Culture Change and the Arts and Aging

A Guide to Supporting Family Caregivers Through the Alzheimer's Disease Trajectory: Grief and Personal Growth. 

This manual is based on results of a study of 201 spouses and adult children of person's with Alzheimer's disease. It is targeted to professionals and paraprofessionals who work with family members of persons with dementia.
Cost: Free. 71 pages

• Download (pdf 910kb)

Nurse Competencies for Nursing Home Culture Change

In 2008 Hartford Institute for Geriatric Nursing (HIGN) collaborated with the Coalition of Geriatric Nursing Organizations (CGNO) and Pioneer Network (PN) to convene a panel of 31 nursing and other experts to explore opportunities and barriers for nursing and culture change.

The panel worked to answer the question, "what is the role for nurses in achieving and sustaining this change?" The decision was made by a core group of nurses and clinical nurse leaders involved in cultural transformation to concentrate on those competencies that are unique to culture change nursing, building on the work already done to identify specific clinical competencies for geriatric nursing (see www.aacn.nche.edu/Education/gercomp.htm) and Position Descriptions and Related Competencies for Long Term Care Nursing Positions (www.ltcnursing.org).

"Nursing Competencies for Nursing Home Culture Change", release May 27th, 2010, is a result of that collaboration.

http://pioneernetwork.org/Data/Documents/TenCompetenciesReport0510.pdf

From the Pioneer Network press release.

Crane Library Web Pick of the Week: Artifacts of Culture Change

The Pioneer Network has developed an interactive web-based version of the Artifacts of Culture Change tool for providers to input and score their data online. This free tool is designed to measure five specific areas in the culture change journey: care practice; environment; family and community; leadership; and workplace. While you must register, registration is free. Information about your care home is coded and is never identified, although you may compare your data to similar care homes. You are also able to monitor changes in your home periodically. Providers will be able to access current and historical data and are encouraged to complete the tool at a minimum of twice a year; and create high involvement of staff, family and residents in completing the tool and solicit feedback from varying perspectives.

Coming soon: Although providers will not be able to view peers' data, the online collection of consistent and measurable variables will allow Pioneer Network to aggregate culture change implementation measures and benchmark data for homes throughout the country to develop reports by multiple characteristics (such as home size, market concentration, staff hours and census data).

To subscribe to the Web Pick of the Week, go to:
http://www.artifactsofculturechange.org/ACCTool/Default.aspx

Nurses' Involvement in Nursing Home Culture Change

The Hartford Institute for Geriatric Nursing at New York University College of Nursing, in collaboration with the Coalition for Geriatric Nursing Organizations and the Pioneer Network, has published an issue paper, Nurses’ Involvement in Nursing Home Culture Change: Overcoming Barriers, Advancing Opportunities.

The paper, addressed to nursing homes and professional RNs practicing in nursing homes, discusses the move toward culture change—a movement away from institution-driven models of care toward more consumer-driven models that embrace flexibility and patient self-determination.

The issue paper grew out of an October 2008 meeting of an interdisciplinary expert panel of leaders in culture change and in gerontological nursing. The paper summarizes the panel discussion and frames the competencies that need to be developed for nurses involved in culture change and resident-directed care.

Recommendations are provided for nursing homes regarding practicing nurses and for academic programs preparing professional nurses.

http://hartfordign.org/policy/position_papers_briefs/

Culture Change Toolkit

http://www.aahsa.org/CultureChangeToolkit.aspx

The State Investment in Culture Change Toolkit is designed to help states initiate or expand culture change efforts in nursing homes. The toolkit is a collection of programs and activities that seven states created to support culture change initiatives in nursing homes. The materials were collected from a case study supported by The Commonwealth Fund. The goal is to provide other states with this information, so they can learn from these experiences, and to create a network among state governments and other key organizations.

The toolkit organizes the descriptions of the initiatives into three areas:

• Workforce Improvement Initiatives;
• Person-Centered Care Initiatives;
• Continuous Quality Improvement Initiatives.

