​​​
Joanne Smikle, PhDOne of the greatest hurdles of navigating a change as huge as PDPM is maintaining focus, and focus needs to start at the top. “Clinical leaders are pulled in 50 directions at once, and it can be difficult for them to have a clear focus on the bottom line,” says Joanne Smikle, PhD, consultant, speaker, and author of “Coaching: The Lost Leadership Art.” 

Just as these leaders need to support their teams, they need the support of administrators and other management, she says. A key part of that support is giving clinician leaders the ability to engage their teams on their own terms. 

For instance, Smikle says, “They need to have the opportunity to create dialogues and address people’s fears.” Activities such as listening sessions give clinical leaders a chance to hear what people are thinking and feeling. This is an important opportunity to “gather what people are concerned about and respond with factual information.”

While this requires leaders to have a certain level of knowledge, they also need to be able to say, “I don’t know,” Smikle says. “When new regulations and big changes come in, no one can know everything. Clinical leaders need to be able to acknowledge that ‘we’re all learning together.’”

Communicating Effectively

Leaders need to communicate to their teams the rhyme and reason behind the regs and the facility’s response. “They need to help employees understand the strategy behind efforts to comply with PDPM. They need to know that leaders are addressing the mandate of the regulations in a thoughtful, planned way,” she says.

Smikle suggests a few tips to help clinical leaders successfully manage PDPM. 

■ Be prepared for disagreements and conflicts. When there is a major change or shift in processes and procedures, there will be disagreements and conflicts. “People can become defensive when things are uncomfortable. Leaders sometimes surround themselves with people who agree with them,” Smikle says. “However, they need people who will challenge their thoughts and approaches and can suggest different, better ways to do things.” Leaders, she suggests, need to resist “knee-jerk” reactions and be open to thoughtful responses and constructive debate.

■ Conduct thoughtful needs assessment. Don’t just assume what training or information staff want or need. “You need to conduct a thorough needs assessment to identify what skills and competencies are necessary for the future and which of these you have it place,” says Smikle. “When money gets tight, people want to cut learning first, but that is the last thing that should be cut. You will need a skilled, competent workforce, and that requires an investment in their learning.”

■ Don’t try to learn in isolation. “When you determine that you need to work on or learn something, likely others will as well. Pursue common learning opportunities as a team,” Smikle says.

■ Conduct a cultural check-up. “If you have a healthy culture, you can more effectively manage change,” says Smikle. Assess the organizational culture and check to see if employees feel comfortable speaking out and sharing ideas, are willing and able to work together, don’t fear retribution or punishment if they make a mistake, and aren’t ashamed or embarrassed to admit that they don’t know something and need more training.

■ Focus not on crises and problems but on the solutions. “Make sure that you have a positive culture that encourages and enables a focus on what we can do instead of what we can’t,” says Smikle.

■ Model optimism. Leaders at all levels and in all departments throughout the organization need
to model positive behavior. At the same time, they need to be able to seek help and support if they start to feel worried, overwhelmed, or stressed out.