A Long-Term Care Leader's Guide to High Performance

A Long-Term Care Leader’s Guide to High Performance


Doing Better Together

ISBN 978-1-938870-50-7
6×9 paper
approx. 416 pages
© Feb 2018

Product Description

Learn the leadership practices and systems for continuous quality improvement in your long-term care organization! From the authors of the award-winning Meeting the Leadership Challenge in Long-Term Care, this new book describes how to develop the necessary systems, staff, and processes to deliver optimal care for each resident. Outlined here are the critical steps needed to achieve and sustain staff stability, prevent adverse events, and provide person-centered care, even in struggling care communities. This practical guide details how to implement well-established, interconnected practices that engage staff and promote teamwork to achieve the highest practicable well-being of your residents.

Key practices include:

  • Building a team of high performers
  • Creating daily stability
  • Regular communication “huddles”
  • Quality improvement that includes staff closest to a resident
  • Involving CNAs in care planning

Evidence-based results include:

  • Better quality measures
  • High staff performance and engagement
  • Improved dementia care
  • Preventing avoidable hospitalizations and reducing off-label antipsychotics
  • Increased staff retention and resident, family, and staff satisfaction

Foreword by Jody Hoffer Gittell
X Marks the Spot by Amy Elliot
Note to Readers

A Journey: Shock and Awe

Section I – PEOPLE: Bundle of Leadership Practices for Bringing Out the Best in People

  1. High Performance Leadership
  2. Staff Stability: Why and How
  3. High Performance Leadership – Why and How

Section II – SYSTEMS: Bundle of Leadership Practices for Systems to Maximize Teamwork

  1. Relationships Closest to the Resident Matter Most
  2. Quality Improvement Closest to the Resident
  3. Care Planning for the Highest Practicable Well-Being

Section III – PROCESSES: Bundle of Leadership Practices for High Involvement Processes to Do Better Together

  1. Doing Better Together
  2. A Doing Better Together Story: Finger Foods
  • Appendix A: Consolidating and Individualizing the Med Pass
  • Appendix B: Rethinking the Use of Position Change Alarms
  • Appendix C: 10 Steps to Eliminate Off-Label Use of Antipsychotics
  • Appendix D: Steps to Implement MUSIC & MEMORY to Maximize its Benefits


Coming soon!

Cathie Brady, M.S., has more than thirty years’ experience providing services and advocating for the elderly in a variety of settings, including serving as Executive Director of the Department of Aging Services for the city of Bristol, Connecticut, and for 10 years as the Regional LTC Ombudsman for Eastern Connecticut. Cathie has an M.S. in Organizational Management from Eastern Connecticut State University. She is co-founder (with her co-author Barbara Frank) on B&F Consulting, where she co-produced a Webcast for the Center for Medicare and Medicaid Services on “The How of Change: ‘What a difference management makes!’” Cathie directed the Connecticut Career Ladder and Culture Change Initiative. For 3 years, she worked with the New Orleans Nursing Home Staffing Project, which helped nursing homes recover from the aftermath of Hurricane Katrina. She co-produced a film with Louisiana Public Broadcasting called The Big Uneasy: Katrina’s Unsung Heroes. Cathie is a frequent speaker at state and national conferences and specializes in leadership development at all levels of an organization to assist nursing homes interested in being better places to live and work.

David Farrell, M.S.W., L.N.H.A., is a licensed nursing home administrator who has spent over 30 years in the health care profession. He started as a certified nursing assistant in order to earn extra money while attending college. That experience inspired him to pursue a Master’s degree in Social Work with a concentration in gerontology and administration from Boston College.  Throughout his career in various leadership positions, David has advocated for patient-centered care using quality improvement practices. A nationally recognized leader in the field, he has traveled the country to deliver inspiring presentations to health care executives at conferences and training events.  Currently, David is the Vice President of Subacute Services at Telecare Corporation located in Alameda, California.

Barbara Frank, M.P.A., began her career in long-term care by serving 16 years at the National Citizens’ Coalition for Nursing Home Reform in Washington, D.C., where she facilitated the Campaign for Quality, through which providers, consumers, practitioners, and regulators developed consensus on what became the OBRA 1987 legislation that overhauled nursing home regulations to require more individualized care. She has served as state ombudsman for Connecticut. Barbara facilitated the first Pioneer Network gathering in 1997, and in 2005, she facilitated the St. Louis Accord, a national gathering of providers, consumers, regulators, and quality improvement organizations that came together to improve clinical outcomes through culture change. Co-founder (with her colleague, Cathie Brady) of B&F Consulting, she works directly with individual nursing homes to improve their performance measures through workforce retention and culture change. Barbara led a team in the New Orleans Nursing Home Staffing Project, which helped nursing homes recover from the aftermath of Hurricane Katrina. She co-produced a film with Louisiana Public Broadcasting called The Big Uneasy: Katrina’s Unsung Heroes. She co-authored Nursing Homes: Getting Good Care There (1996) and has written extensively on efforts to improve care and outcomes in nursing homes. Barbara has an M.P.A. from the Kennedy School of Government.


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