S2E14: Leading as a Team: Building a People-Centered Model at The Towers (feat. Jesse Wescott, Tim Smith, and Karisma Quintas)
Rahul
Welcome to Learning to Lead, a podcast about leadership, teamwork, and reimagining healthcare. This podcast is for learners, educators, and healthcare professionals interested in building leadership skills in a supportive community.
We are your hosts Rahul Anand, Maya Doyle, Peter Longley, Amber Vargas, and Brooklynn Weber.
Together we bring you conversations with emerging and established leaders, deep dives and hacks to help you become the best leader you can be.
Maya
Hello everyone and welcome to the Towers Edition of Learning to Lead. I'm Maya Doyle, your host for this episode from the Department of Social Work at QU. Joined by my colleagues Rahul Anand from the School of Medicine.
Rahul
Hello
Maya:
And Pete Longley from the School of Nursing.
Pete
Hello everyone
Maya
And our fantastic med student producer, Brooke Weber.
Brooke
Hello.
Maya
Today we are connecting back to our interprofessional roots and we are talking about leadership, teamwork, leadership as a team and a leadership team As a model for all the people working in an agency or institution. The Towers is an innovative senior living community in New Haven. We are thrilled to welcome Jesse Tim and Karisma the leadership team from the Towers. I'm gonna let them each introduce themselves and then we're gonna talk about the elements of teamwork and leadership that allow the towers to serve and support their residents so well. So I'm gonna toss this, Jesse ,to you first. Tell us a little bit about The Towers and who you are and then tell us about the team that works at The Towers and we'll introduce Tim and Karisma as well.
Jesse
My pleasure. And let me start off by saying that we are humble to be a part of the recording and we hope that we can stand up to some of the amazing recordings that have already happened. The Towers is a, a unicorn of a facility located in Urban New Haven. We've been around since the late 1960s and we have 328 apartments in our two towers. We've got a couple of different subsidy streams through hud. We have some Section eight housing, we have some middle market housing and we also have some pre 1974 prac 2 0 2 housing. And at any given time we've got about 320 seniors, 62 to 104 who live with us. And between our residents, our staff and our direct provider partners, there is over 500 people who call the towers home every day. And that's very, very humbling for us. I found the towers about seven years ago when I came with our current president and CEO Gus Ke Longo from a state pilot demo assisted living in Hartford.
And this was my first journey from a finance and care background into operations. And it's been just an amazing journey. We have built systems and we just cut the ribbon on our 32,000 square foot ground floor project, which gives our residents such an amazing envelope to live their lives. Outside of that, I'm really excited to be here with Tim and Karisma who are really and truly the, the wind beneath my wings. They're the reason why the towers shines. Aside from other parts of our leadership who aren't able to join us are finance department, our foundation. So they're, our team is a little bigger than than the folks you're meeting today and I wanna make sure that they're acknowledged for their amazing work. And with that, I'm gonna pass it over to Tim.
Tim
Thank you Jesse and thank you Quinnipiac for having us. I echo Jesse's remarks there at the beginning. So my name's Tim Smith, I'm the director of Quality Operations here at the Towers. I oversee everything that is related to brick and mortar and I know we'll get into that a little bit more later. But specifically our security and front desk team, renovations, housekeeping, maintenance, so on and so forth, really falls under my purview. I've been here at the Towers for just about a year and a half now, although I have been associated with the tower since 2018. When I met Gus, Jesse and team, I was working for a contract food service and facilities provider operating facilities from Roanoke, Virginia all the way up to Burlington, Vermont. The towers at the time happened to be one of my clients and at one point back a couple years ago, I had a conversation with Gus and Things Unfolded where I had the opportunity to join the team at the Towers here. And after having been with them and associated with them and for a couple of years, seeing how they operate, what their vision was about and how they do things, I was very impressed to the point where I jumped ship from a company that I had spent the last 22 years with and decided to join Jesse and Gus because of their vision for the future of senior living and what the towers does.
