Archives for July 2020

Better time management

David Kinnane · 17 July 2020 · Leave a Comment

Providers: how to get it all done, even when you’re off your game or feeling burnt out

Working as an NDIS provider or health provider can wear you down and burn you out over time if you’re not careful. On Monday mornings, my average to-do list includes:

lots of sessions to plan;
new client intakes and interviews;
assessments;
therapy;
calls to parents, teachers and others to help my clients;
home/school visits;
reports to write; and
researching, buying and mastering new resources.

In my “downtime” – I have lots of other fun things to do like managing bookings and cancellations, sending out letters and other resources to potential referrers, responding to online and offline feedback and queries from the public, reading new research and writing blogs, participating in social media, getting the pesky accounts to balance to ensure I don’t go bust and attending to any legal, HR, professional development and ethical/professional requirements.

Pushing all those half-written assessment reports up the deadline hill can feel a bit Sisyphean, knowing that, come Monday, it will all start again.

How to wear yourself out

In my early years of practice, I found myself stuck at work for very long hours, working late into my evenings, and often on weekends, too. My workload was eating into quality time, as well as time to exercise and meditate regularly, to work on projects to help others (like this one) and to have a life! I’d also fallen into the trap of working too much “in” my business – attending like a busy worker ant to the day-to-day tasks – and not enough time “on” my business, such as improving the quality of my services for clients. It was starting to affect my relationships and health, my mood and creativity, and my motivation to keep doing the work professionally.

Something had to change. Quickly.

So how to do more in less time?

More recently, I’ve focused on getting more done at work in less time while maintaining ethical, and evidence-based standards and good client service. I tried out several leading “productivity systems”, and found many of them were too complex to use in practice. Then I found one that worked. I’ve used it ever since.

1. First, know your enemies: procrastination and Parkinson’s Law

For a couple of weeks, I wrote down everything I did at work, tracked my time, and then reviewed it. It was horrifying.

I found:

A. Heaps of wasted time, then guilt-laden attempts to make up for it:

staring at my computer, mulling big unanswerable questions;
getting side-tracked, starting lots of projects in parallel and not finishing any of them;
checking emails obsessively, a hangover from my law firm days;
reading breaking news on my phone;
engaged in pointless social media discussions; and
feeling guilty about not getting stuff done, so working on into the evening.

These are all examples of procrastination. They steal time from things that matter. They also deplete your attention, energy and capacity for critical thinking, which means all the “brain work” takes longer than it should to complete.

B. I was a hostage to Parkinson’s Law.

On the clinical-management side of my practice, I found myself enslaved to Parkinson’s Law. Even if you haven’t heard the name, you’ll be familiar with its effects.

Parkinson’s Law says that:

Work expands to fill the time available for its completion.

I found regular weekly tasks, like planning therapy sessions, or writing reports, seemed to take the same amount of time in total, regardless of the number of clients I was seeing, or the number of reports outstanding. For example, I found that four-client-days took me roughly the same amount of time in total to prepare for as eight-client-days. I had unconsciously determined that planning took X hours, and then gave myself X hours to plan the sessions.

2. Use The Pomodoro Technique

I first heard about this simple concept when listening to a podcast while out on a jog. At first, it seemed a bit gimmicky. But I decided to give it a go. And now I’m sold on it. A Pomodoro Evangelist, if you will.

The Pomodoro Technique is named after the tomato-shaped timer that was very popular in the 1980s. But you don’t need a tomato-shaped timer. I use my phone.

Here’s how to do it:

(a) Decide and stick to your “home time”. One way to stay focused is to force yourself to leave at a decent hour. (I like to have dinner with my kids, so I need to leave work in time to get home. It’s almost non-negotiable, although I still make the odd exception, e.g. if an adult client needs to see me urgently.)

(b) Jot down your “to-do” list the night before, with a “frog” at the top. This is the last task I complete before leaving work each day. I try to put the least thrilling important task at the top of the list – something Mark Twain called “eating a live frog first“. It means I can hit the ground running.

(c) Be ultra-specific in defining your goals for the day. Rather than set big, ambiguous goals (e.g. “Become a better speech pathologist”, or “Do marketing”), I set very specific goals, always starting with a specific verb/action e.g. “Plan [X] therapy sessions”, “Call [specific teacher] to discuss [specific client’s] progress”, “Read [specific article]”, “Score Assessment results for [client]”, “Write 1000 word blog on [reviewed article] for website”.

