Culture Change and Person-Centered Care
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A description of culture change principles. Why culture change works, and why consumers will demand culture change communities as awareness grows. A description of the Texas Culture Change Coalition's history, principles, and how it serves as a resource to spread culture change awareness and educational opportunities. A great start to your culture change journey with a guide to culture change tools and resources.
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Culture Change and Person-Centered Care
- 1. CULTURE CHANGE AND PERSON-CENTERED CARE
- 3. CULTURE CHANGE National movement aimed at improving long term care services for elders and individuals with disabilities.
- 4. THE THREE COMPONENTS OF CULTURE CHANGE Personal Organizational Physical
- 5. THE INSTITUTIONALIZED MODEL Medical Custodial System- Task- Conformity Model Care Centered Oriented
- 6. CORE PRINCIPLES OF CULTURE CHANGE Self Determination Sense of Community Dignity Choice Belonging Support Purposeful Living Contributing
- 7. PERSON-CENTERED CARE Know the Person Individuality and Uniqueness of Every Person Empowerment Responsive, Permeable Environment Person Has Input About Wants
- 8. A NEED FOR CHANGE Leading Organizations in Culture Change
- 10. THE EDEN ALTERNATIVE Founded by Dr. Bill Thomas End the Three Plagues Found in Nursing Homes: Helplessness Loneliness Boredom
- 11. ANTIDOTES Helplessness Purpose Loneliness Companionship Boredom Variety
- 12. EDEN LIFELONG LIVING Applies the Eden Principles to individuals with disabilities.
- 13. SAME PRINCIPLES, DIFFERENT NEEDS Full Life Life Interrupted Nursing Home Residential Home Elders Non-Elders Shorter Term Longer Term
- 14. HOW DO WE GET THERE? Empower Education Residents and Staff Create Get others Urgency on Board Incorporate Feedback Artifacts of Change Improve Improve Quality of Quality of Life Care
- 15. ARTIFACTS OF CHANGE Staff and residents are at the center of the change process! New Paint Self managed work teams Children Elimination of Animals call systems, nursing Plants station
- 16. WHAT IS THE KEY? Complete Support From Leadership!
- 17. Culture Change is NOT a: • quick fix • marketing ploy • new program It is a process that creates a better place to live and work.
- 18. CULTURE CHANGE SUCCESS Research shows that Culture Change implementation increases quality of life and decreases staff turnover.
- 19. CULTURE CHANGE SUCCESS Nursing homes engaging in culture change can not only improve their residents' quality of life, but can also achieve better financial returns. E. Elliot, "Occupancy and Revenue Gains from Culture Change in Nursing Homes: A Win-Win Innovation for a New Age of Long-Term Care," Seniors Housing & Care Journal, 2010
- 20. CULTURE CHANGE AND SATISFACTION Studies have shown that culture change adoption increases family, resident, and staff satisfaction. This leads to decreased turnover and increased occupancy rates. (Seavey, 2004 and Grant, 2005)
- 21. WHERE ARE WE HEADED? In 2011, the first Baby Boomers reached age 65. By 2030, 72 million people will be aged 65 or over.
