Over the past 17 years we’ve posed this same question to hundreds of executives. Invariably, their greatest challenges remain the same. This is what executives say weighs most heavily on their minds: how do I manage employees’ performance, what can we do to retain our talent pool, how do we keep our current customers happy and how can we increase our revenues?
       Their issues focus mainly on people (employees and customers) and management.Yet, some new issues are also emerging which center on technology and leadership. If we asked you, would your answers be the same?
       Even though you may want to stay on top of best practices, we recognize that most executives do not have time to read the huge volume of books published each year, nor do they have time to spend on research. There just aren’t enough hours in the day to accomplish everything that’s already crowding your overloaded plate.
       This year, in each issue of ECPN,The Executive Desk will examine one of the challenges in depth.We’ll review the literature, the current research, add our own perspectives, as well as, offer some insights from executives we work with in long-term care, healthcare, and other industries.

       The following is a summary of the top five subjects this column will pursue this year.

1. Management & Leadership
2.The Aging Workforce & Generational Differences
3. Employee Selection & Retention (Becoming an Employer of Choice)
4. Long-Term Care Meets Technology
5.The Customer Satisfaction Employee Satisfaction Equation

MANAGEMENT & LEADERSHIP
       “No job is more vital to our society than that of the manager. It is the manager who determines whether our social institutions serve us well or whether they squander our talents and resources.” – Henry Mintzberg
       Lately, it seems that “leadership” is being touted as the panacea to all of our ills.Yet, leadership could not exist without management. It seems nobody aspires to be a good manager these days. Much attention and resources are devoted to leadership development as everyone wants to be a great leader, yet all leaders have to manage people.The separation of management from leadership is dangerous. Leading without solid management skills results in a failure to execute.
       According to traditional management theory, managers are supposed to plan, organize, coordinate, and control. The truth is, pressures of reacting to urgent matters supplant most reflection and planning. Managers respond to the urgencies of each day, take on too much work, operate with continual interruptions, and make instant decisions. There is no time to step back and consider bigger issues. This leads to acting with superficial and fragmented information.
       The management skills taught in business schools today bear little resemblance to what goes on in the trenches. Management theory is based on the studies of Taylor, Follet, and Fayol that date back to the beginning of the 20th century. Each decade has brought more research and authors who have contributed to the understanding of how to manage organizations effectively. Gurus come and go. Managers still strive to get work done through others.The way they do this, however, has been changing.
       Organizations, as they become less hierarchical in structure, are evolving to more democratic styles of managing people. As organizations and businesses become more technologically adept, marketing is more global and more consumer oriented, and managers must have high levels of interpersonal and intrapersonal communication skills, emotional intelligence, and strong collaborative abilities.
       Technology, marketplace, and social changes have trained and developed today’s managers with even more sophisticated resources. Most managers know more about how to collaborate, how to communicate, how to make decisions, and how to “get stuff done” than their predecessors ever did. But the overwhelming majority of the tools and structures and support they get are still designed to ensure success of the corporation—not necessarily their own personal success.
       Companies that wish to retain top managers with the crucial skills and extraordinary talents so necessary to sustaining business results will have to look upon their managers as important resources and nurture them accordingly.

HOW DOES EFFECTIVE MANAGEMENT DIFFERENT FROM EFFECTIVE LEADERSHIP?
       A search on amazon.com reveals that when using the keyword “leadership” 249,455 book references are available.A quarter of a million books on leadership. Situational leadership, servant leadership, principle centered leadership, primal leadership, emotional intelligence, difficult conversations, dysfunctions of a team, the challenges of leadership. You are probably thinking to yourself,“Where does one begin?” In our March/April issue we will discuss what it means to be both a good manager and a good leader. Since we believe theory is only as effective as its application,we’ll provide ideas for you and your team.
       John Maxwell, author of a number of leadership books, said "ninety-five percent of the decisions a CEO makes could be made by a reasonably intelligent eighthgrader. The CEO gets paid to make the other five percent."

THE AGING WORKFORCE AND GENERATIONAL DIFFERENCES
       Is Your Facility Generationally-Rich or Generationally Challenged?
       More than a dozen years ago, we realizing that the composition of the workforce would change significantly by the year 2010. Ken Dychtwald called it the “Age Wave.” In the past two years we have seen the early beginnings of the shift. In the United States, every 7 seconds, a Baby Boomer turns 60. While they may not be ready to enter a skilled nursing facility for another 20 years, the shift in the workforce is already being felt.As your manager and leaders grow older, do you have succession plans in place for your top-performers (including yourself)?
       Look at your current workforce and you cannot help but notice that the members of the boomers, Gen X and Gen Y (Millenials) generations are all working together. What is the impact when Boomer bosses are expected to lead and mentor the younger generation( s) with their different value systems and work ethics? What about the socalled “slackers” who do not show loyalty to a company and will quit without hesitation? What is it like when a Gen X manages an Early Boomer: someone with a lifetime of experience who is not yet ready to languish in a rocking chair?