Karisma
So I'm Karisma and thank you for having us by the way Maya, this is very exciting stuff. I started at the Towers about three years ago as the resident care manager overseeing the RSC team, the social workers, right. I am at a new role right now, which is the assistant director of resident support. Since July, before I started at the Towers, I worked in an access agency agency on aging coordinating care and support to the elderly. And I jumped at the chance to work at the Towers because of the unique approach they had to support the elderly. One of our guiding principles and our mission is to lead with quiet competence serving one another with care, strength and humility. It is a great to be part of this team, which is genuinely looking to better a marginalized community. So I love this team. This is like where I was meant to be when I finished my master's in social work. It just fits right in to my core values also.
Maya
That's amazing. Karisma. It's so great to hear that. And actually that it transitions really nicely sort of into my next question for you all. You know, we think a lot about interprofessional teams at QU and interprofessional competencies that make healthcare better, that make healthcare work. And I know you are in senior living, which maybe is part healthcare and part other things, but we'll keep that healthcare lens a little bit for today. But one of the competencies that we talk about there is this idea of shared values. And it's so clear from what you've already said, what the shared some of what the shared values are at the towers. But can you kind of operationalize that for us a little bit more about what those values mean at the towers?
Jesse
Absolutely. So I love the segue that Karisma gave us here. And I will say as a whole, we're a small but mighty team. So our core staff is around 50. And then when you add in all the direct providers, we get up to about 200 folks with 50 our Core Tower staff. And when you look at the heart of our values, it's to create an inclusive community to put the person before the task and genuinely connect with them and to find innovative ways to help. And then as Karisma said, to lead with that quiet competence. And really what that means for the towers is that the resident is the center of everything. So all of the services, all of the housing piece that Tim will talk to, all of the model that we have for our support and engagement that Karisma will speak to all keeps the resident at the center.
And part of why it's so successful, or we feel it's so successful, is a couple of things that really lend themselves to what Tim and Karisma really live with their teams, which is tools and permission. So if you have both of those things, there's no reason why as a leader, like Rahul mentioned, you can't just get out of the way. We love quotes. And so like, you know, Spider-Man's uncle said, with great power comes great responsibility. And when you think about what we do at the towers from the housing perspective, we are taking on somebody's loved one. We have an exercise that we do as a group where we bring everybody together and we ask them to put their cell phones on the table and then we ask them to walk away and we ask our, our new teammates how do they feel? And when you think about how that relates to caring for somebody, you know, these are folks who have had a career, who have lived their life, who have raised children, and then suddenly they're supposed to put their entire life in the hands of a group of folks they've never met.
So when we talk about living our values, we really are talking about how do we care for somebody who potentially cared for somebody else, right? How do we pay this forward and how do we live those values? And one thing that I've noticed over time is that when new folks join our team, they either flourish immediately. And that's something that I can say about Tim and Karisma. They jumped right in and they were a perfect fit. We've also noticed the latter that there are folks who join our team and it's pretty apparent after the first couple weeks of newness wear off that this, this just isn't a good fit. And that doesn't say anything about their professional skills, it's just that our Kool-Aid is a little different at the towers. And folks who live our values are assimilated quickly. And the folks who maybe are not do really well in other facilities and we wish them well, but it's very apparent from the start that this isn't a good fit.
And the last piece of of that is that we all have this philosophy that comes down from our president, CEO, that our ideas are organic and the cream always rises to the top. So the tower's philosophy is starting with yes. And so we always start with a yes. And sometimes that yes can turn into an idea that's not feasible, but nonetheless it's always a yes. It's never a no. And Tim and Karisma have been really phenomenal at walking the yes through. 'cause sometimes the yes is a little out of left field. So as a whole to circle back, I think that the real core competency of how we really mesh as a team is, is that everybody there is speaks with the passion that Karisma speaks with, right? When she said she loves being there, it's evident she walks in and the amount of caring that she has for the folks that come into the office when they're in crisis is just incredible to watch. And so I, I don't want to steal thunder from Tim and Karisma as their pieces will be segued in, but you'll hear it from them and you'll feel it from them. And I'm, I'm just so proud of both of them.
Maya
That's so great to hear. Jesse, I know you talked to me a little bit about, you know, how Tim and Karisma's role gets differentiated in terms of pulse and no pulse, <laugh> <laugh>, which I really loved. And I want you to talk a little bit about that and then really thinking about sort of how you use that method to really wrap around the services and support that you provide and, and all of us can kind of think about how we wrap services around the people that we're taking care of.
