Strategies to Fight the Silo Effect in Senior Care

Danielle Myers, general manager, Status Solutions

Senior care facilities need to be able to work cohesively to achieve common goals, but often, that is more difficult than it would appear. The silo effect – the process by which businesses’ employees and even systems become separated and divided – makes this cohesive, unified approach a challenge. It can erode performance and cause employees to feel like they’re operating only within their own teams, rather than together with staff from across the organization.

The silo mentality can take effect rather easily in senior care settings, which means taking an active stance to prevent and fight it is even more important.

Why the Silo Effect Occurs in Senior Care

The silo effect occurs in senior care settings almost by design. Bette McNee, RN, senior clinical risk management consultant at Graham Company, is also a former nurse and has seen the silo effect in action. She attributes the silo effect partially to the education that nurses receive. “As new nurses in school, the focus is so much on that nursing space that there isn’t a whole lot of focus on collaboration and care teams. We don’t get a lot of exposure from therapy or other disciplines. Nursing is its own discipline, so we come out with those blinders on,” she explains.

When senior care operations hire nurses, their orientation and mentor program is all departmental, says McNee. While nurses might meet briefly with other department heads, that exposure is limited. “I think our processes keep people focused on their function,” she says.

Danielle Myers, general manager at Status Solutions, offers insight into how the silo effect can occur when it comes to the tools and systems senior care settings use. “The silo effect occurs because senior care facilities are approached by companies that promise a quick fix to a specific problem, but often these systems fail to address or contribute to improving the overall operation of the facility,” says Myers. “Instead, senior care facilities are flooded with various siloed systems that don’t work together, require separate training, and only solve a portion of the problem.”

Whether a facility’s staff and/or systems become siloed, problems can result. McNee notes that breaking down silos opens up opportunities to improve care. “It’s the residents and their families who really lose out when we function as silos instead of the big-picture,” says McNee.

Myers explains that siloed systems create an extra burden on staff. Though those systems are implemented in hopes of improving elements like communication, working conditions, and workflow, staff then have to learn to use systems that operate separately. The result can be complicated systems, and when staff are already stressed from the pandemic and being short-staffed, the silo effect only creates more work.

Strategies for Combatting the Silo Effect

McNee has found that working together on initiatives can help to reduce the silo effect. She recommends that when department heads have come together and worked on an initiative, it’s resulted in better collaboration and even a shared language across staff. “It’s during those projects that I think senior care has done a better job at trying to gain an appreciation for the part that another department plays,” she says. Those initiatives are often project-based, and they might focus on improving the length of stay or another particular goal.

Though bringing together teams to work on an initiative is ideal, that’s not always possible, especially given the current pandemic challenges. “With the pandemic and the nursing shortage, it’s really hard to get people to communicate – there’s no time,” says McNee.

As an alternative, she recommends that leaders initiate communication by discussing processes that should be improved and by opening the floor for discussion through team meetings and recording monthly staff meetings so all staff can see them. “Say as an organization, ‘We want to do better with this initiative and I want to hear from you,’” she suggests. She also recommends allowing staff to contribute thoughts anonymously, such as through a suggestion box.

McNee notes that residents and their families often have a broader perspective about the silos that exist than staff. She recommends administrators elicit family feedback and then value that feedback. ”It’s important to promote within our departments that that’s a perspective we need to be listening to,” she says.

Myers also feels that upper-level management can play a key role in reducing the silo effect in their facilities. She suggests that they focus on creating a unified solution, rather than fixing individual problems with individual systems. “This can begin by auditing what their senior care facility already has implemented and then integrating those existing systems onto a single platform. Once this is accomplished, only systems that can work as part of this overall solution should be added.”

She also recommends that a facility find a partner who has the expertise to help them create a holistic solution. “Any company that is interested in selling a quick fix won’t be able to help with this,” she says. “Instead, find a partner who takes the time to understand that your senior care facility has unique needs and that is willing to work with you directly to achieve your desired outcomes.”

Preventing the silo effect and breaking down silos that have already been created takes time and deliberate action. However, the results can be a team of staff that’s better able to work together toward goals, and that performs better, as a result. Whether breaking down silos in terms of staff communication or systems, the staff, residents, and their families stand to benefit.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.