Latest / Home Health Revealed (+Palliative and Hospice) / Leadership, Change, and the HOPE Assessment in Hospice Care With Demetress Harrell

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Leadership, Change, and the HOPE Assessment in Hospice Care With Demetress Harrell · Home Health Revealed (+Palliative and Hospice)

• 0:02
  Speaker A: Welcome to Home Health Revealed, where we share real stories from industry leaders about home health, palliative and hospice care. Brought to you by Velocity. Velocity's easy to read coding and revenue cycle dashboards let you grab your cup of coffee and quickly see the health of your organization. Well, welcome to another episode of Home Health Revealed. I am Hannah Vail. Thank you so much for joining us today. I have a very exciting guest that's her name is Demetrius Harrell and if you've been in this industry very long, across her because she is very involved in so many aspects. She has been in this industry for 32 years and her passion for education really just shines through in everything that she does. She really cares about the people in this industry and the people in these communities. If I were to read her bio, you would be very, very impressed. But I just want to mention a couple of things that I know are near and dear to her heart. And one is her involvement in the Rotary Club. And as well as her chair position, she is a board chair for the Texas New Mexico Hospice Organization along with the national organization alliance for Care at Home, which was formerly NHPCO. She is a board director there. Her PhD in public health administration really just gives those letters behind her name for the person that she is. She just embodies the care in this industry as I see it. So welcome, Demetrius.
• 1:31
  Speaker B: Thank you so much, Hannah. What a pleasure to be with you today.
• 1:35
  Speaker A: In today's episode, we're going to talk all about leadership in hospice care, how to lead through changes in our industry, and what hospice leaders should know about the upcoming Hope assessment, which is a lot of buzz right now. I really just want to start with Demetrious. Tell us how it feels because I just saw your LinkedIn post. To have been in this industry for 32 years. Congrats.
• 2:01
  Speaker B: Well, I first must say it is tremendously an honor and a privilege to serve in a capacity of helping others during most difficult time of their lives. You know, I spent the majority of this week at our inpatient unit where we're seeing families very distressed and we're seeing patients in the same regard and being able to stand beside them, help lead and guide them, and also listen and hear their stories. One family said that her husband recently died and she wanted to know how much time it would be before her father. I not only felt so much of my heartbreak for her, I hugged her and she said thank you. You know, if we could just open up our hearts and remember to care. We never know what other people are going through we saw it as we're caring for her in the transition of her father, but the reality is we're caring for her in the compounded effects of her GR alone.
• 3:07
  Speaker A: So, so true. And man, what a leader you are. I want to start with how you define effective leadership in hospice care, especially when you're balancing that compassion that you show with the need for accountability.
• 3:23
  Speaker B: You know, the first thing I would say is presence. You know, being present for our team, recognizing that all of our leaders are at different levels, not only in their career, but in hospice journey. But I lead with one quote at mind and my team all know it. I say it often and I recognize that I too fall short of accomplishing all of my goals. But that objective is actually this. And I say it with great conviction. It's not what you expect always. So it is not what you expect is what you inspect. And that's where we really focus on accountability, is recognizing that we have to go back and examine and evaluate the quality of all of the work that we do each and every day. And I do it with myself and I do it and say it with my team. It's not what you expect, it's what you inspect.
• 4:26
  Speaker A: It's what you inspect.
• 4:28
  Speaker B: And I've been saying that for 32 years. And it started with my first appointment within this organization where the previous leader had not gone out and looked to see if the documentation had been completed. And I saw documentation deficits from individuals with six month deficiencies to almost a year.
• 4:53
  Speaker A: And makes such a big difference when you're in the detail, in the weeds, not only for the fact of accuracy and things that we know, especially now, are so important. And with the HOPE tool coming, I know we'll get to that too. But just for being alongside your team, what strategies have you found maybe in addition to that? Because that sounds like a strategy most successful in leading your team through periods of change and uncertainty.
• 5:22
  Speaker B: You know, the strategies will vary among all leaders. And you know, when I think about effective leadership, I want to say it begins with optimism and understanding the evolution of our industry, which has changed dramatically from the beginning of my 32 years to the today, regulatory compliances and also our commitment. But I would say that first of all that number one strategy is establish a clear vision and be flexible in that vision. Understand how to articulate concise, helpful guides that help in their decision making. Because critical thinking is not where everyone is. Sometimes we just look at it from a surface, when in reality we have to look at the big picture. So communicate that the plan must require more adaptation and emphasize on the end goal. Then number two, I say improve transparency and set a regular predictable communication rhythm. Check your teams regularly. I had a leader even ask this morning, how do I say that to not make them feel less? How do I say that to encourage them and not make them feel as. As though we're making them do more? And so the reality is to prioritize and lead in a safe psychological method with techniques that encourage a dialogue, to invite open communication, open communication among the front desk receptionist all the way to the director of Nursing and acknowledge that uncertainties will occur and we're going to make mistakes. You know, I think that the world doesn't ever want to say I failed, but the reality is, how can we improve outcomes if we don't acknowledge our failures? And so that's something that I also say is I'm human. And the aspect of human and humility is being able to acknowledge it.