- 22. CULTURE CHANGE AND CONSUMERS Pioneer Network Study on Consumer Awareness • 97% of consumers strongly agreed or agreed that they would rather live in a culture change community than one that practices a traditional model of nursing care. • 79% of participants indicated the desire to become advocates for culture change. http://www.pioneernetwork.net/Providers/AdvocatingForChange/
- 23. AWARENESS IS GROWING Pioneer Network Reports 39 State Coalitions Today
- 24. • History • Our Principles • Our Objectives • Elders and Individuals with Disabilities • Annual Symposium
- 25. WHAT WE’VE ACCOMPLISHED • First Annual Symposium • Dr. Thomas Visit • Pioneer Network Partnership • Educational Offerings
- 26. SECOND ANNUAL SYMPOSIUM September 28, 2012 Texas State University, San Marcos Keynote Speakers: Karen Shoeneman of CMS Richard Taylor, PhD. Topics: • The Dining Experience • Person-Centered Care Planning • Non-Verbal Communication Skills • Dance Therapy
- 27. WHERE DO WE BEGIN? • Education – Gain Knowledge • Sense of Urgency • Get Inspired • Get the Tools • Get Others on Board
- 28. RESOURCES • Picker Institute’s Long Term Care Improvement Guide • CMS “Artifacts of Culture Change” Tool • Action Pact’s “Culture Change in Practice” Weblog • Pioneer Network Webinars • Eden Alternative Webinars
- 29. PICKER INSTITUTE’S LONG TERM CARE IMPROVEMENT GUIDE • Culture Change Background • Assessments • Tools • Practical Applications • Online • Free http://www.residentcenteredcare.org/
- 30. ARTIFACTS OF CULTURE CHANGE ASSESSMENT • Developed by CMS • Gives practical focus and tips • From Snacks to Self- Scheduling • Online • Free http://www.artifactsofculturechange.org
- 31. OTHER RESOURCES TO EXPLORE Old Age in a New Age: The Promise of Transformative Nursing Homes by Beth Baker What are Old People For? How Elders Will Save the World by William H. Thomas, M.D. The Journey of a Lifetime: Leadership Pathways to Culture Change in Long Term Care by Nancy Fox Life Worth Living: How Someone You Love Can Still Enjoy Life in a Nursing Home by William H. Thomas, M.D. The Silverado Story: A Memory-Care Culture Where Love is Greater than Fear by Loren Shook & Stephen Winner
- 32. A BETTER PLACE TO WORK…
- 33. A BETTER PLACE TO LIVE.
- 34. TAKE CULTURE CHANGE WITH YOU! Small Steps Can Have a HUGE Impact!
- 35. DINING WITH DIGNITY From Linda Bump, MPH, RD, LD Action Pact Listen to some descriptions and examples of the dining experience…What aspects do you see in your own community?
- 36. SOME FOOD FOR THOUGHT… When I think of the dining experience of our residents: I am most proud of... I would most like to change... In a perfect world of unlimited budgets and staff, my dream vision of dining in our home would be… When I’m old, I want my meals to include… Adapted from Action Pact’s workbook, Life Happens in the Kitchen by Linda Bump
- 37. THANK YOU! Sign up to receive emails and see TxCCC news at http://txccc.net
Editor's Notes
- Origins of the CC movement can date back to the mid-90’s with the founding of the Pioneer Network and the Eden Alternative.
- Personal – Mindset change (You support residents in their own home, not “care for residents in a facility”)Organizational – Empower staff to support residents and build relationshipsPhysical – Make it look like home with artifacts of culture change
- This is what most consumers think of when they think of a nursing home. “Don’t ever stick me in a nursing home!”Characterized by loss – individuality, dignity, independenceThe resident conforms to the organization
- The organization conforms to the resident!Turn the institutionalized model on its head. Shift priorities. Provide choice. Support residents with dignity as the central focus.
- Listen to residents! Understand who they are, what their needs are. Create a permeable environment that adapts to them and fosters growth.
- PN – Amazing amount of resources on CC. Umbrella of support for State CoalitionsEA – Leader in CC – Registry process and supportsPicker Institute – Extensive research and support on person-centered carePHI – Consulting Company (Paraprofessional Healthcare Institute) works to improve the lives of people who need home or residential care—by improving the lives of the workers who provide that care.Action Pact – Consulting Company focuses on training and the household model.
- Summary of PCC from PN. One of so many resources they’ve developed.Compare the extreme sides of the spectrum.
- Dr. Thomas’ Story…The three plagues are the most harmful to elders, not medical diagnoses.
- How to combat the three plagues.
- Founded by David Seaton, who owns and operates his own long term care communities for individuals with disabilities.He saw the same plagues in the population that he supported. Adapted the Eden Principles to better reflect individuals with disabilities.
