Texas VNA uses volunteers in significant new ways
Texas VNA uses volunteers in significant new ways
Volunteer program can reap big rewards
The Visiting Nurse Association of Texas in Dallas has used volunteers since its founding 66 years ago. Traditionally, volunteers helped extensively in hospice care and provided some office staff support in home care. Two years ago, the agency discovered that home care volunteers could open up a whole new world, saving money and providing services the agency might never have been able to afford otherwise.
"Two years ago, we had to eliminate a position in the quality management department, so we used volunteers to call patients for patient satisfaction surveys," explains Mary Suther, president and chief executive officer of the large agency, which now has more than 5,000 volunteers working in home care, hospice, Meals on Wheels, and elder care programs. Suther spoke about the agency’s volunteer program at the National Association for Home Care’s 19th Annual Meeting & HOMECARExpo, held Sept. 23-27 in New Orleans.
"That worked very well because, before that change, we weren’t getting a good return on our surveys since many older people do not respond well to written surveys," Suther says.
The agency began to look at other needs that might be filled by volunteers. For example, the agency needed an engineer to assess work flow and the physical building and then develop a way to improve processes so the agency could make the best use of its space. Volunteer engineers did that job.
Volunteers even helped prepare for Y2K
Volunteers also have completed special projects in flowcharting, developing databases, writing computer programs, developing the most efficient routes to patients’ homes, and preparing the agency for Y2K. "We have two volunteers who work 30 to 40 hours a week on computer programs, such as helping us develop the kind of management reports we need for the prospective payment system and helping us to create tighter controls," Suther says. "And last year, we had volunteers do the rewiring for fiber optics to make our computer systems run faster."
Before the Y2K conversion in 1999, the agency enlisted the help of a company that volunteered several weekends to install new software in the agency’s computers.
"We also have had volunteers come in and paint the building inside so we wouldn’t have to pay for that," Suther says. "We have had medical students, pilots, and CEOs come in, and the summer of 1999, when we needed a new air conditioning unit, we found volunteers to come in and do all of the work for that."
In 1999, the agency had an estimated $3 million in volunteer labor, although that figure is conservative, Suther says. The agency had used the $10 per hour standard to arrive at the $3 million figure. If the agency had looked at the fair market value of the various skills and time of volunteers, including computer experts who might have been worth $40 to $50 per hour, the dollar figure would have been higher, she adds.
In larger communities such as Dallas, finding volunteers isn’t difficult. But even in smaller cities, home care agencies can beef up their volunteer programs or start new ones by following these steps:
• Use local resources in finding volunteers, especially those with professional skills. Before an agency puts out the word that volunteers are needed, someone needs to write a job description for each specific volunteer assignment.
"We have a volunteer center here in Dallas, and after we give the job description to the center, they recruit volunteers," Suther says. "We also make our volunteer needs known in the community." The Visiting Nurses Association of Texas has formed volunteer partnerships with 150 churches, 40 businesses, and 20 service organizations. "We let them know we need these volunteers with specific skills, and they are very interested in that."
Volunteers also are more willing recruits when they are given tasks that fit their particular skills and talents, instead of busy work, she adds.
• Use the Internet to find volunteers and free equipment. The agency has used the Internet to find companies with skills, equipment, or supplies that could be donated for specific purposes. For the past couple of years, the agency has had its own Web site, which it uses to recruit volunteers.
Community restitution programs also provide volunteers. The agency doesn’t use those volunteers for any tasks involving patient contact or access to patient names or records, Suther says. "Most of these are DUI offenders, and we’ve had everyone from lawyers to presidents of companies. They may paint or stuff envelopes or scrub coolers for Meals on Wheels."
• Treat volunteers like employees. Volunteers, like employees, must provide personal references and, if they will be in contact with patients, permit a criminal background investigation. Home care agency directors need to know the laws of their states before writing guidelines for recruiting and training volunteers. "Volunteers are, in essence, employees who are not being paid," Suther explains.
Volunteers also complete an employment application that is reviewed by human resources. In the past, each department reviewed prospective volunteer files, but there was a problem with consistency, she says. "Some departments were not being as strict as others, so now we have it all go to human resources."
Managers and human resources personnel make sure each volunteer is a good fit with the agency, department, and job. Then the volunteer receives orientation and training, which includes a written job description and a handbook listing policies and competency requirements. Each department provides orientation and training, including written material and inservices that often are conducted by volunteer trainers.
• Provide performance appraisals to volunteers. All volunteers are given an informal annual review, except when there is patient contact and a formal performance review is required. "You talk about the positive things they’ve done and how you couldn’t have done this without their help," Suther says. If a volunteer is not working out in a particular job, the manager might suggest other areas where the volunteer would be very useful to the agency. "Do this diplomatically," she advises.
• Direct volunteers to jobs that better suit them. Suppose a volunteer has been assigned to calling patients to conduct a patient satisfaction survey, but the volunteer is not interested in listening to the casual conversation of a lonely patient. Instead, the volunteer hurries the patient along in order to get through the survey. That particular volunteer might not be the best match for that role because volunteers conducting patient surveys are supposed to fulfill two tasks: to see how satisfied the patient is with the agency’s service and to provide a source of communication to a patient who is lonely.
So the manager could say to the well-meaning but not perfectly suited volunteer, "I noticed you were really good with details, and we could use your skills in this department, doing such and such," Suther suggests.
The Visiting Nurse Association of Texas also rewards volunteers. At an annual awards luncheon, a Volunteer of the Year is selected for each department: hospice, home care, administrative, elder care, and Meals on Wheels. Awards are given for the most innovative volunteer activity, as well as the small and large corporations that do the most volunteering. One year, a school for children with learning disabilities was given an award for having students come into the agency and put together packages.
The agency also provides volunteers with opportunities for socialization by holding regular potlucks for hospice volunteers or coffee gatherings for elder care volunteers.
• Teach staff to appreciate volunteer labor. "When I first came to this agency, we had not used volunteers except for Meals on Wheels and the hospice program," Suther says. "So other departments weren’t convinced the volunteers could actually do the job, and some employees thought volunteers would make their own jobs harder."
Suther told employees that the more precise they were in writing a job description for volunteers and the better the orientation program, the better the volunteers would be. Employees were told to make volunteers accountable for their work and to give them feedback on a daily basis.
Still, some departments have done better than others on accepting volunteer labor. For example, Suther says, the information systems department has adapted very well to having volunteer computer experts.
"They come to me now and then and say they need a certain expert, so I get on the Web and see who is interested in that task," she adds. "We also receive donations of hardware and software and say to companies, Would you be interested in installing that for us?’"
Nurses have a harder time accepting volunteer help, Suther has observed. "They think nobody else can do the job, and sometimes they want patients to be dependent on them even though our job is to work our way out of a job by teaching patients from the first day we go in there."
The key to both staff and volunteer satisfaction is to make sure each volunteer is best suited for his or her job, she adds.
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