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Below is this week's issue of the Connecter newsletter, which is required reading for all employees. The next edition will be published on Monday, August 17, with articles due to connecter@vnacarenetwork.org by Friday, August 14.

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IN THIS ISSUE:
August 10, 2015
Volume 4, Issue 32
 
 
SERVICE EXCELLENCE
CustomerContact
Service Standard of the Week
 
Service Recovery:
We ensure complaints are acknowledged, addressed, and proper action is taken by utilizing LEAP.



Champion
Service Recovery
By Lori DeRosa, Clinical Service Manager and Service Excellence Champion
 

Definition: A service failure occurs when customer's perceptions of the service they received does not match their expectations.

We provide excellent care to our patients but sometimes our responsibilities and guidelines don't match the expectations of our customer. When the expectations of both parties don't match there is conflict which can have a tremendous negative effect on an organization. At one point or another we all encounter conflict; how we handle the conflict will result in the customer's perception of our abilities.

To provide great service recovery we need to remember that everyone who interacts with the customer creates their experience.  Customers who vocalize a negative experience are more satisfied if the first person they share their concern with is able to take the initiative to fix their problem. As we discussed in our Service Excellence training: LEAP (Listen, Empathize, Ask, Produce) You may not have the answer and someone else may need to get back to the customer but taking the initiative to Listen, Empathize and Ask is an essential part of the recovery process that everyone can help with.  
 
Another area of service recovery can be in relationships with our colleagues. I can honestly say I have never met anyone who gets up in the morning and says "I can't wait to have a bad day".
 
There are times when our perceptions and expectations don't match in our work relationships. Acknowledging our conflict, understanding each other's position, apologizing for our individual roles in the conflict, and learning how to better communicate with each other takes time to develop but is truly the success and "Art of Service Recovery.

Spotlight

 

Please share all your notes of praise and recognition with connecter@vnacarenetwork.org

 

 

 


 

 

scene
Scenes from the Street


Share your pictures from the office or the field with us by sending them to connecter@vnacarenetwork.org!







AGENCY ANNOUNCEMENTS AND UPDATES
Strongwater
 
 
Population Health is Moving Forward!
By Emily Bower, Vice President of Population Health, Atrius Health

As some of you may have heard, the "ACO Department" has expanded its role and is changing its name to the "Department of Population Health". I will continue to lead this department, reporting to Rick Lopez, MD, Chief Medical Officer.

Why the change? What we have been calling "our ACO" was focused on the Medicare population. What we learned is that the set of resources and strategies that we applied to the Medicare population can work for any population for which we want to improve care. We have developed an internal expertise in engaging existing clinical, analytic and operational experts to stratify a population, detect gaps in care, and identify opportunities to improve outcomes and close those gaps. We can use this strategy to improve care for any population of focus. While the Medicare or Geriatric population continues to be our focus at present, as we integrate clinical programs across Atrius Health, we will look for other "high-stakes" or "high-opportunity" populations that would benefit from the population health approach. Our new name reflects this focus on a broader range of populations.

Integration of SNF/Home Based/ Palliative Care/Ambulatory Geriatrics
Prior to and as part of the ACO work, each of the Atrius Health medical groups had developed ways of caring for patients in Skilled Nursing Facilities (SNFs). This is a group of patients who need close management to monitor their care after discharge from a hospital and prevent re-hospitalization. We have designed an integrated SNF program to care for patients across Atrius Health with agreements about the population to be cared for, scope of work of the teams caring for them, roles and responsibilities and standard work. Working together in this way, we believe we can get even better results for our patients and better support for our staff.

To implement the SNF design, continue the work to integrate the other Geriatric programs, and ensure that our efforts are effective, we are recruiting a Director of Clinical Programs, Population Health who will function as the "Specialty Administrator" for Geriatrics. We are also recruiting a Chief of Geriatrics. The North, Urban, and West regions have agreed to have the Population Health Department manage these clinical services for them in a shared services model to maximized effectiveness and manage costs efficiently. The South region, which had already developed a regional program, will resource that program locally while continuing to design and implement the expectations and agreements we are setting together for Atrius Health.

Many thanks to Linda Oliver for leading this work and best wishes in her new role at the Wellesley practice.

