Survey results re 15 dec cs meeting narr test

MVES Client Services Survey
Your feedback from the
15DEC2011
Department Meeting

1

Survey Responses by Role
RN/Health Srvcs CM Care Manager Other

21%
30%

49%

N = 47

Survey Responses by Role
Survey Responses re: 15DEC Meeting 2

Count by Role & Tenure
12

10

8

6

4

2

0
Care Care Care Other Other Other HS CM/RNs HS CM/RNs HS CM/RNs
Managers Managers Managers (0 to 2 (3 to 5 (6 years (0 to 2 (3 to 5 (6 years
(0 to 2 (3 to 5 (6 years years) years) plus) years) years) plus)
years) years) plus)

Role & Tenure of Survey Respondents

HS Care MGR/RN Count Other Count Care MGR Count

Q3: Overall, I am clear about the
organizational structure and
operations the Client Services
Strongly Disagree Management Team is proposing.

Disagree
Disagree Not
11%
Sure
8%
Not Sure
Agree
81%
Agree

Strongly Agree

0 5 10 15

Q3 Response Counts

Q3: “Overall, I am clear about the organizational structure and operations the
Client Services Management Team is proposing.”
I understand the structure, it is easy to follow.
not sure about the change in the RN. Nurses have been assigned to building just as they are
assigned to Nursing Homes . They know the residents in their buildings especially consumers
in special programs. Not sure how this will affect the consumer
It sounds like a great idea to me - it is definately time for a change - it is just the way the dept is
reacting that concerns me.
I am clear about the proposed org chart.
Other than the fact that the health services manager supervises the nurse manager, it is not clear
to me what the difference is between the health services manager and the client services
managers. How will this distinction impact the cm's?
I had no problem with MVES structure. I enjoy my job and am very happy.

Q3 Comments

Q3: “Overall, I am clear about the organizational structure and operations the
Client Services Management Team is proposing.”
I think an interdisciplinary model is a great idea, and I think it will provide better customer
service to clients, which is what we are all here to do. I hope people are better able to grasp
the fact that we are all serving all the clients, not just our own individual caseload. I think
the concept of working together as a team across disciplines is a great idea.
Mixed-position teams and mentoring sound like great ideas.
I love the idea of the CM mentor. I think ALL teams would benefit form this role. (Supportive
Housing, PS and intake)
Unclear about what issues to bring to team manager instead of Roza. How will Roza keep us
abreast of the ever changing directives/ guidlines, work distribution, back-up
coverage, urgent case visits....
I understand what is going to happen but I don't understand and am not convinced that such a
big change will improve the quality of our work (and Cmr Satifaction), and will decrease our
stress. We want to be great but not at the point that it will keep us stressed.

Q3 Comments (continued)
Survey Responses re: 15DEC Meeting
6

HS CM/RN Count Other Count Care MGR Count

Strongly Disagree Q4: Once the plan is effectively
implemented, I believe the proposed
organizational structure will help us to
improve customer service quality.
Disagree

Not Sure

Agree
Agree Disagree
27%
27%

Strongly Agree Not Sure
46%

0 2 4 6 8 10

Q4 Response Count
7

Q4: “Once the plan is effectively implemented, I believe the proposed
organizational structure will help us to improve customer service quality.”
It seems like it will work out great. But we don't really know until we try it.
The current organizational structure is effective.
This will not improve customer service because it is not giving the CMs any less of a work load
so we can devote more time to the consumers.
I did not get a clear understanding of how new plan will enhase or make client services any
better. I other words, how. No clear case was made to show how quality will improve.
Appears to be a disruptive move.
not sure again as some of the consumers have trust issues and will only speak with the RN they
know
I'm optimistic. I think smaller teams who meet regularly will ultimately be good.
I will see. I can only try and do my best.

