0ptimizing Long-Term Care Management

Kelley [00:00:00]:
Hello everybody, and welcome back to the Caring without a care podcast. I’m here today with Anand and we’re going to continue our conversation around the long term care industry and this concept of lean management. Welcome back, Anand.

Anand [00:00:16]:
Thank you, Kelly. Thanks for having me again.

Kelley [00:00:19]:
Yes, now, I know in some of our previous conversations we’ve been talking about lean management and how lean care management can solve a lot of problems that business owners are seeing when it comes to care management. And you’ve mentioned before that there are four components of lien management. Could you briefly just remind us what those four components are?

Anand [00:00:42]:
Yeah, Kali, when we look at long term care and the implications of lean in the lean care management, there are four components, as you reminded us. First is of course, people getting the right people for the right jobs. Second is process having right processes in the business. The third piece is technology, giving everybody the technology tools that they need to do their jobs. And finally is training. Because as the tools are evolving, as we have new people coming into these roles, training has to be an ongoing endeavor. So if you combine these four pieces, people, process, technology, hand training, you have the all components of lean care management.

Kelley [00:01:26]:
So today I would love to speak to you about process. I think, you know, as a business owner, I can attest to this, and I feel like it is something that I hear quite often among entrepreneurs and small business owners is the recognition of how important process can be in your business, but some kind of confusion or maybe a feeling of being stuck when it comes to actually understanding what types of processes you need in your business and how to go about even identifying what those processes can be. So can you share with us when it comes to process, how do we even start developing or identifying the types of processes that we need?

Anand [00:02:11]:
That’s a great question, Kelly, because most of the people think that that creating process is a very cumbersome exercise. Or perhaps you need to hire consultants, or maybe this is something that a small business owner or small business cannot do on their own, but that can be untrue. The reason is any business, any care business, whether it’s a whole care, everyday, health, case management or you name it, they always have one of the four outcomes in the mind, and they are not mutually exclusive. You can have all four, or perhaps at one point in time you would like to focus more on one. Those four outcomes are growth, operation, excellence, retention of good people. Right? So if you look at the first three, growing your business without hiring more people, managing your compliance, without, you know, getting confused or without adding too much work for everybody and retaining the right people. The fourth component comes into, how do I do it? With the least amount of expenditure in people, which is operations excellence. Any business, any care business, I would argue, is focusing on those four outcomes.

Anand [00:03:33]:
So if you think of any process within the business, the question you have to ask yourself as a business owner is, will this particular process help me get to this desired? Does it make sense?

Kelley [00:03:47]:
It does make sense. And, you know, I’d love for you to expand a little bit on this idea of desired outcomes, because I would imagine that many business owners have a lot of desired outcomes that they would like to see in their business, whether it’s scaling their business, increasing revenue, streamlining, maybe getting more leads, getting more clients. So how can a business owner know how to prioritize or what to prioritize when it comes to developing out those processes and really identifying those desired outcomes?

Anand [00:04:20]:
So let’s look into a hypothetical scenario. Let’s say if I want to start a business today from a non medical home care, or what we call personal support services from the get go, the first thing I would need are employees. Because without employees, I don’t have a business. You know, even if I have a first client in the door, I need to have somebody to staff this ship, right? So for that initiative, I need to have new hiring. Hiringput basically means I am taking steps to grow from where I am, from one person company to the two people or three people. Well, how do you do that? Do you have a story to tell? Do you have a process to post a job? Do you have a process to interview? Do you have a process to onboard? If you have hired this individual, do you have something to give them as a handbook, employee handbook, all those things. Now, why I am doing all those things, one can argue, well, you just narrated us like eight different things. Yes, they are create different things, but tied to one outcome, which is I need to find my first employee, which is gonna get me my first revenue dollar.

Anand [00:05:37]:
That’s good. But then when you look into, from another perspective, not only you have to service these clients, you have to make sure you are also following all the rules of the land, which is compliance. Now, compliance would require us to have formal documentation to make sure these employees are trained to do their jobs. Not only that, we have process to keep those records. And all of those, although they are important, is leading to a different outcome, which is better compliance. Now, as we do this, as we do this, there again, there are various ways to, to achieve any outcome. One, when I, I can hire a consultant, they can give me a good books. They can give me a process to follow, but I have to pay.