How the work comes together to support a medically complex patient
To put this work in context, it might be helpful to provide an example of the coordination that it takes to properly manage the care of a complex patient across and beyond the Atrius Health system of care:
 
A 70 year old Harvard Vanguard patient with a medical history of chronic lung disease and multiple cardiac issues fainted at the grocery store and was admitted to Norwood Hospital. Prior to the event, he was being managed by Harvard Vanguard pulmonology and Chronic Heart Failure (CHF) teams, and also had a Brigham and Women's Hospital cardiologist. While at Norwood Hospital, the patient was seen by both cardiology and pulmonology, his diuretic was increased and he was placed on oxygen. He was transferred to Ellis Nursing Home for rehabilitation and continued medical management where he was cared for by a Dedham Medical Associates nurse practitioner and physician. At Ellis Nursing Home, the patient's treatment plan included physical and occupational therapy, and management of multiple medical issues as well as some new orthopedic issues. The Dedham Medical Associates team coordinated his care with pulmonology at Harvard Vanguard to create a seamless discharge plan, including follow-up evaluation for some abnormalities found on a Chest CT at the hospital.
 
The patient was discharged without the need for supplemental oxygen, and with a good understanding of his condition from the extensive teaching provided by the team, a clear medication regime with changes understood by the patient, and a set of follow-up appointments in place, all supported by documentation in an after-visit summary. Our team at Ellis Hospital worked with the Harvard Vanguard case manager to transition the patient's care successfully to his PCP/CHF providers, where the patient continues to be monitored. He was seen by his primary care NP within ten days of discharge, while he was being monitored telephonically by the Harvard Vanguard CHF RN, who also saw him soon after. The patient's Brigham and Women's Hospital cardiologist is also involved, supported by communication via the web portal between Atrius Health and Partners hospitals. Harvard Vanguard Pulmonology has been following his condition, and the patients has since had a repeat chest CT, and continues to be stable.

A few points to note:
  • This patient had many, many complex chronic issues and when he went to the hospital, many "abnormalities", which weren't necessarily of the highest priority, were found among all of his testing. These issues many times can slip through the cracks. The ability of the Atrius Health SNF team to gather the extensive hospital information, sort it out, and distribute it to the appropriate follow-up helps to prevent missing many of these important details.
  • The ability of our technology enables us to be very thorough. For example, having the web portal in addition to EPIC allowed the nurse practitioner to pull in what his specialists already know about him and what their approaches to his treatment are. 
  • The nurse practitioner noted that for this patient, it was remarkable to be able to copy her note to all of those people and get this patient in for such quick follow-up. This is so important for patients like him with complicated heart and lung issues which lead to re-hospitalization.
This is a great example of how we can work together to coordinate care across the continuum and improve the experience for our patients. It is why we work so hard to develop the systems that will allow care of this complexity to occur as seamlessly and efficiently as possible.






walk 

The VNA Walking Warriors want to invite you to please join our team today!

The 2015 Boston Heart Walk
Saturday September 12, 2015 @ 9:00am
DCR's Hatch Shell on the Charles River Esplanade
 
Each registered participant is eligible for an Atrius Heart Walk T-shirt.  Please contact me by Wednesday, August 19th with your order and size information.
(Youth Small, Youth Medium, Youth Large, Adult Small, Adult Medium, Adult Large, Adult X-Large, Adult XX-Large, Adult XXX-Large)

VNA Care Network Foundation is making a difference by participating once again in the American Heart Association's Annual Heart Walk. I need your help to make our team a success. Are you ready to build healthier lives by joining our team?

It only takes 2 easy steps!
1) Click on the link below to visit the team web page. 
2) Click the "Red "Join Team" button and follow the prompts to register.

Once you've joined the team, we'll need your help to reach our team 
fundraising goal. Don't worry - fundraising is easier than you think. The American Heart Association provides all the tools you need, including your own personal fundraising page. Plus, I'll be here to support and encourage you along the way. Please don't hesitate to contact me with any Heart Walk questions.

Why Heart Walk? Did you know 1 in 3 Americans have some form of cardiovascular disease and that heart disease kills more women than all forms of cancer combined? We can change these statistics by joining together to walk and fundraise for Heart Walk.