Q4 Comments

Q4: “Once the plan is effectively implemented, I believe the proposed
organizational structure will help us to improve customer service quality.”
I do not see the effectiveness of using the “Interdisciplinary Team” concept as a model for the
new teams. To dismantle the strong dynamic that exists among the HS team is to dismantle the
Good to Great mission MVES is preparing to launch rendering us ineffective.
Nurses on ALL teams seems like somethign we should have thought of a LONG time ago. I never
know who my team nurse is at this point.
I understand it will improve communications but am not sure how it will impact/improve
services.
Customer services has always been of a high quality (surveys have been sent out to consumer's
and feedback has always been positive). I thought and so did other's in my department the
reason Linda got involved was due to poor morale among the employees (this was never
addressed). Instead this turned out to be what we the employees can do for MVES to improve
efficiency for the agency.


9

8 No
30% Yes Count
7
Yes No Count
6 70%

5

4

3

2

1

0
Care Care Care Other Other Other HS CMs/RNs HS CMs/RNs HS CMs/RNs
Managers Managers Managers (0 to 2 (3 to 5 (6 years (0 to 2 (3 to 5 (6 years
(0 to 2 (3 to 5 (6 years years) years) plus) years) years) plus)
years) years) plus)

Q5: The new organizational plan is designed to standardize
supervision and training efforts through a coordinated, action-
based mentoring approach. Do you think this system has the
potential to work better than our current system?

Q5 Response Counts
10

Q5: “The new organizational plan is designed to standardize supervision and
training efforts through a coordinated, action-based mentoring approach. Do
you think this system has the potential to work better than our current system?”
As long as there is an open ended structure for change if certain aspects do not work.
I think it has the potential to work and the potential to not work. It seems as though alot of
people are not on board but we won't know until this program is implemented. Being a new
hire, I would have loved to have a mentor on my team to take some of the pressure of my
teamates to help me.
I believe the mentor program is a good idea for MVES. After being here some time, I have seen
new hirers come in and sometimes not ask for help when needed. I think this mentoring
position will help new hirers feel more comfortable asking the right questions and will
enhance their knowledge of MVES after orientation.
I feel having dedicated nurses on every team will greatly help both CMs and Nurses.
It has not been explained what the mentors will do when there is no one new to train, considering
the mentor will be making more money. The mentors should get paid a stipend instead.

Q5 Comments

Q5: “The new organizational plan is designed to standardize supervision and
training efforts through a coordinated, action-based mentoring approach. Do
you think this system has the potential to work better than our current system?”
I believe that the mentoring will be very helpful as the mentor will be someone who has been
doing the direct job and dealing with the day to day issues of working with the consumers
i did not think the old system was broken or bad
The case has not been spelled out how this will work so as to compare it with current system.
More responsibility will be placed on CMs and RNs with less time to devote to consumers
and home visits. Less responsibility/work load by supervisors.
While I agree with the concept of the mentoring program. It may serve us/our consumers well to
move forward with trainings within the current team formats. This reasoning is based on the
intensity of data a mentor will have to digest in order to successfully serve as mentor. If a
mentor were to be cross trained in every program and the minutia of each program offered at
MVES it is inconceivable to forecast a positive outcome. Adding a mentor to each existing
team would effectively improve the communication efforts, given each mentor would have the
baseline information of their respective teams/programs to build from..

12

Q5: “The new organizational plan is designed to standardize supervision and training
efforts through a coordinated, action-based mentoring approach. Do you think this
system has the potential to work better than our current system?”
This will be good for new people. it's not clear how the mentor will interact/assist more seasoned
cm's.
I believe is some of the teams it will work but not sure again on the clustered sites.
change is always good. But I did not see a problem wiht the past.
Absolutely! I think the mentoring concept is great. It gives an opportunity for a CM to develop
leadership skills and work on coordinating a team. I think the mentor has an important
role, which goes beyond just assisting new employees. I think it's really great that there are
multiple LICSW's to access and receive supervision from.
People thought that teams were supervised differently and that some teams were held to another
standard. This plan seems like a valid solution.
i think the role of the supervisor needs to be clarified. Some sups are lenient, some a "strict". For
example, I know on my supervisors day off, if I have a request, I know what SUp will say
YES, and what Sup will say no for a Client related approval.