• 7:30
  Speaker A: So true. I love that perspective. And what speaking of mistakes in your bio, I forgot to mention that you are the CEO of Hospice in the Pines, which just is so much of what takes up your time as well as the other volunteer activities. But I want to talk specifically about your staff and your leadership there at Hospice in the Pines. Can you share how emotional intelligence plays a role in fostering that positive staff culture at Hospice in the Pines?
• 8:03
  Speaker B: Specifically, you know, when we look at emotional intelligence, if I pulled from my book bag, I have a book on emotional intelligence. And EI is a critical driver in helping to secure positive staff culture because it shapes how we lead. It aids in consistent understanding of the goals and the mission of alignment. You know, I can quote our mission statement, and I recognize that it's a labor of love undertaken by our staff, our board of directors, and our volunteers. But it also is understanding communication, collaboration and improving interdisciplinary disciplinary teamwork. So EI is pivotal in fostering a culture of one, self awareness number two, interpersonal effectiveness and resilience. You know, if we learned anything during COVID it was resilience. And people said, I'm tired of hearing that word. But the reality is, how do we still become the director? How do we stay in place when we have challenges? We have to be emotional intelligence and those techniques enhance our social skills. You know, it's nothing like a leader who is not willing to be out front. You know, I feel like it is important that not only I see the admission process and understand how to do it, but also how to facilitate post mortem care. And I've been involved in both of those. Not just 32 years ago, but even today. And so I see it as a motivation with clear, respectful and honest conversations while modeling coping mechanisms. You know, I have to be in front to say that you do this, but I also am willing to do the same. Practice coaching and making sure that we have reflective mindfulness. And that is key in emotional intelligence.
• 10:14
  Speaker A: And Amen. I'm just over here nodding away.
• 10:20
  Speaker B: I have to turn around and pull this book out. And I think it's in here. So I'll say this, here's that guide. And it's kind of a human resource guide to emotional intelligence. It's ironic that that was one of the topics that we're talking about because I feel like I have to refer back to that as a resource often.
• 10:40
  Speaker A: And those soft skills, I'll call them, are so important. And I feel from my perspective, and even when I talk to my kids, we're in a day where so much information is at our fingertips. But information alone, without the intelligence, especially the emotional intelligence of what to do with it and how to interact with others in relation to that information is key to success.
• 11:08
  Speaker B: Absolutely. It absolutely is. And you know, getting people to adapt and adjust to their own personal why is also important. You know, we do this work and it has to be more than just doing it for our own self gain. If we don't care enough about the people that we are caring for, then we are losing sight of the true mission in our lives as humanitarians.
• 11:41
  Speaker A: And the HOPE assessment, which we've anticipated for a little while here. I know I'm pulling in some regulatory information, but I think we have to. We have to be able to put all those things together. And leaders like you who are leading through change, we have to have that adaptability ourselves, but also bring people along to be adaptable, leading by framing change and talking them through what's coming, maybe pivoting when things change again and again. And so they do directly impact hospice impact. They do directly impact hospice operations. How is your agency, Hospice in the Pines preparing leaders and staff for this shift that's coming in just two days?