(d) As soon as I get in to work, I set my phone timer to 25 minutes. No time for checking the news or email, or reflecting on the success of my Sunday BBQ. Just straight down to “eating that frog”. During that 25 minutes, I focus on the single task. No distractions.

(e) Once the timer rings, I cross off one “pomodoro” and rest for a full five minutes. I stretch, drink some coffee or water, walk around the clinic and have a chat with my team members about the day’s workflow. I do not check emails, or social media. I know exactly what’s coming up because it’s on my “to-do” list. If something unexpected and urgent comes up, I amend my “to-do” list, but only when absolutely necessary.

(f) After the five minute break, I set the timer for 25 minutes, and get stuck into the next item on my list.

(g) After four “pomodori“, I take a 15-30 minute break.

That’s it! You can add bells and whistles as you go: I stepped up to using the Forest app to count my Pomodoro sessions for example.

3. How I use the technique in my clinic

I try to do at least 8 of these 25 minute pomodori a day – 200 minutes of solid work – outside therapy sessions. Where possible, I try to set each goal to something I can do well in 25 minutes. (I got better at this over time.) If I finish a task within 25 minutes, I spend the “leftover time” improving whatever I was working on, rather than jumping to the next task or *gasp* checking my email. For longer tasks, like writing an assessment report, I dedicate multiple pomodori to it over the course of the day (usually with other tasks scheduled between each to keep me focused).

Despite the temptations, I try to take the full five minute break after each pomodoro; and reward myself with a longer break after four, even if I feel I’m “on a roll”. If I have a “great idea” about something else in the middle of a pomodoro, I simply jot down the idea in my Evernote notebook dedicated to “random thoughts”, and get back to work. At the end of the pomodoro, I review the “great idea”. If it is in fact great (which is rare), I add it to my to-do list. If not, I delete it.

I never check emails during a pomodoro. I let calls go through to voicemail if I’m in the middle of a pomodoro and there’s no-one else to pick up the phone. If someone at work wants to speak with me, I ask if it’s an emergency. If not, I tell them I will speak to them at the end of the pomodoro. (My team members are used to this now!)

4. Why does it work?

Not entirely sure! Here’s what I think:

Chunking big tasks into smaller tasks makes them less intimidating – easier to start.
More control over my day. After doing it for over six months, I’ve now internalised the habit.
I find it easy to focus for 25 minutes. Any longer than that, and I get bored and distracted.
It combats Parkinson’s Law: e.g.:
- each Monday, I assign three pomodori to plan all my sessions from existing management plans;
- every work day, I assign one pomodoro to resource and set up each therapy session – no more, no less.
The timer jolts you out of procrastination or gazing blankly at the computer.
As you tick off each 25 minute pomodoro you build momentum and get more out of your day.
When I leave at my designated “home time”, I feel like I’ve accomplished a lot. I’ve also used up most of my mental energy and attention for the day on tasks that matter. I can relax and hang out with my family without guilt.

Whatever the reasons, implementing the Pomodoro Technique has led to big and sustained improvements in my productivity. If you’re struggling to get things done efficiently, give it a go!

Principal source: Cirillo, F. (2013). The Pomodoro Technique. 3rd Edition. Updated & Expanded by FC Garage GmbH (first published 2006).

Image: http://tinyurl.com/z7lmpxq

Better learning

David Kinnane · 17 July 2020 · Leave a Comment

Providers: How to learn new skills rapidly.

By nature and necessity, NDIS providers and health providers are life-long learners. Not only do we have to stay on top of research to keep our skills up to date, we have to learn finance, marketing, technology, compliance, and other business skills, too.

Learning is essential to providing quality care to clients and for running our businesses. But there are so many things to learn, and so little time. So what can we do to learn new skills rapidly?

Skills and knowledge are related, but different. Both are necessary to do professional work well

Professional work combines practical skills with special knowledge. They are not the same thing:

In law, I graduated with good academic knowledge of the laws of evidence, but then found myself as a new grad unable to make a simple filing because I didn’t have the skill to know how to draft the filing in a form that would be acceptable by the Court. I needed my supervisor to show me how to do it, using a template and modelling.
In the first semester of my speech pathology degree, I memorised head and neck anatomy, but then struggled to complete my first cranial nerve exam on a real, breathing person. It took me a good 15 tries before I could smoothly coordinate the practical motor requirements of the tests with my theoretical knowledge of the cranial nerves.

