by Patti Moore

How can we in hospice management create a robust culture of care in our organizations? In the past I consulted with a hospice run by an autocratic leader who really didn’t want to know what the staff thought or cared about; his big concern was his bottom line, not his front lines. How is staff likely to respond to leadership solely focused on dollars and cents, even at the expense of their mission of care? Not well, in my experience, because it’s so at odds with the animating ideals of hospice itself, and of the people who go into this work.

That’s why it’s critical to create a corporate culture that supports our work and our people – and that culture begins with transparency and trust.  

Here are 5 ways to improve your hospice’s culture of care, and better support your mission:

1. Show them what’s under the hood. Share your view of the nuts and bolts of running a hospice with the staff, starting with how you budget. Helping staff to understand what things cost and what our expectations are helps them to be better stewards of the dollars we get from Medicare, Medicaid, private insurance and donations.
2. Share the daily census. Staffing is the biggest item on the balance sheet. All staff members should know how many patients the organization is serving each day. Having clarity around staffing guidelines – how many people are required to care for that number of patients - creates accountability, so that staff understand when the census goes down, they’ll either need to help out somewhere else or take time off.
3. Establish medication guidelines. An automatic order for a 14-day supply of any medication should be reduced, particularly if it’s clear that the patient may only live a few more days. Medication formularies can specify types of medications allowed, generics versus brand names, etc. This helps insure the best care at the best cost.
4. Be clear about the core business you want to offer. Make sure that all the people who work for you understand what your hospice’s mission is, and how you expect them to put that mission into action.
5. Regularly ask the question, “Is this program or process still working, or do we need something else?” As dollars in healthcare continue to shrink, it’s more important than ever to discover what your community wants and will support and offer that.