11/11/08 — Cherry staffers will be uniformed

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Cherry staffers will be uniformed

By Phyllis Moore
Published in News on November 11, 2008 1:46 PM

Cherry Hospital was already headed in the right direction before the state stepped in to correct practices that led the federal government to pull its support, says one of the consultants hired to aid the hospital in regaining its Medicaid funding.

Carl Fitch, a consultant with Compass Group Inc., based in Cincinnati, is one of three consultants that has been hired by the state to do on-site management and training during the transition period. He is currently assigned to work with Hospital Director Dr. Jack St. Clair and hospital management.

Part of the initial state efforts center around nursing services, patient safety and staff morale, areas mentioned in a report Compass released Oct. 3 after a team of senior health care executives conducted an assessment in Septem-ber. The group was contracted to continue working at Cherry through the transition to renewed funding status. They returned in mid-October.

Cherry's federal funding was revoked Sept. 1 by the Centers for Medicare and Medicaid, resulting in the loss of an estimated $800,000 a month that the state is currently picking up.

Officials at Cherry hope a professional image policy -- and the introduction of uniforms -- will be one way to improve nursing services and campus morale.

Effective Jan. 5, nursing staff will have a choice of light blue or white uniforms, while health care technicians will wear navy blue. Holiday-themed scrubs may also be worn on several major holidays.

Representatives began meeting over the summer to draft the professional image policy, narrowing down the color choices before a campus-wide vote was taken.

Part of the rationale for the change is to distinguish patients from staff.

"Nursing personnel wear street clothes. ... Patients also wear street clothes," explained Bonnie Gray, director of nursing. "That presents challenges in identifying nursing personnel and differentiates nursing personnel from other disciplines and from patients."

For ease of identification as well as safety, especially on wards where the average patient stay is a week, it will be beneficial to have staff more readily recognized.

Despite advance notification, some concern was raised about staff having to purchase their own uniforms.

As of last week, the state granted the hospital permission to purchase three uniforms for each employee. The move is expected to help, at least economically.

While Fitch came on board after the uniform policy was being developed, he supports it.

"As I started getting oriented to the hospital, it became very apparent to me that it was very hard to distinguish staff from patients," he said. "Together Jack and I thought it would be a great idea to answer the concerns of staff."

Putting uniforms on staff will contribute to a "big cultural change" at the hospital, Fitch said -- in professional appearance as well as building pride.

Still, he noted, it is not the ultimate solution. Other areas will have to be addressed, he said, but they all lead to the ultimate goal -- getting Cherry's funding status back.

"The main reason is to help the hospital get its CMS accreditation back," he said. "To get it back at this point we're going to have to meet all the conditions of participation for the Medicare program. We're going to have to take a strong look at everything because when we're ready to go back to the feds and say, 'Come inspect us,' we want everything to be in line with the conditions of participation."

The consultants will look at everything from communication to morale to recruitment, Fitch said. For now, it's about shoring up the fundamentals.

"Morale is a very important thing in this organization right now," he said. "Morale is not as high as I would like to see it. ... Getting our employees to feel proud of where they work is certainly on our agenda."

That is not to say it will be a quick fix, or that the changes will meet with everybody's approval, officials say.

"There are still a handful of people who do not see the wisdom in doing it, do not see the value in setting apart staff from the patient population," St. Clair said. "But I think that's just a handful of folks who will come to realize that there's great value and wisdom in doing this."

That speaks to the whole need for having a cultural change on campus, said Fitch.

"It's important that we listen to employees and listen to their concerns and when we make decisions, we let them hear of the reason the decisions are made," he said. "I don't think there's an institution around that can satisfy every employee with everything."

Just as change is afoot for staff members, hospitals across the nation are also moving in another direction, particularly those dealing with mental health patients.

Fitch said one of those areas involves being more transparent.

"We don't have anything to hide in this organization," he said. "Unlike an acute care hospital, there are issues here that the normal hospital doesn't have, in terms of protecting patient care, in terms of protecting our employees."

"And in terms of meeting the standards of care," added St. Clair.

Since more improvements are imminent, the hospital director said it has been beneficial having the consultants on campus.

"These people bring a vast array of knowledge and experience, the best practices of policy and procedure operations," St. Clair said. "They have given us already invaluable advice and great recommendations on what their perspective is about our facilities here. We intend to take advantage of this very valuable resource. ...

"We don't want to just get better. We want to become the best in our field and you only do that by lining yourself up with those who have been there and those who have done that. We want to move forward in a positive way with services here."

Likewise, Fitch said the officials and staff at Cherry have been very cooperative and receptive to the input.

"The management team here was on the right direction before we got here," he said. "You can't tell people what the culture's going to be and what the attitude is going to be. You can't tell people to care. You have to build that into the organization and start from the grassroots."