Help grow our team, please feel free to forward this email to anyone you think will want to walk, raise funds and make a difference in our community. All are welcome; it's the more the merrier, when it comes to our Heart Walk team!

Follow This Link to visit our team web page and help with the efforts to support American Heart Association - Boston, MA
 
We would like to thank you in advance for your participation!
 
Cyndi Anderson
 
HR Administrative Assistant
(508) 751-6806
Fax:  (508) 373-7598
  







 
CLINICAL SERVICES
 
Clinical Services Announcements and Updates
OASIS
OASIS Definitions vs. Rehab Definitions
Kyra Mihalick, Rehab Patient Care Manager
 
What you learned in [physical, occupational, speech] therapy school:
  1. Minimal assistance- Definition: The patient performs 75% or more of the task and requires assistance for 25% or less of the task
  2. Toilet Transfer- Definition: Getting on and off of the toilet
For a rehab clinician, that may seem simple, straight forward, and second nature. However, OASIS and rehab interpretations do not always line up. Below is a summary of OASIS Interpretations vs. Common Rehab Interpretations to guide you as you perform an OASIS assessment.

OASIS
OASIS-C Interpretation
Common Rehab Interpretation
"Assistance"
Any type of human assistance: verbal cueing, supervision, spotting, contact guard, any type of physical assist
Supervision, contact guard, min A, mod A, max A
"Independently"
Performs SAFELY, requires no human assistance (see above definition), and requires no further instruction or training. Not included ANYWHERE in plan of care/interventions
Performs task by self with or without equipment
"Minimal human assistance"
Any type of verbal cueing, S, CG, spotting, environmental set up, physical assistance
Pt performs 75% or more of the task and requires assistance for 25% or less of the task
"Toilet transfer"
Getting on and off the toilet AND getting to and from the toilet
Getting on and off the toilet
"Bed to chair transfer"
Ability to safely move from the bed to the nearest sitting surface, which may require ambulation to another room
Stand/pivot or stand/step transfer to/from bed and chair. Chair is generally next to the bed
Assistance of person at all times
Pt is UNSAFE and requires assistance (see above definition). May or may not have caregiver available
Pt lives with someone who is able to assist

 



Education
WOC


 
FUND DEVELOPMENT
Mallika
WBZ-TV's Dr. Mallika Marshall to host Heroes in Health Care Gala
 

WBZ-TV News Medical Reporter Dr. Mallika Marshall will help VNA of Boston celebrate 10 years of Heroes in Health Care as mistress of ceremonies for the annual gala on Saturday, Nov. 14, at 6 p.m. in the Mandarin Oriental Hotel, 776 Boylston St., Boston.
 
"As a practicing physician at the MGH Chelsea Health Center, I have a lot of experience working with home health care, and I had the opportunity to see what these incredible (VNA of Boston) clinicians do up close and personal. Their work is nothing short of incredible," Dr. Marshall shared with the crowd gathered at last year's event. (She's pictured during an MCH home visit to a VNA of Boston patient.)

Dr. Marshall is board-certified in both internal medicine and pediatrics. In addition to practicing at the Massachusetts General Hospital Chelsea Urgent Care Clinic, she also serves on the staff of Harvard Medical School. This is the third year Dr. Marshall is serving as mistress of ceremonies for VNA of Boston's Heroes in Health Care Gala.
 
Heroes in Health Care has raised nearly $2 million in essential funding for VNA of Boston's direct patient care and support for vulnerable, underserved populations through the nonprofit's Maternal Child Health Program and Charitable Care Fund.
 
For more information, please contact Laura Wise, manager of fund development, at 617-886-6460 or lwise@vnab.org or visit www.bostonvna.org/gala.





CaringSociety
Patients and Families Honor Staff through Thanks for Caring Society
 
Often, patients and family members make donations in appreciation of the exceptional care and service provided by our staff. These donors become part of the Thanks for Caring Society, and we'll be recognizing the staff they've honored with a new, monthly column in the Connecter and annually in the donor report.
 
The Thanks for Caring Society is organization-wide. Moving forward, it will combine VNA Care Network & Hospice's Thanks for Caring Society and VNA of Boston's Grateful Patient Program. This Society is new to many VNA Hospice Care employees.
 