As a nerd, I’ve always found it easier to start with knowledge, and then learn the practical skill. Some of my colleagues do it the other way around: throwing themselves into practical tasks and then building the necessary professional knowledge around what they do.

Both ways can work. But good providers learn quickly that, in clinical practice, you need both skills and knowledge to do a good job.

Learning a new skill isn’t the same thing as improving an existing skill

Seems obvious, right? But we sometimes forget that you need to walk before you run. Many providers I know (including me!) sometimes forget that acquiring the basic skill requires a different approach to training an existing skill. Learning to walk is hard. Going from walking to jogging is less hard; and accelerating your jog into a run is easier again.

How to learn a new skills quickly?

Josh Kaufman, in his excellent “The First 20 Hours: How to Learn Anything Fast”, recommends 10 key principles of rapid learning. Here they are, paraphrased and ‘translated’ for NDIS and health providers:

1. Choose a loveable project: Rapid skill acquisition is hard. It helps if you choose a skill that is important to you and your business – a skill that will make a difference, and ideally, that you will enjoy having. For example, early on, I decided to learn how to do evidence-based voice therapy for people with Parkinson’s Disease because I found the work very rewarding. I learned how to blog properly because I love sharing knowledge. I learned how to use video editing software (like Camtasia) to make training videos for my team because I was sick of spending my time saying the same thing over and over and wanted to save time. In each case, I had a compelling reason to do the work.

2. Work on one skill at a time: Focus! In our clinic skills improvement program, for example, we focused first on deepening our knowledge of language stimulation skills for children with Autism Spectrum Disorder before we kicked off a project to improve our diagnosis and treatment of childhood apraxia of speech. In business marketing, we decided first to learn the basics of Facebook, Twitter, LinkedIn, then Instagram because my target audience was interacting on those platforms. I don’t worry too much about TikTok at this stage. But, like Instagram, I might change my mind if it makes sense from a business perspective to do so.

3. Define your target performance level: To be good at my job, I don’t need to become a web or graphic designer, or produce award-winning documentaries. I need my work to be clear and useful. What does good enough look like to you?

For new business skills, our base-line is competence. We won’t offer a service until we’re sure we can do it competently. In business marketing and advocacy, our base line is based on the usefulness of the information we present. Will a particular blog post give participants enough evidence-based information to know what to do next or where to go for more information?

This means we always proofread our work for readability, and cite our sources. It doesn’t mean that we aim for perfection. Trying to be perfect is a fool’s game, and can lead to procrastination and paralysis.

4. Deconstruct skills into sub-skills. Most important skills can be broken into sub-skills. For example, when learning to do Cycles Phonological Remediation Approach, we broke the program into sub-skills. We read a few of the leading peer-reviewed articles. We blogged about it (mainly to explain it in Plain English to ourselves). We broke the research down into chunks, like how to choose targets, how to do auditory bombardment, how to explain the program to parents, how to give clients feedback on attempts, how to use reinforcement and feedback, and how to ensure adequate dosage/repetitions in sessions. We then story-boarded a sample session and tried it out on each other in role-plays. We then developed resources (e.g. audio recordings and target word lists) to support efficient and consistent delivery across the practice.

This approach works for business skills, too. For marketing with infographics, we first sat through a tutorial on how use the software properly (Canva), then worked out how to make a readable template, then practised summarising some of our more popular blog posts into single page bullet point lists, and finally mapped out how to get the work done on a schedule.

5. Obtain critical tools. It’s hard to practice a skill without the right equipment, and it’s easy to put things off because you don’t have the right tools. In business, having access to quality templates, procedures and management systems is essential when learning, for example, how to improve client satisfaction ratings and retention, or to reduce your failures to attend.

6. Eliminate barriers to practice. You need space, resources and time to practice new skills properly. Distractions (e.g. emails, phone calls, texts, Facebook) and emotional blocks (like fear, doubt, imposter syndrome, and embarrassment) can get in the way of learning new skills. In the clinic and in business, I block out times to work on new skills. I unplug my devices and force myself to persevere, despite my internal doubts.