13

Q5: “The new organizational plan is designed to standardize supervision
and training efforts through a coordinated, action-based mentoring
approach. Do you think this system has the potential to work better
than our current system?”
As long as the Mentor is well informed, organized and has good communication skills. It is
important to choose someone who does an excellant job as a CM.
Part of the new organizational plan will put all staff in a pool, shake it and redistribute it. I don'
see any advantage from this.
As long as the mentor is there to ans questions. What doe the mentor do when there is no new
hires? Why should one person get paid more money to be a mentor when in their absence a
person not being paid to be a mentor ans a questions? Sounds like this could cause some
friction....
Hopefully

14

Disagree
Strongly Disagree 17%

Agree
43%
Disagree Not Sure
40%

Not Sure

Agree

Strongly Agree Q6: Once implemented this plan will result in greater
standardization of service delivery for MVES consumers.

0 2 4 6 8 10 12

Q6 Response Counts
15

Q6: “Once implemented this plan will result in greater standardization of service
delivery for MVES consumers.”
Each team will still act indivually.
No case was really made. What standardization components and measures are we talking about.
Sees like a lot of general language, low on specific. Like buying a car and not knowing how it
improves what we formerly drove.
No. Not under its current format. I don't like the goal being "standardization of service delivery".
The goal should be individualized services which meet each cmr's needs...and each cmr has
different needs. Let's not lose sight of this.
So much depends on the individual, what the job means to them, how much they care.
As long as the Team manager are on the same page and keep to the same standard. I don't
believe that the new plan will improve the standardization. This could be improve without
changing all the teams. Communication and problem solving as well.
We are already overburdened with rules and regulations.

Q6 Comments

HS CMs/RNs Count Other Count Care MGR Count
Strongly Disagree
Disagree
9%
Disagree
Not Sure
23%

Agree
Not Sure 68%

Agree

Strongly Agree

0 4 8 12
Q7: Interdisciplinary teams that practice problem solving
in the consumer's interest will improve information flow
within the Client Services Department.

Q7 Response Counts
17

Q7: Interdisciplinary teams that practice problem solving in the consumer's interest
will improve information flow within the CS Department.
Having the same people solve a consumer's problem is helpful at time, but the whole team will
get used to a consumer and this does not allow fresh eyes to see the consumer, which is nice
about the way things are now.
No case has been made. The current teams to such problem solving. What is the add on value
here?
Interdisiplinary practice is already in place now and not sure how the change this
I definately agree with the above statement but with the attitudes of the members of client
services and the anger about these structural changes I am concerned that the plan will not
flow as expected.
The effectiveness of the current HS model is a mutual understand, approach and plan of action
for consumers who share a great deal of health commonalities. It’s a mind set that has
multiple facets and is continuingly changing and developing based on the problem solving
skills of those of us who manage this population. It is evident in team meetings and
impromptu cube discussions. It’s a HS language that flourishes because there is a baseline of
understanding among HSCM who we are serving these consumers. I am confident my
respective colleagues on other teams share a similar sentiment.

Q7 Comments

Q7: Interdisciplinary teams that practice problem solving in the consumer's
interest will improve information flow within the CS Department.
This is the part of the change that i most look forward to.
Hopefully
i dont understand the question
Good Care Managers have less problems to solve, others could benefit from the team approach
to improve their skills.
Team managers will needs to learn to manage problem solving meetings
we already do this in Health Services
We already do
I think it will work beautifully but hear an awful lot of negative feedback from certain
departments it will directly affect.
I think it will work beautifully but hear an awful lot of negative feedback from certain
departments it will directly affect.


Strongly Disagree HS CM/RN Count Other Count Care MGR Count

Disagree
23%
Agree
Disagree 45%

Not Sure
32%

Not Sure

Agree

Strongly Agree

0 2 4 6 8 10

Q8: The proposed changes have the potential to
improve the workflow for care managers/nurses.

Q8 Response Counts
20

Q8: The proposed changes have the potential to improve the workflow for care
managers and nurses.
I think it will take alot of adjustment, but once everyone gets used to it, it could be great. I think training
for care managers on nurse programs/procedures may be helpful to make CMC calls less confusing.
RNs do not know CMC stuff meaning that CMs will need to always be there to assist unless you train
them but that means more work for RNs. Also, if health services CMs are on the same team, doesn't
that mean that home care CMs need to know more about their stuff too for CMC calls? Sounds like
more work for everyone.
The work load for the CM will stay the same-except when there is a new person training. The fact that
the client services are on the same team with the health services CM is increasing the work load.
The client services CM do not deal with all of the program the health services CM does and the
client services CM is working in client services out of choice-therefore, the client services CM
should not be forced to do work for a health services CM who is making more money than the client
services CM.
I did not feel there was anything said that made me feel workflow would improve. I actually remember
hearing very clearly that our jobs weere not changing.Which to me means workload and flow
No case was made to show how this could or will be true. What is one specific change that would make
an improvement - an example would help.

