How hard is it to develop a culture? One definition of culture: A culture is a way of life of a group of people–the behaviors, beliefs, values, and symbols that they accept, generally without thinking about them, and that are passed along by communication and imitation from one generation to the next.

Would it not be amazing if we developed a culture of quality within our home health agencies including behavior, belief and values that everyone accepts that we “generally without thinking about them” implement and provide amazing quality care and our documentation supports that fact.  Home health, for the most part, has developed a culture of caring for patients and that quality care is top priority.  The problem, that seems to be prevalent, is that documentation does not always reflect the excellent care that was provided.  Whether we are referring to visit notes or OASIS C-1 documents, there is documentation missing that is needed to support true quality care and positive outcomes in a large part of home health agencies.

Where do you begin to change your agency’s current culture?  The beginning of building a culture must begin with leadership.  Agencies that still have owners, directors or board of directors that continue to push for more visits and more patients and are only worried about the current monthly revenues or cash flow, with no focus for the future and the effect that continued change will have, will not have an agency moving toward the evolving quality culture until it is possibly too late.  The day is here and the time is now and Value Based Purchasing (VBP) ) is not a fad that will pass, if we just hold out long enough.

Leadership needs to obtain a complete understanding of the current VBP pilot and begin to move their agency in the direction of being successful in that realm.  There are only 9 states currently required to participate, but some form of VBP is here to stay.  There is the expectation that there will be changes to the pilot in less than 5 years and many believe that it will be expanded to the entire country in less than 5 years.

Leadership must be forward thinking and develop a vision for where they want the agency to go.  Once that vision has been developed, a team needs to be appointed to make the vision come to be reality.  When determining who that team will be made up of, some of the following things should be considered:

  • Team Leader – must be upbeat, a visionary, totally bought into the vision, a true leader, fully committed to the agency and its success
  • Members of the Team –

o    Clinicians – Nursing & Therapy

    Quality Team Members
    Field Staff

o    Information Technology Staff
o    Software Vendor
o    Others felt significant contributors

Leadership must ensure that the team that is assembled develops a plan with timelines and short term and long term goals corresponding to that timeline.  Leadership holding the team accountable is essential.

Discussion of developing that plan and key factors in that development will be discussed in future blogs.