7. Dedicate time to practice. You have 1,440 minutes a day to get things done. We all have work and family commitments. We all need leisure time, exercise, and sleep. But we all have time-wasting behaviours, too. I did a time audit and discovered mine were Netflix binges and reading the news on my phone. By reducing both, I found the time to learn new skills.

8. Get fast feedback. After learning about a new skill you think is important, don’t wait months to get your hands dirty. Try things out safely in the real world as soon as possible, and be prepared to make quick changes to improve your accuracy and skill level.

For skills like book-keeping and social media posts, you might get instant feedback from your system or followers (sometimes a little confronting!). For new client skills, try to gets lots of immediate feedback on how you are doing when you are first practising the skill; then move to delayed and less frequent feedback as you master the basics and start training the skill. Experienced mentors can be a big help here.

But, if you don’t have one to hand (and you should!), tools like biofeedback, or video and audio reviews of your performance can help you assess how you are doing – even if they are painful to sit through in the early days!

9. Practice in bursts, by the clock: When you’ve mastered a skill, time flies. But, during your first few attempts, time can drag. In the early stages, set a minimum block of time to work on the skill, e.g. 20 or 25 minutes. Once you start, keep going – even if it feels like you’ve been making mistake after mistake for hours. When I’m particularly hopeless at something (usually fine motor-related), I sometimes feel like the timer will never go off!

Hang tough, even if you feel terrible about your poor performance and ‘urgently’ need to know all about the local footy scores or have a sudden urge to Marie Kondo your garage. Aim to distribute practice throughout the day when learning a tricky motor skill. Kaufman recommends practising new motor skills just before bedtime so that your brain can consolidate your learning during sleep.

10. Go for massed practice and fast repetitions: you need sufficient quantity of practice and speed of trials. Once you’ve achieved acceptable ‘basic form’ in whatever skill you are learning, practice as much as you can, and as often. The faster and more often you practice, the more rapidly you will pick up the skill. For motor skill acquisition (e.g. like touch typing or learning to use a new resource requiring manual dexterity), many of these principles will sound familiar to those of us trained in principles of motor learning.

What about rapid learning of knowledge?

Aha! Good pick up and great question. Regular readers will note that some of Kaufman’s principles are consistent with evidence-based studying techniques, such as spaced practice, forced retrieval, and doing practice tests with the same structure as the real test.

This is one of my favourite subjects and an excellent topic for another day, don’t you think?

Bottom line

For NDIS providers and health providers, learning new skills is hard, but essential. When next preparing to learn a new skill, use the 10 principles above to practice it in the most efficient and effective way possible.

Principal source: Kaufman, J. (2013). The First 20 Hours: How to Learn Anything Fast. London, England, Penguin Books.

Image: https://tinyurl.com/y2pnmxx9

Better management of online reviews

David Kinnane · 17 July 2020 · Leave a Comment

Dealing with negative online reviews: evidence-based strategies for NDIS and health providers.

Online review sites are fairly new in disability services and healthcare generally. Australian examples include Whitecoat and the NDIS-inspired Care Navigator.

Negative reviews hurt

Negative reviews on sites like these – or on social media platforms like Twitter and Facebook – hurt. They may make us angry, anxious, embarrassed, sleepless – even sick. They can decimate team morale and confidence. They can tarnish reputations. They can lose us business. In extreme cases, they can even drive practices into the ground.

To compound the problem, many NDIS and health providers are constrained by legal and ethical rules about advertising (e.g. testimonials) and client privacy. In practice, these limit our ability to respond to negative reviews, even if the reviews are exaggerated, incorrect, anonymous or even fabricated.

Review sites are here to stay

Consumers have a right to be informed about their treatment options. Despite all the risks of review sites for speech pathologists and other health professionals, it’s clear regulators (and some self-regulatory bodies) in Australia see review sites as an important way of promoting consumer rights.

For example, Speech Pathology Australia’s Advertising FAQs state that:

advertising is not considered to include…comments made by a patient/consumer about a practice or a practitioner where the comments are made on a social media site or account or patient/consumer information sharing site or account which is not used to advertise a health service, and that site or account is not owned, operated or controlled by the practice or practitioner referred to in the comments”.