Jesse
Absolutely. This is Jesse, and I am going to tiptoe my way through this because I want to make sure that Tim has the ability to talk about maintaining the envelope and Karisma has the opportunity to talk about our proactive partner model and how that handles there. So I can say from a, from a top down perspective, when you think about housing and you think about elder care, a lot of times your mind goes to the traditional model of a nursing home or the traditional model of an assisted living and the towers being the unicorn that it is. We are really just the envelope and you can fill your envelope with different providers, you can fill your envelope with different amenities. And so I'm really excited to hear them both talk about that. But from a a leadership piece, the only way that this works is that there are zero silos.
So there are no departmental barriers, there are no, you know, I don't do this, this isn't my job. Or there's absolutely no, hey, a resident told me this, I'm passing it off to you. There's really this underlying culture of ownership. And I want to speak a little bit about kind of how everybody's title has a slash in it. And I know Maya, that was something that you and I had talked about and I watched your face just get very excited. So I wanna make sure we really honor this. So everybody's badge has a title on it because you have to, you know, you have to have a title, you have to have a job description. But everybody's title at the tower is very clearly, and we speak about this a lot, has a slash with a caregiver. So at the end of the day, you're a caregiver, I'm a caregiver, Tim's a caregiver.
Karisma is a caregiver. And so what that means in practice is I can be walking through our community on the way to meet with Tim to talk about capital expenditures and, and large purchases for operations. And I might see somebody sitting down crying. And the expectation for all of our team is that in that moment you stop, you take a knee so that you're on eye level with that person and you say, how you doing? Letting somebody know that I see you. And when we think about a word that we use at the towers is Hamish, which is a Yiddish word that we try to embody as homey and cozy and pleasant. That's really the environment that keeps me invigorated. You know, I go into our building every day and I watch our front desk officers hug people. I watch our food service providers call people by nicknames.
I watch our housekeepers come up and hug folks. I watch our maintenance people walk by and fist bump or talk about the game with residents. And so as you, as you walk through the towers, you can't help but notice that albeit dysfunctional occasionally we are one big family. And I can tell you, looking at origin stories, I couldn't work somewhere where that wasn't the case. And so as, as we're describing this amorphous amazing model to people who have only known what they read on the internet, you know, they need to know who Tim is and they need to know who Karisma is. So the easiest way to segue that is to say that, does my concern have a pulse or no pulse? If it's a pulse that's a person related concern, we want Karisma and her team to spearhead that. They may pull Tim in and if the problem is no pulse, that is my light bulb needs changing or there's something wrong with my TV or, or something like that, that's a no pulse problem, we're gonna push that over to Tim's teams and he's gonna triage that with them. So we found that as, as we try to describe what we do, because I think it confuses people because there's absolutely titles, but then all of us are walking around helping each other with things. It, it's nice to be able to say, you know, Tim and Karisma Pulson No pulse.
Maya
I love that. Pete, I always think about our conversations about sort of making healthcare better and just that idea of breaking down silos, like that's such a different, it's such a different way to think than probably a lot of the institutions that maybe we've worked in over the years. And that idea of really kind of co-branding everyone as a slash caregiver is, is so beautiful. Yeah. Rahul, go ahead.
Rahul
Yeah, so as I'm listening to you, it's beautiful. Uh, and a couple of concepts are coming through. One is what I've read in team of teams by Stanley McChrystal who was spearheading the US charge in Afghanistan at one point. And what he described was having a shared consciousness as you described, like we have shared values and purpose. And then secondly, you've given the tools and permission to the team on the ground so that they can execute without having to be held back or coming back up to you for permission. The other thing which resonates even more is your idea of breaking the silos. And I remember hearing from Paul Leblanc who was the president of Southern New Hampshire University and wrote the book Broken about when organizations become bigger, they try to build these processes to scale things. But what gets lost in that scaling is really the people, because they are now running into these rules and policies and procedures and systems that we've built to scale organizations, but it frustrates the hell out of them when nobody's listening to them and caring for them. And so you describe a beautiful way to break through that, that there are no silos and that it's a simple process, whether it's a person issue and Karisma's team takes care of it or it's a non-person issue and Tim's team takes care of it. So it's very people centered rather than being process or organization centered, which is beautiful.
