Lumetra Healthcare Solutions

The Laguna Honda Hospital and Rehabilitation Center (LHHRC) is at a crossroads. Having inhabited its current building since the 1920s, this general, acute care skilled nursing and rehabilitation center operated by the San Francisco Department of Public Health, is slated to move into a new, state-of-the-art facility in spring 2010. This transition provides an unparalleled opportunity for the hospital to establish itself as a leader in both acute and long-term care. The Laguna Honda Organizational Effectiveness Project, led by Lumetra Healthcare Solutions (LHS), seeks to do just that by identifying how the hospital can best serve the needs of its patients and residents and maximize the opportunities offered by its new facilities. The goal of this project is to assess where Laguna Honda is today and to determine how the hospital can move forward in its efforts to provide the best possible care for its patients and residents, to increase staff satisfaction, and to build on its already important role as an integral part of the San Francisco community.

In collaboration with the City and County of San Francisco, Lumetra Healthcare Solutions has partnered with Barbary Coast Consulting and B&F Consulting to help guide Laguna Honda through this effort. Launched in December 2009, the LHS team is currently five months into the project. The assessment phase, which has consisted of working closely with staff, patients, and residents, with additional input from members of the wider community, designed to identify best practices and key areas for improvement at Laguna Honda, has just been completed. This collaborative learning process included one-on-one conversations between the LHS team and stakeholders throughout the Laguna Honda community, including management, patients, residents, and staff. “Discovery assignments,” that included focused conversations with patients, residents, and staff to deepen their understanding of what is experienced on a daily basis, were also developed for the Laguna Honda community. As a result of these discussions, every Laguna Honda unit and department has been asked to try one small, new approach designed to reduce stress, strengthen interdepartmental relationships, and increase the hospital’s ability to provide individualized care to their patients and residents. Units identified areas to work on from a list of possibilities, including these types of assignments:

• Paperwork reduction
• Building stronger ties between unit staff and social work, activities, and maintenance departments
• Improved clinical outcomes
• Utilization of consistent staff assignments
• Initiation of a “gentle awakening,” whereby residents can maintain their morning routine through a relaxed breakfast schedule.

While the results from this exercise are still being gathered, the early feedback indicates that the units are responding well to these changes and look forward to implementing many of them on a permanent basis.

Going forward, Lumetra Healthcare Solutions will continue to use this collaborative learning method to help Laguna Honda identify additional ways to maximize the opportunities and minimize the challenges offered by the new facility. Our progress will be closely monitored and measured, and — at the conclusion of the project — Laguna Honda’s roadmap for implementing the recommendations that are identified throughout this process will be documented. These recommendations will address staffing models, patient and resident care, employee satisfaction, community engagement, and the integration of technology. All of this work will build on the efforts already underway, taking great care to always put the needs of the patients and residents first. Lastly, the LHS team will work with Laguna Honda to develop easily usable tools to measure and report on the ongoing success of these outcomes, ensuring that the goals of the project are sustainable for the long term.