Dove Healthcare : The Long Road to Success - Health Executive - RedCoat Publishing - Inside Healthcare

Dove Healthcare Nursing and Rehabilita-tion had a rough year back in 2001: the company went through four directors of nursing in that year alone and handled four lawsuits. Jim Deignan, executive director and CEO, said that year was a wake up call.

Dove was originally owned by the Eau Clair County of Wisconsin and was known as Center of Care. A private owner bought the facility in 1997 and renamed it Dove Healthcare. Without the generous wage and benefit package guaranteed by government employment, more than half of the former company’s employees decided not to reapply for jobs under the new ownership, leaving the long-term care facility desperately short staffed.

Jim Deignan, executive director and CEO

“We started hiring people without any guidelines or policy, and that bred failure across the board,” said Deignan. He said turnover that first year was 200%, adding that in the five following years, it never dipped below 125%.

After making some progress during the organization’s first five years, Deignan decided Dove needed outside help. In early 2002, he employed a placement and consulting firm to bring in some expertise. Particularly helpful, he said, was the addition of Joey Pettis as DON for the Dove team. With more than 30 years of nursing experience, Pettis was able to redesign the nursing department and help implement successful hiring practices for all departments, such as screening applications on multiple levels and clearly explaining job expectations before an interview.

The company also established a two-day orientation for new employees and began requiring all staff to attend one orientation session a year. Deignan reported that one year after implementing these changes, Dove’s turnover rate was cut in half. Today, it is down to about 40%. At half the industry average, that number includes turnover generated each year after local healthcare students Dove employs graduate. Taking them out of the mix would put the company’s turnover closer to 25%.

“We didn’t reinvent the wheel. All we did was adapt best practices to serve our needs,” explained Deignan. “There are a lot of great ideas floating around out there; we just needed to be smart enough to apply those that work for us.”

Code of conduct
The new hiring practices have been instrumental in Dove’s success, but, without a clearly defined culture, no best practice would have been able to save the company. One of the first steps Deignan took after 2001 was to enroll in a local leadership education program and initiate ongoing leadership training for his management team. The training guided the company’s managers in developing a detailed code of conduct, which Deignan said was the most helpful tool in turning the company around.

New hires are required to sign the document during orientation, and all employees resign it each year. “There isn’t a word in that document that refers to anything technical or to specific services Dove provides,” said Deignan. “It is all about how we expect each other to treat our customers and each other”

Deignan commissioned Dove’s marketing partner to create 45 poster-sized prints to hang throughout the building, representing aspects of the code’s nine basic tenets.

“With the posters, we can’t hide from these ideals; we can’t sign the paper once a year and then forget about it,” he said. “At every orientation session, I say I can’t demand our staff behave a certain way in their private lives, but if everyone adheres to this code while they are here, the company as a whole will be successful, which will make everyone more successful as individuals.”

Catching up
As Deignan and his management team codified Dove’s culture, they also developed a strategic plan for the company, with a heavy emphasis on bringing in state-of-the-art technology. When Deignan came to the company in 1993, it was operating on a traditional, 26-year-old nurse call system, and there were maybe 10 computers in the building.

The expenses associated with the highest rate of Medicare and Medicaid patients in the healthcare industry—75% to 80% is the national average—keep most long-term care facilities from affording the latest medical technology.

“The products we’re implementing now have been around in acute care for a while and are usually beyond the financial reach of long-term care facilities,” Deignan said. “In our planning sessions, we made it a priority to enhance our charting capabilities and improve our reimbursement but most importantly to use technology to improve the quality of our care.”

Already in place at Dove’s newer assisted living campus, a wireless nurse call system and electronic charting system will be functional in August in the Dove skilled nursing facility. Staff will have portable handsets that will alert them to calls with varying levels of importance. A call from a toilet room will have higher priority than one from a bedroom, for example. In addition, touch screens throughout the building will allow caregivers to keep residents’ charts accurately and timely updated.

“One of the most common stated needs of our staff year after year has been something to help them communicate better, and that is the goal of these upgrades,” Deignan said. “Our systems are data-driven, so that will keep us all accountable. We will never rely exclusively on technology, but it is a wonderful tool.”

The installation of this new technology will help Dove continue to deliver high-quality care, said Deignan, but the organization’s success truly lies in its development of clear, core values and a detailed code of conduct. The company applied these tools to a failing skilled nursing facility it acquired in 2005. Once on the Centers for Medicare & Medicaid Services’ Special Focus Facility watch list, the facility now operates in the black, offering 135 beds for quality care.

Deignan said that turnaround is one of the most obvious examples of Dove’s recent success, but there are more. For every year between 1999 and 2003, the Wisconsin Health Care Association awarded Dove an award in one category or another, culminating in the Facility of the Year Award of 2003/04. Dove was also chosen in 2004 as the best place to work in the area by Chippewa Valley’s business magazine, Chippewa B2B. Such a record is proof the company has come a long way in the last 10 years.

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