• 12:28
  Speaker B: Absolutely. It is on us. You know, one, one. I don't think that we had just a tremendous amount of information as to what the true measure of the HOPE tool, you know, getting adjusted and adapted hospice outcomes. We always feel like we're doing patient assessments and patient evaluations, but now we have this instrument and it will change how we do our work. But the reality is, I say that we should have always been focusing on Patient outcomes in a positive manner. So I say, number one, we are building a framework for this quality assessment tool to improve outcomes by one, clarifying how hope will align more with our mission. You know, I love that word hope, because we have to have hope in the work that we do here at Hospice in the Pines. And I will say, not only did I just celebrate 32 years, but our Hospice in the Pines will celebrate 40 years in a few months. And that says something, that's a milestone and it also says something about our resilience and ability to have long term effects and impacts on those that we support. So one, I think that we had to make sure that we were getting guidance from our EMRs, you know, and of course there's lots of them out there, some a little slower than others, to get the information we needed and how it will transcribe in the documentation that we do so improve the goals for patient care. Number two, I think that the tool will empower us as leaders to better align with the strategic objectives that we have within our organization. I think so oftentimes we think about our work as just interdisciplinary of disciplinary, you know, what the nurses have to do, what the social workers have to do, and we don't take into consideration. It is what we as an agency will do. And so I know for us, we have spent a lot of time, one, training, learning, and also onboarding our new members to this change. I think probably for the newer members it will be a little bit easier because for them they didn't have to relearn. Right. And then I think, you know, support competencies, the competencies of each discipline and adapt the leadership values to better curate the quality of stewardship. I don't think we oftentimes look at stewardship, but the measurement of the impact to address the common challenges that patients and families go through. One of the things that Hospice in the Pines did during our last accreditation is we became age friendly certified. And it has four key modalities that I think will overcome some of the challenges that we may see and hope because it will improve our outcome. The first one is what matters. What matters to not only the patient, but the families. You know, we should be going in with that question. What matters to you? What would you like to see over the course of your career? It also, it says, what are the medications you're taking? And looking at the side effects, because so oftentimes families are taking holistic medications. They're taking prescription medication, they're taking over the counter medication. What and how do those interface with one another. It also looks at the mentation. The biggest thing we've talked about over the years is mental health. But we have to look at not only that of the patient, but that of the family. And we know in hospice care there are patients that unfortunately don't die because of their transition of their terminal disease. They take their life because of their inability to cope the cope of change and the hope that they have lost. And then that final piece is the mobility. So I think that those are samples of how we've been preparing through an accreditation that we received and then lots of training, small groups, samples in how to roll out this new hope tool and then how the data is going to be collected in the time points, the flowcharts, determining how we will complete and compete in compliant documentation. Because at the bottom line it will affect not only the care, but it'll affect the operations and income. So it is one thing that we've taken serious. We are not playing with this new requirement, but we hope that it will only improve the care that we provide every single day to every single patient, regardless of their condition.
• 17:43
  Speaker A: Looking at it as the tool that it is to align. I really like how you have approached this. If there are people, emerging leaders out there, what advice would you give to those emerging leaders in hospice so they can develop resilience, adaptability and this strong patient centered focus?
• 18:05
  Speaker B: It's amazing. I teach a lot of emerging leaders in a variety of different capacities, not just in hospice, but in other professions, within the work that we do as leaders. And first of all, know why you're doing the job, know your why, you know, being patient and adhering to, leading with a passion. I think people always say, demetrius, we know you from around the industry because of your passion. You know, I don't want to do anything that I'm not passionate about and I'm not certain will change. But you know, one of the things, Hannah, that I believe is that one day too I will transition. I know that it'll happen. The one guarant that we all have is that we will die. We don't spend a lot of time at the breakfast table talking about what kind of quality we want that to be. But we have to start thinking about it. So I want to communicate with clarity and change the skepticism around dying and integrate leadership development that is regular in our work. We need to always be developing and we have to develop with processes.
• 19:22
  Speaker A: And I can tell you from the passion perspective, your passion is contagious to the others around you, to the people you're teaching, I'm sure. But I was actually at one of the Texas, New Mexico events and it was very clear from the outfits all the way to the countenances of the people who work at Hospice in the Pines. It is so apparent to me that your leadership and your passion is contagious from the top down. And I just want to tell you how refreshing. Refreshing that is and how much it's appreciated, even from a vendor. Right. A partnership perspective. To be able to see, see that sense of belonging in that sense of mission driven work in the industry is amazing. So thank you so much.
• 20:09
  Speaker B: Thank you, Hannah. You know, I appreciate you saying that. This morning I brightened the eyes of leaders because I gave them some new logoed apparel because we'll be going to a new billing conference in a week. And so I think that one we have to address appropriately, but we also have to brand right. And we have to remind people the work that we're doing. So not only will I say this in closing, but know your why and make your why your rationale for avoiding common pitfalls and to ensure positive action. So your why is why. Me and you are here today because we're celebrating our leadership and the action that we want to put forth, but we're also reminding other people, especially those emerging leaders, that the sky is bright and there are roads of greatness before them. And I hope that everyone will know that they will make a difference. Just giving each time a try. And if we fail, get up and start again. It is for the benefit of your future as well as that of our patients. Bless you for this opportunity.
• 21:24
  Speaker A: Well, thank you so much and thank you for sharing all of your valuable insights. You are such a great leader. We appreciate your leadership in this industry and your dedication to quality care and to staff development because we're, we're raising up those emergent leaders for the future, that next generation. If our listeners want to learn more about Hospice in the Pines or connect with you, can you tell them where they can find you?
• 21:50
  Speaker B: Absolutely. We would love for you to Visit our website, www.hospiceinthepines.org and of course they can reach me at 936-632-1-514 or 1-800-324-8557. I am also on LinkedIn on all the other social media, Instagram, Facebook, and I would love to do whatever I can to ensure that we together are united. I never see it as a competition when we're caring for patients. I just believe that they deserve the very, very best and how we do that is we stand together in uniformity. So please, anytime, reach out if I can do anything.
• 22:36
  Speaker A: Thank you, Demetrius.
• 22:37
  Speaker B: Thank you so much. Hannah. What a blessing.