Anand [00:06:23]:
I still don’t have revenue coming in. So that basically means I have to be smart in terms of how I hire people for growth, manage my compliance, too, but also being operationally excellent, which basically means I’m able to do this without spending too much money. Now, how do you do that? Well, you should do that by making sure you are not doing any wasteful activity. So perhaps at some time it is good to hire an extra help because you will save time. You might be hiring an expert, compensating them for their time, but you are saving your own time. But you do that to be operationally excellent. So in nutshell, you are saving money. And then as you do all these three things, make sure by making sure that you are not making it overly complicated for your new hires to do their jobs, you are able to retain them.

Anand [00:07:20]:
So the fourth outcome is always retention. So if you think from that perspective, Kali, every entrepreneur is always balancing among these four out, one can argue that you can become operationally excellent by cutting all sorts of expenditures. You know, don’t feed them, don’t treat them, don’t treat your employees nicely. But if you do that, guess what? You will lose people. And if you’re managing only two out of the four, you are not growing because you are not. So every entrepreneur has to balance among these four outcomes and create processes which are not in conflict with any of those. Does it make sense?

Kelley [00:08:06]:
It does make sense. And I think that that example that you just gave makes it really clear in terms of, regardless of your priorities, like you said, whether it’s staffing, whether it’s scaling, whether it’s lead generation, there’s still always those four pieces that you have to link back to, right? Like the growth, compliance, having the right people, operations, excellence. Every part of the business can be linked to those four goals.

Anand [00:08:34]:
Right.

Kelley [00:08:35]:
And I think that’s important because, you know, quickly, can you share maybe a case or an example that you’ve seen of what can happen if somebody does not consider those four desired outcomes?

Anand [00:08:49]:
Absolutely. I would love to. This is my favorite example, Carrie. I have seen countless businesses who start and grow from zero to 30, 50 clients. And by that time, they have the confidence that they have built this business with their own effort, expertise. They don’t want to let go. They don’t want to share or delegate responsibilities because they would like to do the billing. They are the best people to steady.

Anand [00:09:21]:
Right. And they think this is operationally excellent because I don’t have to hire someone. I don’t have to pay somebody to do these things. But guess what happens when you try to take too many things on you. Couple of things start to crack. First, you are not able to devote time in growing your business because you are working in the business, not working on the business. So, yes, you are able to save some money by not hiring people. But the key, being the founder of a company, being the CEO of this care business, if you’re not going out meeting more people, building relationships, developing your referrals, you’re not growing your business.

Anand [00:10:02]:
That’s the first part. The second part is, since everything is being done by the owner entrepreneur, if something happens to the owner, interpolate. Only she knows where documents are. So at the time of compliance audits, if she is not available for any reason, no one in the business knows what’s going on. And the third part of this puzzle is if you just extend that scenario, the owner would like to see her own reflection in every employee. So then she is always finding that no employee can meet her stature. No one is as hardworking, as committed as the owner herself. So what happens is you have, you will see many businesses plateau at a certain size.

Anand [00:10:58]:
And why is that? Because they don’t consider all four outcomes that they need to balance. They just focus on one or two. And then what happens is a couple of these places get left behind.

Kelley [00:11:09]:
I can definitely see how that can be like the beginning of the spiral, right? Like you, how quickly you can just hit the ceiling when you’re trying to stay inside of your business. In fact, I’ve heard a lot of conversation, just in all industries, talking about how if you’re in the box of your business, you can’t be outside growing the business. Right. If you’re in the business, you can’t be working on the business, like you said. And I think that’s such a great example. So thank you so much. Today we talked all about the importance of processes and really thinking about those processes from the four desired outcomes that you shared, which was growth, managing compliance. Right.

Kelley [00:11:48]:
Having the right people, and operations excellence. And I think today was a great testament in terms of what can happen if people don’t really start to consider what types of processes they need and putting those processes in place. So thank you so much for your wisdom today. Thank you, kind, and thank you, everybody, for joining us on this episode of caring without a care. We’ll see you in the next session.

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