You can download the programs and activities either through the Full Toolkit or by accessing specific sections of the toolkit: The sections are:
• Introduction and How to Get Started
• Workforce Improvement Initiatives
• Person-Centered Care Initiatives
• Continuous Quality Improvement Initiatives
• Appendix - Resources Outside of Case Study States

The webpage also includes the Culture Change Geriatric Aide Curriculum, designed for certified nursing assistants to become a geriatric aide. The curriculum focuses on innovative nurse aide care and clinical topics such as pressure ulcers, depression, dementia and challenging behaviors, mental health and death and dying, incorporating person-centered care concepts. The curriculum can provide a template for other states interested in creating a similar curriculum.

The curriculum is divided into five main topic areas and several modules within each topic area: Person-Centered Care; Nurse Aide Tasks; Nutrition and Hydration; Challenging Behaviors; and Pain and Palliative Care. The documents listed below include the instructor manual for each topic area, the participant manual for each topic area and the PowerPoint slides that accompany each module.

Implementing Change in Long-Term Care: A Practical Guide to Transformation

The Advancing Excellence in America’s Nursing Homes is now offering nursing home staff an evidence-based guide to preparing, implementing, and sustaining clinical and cultural changes.

Implementing Change in Long-Term Care: A Practical Guide for Transformation (pdf) is a 134-page manual written by Barbara Bowers, Ph.D., R.N., Kim Nolet, B.S., Tonya Roberts, B.S., R.N., and Sarah Esmond, M.S., of the University Wisconsin–Madison School of Nursing, and published in April 2009.

In its introduction, eight chapters, and four appendices, the manual offers various strategies for developing:

• person-centered care and culture change models
• strong leadership
• effective teams
• skilled staff
• preparation activities and organizational assessments
• accountability systems

Each chapter provides an overview of its topic, practical suggestions, and hands-on exercises. The manual also provides clinical training materials in the form of case studies, organizational assessment sheets, and more.

http://www.commonwealthfund.org/Content/Innovations/Tools/2009/Apr/Implementing-Change-in-Long-Term-Care-Bowers.aspx

Holistic Approach to Transformational Change: Changes Idea Sheets

Holistic Approach to Transformational Change (HATCh) model was developed through a collaboration led by Quality Partners, Rhode Island. The model is a guiding philosophy to assist with a a nursing home’s culture change journey and. includes six inter-related topic areas or domains, that lead to individual, organizational, community and systems changes.

The Changes Idea Sheets, which can be issued as an educational tool to help nursing home staff talk about how to improve resident care. These tools include ideas implemented by nursing homes.

The Changes Ideas sheets include the following topics:

Consistent Assignment
Creating Home
Dining
Individual Choice
Pleasant Bathing
Waking and Sleeping

http://www.riqualitypartners.org/cfmodules/objmgr.cfm?Obj=NH_OrganizationalCulture&pmid=121&mid=128&cid=128&clear=yes&bc=Individualized%20Care&bcl=2

Culture Change in Nursing Homes: How Far Have We Come? Findings From The Commonwealth Fund 2007 National Survey of Nursing Homes

On Monday, May 19, 2008, The Picker/Commonwealth Fund Quality of Care for Frail Elders (U.S.) program and the Pioneer Network co-hosted an online meeting, "Culture Change in Nursing Homes: How Far Have We Come?"

The meeting addressed the issues raised in the Commonwealth Fund's national survey of nursing homes designed to learn more about the penetration of the culture change movement at the national level and measure the extent to which nursing homes are adopting culture change principles and practicing resident-centered care. A representative sample of 1,435 nursing homes was surveyed between February and June 2007.

This site reports the study findings, as well as a recording of the May 19 meeting. Also available at the site are related Commonwealth Fund publications.

The site also links to other related Commonwealth Fund program sites, including the Quality Care for Frail Elder site

http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=684709

Culture Change in Practice Blog

Culture Change in Practice: Tools for Changing Nursing Homes with Person-Centred Care

This blog focuses on culture change in long term care. Visit the blog at http://www.actionpact.com/weblog/archive/2005_01_01_archive.html