Q8 Comments

Q8: The proposed changes have the potential to improve the workflow for care
managers and nurses.
Feel both RNs and CMs will be bogged down by duties/information that will take away from time
and efficiency of providing good customer service and may result in added frustration for both
CMs and RNs
The Nurses are very angry about the CMC responsibility-they feel it will hinder their work.
having assigned nurses to a team will simplify the cm's work. However, nurses who have long
established relationships with cmr's will lose the richness of these relationships.
I like the idea that each team will have a nurse or two assigned to them.
Especially the nurses, I hope. They have incredible responsibilities. I feel that having RN's to be
"on call, CMC," is a waste of their time. I believe they should not have to give up a half a day
of their experience to deal with CMC issues.
It remains to be seen how this will improve the workflow for the nurses and not drain more of our
time. Much of our work is time sensative.
I think that RNs are already available for CMs. The new plan might bring more comfort for CMs
but will be a additional source of interruptions for RNs.
time will tell, who is the one gauging this? What are you using to compare it to? More visits?


Strongly Disagree Disagree
6%

Not
Disagree Sure
15%

Not Sure Agree
79%

Agree

Strongly Agree

0 2 4 6 8 10

Q9: The presentation made it clear that the Care
Manager Mentor is not a supervisor, but a teacher who
coaches new hires in service delivery best practices.

Q9 Response Counts
23

Q9: The presentation made it clear that the Care Manager Mentor is not a
supervisor, but a teacher who coaches new hires in service delivery best
practices.
In general, I am not sure about this position. I am not sure that the persons assuming the role
will be restricted to just assisting new hires and also not sure that additional responsibilities
will be given to the persons, with not much of a pay increase.
except, what happens if a particular team has two or three hires per team. I imagine taht woudl
be quite overwhelming. Not only that, the mentor may not be always availabel because of own
case. I feel we as a whole do a great job helping teh new people. And they often find someone
they are comfortable with and find their own mentor.
It looks like this role is more of an assistant supervisor, taking duties from the supervisor, and
carrying them out. A better title might be CM Supervisor Assistant.
Feel mentor will be asked to do more than what was presented in meeting as supervisors do other
tasks.

Q9 Comments

Q9: The presentation made it clear that the Care Manager Mentor is not a
supervisor, but a teacher who coaches new hires in service delivery best
practices.
I feel it's a great idea, in theory. I strongly dislike the name and suggest "Team Captain" or
something less formal. I know people are afraid of a team member making more money but
doing very little additional work and hope the responsibilities of the CMM are outlined very
clearly.
That was made clear. In order to share their specialized knowledge perhaps mentors can meet on
designated dates and communicate updates during team meetings.
This was very clear to me, but from hearing other people's comments I don't know if it's clear to
everyone in the department.
Much will depend on the individual.


Strongly Disagree
Disagree Agree
24% 37%
Disagree Not Sure
39%

Not Sure

Agree

Strongly Agree

0 2 4 6 8 10
Q10: The new system creates the opportunity for care managers/nurses to devote a
greater portion of their time to activities that maximize direct service to consumers.

Q10 Response Counts
26

greater portion of their time to activities that maximize direct service to
consumers.
I don't think this change will change what we do on a daily basis.
This new system is not changing the work load at all giving the CM more time to do anything.
Case never made. I would love to see examples of how these changes will do that. It was never
presented as such. We all already, now, want to maximize direct service. How does this plan
specifically do that?
Feel the opposite will be the case. Less time to devote to consumer's and their needs.
I don't know how this will maximize the time we spend with consumers ?
I worry for the nurses. They are very apprehensive about the work load.
But...the nurses will in effect have very different "caseloads" and will end relationships with
cmr's that they have developed over many years.
I'm not sure about this.