MORE ABOUT EMPLOYEES: HIRING PRACTICES, EMPLOYEE RETENTION & BECOMING AN EMPLOYER OF CHOICE
       With the shortage of nurses and other healthcare professionals, what is the employee pool that you are drawing from and where are you finding candidates? Is your community an Employer of Choice? Do you know what it takes to be considered an employer of choice where employees speak with pride about your organization? It takes much more than a few catch phrases and pat answers. It takes courage, conviction, commitment, and a plan. Why? Because the “Inconvenient Truth” is that sometimes managers do not treat employees with respect. They opt for the easiest or quickest way to complete a task and forget there is a person on the end of a directive.
       Sometimes managers (and leaders) are so enamored with their own tech toys that they forget there are real people behind the receiving end of the emails. Or, they forget about the people in front of the emails. For example, have you ever been guilty of continuing to read e-mails when one of your direct reports stops by to talk with you? Do you respond like a Pavlovian dog when your Blackberry or Treo beckons, telling you there is a message calling for your attention?
       Treating people as though they are not as important as a technological gadget is a factor in employee turnover. Is employee retention as big a problem as the news indicates? If you are the VP/Director of Human Resources or a DON then you know the problem is real. How many vacancies do you have and how difficult is it to find candidates to fill those spots? What is the impact on residents or patients when they see unfamiliar faces, or worse, complain that strangers are bathing them?
       Stop for a moment and personalize the impact of high turnover rates. Think about what you would say to your own parent if asked why there is always someone new coming into their room.
       This year we will cover all three facets of finding, motivating, and keeping employees.

LONG-TERM CARE MEETS TECHNOLOGY: A BLESSING OR A CURSE?

       I was recently on a flight surrounded by people of all ages, each sporting a set of ear buds or wearing a headset. I wondered, are they listening to music, audio books, or simply wearing this electronic ear jewelry to shut out sounds? Perhaps even to prevent their seatmate from starting a conversation.
       We have already discussed how the workforce is experiencing a collision of generations. Never before have such a cross section of people of various ages worked so closely together. And never before in history have we been so reliant on technology.
       When was the last time you went for a whole day without checking email or voicemail—even while you were on vacation? When was the last time that anyone on your staff had to complete a write up by hand rather than use any of the indispensable computer programs for resident care?
       Think about the technological changes that have occurred in the past decade: sophisticated systems for tracking complex medical problems, new technologies everyone in the facility has to master, prospective residents who can now Google communities in geographic areas and conduct virtual visits before ever setting foot on the property.
       In the very near future, prospective residents will expect to find the same level of technology in communities they have in their own homes or businesses—ie, high speed internet access, plasma televisions, and Cat5 wiring. They will conduct Google research on their ailments and question medical staff. They will refuse to accept societal stereotypes about aging and challenge the status quo. Yes, it is happening already with the children of current residents and patients. And in just a few years, these same people will be the tech-wise dubious folks who you and your staff will be serving.
       In the another issue we will examine some of the issues relating to technology in long-term care and aging services—the technology that exists today and possible future environments.

THE CONNECTION BETWEEN SATISFIED EMPLOYEES AND SATISFIED CUSTOMERS
       Where would we be without our key customers—the patients and residents we serve?
       In a Harvard Business Review article, "Putting the Service-Profit Chain to Work," James Heskett and his colleagues maintain that the internal quality of a working environment drives employee satisfaction, which results in employee loyalty, which enhances productivity, which creates value for the customer, which largely influences customer satisfaction, which results in customer loyalty, which stimulates profitability and growth.
       This linear chain has been well documented, yet all too often facilities ignore the connection. Unlike many other industries, long-term care and aging services communities have built-in customer satisfaction measures through annual surveys and mock surveys.
       In a future issue of ECPN, The Executive Desk will explore the employee/ customer connection in greater depth. Throughout the future issues, this department will cover what it is that keeps executives up at night. So, what about you? What are your greatest challenges? ECPN invites you to tell us of other topics you would like us to address. With our collaboration this year, the sky is the limit to change and progression.


       Sylva Leduc, MEd, MPEC, is President of Sage Leadership Strategies, www.SageLeaders.com, a Phoenix-based consulting firm which delivers proven approaches for Performance Management, Leadership Development, and Employee Retention in long-term care, healthcare, and other fields. Syl has partnered with executives in the development of their leadership skills for the past 17 years. Her practical and pragmatic approach is a blend of graduate level psychology, advanced education in executive coaching and leadership development, together with real-world experience as an executive in a start-up software company and as a consultant with a major consulting firm. In 2007, Syl was honored with the PRISM award for consulting/coaching the executive team of a non-profit organization: they increased their overall revenues by 53% by focusing on and executing their strategic plan.
       Visit www.SageLeaders.com and receive the White Paper on Employee Retention, “Love ‘Em or Lose ‘Em.” To speak with Syl directly, call her at 800-509-6823 or send her an email at, syl@sageleaders.com.