Jesse
The reason why it works is one of our leadership methodologies is that Simon Sinek esque circle of safety and that comes from the top down. And so to be able to truly say to Tim and Karisma and our other leaders please take risks. And I think that that, that, especially for Karisma has been something that has probably tasted like castor oil because I'm the first one to say, if somebody's making a bad decision, let it play out. You know, let's support them. But we don't necessarily have to give them the cushion, allow it to feel a little raw. And I know that Karisma and her team sometimes come to me and say, how can we make this decision? And I love the fact that they can come into my office and say that and feel it. And my answer back is, you know, we're, we're adults taking care of adults. And so sometimes you have to let our residents make bad decisions. We can give them some guardrails. But as you know, the lessons learned, sometimes you have to let them be who they are. And speaking to your point, Raul, none of this works if as a leader you haven't created that circle of safety.
Pete
I love that. And I just wanted to bring the point that the towers team is actualizing our ideals, right? They're not just the vision and mission put on the wall and they can speak well to it, but it doesn't feel like they're doing it when you're in the space. So that's great and it speaks well to, to the culture because if the leaders are just talking about it and it's not really being role modeled or actualized in real life, I love that you let people fail 'cause they're gonna learn so much more by doing that. Yeah, gotta have guardrails, but you let 'em, 'cause that's gonna stick a lot more to me telling them saying, Hey, you probably shouldn't do that. Or this is probably a better way.
Maya
And it's not infantilizing either to these folks who have lived full lives and have now come to be your residents, right? That they have all this knowledge and skill and, and life experience that they're bringing to you especially. So it's especially honoring, I think to your residents. Brooke, did you have any questions you wanted to ask or observations?
Brooke
I agree with what everyone's saying. I really think that it's amazing that you guys are putting the person that you guys are caring for. Like at the center, I feel like that's something that I hope to do and that's where, that's a place where I would wanna work. And that's also a place where I would want my loved ones to be. So I feel like that is just really amazing.
Tim
Yeah. And this is Tim. Peter, I just wanted to touch on one thing that you also touched on in what, in your previous comments just now about missions and visions and values. You know, being on the wall of so many different companies and you know how the towers walks the walk and talks the talk, if you will. And we truly do. As I stated previously, you know, in my introduction, being with my former company for 22 years and being in the role that I was in, I, I had the opportunity to work with many, many senior living communities over the years who all had different missions, visions and values. And it's unfortunate and somewhat hurts to say this, that of a lot of those organizations, there was a good portion of them that did not practice what they preach. They didn't follow the the words on the walls. And it's so refreshing to know that we do that and why it was so compelling for me to join this organization because we truly do. We really do live and breathe those words that are on our wall.
Pete
That's great. And it sounds like you make it a family environment for the people also of your residents and having a good time and making it livable. Right? You're fist bumping people, it's their life. Right? And you're just characters, isn't it? It's, it's awesome to see.
Maya
I was kind of gonna go back to our, our tools and responsibility conversation from earlier and maybe ask Karisma and Tim if they sort of had maybe examples of that that they could give us things that maybe you've instituted and how it played out.
Tim
So this is Tim. I don't know if necessarily there's been a lot of things that have been instituted. I think it's more just a fostering as you go along because the guardrails are in place, systems are in place, you know, there's always tweaking. But it's just, as I said, fostering what we're already doing and and reinforcing the good that that people do. You know, we talked, started talking about the pulse and the no pulse and the responsibilities, and I know we'll get into this more, but living in the gray as Jesse says, right? We absolutely live in the gray when it comes to the pulse and the no pulse because when you look at that and if it's a people issue versus a physical plant issue, at the end of the day the teams that report up to me, interact, see, visit, and are in the apartments of all of the residents more than anyone else in the building. Whether that's because we're up there doing a room cleaning loads of laundry, a wellness check or turning an apartment and we're interacting with somebody in the hallway. Those are our opportunities as the no post pulse people to interact with the residents and really gives us the opportunity to be able to see, observe, and hear if there's something going on with that resident. And then we've got our conduit with Karisma to be able to work with her team if we're seeing issues.