- General differences in the two groups, though very similar.Celebrate and respect the life and accomplishments of elders.Younger individuals need more support through life’s milestones.
- CC is an ongoing process!Must start with leaning more and making it a priority (urgency). Leaders have to prove this through action.Must be willing to listen to feedback and make adjustments.There is no “end date” for CC implementation.Quality of care and quality of life will improve.Be flexible and courageous!
- Very important to note that artifacts of CC are the choice of the elders.If something is added to the home to make it look “pretty,” it needs to be added only if the residents want it.
- Success of CC completely hinges in support from quality leadership. Research has proven this. It is the only way that it can take root and grow.
- There are many benefits that come out of CC, but they are not the main goal. Important to remember that the goal is to create a better place to work and live. Other benefits to business, etc. will come in its path.
- CC accomplishes a quality of life increase, decrease turnover, save on cost of staff, increase family satisfaction, increase employee satisfaction.
- Studies show abundant combined savings from increased staff retention and increased revenue from increased occupancy after CC implementation.
- Satisfaction among residents, family, and staff are all linked. This helps an organization to be well-known in the industry among its competitors (word of mouth, happy employees and residents). Not uncommon for a CC home to have a waiting list for both residents and staff.
- Boomers have never settled for the status quo. They will not quietly shuffle into the same institutionalized nursing homes they were forced to take their parents.Because of their sheer numbers, the long term care industry will have to listen to Boomers wants just as society has throughout their lifetime.
- PN determined that once people know about CC, they want it! Almost 100% of people would prefer it. Once they know about it, they want to advocate for it.Can’t ignore what consumers want, or we won’t be able to keep our doors open.More and more people are going to learn about CC in the coming years.
- CC Coalitions serve a huge role in raising awareness. Almost every state has one now. Awareness is growing and inevitable as we age!
- Founded in the Summer of 2010Important to note that we are unique among state coalitions because we advocate for CC for elders and individuals with disabilities. We know that whatever the support structure, all people deserve to receive person-centered care.We strive to promote culture change principles and provide opportunities to learn more about CC.Our main educational offering is our annual symposiumThe CC movement needs provider champions to share their experiences and get involved! TxCCC is here to support that however we can.
- Our 1st Annual CC symposium in San Marcos was a fantastic success – 250 attendees6 mos later- Dr. Bill Thomas came to the Brookwood Community for individuals with disabilities outside Houston – 200 attendees Successful Certified Eden Associate Training has taken place in TexasContact database of individuals has been developed. Anyone can sign up to receive our emails and news on our website.We were chosen as a partner with Pioneer Network to offer theirwebinar series on CMS 3.0 guidelines in a group viewing formatOur Second-Annual Symposium is on September 28, 2012
- We will focus on implementation and offer great practical ideas for adopting CC.
- Where do I start? Always the question that comes after the “awareness” phase.You can start simple with some excellent online tools…
- This is a brief list of resources. There are many more out there.
- This is an online and free tool.It gives an incredibly comprehensive description of CC and how it can be successfully implemented in small steps.Includes very practical tools from providers.Good discussion of why CC works and benefits the organization and its people.It’s online and free!
- Helps you to see things in your home you may not see.It asks many detailed questions that can help you stay focused on CC stepsBuilds from very basic to more comprehensive topics to help you set goals.You input your data and can revisit it – asks that you complete it at least 2x per year.It’s online and free!Side note: One of the developers was Karen Schoeneman, who is TxCCC’s keynote speaker at our second-annual symposium.
- This is a list of just a few resources with extensive information and inspiration.
- The ultimate goal of CC is to create a better place to work…
- And a better place to live.
- Give yourself credit for small steps and remember the huge impact they have.Every journey begins somewhere.Celebrate victories, large and small.
- This weblog posting can be found on Action Pact’s website. It is a good opportunity to get attendees to think about the dining experiences in their own communities.CC can begin in the kitchen (“the heart of the home”), so it is a good activity to get people thinking about a CC starting place.
- Challenge attendees to answer these questions and take these ideas with them.