Quality Insights Podcast

Taking Healthcare by Storm: Industry Insights with Cristina Tarbox and Mary Supey

Dr. Jean Storm

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Cristina Tarbox, NHA, and Mary Supey, RN Staff Educator, from The Meadows Nursing & Rehabilitation Center.

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This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-GEN-032624-GK

Welcome to Taking Healthcare by Storm, Industry Insights, the podcast that delves into the captivating intersection of innovation, science, compassion, and care.
 
 In each episode, Quality Insights Medical Director, Dr.
 
 Jean Storm, will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys.
 
 Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania, and the nation.
 
 Subscribe now, and together, we can take healthcare by storm.
 
 Hello, everyone, and welcome back to Taking Healthcare by Storm.
 
 I am Dr.
 
 Jean Storm.
 
 I'm the Medical Director here at Quality Insights.
 
 Today, I'm always excited about recording a podcast and bringing some diverse voices to you.
 
 But today, I am more than excited to bring the two guests that I'm going to be interviewing today on the podcast, just because I feel like my heart is really in long-term care medicine.
 
 As you all know, long-term care medicine has really been going through some challenges since the pandemic, and I really feel that there's many individuals who have come through and have really shown themselves to be warriors.
 
 I hesitate to use the term healthcare hero.
 
 I feel like it's overused, but maybe the two individuals that I have on today, we can refer to as SHEROs, S-H-E-R-O.
 
 I'm going to introduce them.
 
 Cristina Tarbox is a Nursing Home Administrator, and Mary Supey is an RN Staff Educator.
 
 They are both at Meadows Nursing and Rehab.
 
 Thank you both for coming on the podcast.
 
 Thank you for having us, Dr.
 
 Storm.
 
 So I would love to hear your background.
 
 And maybe, Cristina, if you want to start just sharing your background and telling us what led you to pursue a career in long-term care.
 
 Sure.
 
 I have been in long-term care for over 20 years.
 
 I hold a Master's in Health Policy Administration, as well as a Master's in Professional Studies in Community Service Administration.
 
 And I have been fortunate enough to be the Nursing Home Administrator at Meadows Nursing and Rehab Center for close to 18 years.
 
 I have been interested in health care since I was a teenager.
 
 I was an EMT for my Community Ambulance Corps.
 
 And what really led me to long-term care was my family and I took care of my Oma, who came to live with us when I was in sixth grade until her stroke four years later, where she then resided in a nursing home.
 
 And while she was there, not one day went by that one of us didn't go visit her.
 
 So you could say I was exposed to health care at a young age, and I knew I wanted to make a difference in the lives of our elderly.
 
 Thank you.
 
 Well, I'm Mary, Mary Supey.
 
 I'm a nurse 51 years.
 
 I was originally a diploma grad from a very tiny little community hospital where we still had geriatric wards in those days, because they were largely people with no insurance whatsoever.
 
 And I was always just drawn to geriatric residents.
 
 They just sort of did it for me.
 
 So when I graduated, my first job was in a very large county home back in the dark ages, which was quite a grow up experience as a brand new nurse.
 
 And then I decided to branch out.
 
 I did my bachelor's.
 
 And while I was doing my bachelor's degree, I was then working in acute care.
 
 And we had a professor who was very forward thinking, and we had an entire geriatric course a whole semester.
 
 And it really, it was like the bulb lit up on top of my head.
 
 And I just loved the content.
 
 And so then I went on to do a master's in gerontological nursing with a subspecialty in education.
 
 And I left acute care, went to post-acute care, and have never looked back.
 
 But not unlike you, Dr.
 
 Storm, my favorite thing in post-acute care has always been and will always be long-term care.
 
 So I'm really happy to be here.
 
 Fantastic.
 
 I just, I love when I have individuals who kind of share the same passion in taking care of individuals in the most vulnerable states.
 
 It's so very important.
 
 I said, you know, we have, we have, people typically when we look at who's in the most fragile, vulnerable state, we think of like really little, little tiny babies.
 
 And then, you know, at the other end of the spectrum, older individuals.
 
 And I feel like sometimes we don't have the individuals at both ends of the spectrum don't get the same attention.
 
 So, you know, just bringing, bringing light to that.
 
 So tell me, was staffing in your facility impacted during the pandemic?
 
 Yes, you know, during the initial stages of the pandemic, we only had a handful of team members leave.
 
 We were fortunate to keep the virus out of our facility for 10 months.
 
 So initially, I feel we had a good number of team members remain on board in the first year plus of the pandemic.
 
 But just as everywhere, there were individuals that eventually became burnt out, fearful of the virus, and resigned.
 
 There were times when we were having to operate under CDC's contingency staffing guidelines.
 
 But ultimately, we all got through it, and I hope that we are much stronger for it.
 
 So we know we're here today because Quality Insights offers a staffing stability course for facilities to participate in, and you have participated in that course.
 
