< Culture Change

Customer Satisfaction

Synopsis

Customer Satisfaction has been a service industry buzzword for so long that it's almost lost meaning. Read on to see how the staff and residents at Meadowlark Hills in Manhattan, Kansas are truly putting the meaning back into this time-worn phrase.

Customer Satisfaction at Meadowlark Hills

"It's changed for the better."

"The difference is like day and night."

"I do as I like when I like."

"I take all the time I need."

"I stay busy and I like that."

"I have all I want."

"Happy, happy, happy."

"We all help each other."

"This is my home and family now."

"Come by and visit anytime."

Comments like these made by residents at Meadowlark Hills tell the real story of the organization's culture change success.

They are part of the results of the Resident Experience and Assessment of Life (REAL) surveys conducted over a three-year period by the California firms of Vital Research, LLC, and Bio Research LTD, to measure Meadowlark residents' satisfaction and loyalty to their nursing home provider.

The data shows their level of satisfaction increased significantly as the transition to culture change progressed, from 78% before the move to households to 94% today. Among long-time residents who lived at Meadowlark Hills both before and after the transition, 100% say they are overall satisfied and would recommend the nursing home to friends.

Surveys were taken in September, 2000 before culture change at Meadowlark Hills began; again in November, 2001 during the transition to households; and in November, 2002 after residents had lived for about eight months in the new model.

Interviewers trained in gathering data from the cognitively impaired performed the surveys in private settings of the elders choosing without staff present. Cognitively intact residents were interviewed in-depth while those less so were asked simple, yet statistically significant questions.

The levels of contentment indicated by the 2001 and 2002 surveys exceeded national benchmarks and standards in every category, including help and assistance, communication, safety and security, autonomy and choice, companionship, food and environment and overall satisfaction.

With one exception, every indicator increased with each new survey, a remarkable occurrence, says Linda Bump, Special Projects Mentor at Meadowlark.

Interviewers told her that in most nursing homes, some satisfaction indicators go up while others go down over time. That is because workers in traditional settings tend to focus on improving areas that are deficient to the exclusion of those that are not. For example, staff may concentrate on solving shortcomings around food service while allowing cleanliness to slip.

"I think that's a statement of the traditional, narrow way of thinking (under the old medical model)," says Bump. "The fact that we continually increased in almost every indicator over that two-year period... indicates a powerful difference between our approach and the traditional one."

While the data is impressive, says Steve Shields, Executive Director, it also indicates areas for improvement, like the need for more private rooms. Due to financial limitations, about 40% of the rooms at Meadowlark Hills are semi-private in the traditional sense. Residents living in private rooms voiced a much higher level of satisfaction in response to survey questions about autonomy and choice.

"It's tough, but if we can eliminate semi-private rooms completely... that definitely is another step forward that we need to take," says Shields.

Until Death Do Us Part

Steve Shields knew the Meadowlark Hills staff, residents and family members were becoming more like family since the transition to deep culture change, but he never realized to what extent until he attended "Isabel's" funeral.

Isabel was a prominent community member who had spent the last two years of her life at Lyle House, one of the six households carved out of the old medical model nursing home. Her family was very devoted to her and had become totally immersed in the fabric of life at Meadowlark.

"Relationships became very tight," describes Shields.

Still, he was surprised by what he saw - and what since has become a trend - when he arrived at Isabel's funeral services and made his way to the front through a tightly packed crowd of mourners from the community. Instead of a family pastor and others who typically officiate at funerals, Shields saw only Meadowlark staff in those roles. Rising to the podium with a bible in his hand was Greg, a Life Enhancement - Resident Advocate and volunteer chaplain. Linda, a Mentor, sat at the piano while T.J., an LPN, stood next to her, ready to sing.

Isabel's daughter delivered the eulogy.

"Mom wanted a family send-off, and that's what we're giving her," she said, indicating Greg, Linda and T.J. as the "family".

Shields felt moved.

"Elsie and her family felt so close to these Meadowlark workers, they included them as the family officiators. I thought that was pretty cool."