Achieving Staff Stability:

Using Data-Driven Decisions to Re-Examine Industry Norms

A Unique Collaboration of

Better Jobs Better Care-Vermont and Birchwood Terrace Healthcare

with B & F Consulting, Inc., and Quality Partners of Rhode Island

By Cathie Brady and Barbara Frank

Working with David Farrell

March 2007

“The first step is that you have to be big enough to say what you’re doing isn’t working.

Then you can fix it, do it better and move forward.”

- Scott West, Administrator, Birchwood Terrace Healthcare

To read this case study, click here: AchievingStaffStability Final.doc

For additional information on staff stability, see Staff Stability Tool-kit.

1. Unwittingly, many fiscal and management practices used to deal with chronic staffing instability actually contribute to and accelerate it. This is the story of how one nursing home, Birchwood Terrace Healthcare, broke with convention, re-examined industry-wide norms and changed its fiscal and managerial practices. It is also the story of an analytic process that guided Birchwood’s examination and led it to institute new approaches that led to positive results. The home used classic process improvement to make data-driven decisions. Using a tool B&F Consulting developed with David Farrell, which is available at www.bjbc.org and www.riqualitypartners.org, Birchwood saw how its fiscal incentives were creating instability.  Leadership analyzed the data and put new fiscal practices in place that had an immediate impact in stabilizing staffing.
   

At the same time, Birchwood’s managers focused on strengthening supervisory and management practices and putting systems in place to solidify relationships among staff. By refocusing its fiscal and human resources, Birchwood broke its vicious cycle of turnover and stress and achieved workplace stability and harmony. The intervention at Birchwood provides a valuable and replicable example of an analytic process that workplace leaders can use to identify and address underlying causes of staff instability. While Birchwood’s situation has its own unique characteristics and the tools were customized to Birchwood, the lessons and methods can be applied universally.

The take-home lesson of this case study is that our systems create our outcomes. What we do gets us what we get. To get something different, we have to do something different. To do differently, we need to see with new eyes what we’ve taken as givens. At Birchwood when systematic analysis provided new eyes, the nursing home replaced systems that contributed to instability with systems that helped them stabilize their staff. Theirs is a story of change that transforms our field.