CFOs and caregivers can be an interesting mix—sort of like oil and water or Mars and Venus. When one talks, the other might just be hearing “Waa wa wa…” So a big ingredient of a successful team is for members with different styles to learn how to communicate effectively. Communicating effectively often means learning how to listen and translate the other party’s language. Another key ingredient to successful communication is to avoid being triggered by key words or phrases and to avoid triggering your teammates.
How do you, the Administrator or Director of Nursing, get in the CFO’s wheelhouse? First, you have to remember that there is no one “type” of CFO. However, for the sake of simplicity, we're going to state that the CFO will be more concerned about money than anyone else in the organization, with the possible exception of the owners.
Adverse Event Management and the Bottom Line
So how do we relate adverse event management to money?
- You already have systems in place that your team uses to deliver the highest quality care possible. Inside a community, the DON and administrator track incidents and monitor the care of individual residents as well as residents building-wide.
- Your QA committee(s) may have separate systems to monitor and improve quality and keep certain information quality-privileged.
- The executive team has a system or systems in place to monitor the quality of care across multiple communities.
In other words, you currently have multiple systems, formal or otherwise, in place to help manage adverse events. And you have staff—some highly paid—spending significant time managing those systems.
The reason I point this out is because if we keep doing what we've been doing, we often overlook what it really costs or how to improve it. But time is money, and using team members to do things that aren't the best use of their time is wasting money.
Costs of Inefficiency
So efficiency is the first thing that could really impress a CFO. If you were making a pitch about any subject in senior living and could comfortably say, “We can deliver at least the same quality of care and save time and reduce cost,” you could quickly become a hero.
Costs of Quality Care
The thing that's a real motivator for caregivers and executives alike is gaining greater insight into the fundamentals of your business. What are the biggest drivers for success? It varies from business to business, but in every business, costs matter. In senior living, quality of care matters now like never before—sometimes with a cost attached.
The Costs of Ineffective Systems
So how do we efficiently gain insight into our senior living business in order to drive the highest quality of care possible? One way is to improve the care monitoring systems that are already in place. You already have systems for reporting and managing adverse events and other serious incidents, but here is the nugget: you've been using the same systems for some time and they simply aren't nearly as good as they could be.
If your staff produces paper incident reports or inputs the information into your EHR, someone has to aggregate all of that data. "Aggregate" is a fancy way of saying that some poor person has to type all that into an Excel spreadsheet. A single community can take from 200 to 500 hours per year just on inputting incident report data into Excel. That is expensive.
Just how expensive? 200 hours per year at $20/hour is $4,000—and all we have to show for it is an Excel spreadsheet for one community.
Chances are, your data person is not a data person, but was hired as a nurse manager, maybe even a DON. How good are the reports that are produced? Oh, right, they don’t produce reports out of Excel because Excel is not a database. Some totals are scratched out and we talk about them in our QA committee.
Costs of Inconsistency
If we enter that data for one community, we can do it for the others. But that community down the road has its own reporting format. If each community has its own idiosyncrasies, how can you compare communities to each other?
You can, and you can't. The one thing a modern CFO will understand—and this is a function of his or her accounting background and exposure to IT issues—is process consistency and data integrity. Several CFOs and former CFOs I have worked with were incredible sticklers when it came to data consistency and integrity. To them, if we had a glitch in the matrix one out of one hundred times, then forget it and scratch the whole thing. That's how upsetting it can be to them.
In other words, what's the point of a system that isn't really a system but an activity? Unproductive activities are expensive.
ROI of Adverse Event Management
On top of data integrity and consistency is the fundamental concept of return on investment, or ROI. For example, if you're spending $4,000 to input data from one community into a spreadsheet and then spending a similar amount for your DONs, administrators, QA committee, and executive team to review the data to gain insights, you'll be spending $8,000 per community in an attempt to glean useful information from your adverse events.
Chances are that you're actually spending more money and you're getting very little out of it. Chances are that everyone is at a minimum underwhelmed, unimpressed, and frustrated with trying to reinvent the wheel every month or quarter. The ROI is miserably low.
A Better System that CFOs Will Love
So if we were to construct a more perfect system, what would it do? For starters, it would:
- Minimize staff time for data entry
- Work consistently for communities using paper incident forms and for communities reporting from their EHR
- Notify key staff, including DONs and administrators, of the most serious events
- Have ready-made reports that can be customized
- Allow you to benchmark our communities so we could see who is doing well and who needs attention
- Help prepare for state surveyors
- Help you conform to HUD-232’s risk management requirements
How to Talk to Your CFO
If you wanted to create such a system, how would you get approval from your CFO to fund it?
I would be very careful about what I you say to the CFO, but the gist of it follows:
Our organization has a significant money leak due to the company having multiple manual incident and adverse event management systems used at every level. The adverse event systems cost thousands of dollars per community per year just to get data that's inconsistently gathered and rarely acted on. But that's not all. Then we waste even more executive time looking at data that lacks integrity. Our quality systems lack quality themselves. They aren't productive. They waste money and put the company at risk. We can do better.
So if you've made it this far with the CFO, they're likely to ask, “What do you want to do about it and what will it cost?” This is when you're going to stutter because if you haven’t done software development before, you're probably at the end of your road.
Software development projects scare the life out of CFOs, and for good reason. Sometimes they work. Sometimes they don’t. They are almost always over budget and late. If you don’t have a track record of delivering software projects on time and under budget for a decade or more, you're done.
Well, you aren’t done. You just have to take a different tack. You aren’t going to be able to develop the perfect tool yourself, and you don’t have to.
Your Solution Is Already Built
QA Reader is a cloud-based incident report and adverse event management program that already exists. QA Reader meets and exceeds your specifications of saving staff time, works with your paper incident reports or EHR, notifies key staff about sentinel events, and assists your team in tracking and trending with customizable logs and interactive dashboards. It's built by a trusted source in the long term care industry and provides real-time risk manager review of serious adverse events.
For the sake of your CFO, QA Reader will stop your money leak and pay for itself in a few months. Not only that, but QA Reader will take a jumble of processes and make them consistent and provide the executive and quality teams with real data that has real integrity and real insight. You'll improve quality and outcomes while reducing costs.
Adverse events can ruin your reputation—but more pointedly for the CFO, a single adverse event can cost you upwards of hundreds of thousands of dollars. QA Reader can help prevent that.
What are you waiting for? Call our QA Reader Specialists today—we're here for you!