These types of donations are received directly from patients and family members and as a result of direct mail appeals from the agency. Donors who make gifts in honor of staff will become part of the Thanks for Caring Society. For all staff who are recognized in this way, the Fund Development team notifies the staff person and his/her manager that a donation was made in honor of the care provided. If multiple staff members are honored, each is notified; if a team or group of providers is honored, the manager is notified on behalf of the group. If the donor includes a note with their gift, a copy is included with the notification letter to the manager. 
 
If a patient or family member needs more information or assistance making a donation, please ask them to contact Karen Webber, development officer, at 888-663-3688, ext. 1365 or kwebber@vnacarenetwork.org or Laura Wise, manager of fund development, at 617-886-6460 or lwise@vnab.org.  
 
Staff honored through a charitable donation in July 2015 were:
 
VNA Care Network & Hospice Staff
Sarah Berger, PT
Tonya Bernard, PT
Ruthann Beskrowni, RN
Barbara Betsher, RN
Denise Brehme, RN
Debra Brown, PT
John Budrow, PT
Teresa Burgess, PTA
Linda Carroll, PT
Christine Ciolfi, PT
Kimberly Connelly, RN
Jennifer Croke, RN
Jeffrey Crompton, PT
Diane Crudden, RN
Beatrice Desir, RN
Thomas "Tom" Duffy, PT
Denise Dunn, RN
Linda Gately, RN
Candyce Geshelin, LPN
Kathy Greeke, RN
Valerie Green, RN
Lorrine Johnson, RN
Becky Johnson, PT
Carol Jones, RN
Claudette Joseph, RN
Nicole Kallio, OTR
Lindsay Keaney, RN
Janette Keddy, RN
Brenda King, RN
Diane Kizito, RN
Sharon Kuebler, PT
Catherine Lane, RN
Dianne Lawlor, RN
Michael Leclair, RN
Christine Lorkiewicz, OT
Stacey Maenzo, RN
Janet A. Mancuso, OT
Tara Maughn, RN
Kimberly McLeod, PT
Justin Monigle, RN
Michelle Morfiris, LPN
Laurie Nash, RN
Gail Prisby, RN
David Ramocki, PT
Katherine Riley, PT
Andrea Segel, OT
Deborah Tanner, PT
Julie Winslow, RN
Jennifer Wisel, RN
Erin Woods, RN





 
HUMAN RESOURCES
EAP
EAP Network Employee Newsletter
August 2015


Know Your Strongest Skills
Could you quickly describe your skills and abilities in a chance encounter with a CEO? Be the expert on yourself, and improve self-awareness by periodically taking inventory of your skills. Take a look at the free online Dictionary of Occupational Titles (www.occupationalinfo.org). Search your job (or a similar one). Notice the skills listed, and whether there are some you possess but have never considered. Repeat with your past jobs, and a job you'd like in the future. Now examine soft skills. A list can be found at bit.ly/softskills123. Soft skills are closely linked with emotional intelligence, and those who hire know they can predict job success. Their importance can't be overstated. Consider all you've gathered about yourself. You now have a renewed understanding of yourself, how to advance your career, and how to sell your most important product-you.


"Instigate" Yourself to Exercise
New research suggests an "instigation habit" could be your solution to improving exercise frequency. An instigation habit triggers your motivation to take the next step and "just do it." Its purpose is to reduce the amount of time you spend talking yourself out of it. An instigation may "zoom" you past this rumination stage that zaps your motivation. Instigations are trigger events like an alarm clock going off, the moment you arrive home after work, or putting gym shoes on first thing in the morning. The "auto-response" takes about 30 days.

Source: www.iastate.edu [search "exercise habit"


Understanding Texting Shorthand for Parents
It is healthy and normal for young people to establish bonds, but texting has added a whole new dimension to this phenomenon - a growing shorthand of acronyms. Texting shorthand can be fun, but it presents challenges for parents wanting to know about their children's activities. If knowing more about texting shorthand is important so your children are not KPC (keeping parents clueless), then visit NetLingo.com. It's the one-stop source for texting acronyms. Some may not leave you LOL (laughing out loud), but you will learn what "420" means (marijuana.)