Maya
That's beautiful Tim. And I know from visiting and having students there at the Towers and and talking with Karisma, right, that individual residents may have all kinds of challenges, right? And what's happening in their home space is often so revealing around, right? The other sort of coping mechanisms and wellness and mental health pieces and Karisma. Maybe you, you wanna talk about a little bit more sort of again that tools and responsibility piece, like where does that fit in terms of meeting those mental health needs? It sounds like that's something that you're really working on.
Karisma
So yes, this is Karisma. Piggybacking on what Tim said about they see the residents, their team is larger than ours, right? They have, he has more staff that go into the residents space more than we do. We have a very high caseload, each social worker has a very high caseload. So for Tim's team it's easier to see what's happening. So what happens in this great place is that everyone takes ownership of what they see. So when they go into that apartment, if it's the lady that's going to pick up the laundry and she sees something that concerns her, that person will reach out to her supervisor and that supervisor will immediately email me, text me, see me in the hallway, where are you? We saw this, this and that. We also have apartment inspections every Tuesday that our staff goes with the maintenance people. But sometimes we don't get to every apartment because there's so many needs. We stay in one apartment or two and that communication remains open. Where if they see something, they say something and it helps us all to be able to see what's happening even before the resident voices their their need. So it's like a proactive approach if you wanna call it <laugh>.
Yeah, and we're always thinking outside of the box, this place is, we always coloring outside of the box <laugh>, there's nobody in a box <laugh> trying, I'm limited with this. No, everybody is in the trenches together trying to make this work. So
Tim
Yeah, well said, Karisma. This is Tim. Just to add on and to finish that off maybe, I think our biggest, most useful tool is, and again not to be redundant, but going back to the slash caregiver, everybody understanding that slash caregiver is all of our responsibilities, all part of every single one of our job descriptions. That's the most useful tool that we have as a team that continues to drive us in the direction that we're going with everybody. Understanding that it makes it so fluid to share concerns, ideas, and information across departments regardless of what it is positive or negative. And when we're all embracing that, it's so great to see because it does make things so seamless. Like Karisma said, we, we will do apartment inspections and what those are is every week we've identified one floor of one of the buildings where we need to go in and we need to do a safety inspection per HUD guidelines.
The residents are aware of it ahead of time. We go through and we make sure that there's no unsafe items or situations in resident apartments. The RSC team comes with us when they're able to, but sometimes get called away and when and if that happens, if my team goes in and observes a hoarding issue or no food in the refrigerator or a pet may look neglected or or something like that, it's easy for somebody who doesn't really believe in that slash caregiver piece to sit there and say, well that has a pulse and that's not part of my job. And just to ignore it. But we, we don't have that here. We have people who are caregivers, so as people that work for the no pulse, that's why it goes back to living in the gray. As soon as they're done with those apartment inspections, they're emailing, they're calling or they're walking up to Karisma's office to say, Hey, here's what I saw in so-and-so's apartment and I think we need to follow up on it. And then to take it even further, that person or those people that do that after a week, if they don't hear anything, they'll come into my office and say, Hey, hey, what happened with this? Because they truly do care. So I think at the end of the day, in our toolbox, in my opinion, that's the most useful tool that we have here is that slash caregiver mentality.
Maya
Yeah, it's so powerful and I, I'm thinking about for those of us that have been in sort of classic healthcare settings too about, I think sometimes we forget about the physical plant around us, right? The facility, the space around us and around our patients and how that we can have responsibility and voice even though the roles may be more siloed and more distinct, but just how important that is because that it becomes often those settings are home for us. Like I worked in one hospital for seven, eight years. I would see it every day. I would see where things were working well or not working well for even my patients who maybe were there short term, but it might not have necessarily been the thought that, hey, we have responsibility to speak up for that. Like no that's somebody else's problem. But that idea of really, you know, seeing it all as something that we can be aware of, the physical space and constraints around our patients, I think is so powerful. How do you keep all of your staff sort of empowered to keep thinking this way, to keep this energy up because it's fabulous but it's also a level of attentiveness that is hard to maintain.
