Technology, Part 2

In Part 1, I subtly (in huge print) wrote:

We identified a problem.  We looked outside our industry for a solution.  It looks high-tech but is actually low-tech analog.  You might be tempted to do this too.  If you did, you very well maybe throwing your money down the toilet.

Captain Kirk w/ an evolved Secret Service radio

So, before you go Captain James Kirk on me (I don’t refer to Star Trek nearly enough) and start incorporating the latest tech, consider what another Jim says on the subject …

Jim Collins’ Good to Great is used by many companies today for obvious reasons.  Its a compelling premise … what do these companies have in common that went from good to great?

G2G Page 152:

“This brings us to the central point of the chapter.  When used right, technology becomes an accelerator of momentum, not a creator of it.  The good-to-great companies never began their transitions with pioneering technology, for the simple reason that you cannot make good use of technology until you know which technologies are relevant.  And which are those?  Those–and only those–that link directly to the three intersecting circles of the Hedgehog Concept.”

When it comes to the secret service radios I’ve seen facilities throw money down the toilet as they hope for the internal and external momentum described in part 1 from the radios without going through a Hedgehog type conversion BEFORE bringing in the new technology.

BEFORE introducing the ‘math’ or before dreaming of increased census or community buzz that can and has come from the secret service investment, you MUST wrestle together with your staff to identify your identity.  Defining your culture and then drawing a line in the sand CULTURALLY speaking.

That is the basis for the an enduring momentum to build and without it whatever ‘pop’ you experience from the technology will be short-lived and after 3 months your radios will be in a closet somewhere in your facility and you will curse my name.

Dude, cool brochure!

One of the questions I go back to time and time again is ‘what makes us different in the eyes of the community?’  Usually the answers are things that only the staff would know about us.  We’re nice.  We care.  We love our residents.  I push back and ask, ‘what do you think the staff of our competition would say if asked the same question?’  Smiles.  It’s one thing to be different in your own eyes.  It’s quite another thing to be different/better in the eyes of the customer.

How do you differentiate?  The answer should be found in your values and then powerfully, unforgettably, differently communicate those values to your market.  Why does the message have to match the values?  Because brochures, tag lines, etc. come and go.  Think about that.  I find this idea extremely powerful.  Most of us market our expertise, our technology, our service, our benefits, our whatever you find in a brochure.

Very few companies (facilities) market the ‘why’ they exist.  The HIGHEST why they exist as there are, of course, many reasons and levels …

I’m not exactly sure where this came from but what a find!  Imagine yourself speaking to your staff about your values and how you position yourself in your market like Steve Jobs does here in this video.  Love or hate Jobs, why I find this effective is because while he’s justifying and setting up the commercial, he’s doing so much more.  He’s preaching to everyone in that room about how special they are as Apple employees.  He, indirectly, compares all of them to the geniuses shown in the commercial.  He reinforces their value for people who are changing the world … implying that you ought to use a mac to release the genius within.

It works.  It reminds me of another video showing the power of explaining the ‘why’ behind what and how you do to really rally support.  I posted that video here.

Technology – The Answer,* Part 1

Let me start with this … I’m a bit of a technofile.  I’m not always the early adopter but I’m an early follower and eager adopter once ‘version 2’ comes out whether that be a new mac, iphone, ipad, kindle, etc.  I regularly hit Gizmodo and Wired.  I like this stuff.  A lot.  Since entering long-term care profession this tech love has turned into a love-hate relationship.

An example of why I love it.

This is an admittedly low-tech example … here’s how a conversation has gone that I’ve had many times with groups of nurses & CNAs:

Me: How many times during your shift do you have to ‘look for someone to help?’  Whether it’s another CNA to help with a transfer or another nurse for pain meds or whatever.  How many times do you ‘look for someone to help?’

Them: 10.  20.  15.  25.

Me: Ok.  Let’s say about 15 times.  Now, think about how long it takes you to find that person.  Sometimes they’re right outside the door.  Sometimes they’re in the middle of helping a patient and you need to find someone else.  Sometimes they’re hiding in a quiet place to get their charting done.  Sometimes they’re in the employee break room.  How long on average does it take?

Them: 3 min.  10 min.  5 min.  7 min.  Etc.

Me: Ok.  Let’s figure out how much time you’re wasting during your shift (time that could be used to care for patients but instead is being used to ‘look for someone to help.’


  • 15 times looking for help x 5 minutes = 75 minutes/shift
  • 75 minutes x 10 (# of nurses & CNAs on a shift) = 750 minutes or 12.5 HOURS/shift of wasted time
  • Multiply that by 2 to cover the other 2 shifts (by 2 instead of 3 b/c the other shifts don’t have as many people as the first shift) and you arrive at a hidden, staggering number:

25 hours of care givers time per day that is not used for care giving.

When the nurses and CNAs see that math on the white board in front of them, jaws drop.  DONs are disgusted.  People shake their heads in frustration.  How do you fix that?

Here’s what we did … we noticed at luxury hotels, some restaurants, even at OfficeMax something they use to improve the speed of communication.  We called them Secret Service Radios.

Secret Service radios in nursing homes

As I researched it, I found out that what looks pretty sophisticated with the sneaky ear piece, but in reality is very low-tech.  You have a small 2-way radio that connects to a ear piece-microphone cable that you wear underneath your scrubs.

My staff’s response was, for the most part, positive.*  They welcomed a way to relieve the 25 hours/day pain that was no longer hidden.

The impact both to our culture and to our care and to our census was significant.

Culturally, the staff, families, and patients saw an outlay of money for one purpose with no financial ROI expected.  That message is powerful.  We’re spending this money to make your jobs better.  To make care better.  Period.

The community ate it up.  The case managers and doctors at the hospital loved it.  We played up the ‘secret service’ angle with corny lines like, ‘if it’s good enough for the President of the United States it’s good enough for our patients and residents.’

We identified a problem.  We looked outside our industry for a solution.  It looks high-tech but is actually low-tech analog.  You might be tempted to do this too.  If you did, you very well maybe throwing your money down the toilet.

I’ll explain in Part 2 of this topic why that is.

*A couple of my CNAs doubted my motives.  They thought I was trying to be big brother so I could always monitor exactly where they were at all times.  So, just between themselves, they came up with a code word to alert each other when I was on the floor so they could look really busy.  “7-11.”  One of them would say, “7-11.”  Others would repeat into their radios, “what?” with no reply.  The code word was only meant for the other person who knew what it meant.  Pretty hard for something like that to stay quiet.  So, when I found out about it I invited one of them into my office.

Me: How are the kids?

Him: Good.

Me: Good.  Everything going well?

Him: Yes.

Me: Great.  Hey, really quick … how did you come up with the code word 7-11?

Him: (Deer in the headlights.  Long pause.)  I don’t know what you’re talking about.

Me: Oh.  My mistake.  Let me just take a minute and talk to you about why I invested $5,000 in the secret service radios.  (I did the math with him.  I shared success stories of better, faster care.  10 minutes.  I excused him.  2 weeks later he quit.  Perfect.)