more out of this than the residents in arranging these things and planning them,” he said.
Although 90 per cent of Diversicare’s homes are unionized, Richardson said he has found no resistance among unionized staff, despite the fact they don’t have CQI objectives as part of their performance goals.
“We have two or three homes that are not unionized, and you can’t tell the difference between a unionized home and a non-unionized home,” he said.
One of the unions even wrote a letter of recommendation to support Diversicare’s submission for the NQI award, said Richardson.
Celestica’s change agents
At Celestica, a Toronto-based electronics manufacturer, a continuous quality improvement system was brought in three years ago based on Lean, Six Sigma and Kaizen approaches. This year, the program won an innovation award from the Canadian Manufacturers and Exporters (CME). What drives the program is the need to stay competitive in a changing environment by eliminating waste, improving processes and delivering products on time and at lower costs to customers.
Loretta White, HR director at the Toronto office, said the key to instilling the culture of Lean and Six Sigma is to build on the company’s existing culture of teamwork.
“We have a very strong team culture here,” said White. “So it’s about leveraging that and ensuring that we come together as a leadership team and communicating consistently and listening to employees, and helping them better understand what our objectives are.”
The HR component of this program included creating a supervisory role responsible for leading the charge on change management and continuous improvement at the team level.
“There was a lot of involvement from an HR standpoint in terms of what does that role do, what level is it, how do we make sure they’re well trained to drive the initiative as well as support the entire concept of employee engagement and participation, being able to create an environment that motivates employees and encourages them to step out of standard processes,” she said.
The answer was a lot of training to help managers understand how the Lean and Six Sigma approaches translate into employee performance and what that looks like at their various work environments.
Celestica’s quality improvement approach is very structured, so objectives are set out by the management team and listed on each employee’s performance development plan. Problem solving is left in the hands of employees so they can understand what barriers in their work processes are holding things back.
Over time, the incremental improvements reinforced a sense of confidence among employees, said Leslie Barker, director of Lean and Six Sigma.
“We live in a very dynamic, competitive environment. The pressures around us are constantly changing, which is constantly presenting us with new and unique challenges. Every time a new challenge is faced is another opportunity for all of us to reinforce the confidence that we can tackle this challenge and be successful.”
Rob Schormans, vice-president and general manager of Toronto operation, said the company submitted its program as a candidate for the CME award to recognize employees for being “true change agents in an industry that’s changing everyday.”
That’s what he attributes the company’s success to in its pursuit of continuous quality improvement. People on the front line are sold on the program because it’s about making the lives of residents better.
Diversicare, which recently won the National Quality Institute’s Order of Excellence, introduced its continuous improvement program 13 years ago. Diversicare manages 38 residences in Ontario and Western Canada, 10 of which it owns. In some of the homes, the staff are Diversicare’s employees. In others, they’re employed by other parties but managed by Diversicare.
Huge discrepancies in service
The company’s continuous quality improvement (CQI) program was introduced after managers began noticing huge discrepancies in the quality of service in different locations. Diversicare was operating in both the United States and Canada up until 2002, and at that time, in the U.S. especially, much of the problem was due to high turnover. In some homes in the U.S. turnover was as high as 80 per cent.
To strive for consistent quality, the company brought in a scorecard of 16 indicators. These were based on risk-based, negative factors such as falls and bedsores among patients and absenteeism or workplace injuries among employees. The company also looked at its recruitment, selection and retention processes.
“We said we had to reward the good staff, the staff who are with you through thick and thin,” said Richardson.
Talent teams
Each home put together a “talent team,” comprised of people who performed well and whom everybody else looked up to. The talent team takes part in staff selection, sits in on interviews and asks questions of candidates and mentors new recruits during orientation.
Over time, the talent teams have become “extremely skilled in the kinds of questions to ask (in interviews), the qualities to look for. Nobody knows how a job is done better than the people doing it, I think,” said Richardson, adding that their presence in interviews also helps candidates meet the people they will be working with.
