Moving Toward Person and Family Centered Care

This paper in the "Insight on the Issue" series from AARP looks at the concepts and key elements of person and family centered care with the elderly and their families.

http://www.aarp.org/content/dam/aarp/research/public_policy_institute/ltc/2012/moving-toward-person-and-family-centered-care-insight-AARP-ppi-ltc.pdf

Moving toward Person- and Family-centered Care

This report from AARP defines person- and family-centered care, and outlines the central tenets of each caring philosophy. It explains that family caregivers can be an invaluable source of care for their loved ones. The paper argues that public policies should be instituted to provide greater support to these caregivers, particularly when it comes to supporting them and coordinating care among nurses, direct-care workers, and other professional caregivers.
http://www.directcareclearinghouse.org/l_art_det.jsp?res_id=314410

Financial Implications of the Green House Model

Published in Seniors Housing and Care Journal, 2011, V. 19(1), this article by Robert Jenkens, MSRED; Terri Sult, MBA; Newell Lessell, MBA; David Hammer, MS; Anna Ortigara, RN, MS, FAAN examines the initial and long-term financial viability of THE GREEN HOUSE® model. Developed by Dr. William Thomas and rooted in the tradition of the Eden Alternative, The GREEN HOUSE®model is intended to de-institutionalize long-term care by eliminating large nursing facilities and creating habilitative, social settings. Existing research establishes that the GREEN HOUSE® model nursing home care provides significant and sustained satisfaction and clinical improvements when compared to traditional nursing homes. Recent research on the financial implications of the Model, although inconclusive, have pointed to some mutually reinforcing findings to recommend the model as a strong option for organizations to explore as they seek to address current and future challenges in their nursing home operations and markets.
http://thegreenhouseproject.org/wp-content/uploads/2011/09/NIC_2011_SHCJ_GreenHouseArticle.pdf




To learn more about the GREEN HOUSE® model, check out the web site at: http://thegreenhouseproject.org

The Impact of a Regulatory Intervention on Resident-Centered Nursing Home Care: Rhode Island’s Individualized Care Pilot

Overview

In an effort to use the annual nursing home survey process to promote resident-centered care practices, the Rhode Island Department of Health implemented the Individualized Care Pilot from November 1, 2007, to April 30, 2008.

The initiative promoted resident-centered care primarily through activities integrated with the annual recertification inspection. In addition to enhancing existing survey processes, the pilot incorporated a visit from the state Quality Improvement Organization into the survey process itself.

This study assessed the impact of that pilot on resident-centered care practices. Online surveys were sent to administrators at all Rhode Island nursing homes pre- and post-pilot. Based on reports from participating homes, the pilot helped nursing home administrators understand, consider, and implement resident-centered care. The findings paint a promising picture about the potential to spur provider change through a multipronged approach centered on the regulatory process.

Person-Centered Care: Teaming up to Make the Change

New from the Kansas Advocates for Better Care, this a concise and clear guide to implementing person-centered practices, including team building, staff assessment, an introduction to restorative care and to restorative care activities, and information on abuse.

Kansas Advocates for Better Care is a not-for-profit, membership organization whose services
are free to all Kansas Citizens and persons caring for Kansas Citizens. The site contains a number of useful documents. (http://www.kabc.org).

http://www.kabc.org/pdfs/teaming-up-to-make-the-change.pdf

Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

From the Commonwealth Fund, "In the Literature: Highlights from Commonwealth Fund-Supported Studies in Professional Journals."

This document summarizes an article published online in The Gerontologist, in Aug. 19, 2009, which examined a partnership between an New York City nursing home union and 30 nursing homes to help implement "person-centered care" at the facilities. Results showed an improvement in quality of life, with residents gaining more autonomy and privacy and many employees experiencing greater job satisfaction.