 What motivated your facility to participate in the staffing stability course?
 
 Well, you know, I'm around a long time.
 
 Turnover has always been an issue.
 
 It was an issue way back when I did my masters, and that was what I did my capstone paper.
 
 And it was actually in, you know, nurse aid turnover.
 
 So it's been an issue that I've dealt with through my career for many, many, many years.
 
 And as Cristina said, you know, as a result of COVID, now we all know it's even tougher than it ever was.
 
 So in my position as a staff educator, I've been uniquely aware of the impact of turnover on the facility.
 
 Turnover takes an emotional and a fiscal toll.
 
 It demoralizes our long-term staff, you know, the people who are with us for a long time.
 
 Our residents and families deserve the best we have to offer.
 
 When staff comes and goes and, you know, agency comes and goes and the travel people come and go, how are the residents and their families going to feel secure in an environment where their care is provided by a very rotating cast of characters?
 
 And I'm sure that that's how they see it.
 
 And consistency is a key to good care.
 
 So when I saw this come across as a possibility, I was very much turned on by it.
 
 I can imagine.
 
 So can you share a brief overview of how the Staffing Stability course has impacted your facility?
 
 We're still in our infancy.
 
 We've tried to relate the information that I learned through the sessions to our team members to make them feel included in the process.
 
 We wanted to shine a light on the whole issue of turnover and to show our direct caregivers that we do care about them.
 
 And at some level, we're trying our best to support them as they care for our residents.
 
 Those people who are with us a long time want to do a good job.
 
 And they know they can't do their best job when they don't have their best team alongside of them.
 
 It's really too soon to evaluate the impact of the initiative here, as there are still several elements that we have to achieve before we can even begin to assess the impact.
 
 We are very much a work in progress.
 
 I agree.
 
 I think every facility is definitely a work in progress, but I commend your efforts.
 
 Can you highlight some key strategies or initiatives that your facility has implemented to promote staffing stability?
 
 Well, Cristina is going to go through a whole lot more.
 
 But one of the things that we realized when we tried to kick this off and go through all the processes, you know, I don't know if you remember the pom-pom exercise where they are supposed to put a pom-pom in their good day or bad day little container on the unit every day.
 
 Well, we didn't get the input that we had hoped because we didn't get any input from the pom-pom exercise.
 
 But Cristina and I were talking and we still thought that was a great idea.
 
 One of the things we realized is that we have a lot of very early turnover.
 
 You know, people that don't stay long and they're gone and we don't know why.
 
 Sometimes they disappear and never even respond to an email that Cristina sends.
 
 So in the process of looking at the pom-pom exercise, we thought maybe we could do something earlier on in their time with us as team members.
 
 So she came up with this happy sad face, which is pretty cool and very, very simplistic.
 
 We request the new employees, the new orientees to provide quick feedback as they go through their 10 day orientation.
 
 And it's a very simple, there's a had face, a sad face and a happy face, and they just put a check mark in that day.
 
 Is it a good day or is it a bad day?
 
 And then they're asked for comments.
 
 We do ask them to sign it because if they are having, if they're struggling, we want to know earlier on.
 
 They're encouraged to reach out with any concerns during their orientation on the unit.
 
 We really haven't garnered anything from that yet.
 
 It's pretty early on and we're still waiting for some feedback.
 
 And also one of the other staffing stability initiatives were to review what our organization's mission and value is and how the team members relate to that.
 
 Now in that aspect, we're still in the process of gathering feedback.
 
 And as everyone will see, the process to achieve staffing stability is not easy and takes commitment from every team member, from the top down and all around.
 
 A program that we implemented to promote staffing stability was the development of a retention and recruitment committee, which encourages open communication regarding the programming, initiatives, and services affecting the recruitment and retention of team members, as well as engaging health care team members in creating and participating in these recruitment and retention activities.
 
 And then additional incentives and programs that we have done, which maybe some health care organizations have already done.
 
 We have the monthly team member appreciation meals.
 
 We have a shout out board to recognize fellow team members.
 
 I do want to point out that you're going to note that we refer to our employees as team members, which I feel and the team feels this creates a sense of belongingness and camaraderie.
 
 Some other things that we do, we send birthday cards out each month with a little gift card to our team members.
 
 We offer referral bonuses.
 
 And then around the holidays, we also offer a bonus to our full time and part time team members.
 
 We really try to have a good time during the holidays.
 
 We also do the 12 days of Christmas giveaways.
 
 I started a pie extravaganza giveaway in November.
 
 So we have over 30 team members that win a pie.
 
 Everyone loves winning something.
 
 And then during the other holidays, we pass out treat bags with a note of appreciation.
 
 And then some other things that we have instituted.
 
 We have a Wacky Wednesday.
 
 And on Wacky Wednesdays, we invite our team members to dress in the theme for that day.
 
 And then each month, we have the Extra Mile Team Member Award.
 