As part of the continuous quality improvement program, management also adopted what Richardson calls a “cheerleading management” approach. This involved teaching managers to lead, coach and encourage employees to participate in improvement programs.
Early adopters recognized
The program didn’t take off right away. In the first two years, only a third of the administrators took to it from the outset, with another third taking a wait-and-see approach. The company then included continuous quality improvement objectives in the annual goals of all management and supervisory employees and gave recognition to the early adopters.
Diversicare also started an annual CQI conference to spread the message to successive ranks of employees. Front-line staff now make up 70 per cent of those attending the conference, which is focused on introducing new initiatives, sharing success stories and honouring achievements.
Richardson credits the success of the program to the front-line staff, who are the ones coming up with solutions such as how to sort laundry properly. They’re also the people sitting on the three regional CQI committees, which filter ideas and strategies upwards to the Canadian CQI committee for widespread adoption. In 1999, eight positive indicators were added to the scorecard, and the most popular of these was ways staff could fulfill the residents’ “key wish.”
“When you ask people what they would really like, a lot of them would answer, ‘Well I want to go home.’ Once we’ve gone beyond that, it might be ‘I’d like some wine every Thursday with my meal’ or ‘I want to go to Tim Hortons,’” said Richardson. One resident in Penticton, B.C., used to be a pilot, so the staff arranged for a pilot to fly her and a few staff members in a four-seater plane.
“The staff often get much more out of this than the residents in arranging these things and planning them,” he said.
Although 90 per cent of Diversicare’s homes are unionized, Richardson said he has found no resistance among unionized staff, despite the fact they don’t have CQI objectives as part of their performance goals.
“We have two or three homes that are not unionized, and you can’t tell the difference between a unionized home and a non-unionized home,” he said.
One of the unions even wrote a letter of recommendation to support Diversicare’s submission for the NQI award, said Richardson.
Celestica’s change agents
At Celestica, a Toronto-based electronics manufacturer, a continuous quality improvement system was brought in three years ago based on Lean, Six Sigma and Kaizen approaches. This year, the program won an innovation award from the Canadian Manufacturers and Exporters (CME). What drives the program is the need to stay competitive in a changing environment by eliminating waste, improving processes and delivering products on time and at lower costs to customers.
Loretta White, HR director at the Toronto office, said the key to instilling the culture of Lean and Six Sigma is to build on the company’s existing culture of teamwork.
“We have a very strong team culture here,” said White. “So it’s about leveraging that and ensuring that we come together as a leadership team and communicating consistently and listening to employees, and helping them better understand what our objectives are.”
The HR component of this program included creating a supervisory role responsible for leading the charge on change management and continuous improvement at the team level.
“There was a lot of involvement from an HR standpoint in terms of what does that role do, what level is it, how do we make sure they’re well trained to drive the initiative as well as support the entire concept of employee engagement and participation, being able to create an environment that motivates employees and encourages them to step out of standard processes,” she said.
The answer was a lot of training to help managers understand how the Lean and Six Sigma approaches translate into employee performance and what that looks like at their various work environments.
Celestica’s quality improvement approach is very structured, so objectives are set out by the management team and listed on each employee’s performance development plan. Problem solving is left in the hands of employees so they can understand what barriers in their work processes are holding things back.
Over time, the incremental improvements reinforced a sense of confidence among employees, said Leslie Barker, director of Lean and Six Sigma.
“We live in a very dynamic, competitive environment. The pressures around us are constantly changing, which is constantly presenting us with new and unique challenges. Every time a new challenge is faced is another opportunity for all of us to reinforce the confidence that we can tackle this challenge and be successful.”
Rob Schormans, vice-president and general manager of Toronto operation, said the company submitted its program as a candidate for the CME award to recognize employees for being “true change agents in an industry that’s changing everyday.”