Similarly, the advertising guidelines that apply to regulated health practitioners like occupational therapists and physiotherapists in Australia state that:

There are many opportunities for consumers or patients to express their views online that are not affected by the National Law restriction on testimonials in advertising. Patients can share views through their personal social media such as Facebook or Twitter accounts or on information sharing websites or other online mechanisms that do not involve using testimonials in advertising a regulated health service.
For example, consumer and patient information sharing websites that invite public feedback/reviews about experience of a regulated health practitioner, business and/or service are generally intended to help consumers make more informed decisions and are not considered advertising of a regulated health service.”

Although hard to forecast with certainty, it’s likely that managing online reviews will be an increasingly important part of business for NDIS and health providers.

What do we know about negative reviews?

We can learn from the experiences of business owners who’ve been dealing with online reviews for years: owners of restaurants and hotels. These businesses have had to deal with sometimes very harsh reviews on sites like Yelp, Zomato, Menulog, OpenTable, and TripAdvisor. A growing body of research exists about these reviews.

It shows:

1. Online reviews matter. Online reviews: (a) can attract a wide audience (Hennig-Thurau et al., 2004); (b) are perceived by consumers as credible and trustworthy (Flanagin & Metzger, 2013); and (c) play an important part in shaping client opinions and purchasing decisions (Sparks and Browning, 2010).

2. Online reviews can help improve the quality of services. In traditional management literature, customer complaints are often seen as positive because they give the business a chance to fix problems and improve services (e.g. Reynolds and Harris, 2005).

3. Reviews can also hurt you, your team, and your business. As noted above, negative reviews about your business can affect you, your reputation, your business, your employees and contractors; can affect your morale, health and finances; and may attract the attention of third parties, including government regulators and industry associations.

4. Consumers post negative reviews for lots of reasons and in different ways. Online reviews may be posted for personal, social and even commercial reasons. The trigger is usually a negative experience. The decision to post an online review depends on lots of factors, e.g. a client’s motivations, past experiences, general attitude to complaining, age, and familiarity with the Internet (e.g. Yagil, 2008). Posting reviews may provide an emotional release (e.g. to allay anger, embarrassment or disappointment, or even to provoke laughter), seek “revenge” for a perceived slight, or even the hope of economic gain (Cantallops and Salvi, 2014). Some may be heat-of-the-moment “rants”. Others may be fair descriptions of legitimate concerns. Some will be trivial. Others may allege civil wrongs (e.g. negligence) or even criminal acts. Some may be exaggerated. Others may be completely fabricated (e.g. by ex-employees with a gripe, or unethical competitors). Some are short. Others are encyclopaedic. Some will be shared with one or two followers. Others may go viral. Some will be posted by named people you know. Others may be anonymous. Service quality is very much in the eye of the client, rather than the provider (e.g. Sparks, 2001).

5. Online reviews can be personal. They may name and single out individual staff (e.g. Bradley et al., 2015). They may even be discriminatory or defamatory.

So how can NDIS and health providers manage negative online reviews?

Again, we can learn from the experience of hospitality businesses. As with restaurants, many NDIS and health providers are small businesses with limited time and resources to dedicate to online review management. In this context, the research identifies four broad categories of strategies employed by businesses to manage negative reviews:

(A) Preventative strategies

Improve your services. In theory, improving the quality of your services will reduce problems, complaints and the risk of negative reviews.
Conduct “real time” checks on client satisfaction to identify and, if possible, fix small problems before they become big problems (e.g. Johnston and Fern, 1999).
Manage client expectations about your services.

These are sensible ideas. But, owing to the intangibility of services and the variability of client perceptions, expectations and preferences, preventative strategies are never going to eliminate the risk of negative reviews entirely (e.g. Sparks, 2001).

(B) Protective strategies

The emphasis of these strategies is to shape – not prevent – complaint behaviours to minimise damage to your business.

Give your clients clear encouragement and guidance as to where and how to comment and complain. This can be offered orally, via a leaflet, on your website, or an email. For example, I have a feedback and complaints policy I share with all clients.
Include a request in your feedback and complaints policy that complaints first be presented to staff or the practice directors before being posted online.
Have a physical and email suggestion box for anonymous comments and complaints.
Provide short in-house satisfaction questionnaires and reward clients for using these, rather than going online.
Monitor online reviews and respond:
- privately by email or, better yet, with a phone call or face-to-face open discussion; or
- publicly.