The Commonwealth Summary document is available at:
http://tiny.cc/jeGgQ

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/

Crane Library Web Pick of the Week: Best Practices Toolkit

The Best Practices Toolkit is compiled by the Long-Term Care Best Practices Initiative Team, an initiative led by the Registered Nurses Association of Ontario, which had its origins in a three- year pilot from the Ontario Ministry of Health and Long-Term Care.

The goal of the 'Long-Term Care Best Practices Initiative' is to support long-term care homes in adopting evidence-based practices that will support systematic and consistent approaches to providing quality care for residents. The Toolkit is intended to be used by LTC home staff to support their efforts in best practice implementation. It is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Initiative team.

The five toolkit topics are:

• Client centred care
• Continence and Constipation: assessment and management
• Falls prevention and management
• Pain assessment and management
• Pressure ulcer risk prevention, assessment and management

Each topic is divided into the following sections:

• Best Practices/Standards
• Assessment Tools
• Planning & Implementation Tools
• Quality Improvement Tools
• Additional Implementation Resources
• Policies and Procedures
• Care Planning
• Education Resources
• Evaluation
• Recommended Readings/References


http://ltctoolkit.rnao.ca/content/introduction

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

Rethinking the Nursing Home: Culture Change Makes Headway in California

This issue brief (December 2008) from the California HealthCare Foundation, looks at person-centered care initiatives in California nursing homes.  The brief looks at the long-term care support system, barriers to improvement, financing and payment rates, an overview of culture change, and models for change. Although the brief focuses on California nursing homes, much of this information will be of interest to health care professionals, residents, or families interested in person-centered care.

http://www.chcf.org/documents/chronicdisease/RethinkingNursingHomeCulture.pdf

Patient-Centered Care Improvement Guide

This guide is designed as a practical resource for health care organizations that are striving to become more patient-centered. It contains best practices and practical implementation tools contributed by hospitals from across the United States. The Self-Assessment Tool can help identify and prioritize opportunities for introducing patient-centered approaches into your organization.

This Guide was funded by Picker Institute, an international non-profit organization that supports research in the field of patient-centered care.

A PDF of the Guide is available for download from the Planetree website.
http://www.pickerinstitute.org/Patient-Centered%20Care%20Improvement%20Guide%2010.10.08.pdf

Person-Directed Dementia Care Assessment Tool: A guide for creating quality of life and successfully refocusing behavior

This tool was developed by the State of Wisconsin, Department of Health and Family Services, Division of Disability and Elder Services to be used as a guide for identifying the elements involved in implementing a person-directed dementia care.

The nine sections of the tool examine specific areas of focus vital in providing person centred care, emphasizing culture change elements. The goal is to provide as much planning to meet an individual's social and emotional needs.

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

See Me, Not Just the Dementia: Understanding People's Experiences of Living in a Care Home

This report from the Commission for Social Inspection (England) and released in June, 2008, is based on a study of 100 care home inspections in England. These inspections involved examining directly the experiences of people with dementia. Inspections were guided by a series of questions pertinent to people's dignity and respect.

The report is divided into two parts. Part One provides the findings from the report, and Part Two describes the use of Short Observational Framework for Inspection (SOFI, the Commission for Social Care Inspection's tool for inspectors. SOFI, a methadology still under development, looks in detail at people's emotional well-being, how they are engaged throughout the day, and how staff relates to them).

The full report is available in standard printed form, and also available as an interactive CD-ROM. The electronic format is a pilot version, and includes filmed interviews and good practice discussions.


For a PDF version, and further ordering details go to: http://www.csci.gov.uk/about_us/publications/dementia_report.aspx

Resident Centred Care Resource Kit

Directors of Resident Care from Windsor-Essex LTCHs came together in fall 2006 to form the Essex Long-Term Care Best Practice Workgroup. Their first project was to review the RNAO Best Practice Guideline on Client-Centred Care and adapt the recommendations to meet the care needs of residents living in Windsor-Essex LTCHs.

http://www.rgpc.ca/best/BPC%20-%20Resident%20Centred%20Care/Resident-Centred%20Care%20Resource%20Kit.pdf

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