Source: Netlingo.com.


A Budget Isn't Just About Money
A budget does far more than track expenses; it can positively influence many parts of your life. If you have been resistant about budgeting, you should reconsider, because having a budget helps you:
1) have more control of your life, rather than money controlling you;
2) reduce domestic conflict;
3) improve your sleep;
4) reduce worry;
5) increase feelings of optimism;
6) improve your mood;
7) stop doom-and-gloom thinking;
8) save money;
9) help others (budgets often include a "giving back" section);
10) focus on shared family goals that bring you closer together.

Can you think of more?


Treating the Aftermath of Trauma
All of us handle stress differently, including traumatic stress-experienced when a severe injury or the threat of severe injury or death occurs, or while witnessing these things affecting others. Believability of the threat and fear are key factors that produce traumatic stress. How you react to traumatic stress does not demonstrate weakness or other personality flaws. However, lingering symptoms may cause you to think, "I should snap out of this." Caution: Overcoming traumatic stress is not necessarily a do-it-yourself project. This avenue of thought could lead you to avoid the best form of help-counseling with a professional who could help you return to a pre-trauma state. If you experience sleep disturbances, intrusive thoughts, mood swings, flashbacks, or are easily startled following a traumatic event, talk to a professional counselor, your doctor, or employee assistance professional. Like a cut or other physical injury, traumatic stress left untreated or ignored can fester too. Not with bacteria, of course, but with bothersome symptoms that may cause additional issues if they remain chronic. Proper treatment approaches exist to help you overcome traumatic stress and prevent it from interfering with your life.


Am I Under Too Much Stress?
Could you be under too much stress and not realize it? Being over-stressed (in distress) doesn't necessarily include worry, dread, anxiety, or sleep problems. Though common, these symptoms are not experienced by everyone. Instead, you might experience rashes or diarrhea, bicker more with a life partner, have neck pain, or become disorganized and forgetful. Being quick to anger ("snappiness") is a sign of increasing distress, but self-awareness for spotting it may be minimal. Others are more likely to point it out. Reaction to stress stems from the body's "fight or flight" response to a perceived threat. This response can manifest in different ways, but because life stress is often psychological (fear of being fired, late to work, etc.), there is nowhere to run. Stress therefore will take its toll on your body. When undesirable symptoms of stress appear and don't relent, it's time to intervene. Find a large list of stress symptoms at www.stress.org/stress-effects.


More Worker Diligence: Reducing Errors
Always seeking perfection will exhaust you, but eliminating more errors is possible with a few tips.
1) Do creative work during the day when you are more alert.
2) Step away from your work for at least 15-20 minutes before checking it for mistakes. Not doing so will cause you to overlook even obvious errors.
3) Your reputation at work is built via three primary channels: quality work, responsiveness to others, and ability to engage productively with those around you. Knowing this can motivate you to pursue more error-free work.
4) Understand the "doctrine of completed staff work." A Google search will reveal how heartily this principle is valued by management.

Completed staff work means doing things so thoroughly that an answer to nearly every possible question accompanies the final product. Understand and apply this principle whenever possible and you'll amaze others with your competence and ability to deliver.


Prevent Sports-related Concussions
August is back-to-sports practice month. These few pass-along tips can help reduce risk of sports-related concussions:
1) Wear protective equipment in practices.
2) Never assume a helmet makes you invincible against head injury (especially if used like a battering ram).
3) A helmet protects against external injury, but remember, the brain floats in a fluid. It can be bruised or injured with strong impact.
4) Having no symptoms following a blow to the head does not mean a concussion won't appear 2-3 days later. If in doubt, sit out.
5) Always seek medical care following a blow to the head, and follow a doctor's instructions even if you feel fine.
6) Never risk a second concussion by dismissing symptoms you think are minimal following a head blow.

Find concussion checklists at cdc.gov.

Source: CDC.gov [search: "concussion checklist"]

Important Notice: Information in EAP Network's Employee Newsletter is for general information purposes only and is not intended to replace the counsel or advice of a qualified health professional. For further questions or help with specific problems or personal concerns contact your employee assistance professional at 1-800-333-6624 or eapnetwork.com.

