The Pioneer Network has posted the presentations from their Culture Change symposium online. The presentations are on the following topics:

• Private vs. Shared bedrooms in Nursing Homes
• Lighting: Partner in Quality Care Environments
• Nothing is Traditional about Environments in a Traditional Nursing Home
• Low Cost Practical Strategies
• Creating Home in a Nursing Home: Fantasy or Reality?
• National Fire Protection Association: Codes and Standards Making System
• History, Use and Application of NFPA 101®, Life Safety Code®
• Strategies to Encourage and Nurture Culture Change
• Culture Change Initiative in Oregon
• Individualized Care Pilot for Nursing Homes
• CMS and Culture Change

Click here to see all of the presentations. Use them in developing your culture change initiatives.

The Newshour recently ran an interesting piece on Green Houses. Green houses are “small, homelike settings where care for elders, rather than the demands of the institution, (come) first.” This model is a unique take on culture change that actually changes the physical environment.

According to the Commonwealth Fund there are 4 stages of culture change:

• Stage 1—Institutional model is a traditional medical model organized around a nursing unit without permanent staff assignment.
• Stage 2—Transformational model is the initial phase when awareness and knowledge of culture change spreads among direct care workers and the leadership team.
• Stage 3—Neighborhood model breaks up traditional nursing units into smaller functional areas and introduces resident-centered dining.
• Stage 4—Household model consists of self-contained living areas with 25 or fewer residents who have their own fully functional kitchen, living room, and dining room. Staff work in multi-disciplinary self-directed work teams.

Green houses fall into stage 4. The organization has created smaller houses where there are fewer residents and staff are permanently assigned. Dr. Bill Thomas thinks this is what makes green houses special. He says, “In long-term care, love matters. And the heart of the problem is institutions can’t love.” The setup of green houses allows the group to feel more like a family.

The things that make the green house model different are fairly simple in design. Dr. Thomas notes, “We wanted there to be a heart, a center, a focus of the house. So, you know, what you have in the hearth is sort of food on one end, fire on the other, and a place to share convivium or the pleasure of a good meal sort of in the middle. And this house really does that.”

Green houses are just one of the healthcare models out there to help providers in their efforts to provide more person-centered care. Check out some of the tools available to help you transform your services.

What types of things has your organization done to increase the focus on the resident?