B&F Consulting, Inc.

 

Our Services


  1. • Conference Presentations

  2. • Education

  3. • Strategic Planning

  4. • Consultation

  5. • Facilitation


We work with:

  1. • Individual Providers

  2. • Multi-facility organizations

  3. • Provider associations

  4. • Professional organizations

  5. • Quality Improvement Organizations

  6. • Ombudsman Programs

  7. • Consumer advocacy organizations

  8. • Workforce Intermediaries

  9. • State Culture Change Coalitions

  10. • State Survey Agencies


We work with you on:

  1. • MDS 3.0

  2. • Staff Stability

  3. • New Quality of Life Survey Guidelines

  4. • Quality Improvement

  5. • Culture Change Initiatives

  6. • Individualizing Care

  7. • Creating High Performance Workplaces

  8. •  Organizational Development including:

  9. • leadership development

  10. • supervisory training

  11. • soft skills training

  12. • creating career ladders


Co-founders


Cathie Brady



Barbara Frank



Links to Our Work and Collaborations


From Institutional to Individualized Care


Staff Stability Tool-kit


The Big Uneasy: Katrina’s Unsung Heroes


Achieving Staff Stability: Using Data Driven Decisions to Re-Examine Industry Norms


Individualized Care Training Curriculum


Meeting the Leadership Challenge in Long-Term Care: What You Do Matters

 
 

B&F focuses on the how of change and helps managers, supervisors and staff build systems and skills to work better together. B&F works with individual nursing homes, small companies, and statewide coalitions to stabilize staffing, initiate culture change, and improve performance. In addition to helping nursing homes achieve high performance and individualized care, one of B&F’s specialty areas is helping nursing homes struggling with instability, such as special focus facilities and critical access nursing homes.

B&F was founded in 2004 by Cathie Brady and Barbara Frank. After years of working to motivate people to embrace culture change, Brady and Frank realized that many organizations wanted to change but didn’t know how. B&F works as a partner with the leadership in long-term care organizations to take on change.

  1. Bullet History and Approach


Together, co-founders Cathie Brady and Barbara Frank, have over 60 years experience improving long term care. Cathie’s expertise is in organizational development and “high-performance leadership.” She has directed several senior service operations.  Barbara began her career with the National Citizens’ Coalition for Nursing Home Reform where she facilitated national collaboration to develop and enact OBRA ’87. This landmark law put into federal statute the concept of “individualized care,” the regulatory underpinning for the growing “culture change” movement. 


Barbara and Cathie worked in the mid-nineties, through the ombudsman program, to bring individualized care to Connecticut in “Breaking the Bonds,” an innovative partnership of providers, advocates and regulatory agencies. Then, working for PHI, they brought consumer, provider and labor organizations together in Massachusetts to achieve significant improvements in long-term care policy and practice, through the Massachusetts Direct Care Workers Initiative and the Extended Care Career Ladder Initiative, a workplace training program.


Cathie and Barbara’s unique blend of experience in consumer advocacy, workforce development, and organizational leadership provides a holistic perspective on change. They apply person-centeredness to care-giving and workplace practices.  B&F helps leaders get positive results by aligning the needs and desires of residents with the staff’s intrinsic motivation as caregivers. 


OBRA regulations call for individualized care. B&F helps providers individualize care by creating systems that support front-line staff to accommodate residents’ routines. Through individualized care, homes achieve better clinical outcomes. Individualized care also stabilizes staffing, reinforcing the desire to care for others that draws people to work in nursing homes.


B&F served as the faculty, with Marguerite McLaughlin and David Farrell, for Improving the Nursing Home Culture, a CMS funded pilot project operated by Quality Partners of Rhode Island, while it served as the national support center for the nursing home work of Quality Improvement Organizations. This pilot helped 254 nursing homes in 21 states to initiate culture change and workforce retention strategies that resulted in significant improvements in staff retention and in clinical outcomes.  The tools developed during this pilot were used by the QIOs in their 8th Scope of Work, which focused on improving care by improving the care-giving and workplace culture. B&F and QPRI developed a culture change model called HATCh: Holistic Approach to Transformational Change, and tools to support a quality improvement approach to culture change. These include an Individualized Care Curriculum, and Change Ideas on Consistent Assignment, Creating Home, Dining, Individual Choice, Pleasant Bathing, and Waking and  Sleeping. A report of the pilot and tools developed to during it, are available at www.riqualitypartners.org.


