MDS Alert

This communication technique can hold the key to success.

Sometimes it's not so much about what you're asking your manager for that determines whether you get a yes -- it's how you frame and make the request. That's why you need a game plan to pitch your ideas and requests in the most effective way.

Key point: Rather than just lay out your plans, make sure you consider the manager's perspective, advises Maribeth Kuzmeski, MBA, author of The Connectors: How the World's Most Successful Businesspeople Build Relationships and Win Clients for Life. "A lot of times, staff may ... say to the administrator, 'we know more staff or more resources' or 'what we are doing doesn't work, etc.,'" Kuzmeski tells Eli. But that manager, perhaps only on a subconscious level, may be asking that proverbial question: "What's in it for me?"

Instead: You might say, "If we did this, we'd have better survey outcomes. If we advertised this new program and/or got the local newspaper to write it up, we'd have a better census and it'd be great for public relations," Kuzmeski says. "Couch it in terms of the positives rather than x number of negatives not happening."

Tip: "Public relations often rings a bell with many administrators who might start thinking, 'yes, we need better public relations.' If that happens, then the door is open a little wider" for getting a positive response to your proposal, Kuzmeski adds.

Watch out: If you propose a change or ask for more resources without making your request about the other person, you may find yourself in an argument, predicts Kuzmeski. That's because the person you're talking to might find himself on the defensive and begin raising objections on that basis, she cautions.

That's why you want to come up with the reasons for the person to invest in listening to you, she says.

Example: Suppose you want to go to a conference but training funds are tight. You might point out that if you go to training, you can come back and do in-service training for others, says Francis Battisti, PhD, LCSW, a consultant in Binghamton, N.Y. And that's a win-win for the staff person and the facility.

Simply saying that improved staffing or a new program will improve outcomes may not be enough, however. You may need convincing evidence that will be the case, which requires doing your homework before talking to the administration.

When working as a SNF director of nursing, Rena S hephard, MHA, RN, RAC-MT, C-NE, realized that "you have to speak the language ... spoken by people who make financial decisions and staffing decisions." And that means having "a discussion based on facts and data as opposed to emotion [or intuition]."

Instead of saying: "'We need more nursing staff and here's the proof -- the nurses are working overtime'-- you have to be able to make the case that the job descriptions and designs of positions are appropriate and people are working efficiently," says Shephard, founding chair and executive editor of the American Association of Nurse Assessment Coordinators (AANAC) and president and CEO of RRS Healthcare Consulting Services in San Diego.

Example: "For MDS staffing, you can find out from the MDS database how many of each type of assessment were completed in the last six months," Shephard advises. "Doing the math based on the average amount of time it takes to complete each [assessment]  can be a big help in determining what the staffing level should be." You can get average times from the 2009 AANAC survey, which showed that MDS nurses spent, on average, 2.85 hours on admission assessments, 2.06 hours for annual assessments, and 2.17 hours for significant change assessments. The quarterly assessments took 1.13 hours.

The time doesn't including completing the RAPs or care planning. "AANAC has collected this information from its members," says Shephard. And while it's not scientific, it's the best data available "and can be a big help in determining what the staffing level should be."