Jesse
If I can start, this is Jesse, echoing, Karisma and Tim. It's a top down methodology and that that even extends to our board. So one of the things that we worked really hard on that I'm really proud of for our team is, and I can't speak to pre 2018, but there never was a, a space for our team to, to have a mindfulness minute or to really truly relax. So as we looked at our ground floor renovation, one of the things that was on my wishlist was to actually create a break oasis for our team who deserves it. So our board heard about this and our foundation heard about this and said we're gonna get, we're gonna jump into, so there is a staff break room that I am just uber jealous of 'cause it's on the other side of campus. And for our team to be able to go in there and because of our partners and our board and grants, we've got VR goggles that are loaded with mindfulness minutes and the ability to jump out of a plane or race an F1 car.
We have a on demand gelato maker that makes gelato in the form of a Keurig cup and it is phenomenal and Tim's always finding some great new flavors and twice a month we load up the counter with all kinds of snacks and things and all those funds are, are brought to us from a donor or secretly we pull some out of Tim's operations budget. But this way if staff are coming into work, leaving work or simply just need a moment, right? Because when you, you deal with caregiving sometimes you just need that moment. I love that they can go into this break space and there it's not just chairs, there's sofas, there's uh, like a high back recliner, there's a TV in there that's loaded with our in-house cable network and you know, you can go in there and take a breath, maybe put your VR goggles on and jump out of a plane or you can have a little bit of gelato or a cup of coffee or a little snack and you can kind of take a break.
And I think that realizing that all of us as slash caregivers are humans caring for humans, having that break oasis is huge. And then I also think about how none of our leaders, I can speak for myself, take themselves too seriously. Like I can say one of my greatest joys in the last three weeks was Tim and I were in the back looking at a physical plant thing. I think we were inspecting the need to reduce some of the refrigeration in the back part of our kitchen. And Tim looked away and by the time he looked back I was over mopping the floor with one of our associates and having a conversation. Because one of the things that I've learned is with our line staff, you never want to come in and tell them, I would rather do something and model the fact that I'm not gonna ask you to do something I personally won't do.
And Tim and Karisma and our other director level leaders exude like just ooze that. And I think that getting back, Maya, to your question about how do we keep people bought in is I think that you have to, you have to take a a second and realize that again, we're human right, everybody's gonna have a bad day. And especially when you have this this gray area where people are kind of working on things together, you're gonna have that friction and you're gonna do the dance and you're gonna step on somebody's toes. And so being courageous and and being able to have those conversations or kind of referencing Brene Brown's marble jar, you know, how can we make sure that we are making deposits enough so that when we have to inevitably take some marbles out of that jar, we can come back and say, you know what, I did you dirty or I didn't recognize you when I talked about this, or I may have bulldozed you a little bit here and I'm sorry. And, and I really look at our team and when that happens, I believe every single one of 'em. And, and it's because they have that heart of the caregiver
Maya
That's really powerful. And I thank you for the reminder about the marble jar. 'cause I think that's such a nice, you know, way to think about what we, you know, what we put in ahead of time so that we can support each other when things get sticky and and difficult. So, you know, you all have been building and supporting this fantastic structure and I know physically right renovating and going through all of all of that in my last couple of visits. And congratulations on that, that project being almost done almost right. Tim, what are the sort of, what are the next, like do you have sort of the next big things? I feel like innovation is something that you're, you try to stay so open to. So what are the next pieces for your team and for the towers?
Jesse
So I'm, I'm gonna be a horrible boss and I'm gonna put Karisma on the spot for a moment because I, I really want her to talk about her insight on how we're approaching a model that we're gonna roll out in January where we're going to do something a little avant-garde and we're gonna separate engagement and support. So Karisma's team is going to do some innovative kind of proactive approach using some tools that we got from our partnership with School of Health Sciences at Quinnipiac, right? Shout out to Nicole Fiza and her group for helping us to develop a part of this. So I wanted, I want to pass this to Karisma and ask her to talk a little bit about what we call the proactive partner model, touching on the three legs of the stool and how that helps our residents know themselves sometimes better than they think they know themselves.