Bonus 

Employee Referral Bonus up to $5,000!

 

Employee referrals are often the most successful way for us to find the best candidates for open positions. Demand for physical therapists and nurses continues to be issue throughout the industry and the VNA is no exception.

 

In order to attract and retain new RNs and PTs, we are offering an employee referral bonus of up to $5,000!!! Certain conditions apply and the bonus will be paid in equal installments to eligible employees at the new recruits three and six month anniversaries.

 

Please contact Cheryl Milas at cmilas@vnacarenetwork.org or Debbie Brown at dbrown@vnab.org for more information.

JobsVNAB
Job Postings - VNA of Boston and VNA Hospice Care
To learn more about career opportunities listed in the links above, contact Debbie Brown, Human Resources Manager at dbrown@vnab.org.



JobsNetwork
Job Postings - VNA Care Network and VNA Hospice Care
To learn more about career opportunities, contact a human resources representative:




eat
Employee Advisory Team Suggestions

To suggest an area of focus to the Employee Advisory Team (EAT), please email your suggestion to EATSuggestionbox@vnab.org. Suggestions can include ideas to improve current processes and procedures, remove redundancies, or even to provide feedback on something you think is/is not working.

Please feel free to discuss any issues that you would like brought to EAT with the following members of the committee:
  • Kelly Frew
  • Mary Helen Mahoney
  • Susan Marlin Procter
  • Annemarie Martin
  • Mary McCarthy
  • Ilona O'Connor
  • Mae Powers
  • Maria Rodrigues
  • David Rose
  • Chris Schultz
  • Danny Yan
EAT is also on the lookout for new members. If you're interested in participating, or for more information on what EAT is all about, please reach out to any of the members listed above. Meetings are held monthly and alternate between the Charlestown and Braintree offices.





 
INFORMATION SERVICES
phishing
Phishing Emails
By George Richardson, CIO
 
There have been recent accounts of employee's receiving phishing emails. This is a reminder to be careful with emails that do not look right. If you receive emails from unknown sources, do not open any attachments. Delete the email and contact the MIS Department.
 
Thank you in advance for your attention and cautiousness.





 
QUALITY AND RISK MANAGEMENT
SERS
Safety Event Reporting System (SERS)
 
As of September 1, we will be using the Atrius Health electronic Safety Event Reporting System (SERS). ALL STAFF (clinical and non-clinical) MUST ATTEND ONE TRAINING SESSION.
Please see the additional training dates that have been added below.

DATE
OFFICE
ROOM
TIME
August 13
Needham
Training Room
8a - 9a
August 13
Needham
Training Room
9a - 10a
August 25
Weymouth
Conf Room
8a - 9a
August 27
Weymouth
Conf Room
8a - 9a

Please contact Donna Peters at 617-886-6808 or dpeters@vnab.org with any questions.




PATIENT CARE MANAGERS

Name

Email

Cell

Position

Covering Office

Bowden, Marilyn

mbowden@vnacarenetwork.org

774-502-7478

Patient Care Manager

Danvers and

Gloucester

Dunn, Maria

mdunn2@vnacarenetwork.org

508-688-2449

Patient Care Program Manager

Leominster and Southborough

Gardner, Elaine

egardner@vnab.org

617-680-1105

Patient Care Manager

Charlestown

Gill, Christine

cgill@vnacarenetwork.org

774-502-5725

Patient Care Manager

Worcester

Mihalick, Kyra

KMihalick@vnab.org

617-913-6823

Patient Care Manager

VNAB Therapy

Morris, Carol

cmorris@vnab.org

617-913-3006

Patient Care Program Manager

Quincy

Vitello, Maura

mvitello@vnacarenetwork.org

774-502-7475

Patient Care Manager

Needham


QI SUPPORT

Covering Office

Name

Email

Office Phone

Position

All VNAB

Hughes, Kim

kcao@vnab.org

617-886-6501 x5419

QI Support Coordinator

All VNACN

Schultz, Chris

cschultz@vnab.org

617-886-6501 x6527

QI Support Coordinator

All VNACN

Rao, Shamala

srao@vnacarenetwork.org

508-756-7176 x6876

QI Nurse




August 10, 2015
The Connecter
Volume 4, Issue 32