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What you do really does matter! This award-winning book is a must read for nursing home administrators, directors of nursing, and others in leadership positions in long-term care. It offers practical, commonsense, easy-to-implement approaches that will yield immediate positive results. It also serves as a wake-up call to leaders who doubt their impact and as an affirmation to leaders who struggle daily to do a good job. Let Meeting the Leadership Challenge in Long-Term Care open the door to new possibilities and set your organization on a better course.

Too often long-term care leaders feel overwhelmed by regulatory, financial, and corporate constraints and succumb to the myth that staff turnover is an inevitable cost of doing business. This book debunks this myth, revealing the powerful link between staff satisfaction and successful organizational performance that delivers high quality, high census, good surveys, and a healthy bottom line.

Based on extensive on-the-ground experience with implementing and guiding hundreds of nursing homes through successful organizational transformations, the authors offer advice and wisdom that can make your organization more successful, efficient and stable, whether it is currently struggling or thriving.


Just a few of the take-home lessons from this constructive guide include how to:

  • Get and keep the right staff, including how to identify "triple crown winners"

  • Reduce staff stress and promote solid teamwork

  • Build a positive chain of leadership that brings out the best in the staff

  • Convert money now spent on turnover into resources to support stability

  • Improve corporate support with an instructive "Stop Doing List"

  • Use quality improvement and culture change practices to achieve high performance

  • Increase staff, family, and resident satisfaction

  • Make a meaningful impact as a leader


Watch these benefits unfold right before your eyes in one of the most unique features of this book: a journal documenting administrator David Farrell’s experience turning around a nursing home that was by all measures doing poorly. Through his difficulties, triumphs, tragedies, and everyday experiences, see how better outcomes are attainable by focusing on leadership practices that make a difference.

Widely recognized as experts in the long-term care field, the authors of Meeting the Leadership Challenge in Long-Term Care combine their years of experience in nursing home leadership and management to create a resource that can transform how long-term care facilities are run.


Multimedia Resources:

Through funding from The Picker Institute, we are able to offer multimedia resources that build on the book’s content. Here are some short videos, as well as a downloadable handout for five key topics:

All Hands On Deck: Reducing Stress & Strengthening Teamwork

Learn how the management team at one nursing home pitched in to reduce stress and ensure residents’ needs were met.


Relationship Building & Stress Reducing Rounds: Rounds to Check In On People, Not Check Up on People

Hear David Farrell describe how to round everyday to build relationships and morale, keep his finger on the pulse, and continuously improve.


Community Meetings: Encouraging & Engaging Staff

Hear David Farrell explain how and when to have a community staff meeting, what to include in it, and how it plays a critical role in having everyone on staff “in it together”.


Shift Hand-Off: Facilitating Critical Thinking & Teamwork to Catch Developments Early

Learn how to use a shift hand-off to ensure continuity of care through thoughtful staff communication. The same practices apply to shift huddles.


Everyone Stands Up Together: Closing the Communication Gap

Hear how one nursing home expanded their morning management team stand-up to include staff closest to the residents. Learn how they’ve benefited and hear the how-to.


Reviews:

This book lays it out loud and clear, Our leadership matters! The book travels down the road of daily nursing home life with dignity, respect, accountability, measurement and relationships full of humanity. It then frames out the practices and values that can make this the new reality of nursing homes. With great respect to Farrell, Brady, and Frank who have walked this road, thank you for showing us the way.
— Anna Ortigara
Historically money has been an issue for nursing homes. This book provides a prescription for spending those scarce dollars differently and transforming the bottom line for residents, staff and corporations. Long-term care nurse leaders, who bear the burden of the present regulatory and corporate approach, will throw off those shackles by following the advice of these non-nurses, who have been able to look from outside the system, identify the challenges, and provide step-by-step solutions, based on real experience, to stabilizing staff. This book represents the intersection of nursing and culture change. Read it. Do it with, not for, your staff. This book represents the intersection of nursing and culture change. Read it. Do it with, not for, your staff.
— Sarah Burger
Meeting the Leadership Challenge in Long-Term Care offers fresh insights about the critical role that leadership plays in improving workforce performance, and thereby, driving organizations toward excellence. The book provides descriptive information about the challenges that administrators face based on first-hand experiences grounded in actual case studies. This book applies core constructs about effective leadership to the context of performance improvement in long-term care and offers practical and actionable advice to owners, operators, researchers or others seeking effective strategies to improve service delivery.
— Leslie A. Grant
I just completed reading Meeting the Leadership Challenge in Long-Term Care. This definitely is a significant contribution to the advancement of the specialty. Many years ago after I completed my MPH with a major in Administration I took a position as DON. I was stunned at how much I wasn’t prepared for, despite my degree, and even more stunned at the lack of resources to provide guidance. (This led me write one of my books, Nursing Administration of Long Term Care!). The unfortunate reality is that there remains too few quality resources for LTC leadership. I do think your book addresses this need. The blending of leading thinking in leadership with the practical examples from LTC are rich and rare, making this a special book. I am incorporating this as an important reading in AALTCN’s Culture Change Nurse Certification Program and its DON Certification Program, and recommending it to the Wellspring nursing homes and those involved with the Promote Understanding, Leadership, and Learning (PULL) Program (the project for Baltimore’s critical access homes). You’ve made a true contribution to LTC and I wish you many future editions of this important book.
— Charlotte Eliopoulos
It is refreshing to read a book where the authors provide numerous pragmatic real-life examples of what it means for leaders of health care organizations to “walk the walk” and that “actions speak louder than words”. The authors show leaders how putting the resident and staff first will help you better achieve the goals of the organization.
— David R Gifford
David Farrell’s journal is gripping, compelling, sensitive and realistic. His and his co-author’s analysis of nursing home challenges and the ways to address them are compassionate and full of plain old common-sense. The authors have issued a serious call-to-action to every nursing home administrator and director of nursing. Should be required reading!
— Carol Benner
This book should be required reading for all who work in care settings and the text used for leadership and health care administration courses in colleges . . . Farrell’s personal journal is as compelling as a good novel, except it is nonfiction! You want to laugh, cry, scream and shout hallelujah.
— Joanne Rader
David, Barbara and Cathie have provided compelling and personal insight into the significance of today’s long-term care leadership. Their experiences and research clearly support the call for a new leadership model and spirit of service needed immediately to engage and support the workforce serving our elders. With the aging of baby-boomers, there is no time like the present to create a more effective model of leadership. This book serves as a roadmap that would be excellent in training new Administrators and revitalizing all long-term care leaders.
— Jeff Jerebker
We have numerous and substantial challenges in long-term care. Top managers of long-term care facilities are tasked with dealing with these challenges on a daily basis. Many suggestions and proposals exist to meet these challenges - but to be effective top management leadership is “the” essential ingredient. In my opinion, the authors of this text aptly assert that what these top managers do really does matter! This text provides an essential resource for anyone interested in long-term care. I found the material to provide an exemplary framework for making progress. The information provided is a practical, and welcome, synthesis of what we know in other industries and how this applies to long-term care. I think this text will have a powerful influence.
— Nicholas G. Castle

About the Authors:

Learn more about Cathie Brady and Barbara Frank.

David Farrell, MSW, LNHA
(510) 725-7409
Email David


Special Thanks:

A special thank you to The Commonwealth Fund and The Picker Institute, both of whom were instrumental in providing funding for this project. This would not have been possible without them!