In the hospitality industry, public responses are increasingly viewed as a vital reputation management strategy. Review sites like Yelp and TripAdvisor have even published guidelines on how to do it. These guidelines encourage restraint, courtesy, a focus on specific concerns and an emphasis on the business’ positive qualities.

Jay Baer, author of “Hug your Haters: How to Embrace Complaints and Keep your Customers” says that when you don’t answer a complaint it decreases customer advocacy by up to 60%: when you answer a complaint it increases advocacy by 25%. Customer advocacy – i.e. the client advocating for your service.

Complaint-handling studies (e.g. Davidow, 2003; Bitnet et al., 1990), show that effective public responses often include:

acknowledgement of the problem(s) raised;
an apology for the business’ contribution to it;
an explanation for its occurrence; and
a commitment to take appropriate preventative or remedial action.

Two important points on public responses for NDIS and health providers:

It can make sense, from a business perspective, to respond to negative reviews in a constructive way, acknowledging the client’s concerns (even if you don’t agree with them). However, it’s also important to support staff and others affected by the review, recognising that there are always at least two sides to any story (e.g. Jung & Yoon, 2014).
As noted above, NDIS and health providers must comply with their codes of ethics and legal obligations when responding publicly. This means, among other things, that we cannot disclose any sensitive, health-related or personal information about clients or their care, which means we need to be very careful when responding in a public forum. I’ve given some thought on how best to do this.

Most review sites have moderation guidelines or terms of use that prohibit defamatory or offensive comments. For example, Whitecoat’s Moderation Guidelines and Care Navigator’s Terms of Service (see Sections 9 and 12). If you feel a review breaches those guidelines, you should alert the review site citing specific breaches and ask that the offending review be removed.

(C) Positive strategies

In hospitality, it’s common for businesses to actively encourage positive reviews from happy clients. Evidence shows that this tactic can help push negative reviews down the list and “off the page” and also result in a more balanced picture of the business (e.g. Sparks and Browning, 2011). It can also help build staff morale.

Unfortunately, actively encouraging positive reviews is not an option for many NDIS and health providers in Australia. We’re often not allowed to encourage testimonials or positive comments from clients for ethical reasons.

Providers can – and should – gather and share unsolicited positive feedback with staff to bolster morale. But we cannot encourage or take active steps to share this kind of feedback with the public as this would fall foul of our advertising rules.

(D) Palliative strategies

These emotion-focused strategies seek to counteract the negative emotions and stress caused by negative reviews. Examples of these strategies include things like:

building physical resilience – going for jogs, joining gyms, etc.;
enlisting support from colleagues, families and friends, including through professional networks and bodies (online and offline);
recognising that reviews are transient, surmountable, and often of limited consequence in themselves;
providing professional and emotional support to any staff affected by a review; and
stress management activities, e.g. yoga, meditation, etc.

Although simple and perhaps obvious, these strategies provide powerful ways to combat feelings of powerlessness and isolation, and to keep the real effects of negative reviews in perspective.

Bottom line

Online review sites are here to stay and can help members of the public to make informed choices about their healthcare. Online reviews can help NDIS and health providers to improve their services. But they can also inflict significant emotional and financial stress on owners and staff.

Preventative, protective, and palliative strategies, like those used in the hospitality industry, may help us to manage negative online reviews and their effects. But we need to take care when responding publicly to ensure we act ethically and in accordance with our privacy and other legal obligations.

Principal source: Bradley, G.L., Sparks, B.A., Weber, K. (2015). The stress of anonymous online reviews: a conceptual model and research agenda. International Journal of Contemporary Hospitality Management, 27(5), 739-755.

A version of this article first appeared in Speech Pathology Australia’s Speak Out magazine in August 2016.

Better team work

David Kinnane · 17 July 2020 · Leave a Comment

Providers: How can we make our workplaces more ‘hospitable’ for our staff and ourselves?

Workplace stress!