Q10 Comments

greater portion of their time to activities that maximize direct service to
consumers.
Not the nurses. I don't think they should have to have CMC responsibility.
Unsure for the nurses. Nurses taking CMC shifts could detract from their time.
What opportunities? What activities? What services? Any examples or senerios
CMs and RNs work will remain the same, with increased expectation on the quality of the
servcies. We will have more meetings, more interrupotions. I strognly object RNs doing CMC.
This will increase the RNs work load and be a waste of money ( RN salary for CM work).
we already have been doing that. I did not hear anyone complain about what we do for
consumers, but the time it takes to document what we did. Lack of trust too much micro-
managing and now we will have more.


9
Q11: What are you most worried about
8 as the organizational plan is rolled out?
7
6
5
4
3
2
1
0

Q11 Responses
29

Q11: What are you most worried about as the organizational plan is rolled out?
CMC
I am not really worried about anything at this time. I'm sure things will come up after the plan is
implemented and will be taken care of properly.
That some staff may not react well to the plan and MVES may lose quality employees, namely
RNs. There are many changes at once, with two out of the four managers new to MVES and
three out of the four managers new to the department.
-Teams won't work out. -Mixing everyone together won't work out as you planned. -What will
happen if it doesn't work?
splitting up current teams who work well together.
Resistance from employees.
This new system is not changing the work load at all giving the CM more time to do anything.

Q11 Comments

I am not really worried but concerned that the role of RN on the intake team be clear as it is the CM
who is doing the initial assessment and determining consumer need. RN is important in adding input
as to consumer need much as they are now. I would not want to see the RN think that their role is to
direct that care for that consumer.
Having more shifts on CMC. And effectiveness of plan
I don't think anyone will go for the new Cm mentor postions. I also feel that the Mentor may either have
not ebough to do for what they are being paid for, or have too muhc to do and be paid too little.
I hope everyone gives the new plan a chance.
I'm not worried. I find that no real case has been made to show how the components of this plan make
a quality difference. The burden of proof is on the plan and the presentation, not the workers who
are doing their best right now.
Case loads are still going to be too high to provide excellent care to our consumers and their needs.
Additional CMC duties, responsibilities and knowlege of other programs not needed now by CMCs
will take time away from ongoing duties and responsbilites of RNs and CMs. Going back to weekly
team meetings and adding trainings to implament this plan will take away from time needed for
consumers.


The client services dept is not happy with the plan from hearing people discuss this within teams
- I am concerned that they will have a hard time adapting- Other than that I think this is a
great plan.
That it will be chaotic
CM's dragging the union into it with new jobs, new responsibilities, and new gripes.
That it will role out under its current format.
That other people are very upset about it and are going into this with a very negative attitude.
Confussion....which always comes with change
I have no worries!!


My position is not being affected very much, so I personally am not very worried. However I can
hear a lot of negativity, which is definitely a downer in the work place. I felt like MVES was
getting more negative and now it seems to be getting worse. However, hopefully it's just
growing pains- I know nobody likes change. I think once the new structure is established and
a year or so has gone by we will be able to see the benefits of working on an interdisciplinary
team.
I am most worried about the impact on training NEW staff. It seems to be overwhelming enough
to learn the role as new "vanila" cm. But...... Things change and change again.
I want it to work. Initial trauma of recreating teams.
That there could be some resistance and negativity as with any major change.


disquiet among my peers
I'm not worried.
At first glance, I was not worried, but then to hear people complain that there will be hard
feelings knowing the mentor is making more money annoyed me. I wish some people here
could act like a "grown-up". Also, the nurses seem unhappy, I wish they could see the bigger
picture....not be upset they arent sitting with each other anymore. I also think that the
Mentor role should be sought out by Sup's/director/mgrs. Is length of time at an agency going
to play a factor in who will be chosen? Is that a union issue. Just because you've been here a
long time does not necessarily make you a good candidate for the mentor role. That nurses
will have more work, tasks, and demand on our time. Since this process started we now have
to do OC, MFP in the nursings homes in addition to screenings, CSSM, and discharge
meeting. We now have to do (at some visits) minicogs, Risk assessments, and full CDSs. We
have more Extended care cmrs and all of the documentation that goes with it.
greater work load, more confusion, less ability to effiently manage time and travel demands