B&F’s approach to change is highlighted in a film produced by the American Health Quality Association, called “Culture Change in Long-Term Care: A Case Study” in which staff from MaineGeneral Rehabilitation and Nursing Care at Glenridge in Augusta, Maine tell of their journey to individualized care.  At Glenridge, nursing leadership took the lead in individualizing morning and evening routines to provide residents a gentle awakening and a good night’s sleep. This work, funded by The Commonwealth Foundation and Quality Partners of Rhode Island, became a teaching tool for QIOs and nursing homes looking for ways to get traction in an inclusive transformation to individualized care.


QPRI and B&F staffed the St. Louis Accord, a historic gathering in June 2005 of stakeholders from 49 states. Its purpose was to generate collaboration to move culture change forward.  Many of today’s state Culture Change Coalitions grew out of this historic meeting.


B&F and QPRI developed a wide array of leadership training tools for QIOs and providers, using proven management practices to help nursing home leaders bring out the leadership in others. Through a grant from the family of the late Susan Eaton to QPRI, B&F developed a section of the Individualized Care Curriculum based on Eaton’s work What a Difference Management Makes for CMS.pdf. It guides managers through leadership practices that can reduce turnover and improve workplace performance.


QPRI and B&F co-produced a four part series of CMS web-cast training for surveyors called “From Institutional to Individualized Care.” The series was produced in collaboration with Karen Schoeneman, Deputy Director of the Division of Nursing Homes at CMS. The series provides guidance to surveyors and practitioners on making modest changes to the physical environment so residents feel at home, individualizing the morning routine, eliminating alarm use, decentralizing food services, helping residents to a good night’s sleep, individualizing the med pass, implementing consistent assignment, using individualized care to achieve clinical improvements in pressure ulcers, falls, and depression, and stabilizing staffing.

B&F produced for QPRI a staff stability toolkit to help homes meet targets for staff retention. The tool-kit addresses strategies for hiring right, retaining new employees, scheduling to promote good attendance, and using tools to collect and analyze data to determine how best to use fiscal incentives to achieve staff stability. The Tool-kit builds on work done by B&F with David Farrell for Better Jobs Better Care-Vermont.

Recognizing that the whole long-term care system has room to grow in its adoption of culture change practices, B&F has provided training at national and state conferences for surveyors and advocates to build their capacity to be partners in culture change. B&F worked with QPRI to train surveyors and providers involved in an Individualized Care Pilot by the Rhode Island Department of Health, funded by The Commonwealth Foundation. In the pilot, surveyors learned how to focus on resident choice in areas of waking, sleeping, bathing, and eating. As a result, nursing homes in Rhode Island made substantial progress in individualizing care. A report on this work, and the training tools developed during it, are available at the RI Dept. of Health website.

B&F led a team helping nursing homes in the New Orleans area stabilize staffing in the wake of Hurricane Katrina. Using a collaborative learning format, B&F helped nursing homes share best practices in leadership and workplace strategies with each other for mutual aid in the process of recovery. B&F also worked with homes affected by Hurricane Rita in efforts to stabilize staffing and advance their culture change efforts. Working with Louisiana Public Broadcasting, B&F and Susan Wehry, M.D. produced a film, “The Big Uneasy: Katrina’s Unsung Heroes,” which captures lessons from the experience.

B&F were the lead consultant to Capital Workforce Partners for two CT projects on workplace learning - a US DoL CNA Advancement Initiative and a RWJ Work-based Learning Initiative. Work-based learning is an innovative approach to education that combines learning in the classroom (in your seat) with learning on the job (on your feet). B&F has helped employers with organizational and operational issues needed to make the learning successful. One key area has been the development of supervisors’ skills to serve as mentors to employees enrolled in classes. This is resulting in better relationships and other positive changes in the workplace culture.

B&F has worked under Extended Care Career Ladder Initiative grants in MA with a number of nursing homes interested in culture change and/or workplace learning, and with a 3-year Connecticut Culture Change and Career Ladder Initiative, which supported 5 nursing homes in CT, using culture change to support workplace education. Under Better Jobs, Better Care – VT, B&F worked with David Farrell to develop a process and tools for collecting and analyzing data to spend smart for staff stability, described in their case study, Achieving Staff Stability: Using Data-Driven Decisions to Re-Examine Industry Norms.