1. Most NDIS and health providers feel it

In a typical month, we might experience cash flow issues caused by late payments and unexpected bills, fake and anonymous online reviews, unexplained spikes in ‘failures to attend’, data privacy challenges, client complaints, social media ‘run-ins’, the odd family law-related subpoena, glitches in clinic and business management systems; and of course staff issues, like motivation and performance challenges, staff turnover and handover problems, and puzzles like how to coordinate staff leave and client coverage. I felt my blood pressure rise just typing that list!

2. Staff feel it too

When I speak with grads and others who are in their first couple of years out in the “real world”, I hear lots of anxieties: graduate numbers (particularly in cities), cost-cutting initiatives due to increased competition and privatisation (e.g. reduced hours, cuts in training budgets), limited supervision and mentoring, insufficient “admin time” to call back clients and write reports (and expectations on staff to regularly work outside contracted hours), and struggles to get reimbursed for resources, equipment, petrol, parking and other work-related costs. And I still hear too many stories about straight out ‘shonkiness’ like underpayment of award and other entitlements, sham contracting arrangements, unpaid “internship” offers, and overly restrictive employment contracts.

3. Clients pick up on our workplace stress

One thing I’ve observed in my practice is that clients are very good at picking up on when things aren’t going well behind the scenes. Regardless of how well we try to insulate clients and client care from “back of house issues”, even very young clients can pick on on workplace stress – even when everyone is smiling and pretending everything is fine. And no one wants a grumpy, distracted provider, even if they are doing a good technical job.

4. Is this just how it is?

Is the stress just reality? Should we all just get used to being stressed out? If so, I can understand why so many of us leave the sector so early.

So what can we do to right the ship? Even if we can’t remove the stressors, how can we make work-life better – for owners and our staff?

5. If you can’t take the heat…air-condition the kitchen?

I’ve been looking recently at what others do in other high stress, people-focused occupations. One of the most stressful industries out there is hospitality.

I’ve written before about the importance of learning from other industries, e.g. in how we handle negative online reviews. I think we can learn a lot from how leading restaurant owners – people with skin in the game – have tried to improve their workplace culture despite the headwinds of stress.

One of the most successful restaurant owners in the USA is Danny Meyer, owner of the Union Square Cafe and Shake Shack. And he has some provocative – and useful – tips on how to succeed. Below, I’ve tried to translate some of his key ideas for NDIS and health providers.

6. Change your focus, change your reward system, change your culture, change your outcomes

(a) The Big 5

All businesses, including NDIS and health providers, have 5 key stakeholders:

customers/clients;
staff;
communities in which we operate;
suppliers; and
owners/investors.

(b) Going beyond just providing a service

Obviously, providers provide a service. “Service”, here, is just the word for the technical delivery of what we do. Offering a good service means that you are offering something of value to people that works.

Providing a quality service is of course necessary if you want to stay in business for long. But many clients want more than just a contractual exchange of services for money.

Many clients want what Danny Meyers calls “hospitality”: providers not just providing services to clients, but going above and beyond the call of duty for their clients.

(c) Staff come first

Now here’s the counter-intuitive part of Meyer’s philosophy. He says that, if you want to offer true hospitality to clients, you need to start by treating your staff well and rewarding them, first, for helping each other:

I’m going to give you guys the best recipe you’ve ever had in your life. And it only has two ingredients. So it’s really simple. It’s 49 parts performance and 51 parts hospitality. And that’s what you are going to be judged on. That’s how you’re going to get paid. That’s how you’re going to get your bonus. And guess what guys? In this business, the customer is going to come second.

(d) But isn’t the client always right?

Radically, Meyer says no: “No one is right all the time”.

In Meyer’s businesses, staff come first. Each staff member is responsible for doing extraordinary, expected things for each other. For showing off to each other: to model what it’s like to be great at what you do. And to show what it’s like to make other staff feel good.

Meyers says this to his staff:

You’re responsible for doing extraordinary, unexpected things for each other and showing off for each other what it’s like to be great at what you do and even greater, 51%, at how you make people feel and I believe that if you do that for each other, our [clients] are going to be in for a treat when they come in and they’re second.

(e) Virtuous cycle

Focus on your team, your customers, on hospitality, on your culture.

By doing so, you create a long term “virtuous cycle”, a compounding loop that will ultimately lead to greater long-term success.