A lot of work with reorganizing and moving people around, a lot of time/money to devote to
that, more stress. Potential problem between CMs in a same team due to 3 different
levels of salary ("regular" CMs, previous Health team CMs, and mentors). Concerns, as
a RN, about being supervised by a CM who does not know about Nursing. Worries to be
swamped in a team that expect more than I can give.
I am not worried, I know I always did my best anyways. No sense in protesting if you do
you will be subject to embarassement or ridicule by the management staff.
The plan should have been rolled out by MVES personnal. I was very surprised by the
laughing that went on when it was discussed that RNs would carry the CMC phone. We
all work hard and I am more than willing to assist anyone @ any time. I don't believe
that NFs visits were taken into consideration @ all. I believe RNs work hard and do not
feel that others think so. I am very disappointed and I have never felt this way @ MVES.
It is very sad for me.


8
Q12: What are you most looking forward
7
to as the organizational plan is rolled out?
6

5

4

3

2

1

0

Q12 Response
36

Q12: What are you most looking forward to as the organizational plan is rolled
out?
Getting different opinions on difficult cases.
A new plan could help MVES grow. It could be a change that is really needed.
I am looking forward to having a nurse on my team to make it easier to ask questions and
conduct IDCs.
I hope that the interdisciplinary model works well and helps us better serve our consumers.
having the nurses be more readily available and working with a more diverse team of co-
workers.
The improved workflow.
Nothing
Having an additional team member as well as having nurses directly assigned to the team

Q12 Comments

out?
not sure
I am honestly not looking forward to it.
I think the interdisciplinary approach is a really good idea. I think having all different types of
expertise on one team will be very beneficial.
Not sure if there is an advantage to this plan. Time will tell.
consistent RN to go to
Having normal team names (how about A, B, C, and D like the old days?), having "go to" nurses
on the team, having supervision streamlined, and having all my coworkers who want to
be able to become LSWs.
I look forward to working with a cohesive team. I think change is good.
Less turnover


out?
It is a great idea that a nurse is assiged to our team.
I really like the new structure! I think CMs and employees in general get very territorial in terms
of what "we" do and what "they" do, and I think that's unfortunate. We are supposed to be here
to work together to best serve our clients. And I believe that having the different disciplines
work together will provide a more holistic approach to serving clients. I also feel that the
different disciplines and roles will be able to learn from one another.
Something new is always challenging and good for an organization. I look forward to continuing
to work with those who really care.
For teams to have a broader view and different ideas as to do what is in the best interest of elders
and how to accomplish it.
Working more closely with different teams.
Not looking forward to it but know I must keep an open mind.


These are comments that did not address the Q12 request to cite what an individual is
looking forward to.
I want to understand and see more what will be our benefit in that change. The theories in Change
show that for a change to be successful, the people involved in the change need to see a benefit for
them. I also don't see how the RNs work (with its current load) will be any easier to do and less
stressful.
I am happy for CMs who are working with a supervisor who micromanages their every move- I hope
they will be able to be looked at with new eyes and appreciated for all the hard work they have done
for years instead of corrected on spelling mistakes - that seems like the biggest waste of time to me
and I really think we are at risk of loosing positive employees due to these issues . I don't think the
management team realizes how much this effects the team morale and hinders direct client care due
to fear of being scrutinized for every move. People are so scared of being put on probation for
spelling and administrative tasks that they minimize client time and maxamize time focusing on
paperwork.
I want to understand and see more what will be our benefit in that change. The theories in Change
show that for a change to be successful, the people involved in the change need to see a benefit for
them. I also don't see how the RNs work (with its current load) will be any easier to do and less
stressful.
I am looking forward to the last directive given by Dan "Ask a question and listen for the answer." I
hope our voices are being heard.
pizza

Other Comments
40

Thanks so much for your honesty and your attention.

Let’s keep the dialogue going.

Together we can make this a GREAT year!

41

Survey results re 15 dec cs meeting narr test

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