B&F just completed a one-year four state Critical Access Nursing Homes Initiative for Advancing Excellence. B&F helped local stakeholders who serve on a LANE (Local Area Network for Excellence) to support learning collaboratives in Macon, Georgia; Chicago, Illinois; Gary, Indiana; and Cleveland, Ohio through which 17 nursing homes were able to stabilize staffing, improve quality, and restore their compliance status. The Chicago homes presented their stories, “From Nursing Homes in Need to Nursing Homes in the Lead,” to a sold-out audience of peers in October 2011.

B&F is currently staffing a regional learning collaborative in South Bend, IN, co-sponsored by the Community Foundation of St. Joseph’s County and Health Care Excel, the Indiana Quality Improvement Organization. The collaborative is helping individual nursing homes improve staff stability and quality care. One major thrust has been to improve transitions in care by making better hand-offs between local area hospitals and the participating nursing homes.

B&F is staffing a learning collaborative in New York City with the Quality Care Community and the Labor-Management Project, on how to maximize the potential of the MDS 3.0 by putting in place the organizational practices that support staff to know residents well and be able to share what they know with care team partners. B&F is also staffing for the Pioneer Network a National Learning Collaborative on Using MDS 3.0 as the Engine for High Performance. The work includes webinars and in person learning sessions.

With Farrell and Marguerite McLaughlin, Brady and Frank co-authored A Case for Consistent Assignment, Provider 2006.

Brady and Frank co-authored with David Farrell, Meeting the Leadership Challenge in Long-Term Care: What You Do Matters, a book to guide administrators in best practices for stabilizing and engaging staff in positive practical changes to achieve high performance.

  1. Bullet Cathie Brady

Cathie Brady has over thirty years experience providing services and advocating for the elderly in a variety of settings. Cathie brings a background and expertise in organizational development and high involvement leadership. While working for PHI, Cathie directed workforce projects on culture change and workplace education. As Executive Director of the Department of Aging Services for the city of Bristol, CT, she revitalized the Department of Aging through a combination of staff development, developing new services, and making it a center of vitality for the health and well-being of the city’s seniors. She developed an award-winning computer learning lab where seniors, some with no prior experience in computers, learned to teach other seniors computer skills. For ten years, as the Regional Long-Term Care Ombudsman for Eastern Connecticut, Cathie provided leadership in program innovation. She piloted what became a statewide effort to create a more effective, resident-centered ombudsman program. She developed a 50 person volunteer corps consisting of respected community leaders, turning hers into the volunteer opportunity of choice for Eastern CT. Cathie has a master's degree in Organizational Management from Eastern Connecticut State University.

  1. BulletBarbara Frank

Barbara Frank has over thirty years experience in national, state, and local long-term care and workforce development work.  For 16 years she directed policy and program work for National Citizens' Coalition for Nursing Home Reform in Washington, DC, working side by side with Elma Holder, NCCNHR’s founder and Sarah Burger, RN, a long time leader at NCCNHR. There, in 1985, she directed a landmark study, A Consumer Perspective on Quality Care: The Residents’ Point of View. At NCCNHR, she worked on the establishment of the Ombudsman Program and the development of a support center to guide ombudsman work across the country. Frank facilitated the Campaign for Quality Care, a coalition of provider, practitioner, labor, government and consumer organizations that worked to enact the recommendations of the Institute of Medicine’s report on nursing home care into OBRA ’87. She then served for 4 years as Connecticut's State Long Term Care Ombudsman, where she brought providers, health professionals, and state agencies together to rethink restraint use, institute consistent assignment, and individualize care. Frank facilitated the initial gathering from which the Pioneer Network was formed. Working for PHI, she developed and staffed a Massachusetts coalition of consumer, provider, and labor organizations working together to improve support for direct care workers. Through this coalition, Barbara helped establish the Massachusetts Extended Care Career Ladder Initiative (ECCLI). Barbara co-authored “Nursing Homes: Getting Good Care There” and “Health Care Workforce Issues in Massachusetts.” She has an MPA from the Kennedy School of Government. Barbara is a founder and former board member of the Pioneer Network.

 

About B&F Consulting

Based in New England, Brady and Frank work throughout the country.

Contact us by email at:

Cbrady01@snet.net or bfrank1020@me.com

or by phone at:

Cathie Brady 860-334-9379

Barbara Frank 617-721-5385

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