Karisma
Karisma again, so I have a team of five RSCs now with the new one starting next week. And core of what we do is like we utilize a proactive holistic model of wellness, right? And we prioritize early identification of needs and coordinate support across the continuum of care. So what that means is that, like Jesse mentioned, we use validated assessment tools, some that were created by the QU students and the faculty, like with Nicole Feda, through that partnership we use HealthPRO that they use additional evaluations such as the mini cog, the get up and go, uh, failed assessments and the false tracker. And throughout the year we maintain regular touch points with our residents and provide coaching support, collaborating with the teams, with the family to be able to wrap around services for the resident because we want them to age in place, like we mentioned before, we put the person before the task, the team works cohesively to address both planned and emergent needs, prioritizing dignity and autonomy and individualized care over checklists or routine. So we put everything down, whatever is in front of us, that person comes first and whatever tasks we have to do, we just figure it out later on. The ESS we're working on, like I said something with Jesse where next year we gonna formalize more the deliverables that are designed to support the aging in place, such as the assessments that we do, the A DL assessments, the perceived self wellness assessment and the check-in call, which measures isolation and loneliness, all of that. Plus the documenting is essential <laugh>, you know, that Maya,
It, it never happened. So we have thanks to Jesse, I call him the father of the SOAP notes now because he developed a way for our frontline staff from the front desk officers to write an incident report to Dish to us, you know, the information that we need to continue the care for the residents. So it's called Dish soaps
Maya
<laugh>, I love it.
Karisma
So everybody gets a training every year and a certificate showing that we, we are competently doing the documenting and the follow up notes in a cohesive way so that everybody's on the same page. So that's a little bit of what we're working on.
Maya
The evidence-based assessment is fantastic and you know, the way that everyone is involved in documenting and communicating and I mean, I'll just say, you know, for myself with my own experience with other loved ones in senior housing or in an assisted living, even that sense of really checking in on everybody and everyone having that level of communication is not necessarily certainly what I've witnessed in other places. So, you know, this adds to your unicorn status for sure.
Karisma
<laugh>, right? We have our dashboard that we're working on also where all of that is gonna be in one place and we are gonna be able to tap into that data so that we can see what other things are out there that can help support us.
Jesse
This is Jesse. So we, dating back to 2018, started a process to get to know our residents and, and try, you know, we did some surveys, we did some focus groups and what we saw was that about a third of the respondents of the survey reported feeling isolated or lonely and other teams may have shied away from that, but the leaders at the towers really leaned in. And so over the course of about three years, we've developed what we are gonna call the resident engagement platform. And that takes the assessment tool that Karisma talked about that is administered by an OT that was developed using validated tools from ak and that assesses your level of frailty. And then Karisma spoke about a call and the science behind that really marvels me. That is a, a phone call that uses a, an AI driven transcription to look at the psycholinguistic markers in your conversation and it gives you what we call a social quotient.
Basically how lonely are you projecting to be? And then Karisma spoke about the third piece, which was stemming off the off of Dr. Bill Hitler's six dimensions of wellness. And we've been able to take that and morph that into a survey, which I believe was developed by the University of Texas and Austin and showing the no silos piece. We took that research and our accounting manager figured out how to build the weights of each answer using that methodology in Excel and then partnered with our software developer to put this in. So you can take the survey now on an iPad and once you get the answers to that, you're able to have the coaching proactively from Karismas team to say, okay, here are the pathways based on your answers that I think will give you the best bang for your buck and bring you the most purpose.
We're gonna coach and cheerlead and champion you to attend those. And so what we want to do in 2026 is take that platform that's giving us some of these details along with some really great false tracking and then tie that all together with program attendance, those three validated tools and some impressions from Karisma team and be able to get a holistic look and profile of that resident. And then take it a step further to stem off of what Maya said, my, what do they call it? The big audacious dream is to be able to have this system self-generate reporting with some tips and communication tools to the loved ones of the folks that we take care of to say in this past semester, your mom or dad or loved one attended x amount of programs was was lesser of a risk at fall, had a isolation loneliness quotient that went up or down.
And then based on that, have a couple of, here's what you might do and then I'd love to tie that back to please reach out to your resident service coordinator with questions so we can get a dialogue going. Or if you'd like to learn more, here are some links to Tower's website where you can take a look at our programming calendar to give your loved one, you know, maybe a, a print nudge as they say to go to these programs. And through our website you can even build that into your professional Outlook calendar. So you could be at work, get an Outlook reminder, and then call mom and say, Hey, that's that program that we talked about that I think you really love. I think you should go. And then if you want to volunteer, because volunteerism is huge at the towers, here's a link to our volunteerism page with some opportunities.