The key point, here, is as follows:

If you do not invest in your team – if the are not rewarded for going above and beyond the call of duty to make clients feel welcome, pleasantly surprised and delighted – then the virtuous cycle will break. As Meyer says:

I think it gets back to servant leadership, which is: how do you find opportunities on a daily basis to take care of the people who are ultimately going to take care of you? And I inculcate it by talking about it till people roll their eyes because they’re so sick of hearing me talk about it. And I just feel like culture is driven by language. I don’t know any culture in the world that is not glued together by language. Whether it’s your family, your religion, there’s language. And I think that the CEO of a company is the shaman of that culture. And they either have to be more fluent at that language than anybody else or the language is going to go sideways and lose its very special meaning.

And what better message could you give a NDIS or health provider! We need to communicate better with staff – and to speak to each other in the language of hospitality. If we want to work with people we respect, in workplaces we enjoy, and in businesses that we’re proud of, and in achieving long term success for our clients and practices, hospitality begins with learning to treat each other better – even if it costs practice owners more in the short-term.

Principal source: Reid Hoffman’s interview with Danny Meyer on Masters of Scale.

Image: https://tinyurl.com/y732qnxu

Better workplace safety

David Kinnane · 16 July 2020 · Leave a Comment

Workplace safety for NDIS providers and health providers: 8 things you can do this week to make your workplaces safer for everyone.

We all want our staff to be safe at work. And most practice owners I know do a lot of work to ensure staff are safe, including employees, contractors and sub-contractors, labour hire employees, students and other volunteers.

But we can always do better!

Workplace safety laws are numerous and complex, and it’s not surprising that some providers are unsure about even some of their most basic legal obligations. But – as lawyers love to say – ignorance of the law is no excuse.

NDIS providers and health providers should of course seek detailed legal advice about their workplace safety legal obligations. But, to help get people thinking about it, we thought it would be useful to provide some practical tips about things you can do quickly to improve workplace safety (and work safety law compliance) at your business:

Read the regulators’ fact sheets. If you don’t know the “who, what, when, where, and why” of workplace safety laws or even what “PCBU”* means, schedule and spend exactly one hour reading the fact sheets from SafeWork Australia and your State workplace safety regulator, e.g. SafeWork NSW. Even if you think you are up-to-speed, you’re almost guaranteed to learn something new – and to spot gaps in your current practices.
Display the mandatory “Medical Emergency Plan” poster in your clinic. You can access the NSW version here.

Put up the “If you get injured at work” poster. This is also mandatory. Display the poster prominently at work. You can download the NSW version here.
Create/revise an Injury Register: If you don’t have one (and you are required to!), create a simple injury register to keep records of injuries that occur at work. Courtesy of WorkSafe Victoria, here is a good template.
Double-check your workers compensation arrangements: Details vary State by State, but most providers are required to take out workers compensation insurance. In NSW, for example, we buy insurance from a public financial corporation set up by the NSW Government called icare. You can read more about it here.
Implement an infection control procedure. Even before COVID-19, infection control procedures were required in many states. In other States and Territories, it’s probably required anyway under workplace safety laws. You can write your own. Here’s an inexpensive template tailored for speech pathologists, based on the one we use in our practice.
Revise your emergency and first aid plans. Both written plans are legally required in all States:

for emergency plans, there’s a useful checklist from SafeWork Australia here.
for first aid requirements (e.g. including to have trained first aid providers and first aid kits), check out information from SafeWork Australia here.

Hold a dedicated workplace safety staff meeting. Set up a meeting with all your staff to discuss all the topics above, and workplace safety more generally. Consult with staff about safety in your business. Use the opportunity to explain your legal obligations. Also train/remind staff about their obligations to:

take reasonable care of themselves;
not do anything that would affect the health and safety of others at work;
follow your reasonable health and safety instructions, including to:
- work safely;
- follow instructions;
- ask you if unsure about how to perform work safely (especially in higher risk areas); and
- report injuries and unsafe and unhealthy situations to you and the health and safety representative at your work.

Of course, there are a lot of other things you need to do to comply with workplace safety laws – we’ve only touched on some of the basics. But doing these 8 things as soon as possible will at least get you started as you strive to make your workplaces safer for everyone!

Key sources:

* PCBU stands for “Person Conducting a Business or Undertaking”. If you own an NDIS provider business or health provider business, that’s you!

Image: https://tinyurl.com/yckprbvt