 And we spotlight them on the board.
 
 So everyone in the whole organization can see and know things about this team member.
 
 And whoever gets nominated and recognized for the Extra Mile Team Member, they get a bonus, they get their parking spot, they get a pin.
 
 And we all gather to present the award to them.
 
 And we also are reinstituting our meet and greet, bi-monthly meeting, just to get together with recently hired team members.
 
 And overall, with all these initiatives that we try and do, we try to create a family atmosphere and come together when fellow team members need our support.
 
 This past year, we have done several fundraisers to help fellow team members who had to be out for medical reasons.
 
 So I do look at the Meadows as my second family.
 
 I think that's just amazing.
 
 Because creating that culture, that family culture where employees want to stay, that's how you retain staff.
 
 So I commend you.
 
 That is just fantastic.
 
 So I know you're doing a lot to promote employee wellbeing.
 
 So do you feel that this promotion of employee wellbeing plays a big role in promoting staffing stability?
 
 Well, I'm going to say we hope so.
 
 Yeah, and I think that's important.
 
 It's a priority that employees want to feel that their employees actually care about their wellbeing.
 
 So beyond staffing stability, are there any other noteworthy initiatives or activities that your facility is involved in to improve the overall healthcare experience for your residents?
 
 On that aspect, I am very open to working with local universities and colleges, the nursing programs, and we have had great reception from the universities, and we're bringing in nursing students to get their training, clinical training here.
 
 So what we've been trying to do over the course of the years is to continue to build that healthcare pipeline so that way individuals in the healthcare field, specifically nursing, think about geriatric care, think about joining the nursing culture when they're graduating.
 
 So right now we're in a pilot study with a local university where the RN senior graduating nurses are completing their clinical studies here and getting exposure.
 
 I think it's very important to expose nursing to healthcare, especially long-term care, early on in their curriculum.
 
 I would agree.
 
 You're serving two goals.
 
 You're kind of getting more people into the pipeline for healthcare careers.
 
 You're getting more people into the pipeline for healthcare careers, specifically in long-term care.
 
 And then the residents actually just love to have young individuals come into the facility.
 
 I have three teenage daughters, and two of them are at the age where they can actually work and have part-time jobs.
 
 And they both work in a long-term care facility.
 
 And I can say the benefits are on both ends.
 
 The residents benefit, and my teenagers benefit.
 
 So I think that's just wonderful.
 
 So one last question.
 
 What advice would you offer to other healthcare facilities looking to enhance their staffing stability and overall staff satisfaction?
 
 I'm pretty pragmatic.
 
 My kids tell me my balloon never lands, but it does.
 
 And sometimes it lands with a thud.
 
 But I would say, first of all, to become, you know, really involved in an initiative like this one that we did with you all because it really, it forces you, whether you want to think about it or not, it kind of forces you to shine a light on it, really look at it, you know, be honest and open about what goes on in your facility and what doesn't, what works and what doesn't, and don't become disheartened, you know.
 
 I did most of the upfront work for ours myself, thinking, oh, every, because, because Cristina's a wonderful administrator and she never says no, you know.
 
 No matter what kind of a crazy idea I bring.
 
 And so I did it and I was really happy to do it and she's a great cheerleader, but two people alone can't do it.
 
 So that's why now we've circled back and we're starting all over again.
 
 So don't become disheartened.
 
 It would be lovely if you could find a quote, I hate to use the word cheerleader, but a cheerleader among your stable staff.
 
 We haven't been able to do that yet, but if I could, I would clone that person 12 times.
 
 You know, what goes on in the, what do we call it, the C-suite and what goes on in the units is totally different, as we all know.
 
 And if there's no buy-in among the team members at all, then it's impossible.
 
 This can't happen, which is why now we've doubled back and we're starting all over again, which is fine with me.
 
 I'm not ready to give up and neither is Christina.
 
 So as Mary says, you know, stick to your guns, go slow, be cautious, have those realistic expectations, and slow and steady wins the race, hopefully.
 
 Changes will not happen overnight.
 
 And just remember, any initiatives or measures that you put into place, they need to be constantly encouraged and monitored.
 
 So it takes a lot of effort and time to change a culture.
 
 So stay positive.
 
 Not everything you implement will work.
 
 And what works for one organization may not work for another.
 
 So stay the course and be a cheerleader, as Mary said.
 
 Thank you so much, Cristina and Mary, for coming on the podcast.
 
 Such valuable information and insight.
 
 We all wish you continued success in your facilities.
 
 Thank you very much.
 
 Bye-bye.
 
 Thank you for tuning in to Taking Healthcare by Storm, Industry Insights, with Quality Insights Medical Director, Dr.
 
 Jean Storm.
 
 We hope that you enjoyed this episode.
 
 If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.
 
 If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website.
 
 We would love to hear from you.
 
 So until next time, stay curious, stay compassionate, and keep taking healthcare by storm.