So we really want to take what Karisma and her team have been doing for many years and bring in some volun, extra volunteerism, bring in those stakeholders and be able to really wrap everything while keeping that resident at the center so that Karisma and her team are able to have more engaged families and have some sort of rapport so that when they need to call and say, Hey listen, we're following up because your loved one came down and we need to quickly get this paperwork in for a Medicare redetermination. Or Hey, there's been a change of status and we're gonna need to bring in assisted living services agencies or, uh, blocks of home care. It's not a cold call. So really wanting to take that feel that we talked about, that Hamish feel of the towers and extend it out further than our community and with Karisma at the helm. I have zero doubt that this is gonna be wildly successful.
Maya
And it is just wonderful that you've really tied in all of this, right? You're tying together that sort of mission and goals and shared values from the beginning to like now. And this is how as a team, as a whole agency and residents, right, you're using technology to do the next thing. Putting your patients at the center like and, and living the value, you know, where we started at the beginning of this conversation. So that's really, that is so exciting. And I think a lot of our listeners are gonna wanna come and work at the Towers, have their loved one live at the Towers <laugh> might be part of, you know, be part of this community that, that you've continued to build.
Rahul
So this is Rahul, what I'm taking away from this incredible conversation, first of all is how great of a place you've built congratulations. And secondly, the major innovation that I'm hearing, which I'm gonna put this on my ID badge right now, is that you've changed the identity of everybody who's in that building to a caregiver. And so by doing that one thing, you've really, across the organization, made it people centered. And I'm gonna put it on my ID right now. I hope I live it up as much as you do. So you've really inspired me for that.
Pete
And Rahul, to go off of you a little bit is that makes it a place you wanna work and it's just not, I work at the Towers, right? It's, I'm at the towers and I care for all the residents, et cetera. It, it's not just an organization, it's a place you want to be. I think two things that I'm taking away is I'm not as anxious, um, getting old 'cause I have a place to go to now you'll feel like home.
So in the Hebrew Hamish, you know, so, um, I love that you have created this and you wanna just keep spreading that. So when I do get older, 'cause I don't think you're all gonna be around still when I, when I need you, but your concepts could be there. So I love it. It's, um, great work.
Jesse
Can I just thank Pete for teeing me up for like one of my favorite quotes. So one of the things that we, we always love to finish with at The Towers is, “We are planting the seeds for trees, which we will never get to enjoy the shade from.” And that is a total plagiarism from a famous quote. But when we think about the fact that Tim, Karisma, and myself stand on the shoulders of giants over the past 50 plus years that have gotten the towers to where it is now and looking to the future where we may build a third tower in the future speaking, I hope for Tim and Karisma and myself, we find ourselves incredibly and humbly fortunate to have landed in this fertile ground where, like Pete said, our ideals and our systems and the the things that we are doing today will hopefully resonate for that next generation and pave the path that one day we will walk.
Pete
Well said.
Maya
I love that. I think that resonates for us so well on the educator side too, right? We're planting seeds that we hope and we have strong sets of values and mission that we hope we're sending our students out into the world in. But we may not see it, but we have to have some sense of trust that this is what we're doing and that, you know, that's what's gonna grow in the future.
Well thank you all for spending time with us here on learning to Lead. This has been wonderful and I don't know, I feel really good after this whole conversation, <laugh> <laugh>. So you brought your magic to the rest of us today. So thank you so much and we look forward to talking to you all again soon. And thank you to our audience.
Brooke
Thank you for listening to our show. Learning to Lead is a production of the Quinnipiac University podcast studio, in partnership with the Schools of Medicine, Nursing and Health Sciences.
Creators of this show are Rahul Anand, Maya Doyle, Peter Longley, Amber Vargas and Brooklynn Weber.
The student producer is Brooklynn Weber, and the executive producer is David DesRoches.
Connect with us on social media @LearningToLeadPod or email us at LearningToLeadPod@quinnipiac.edu.