Question

Define and describe culture change movement that is occurring in long term care organizations and connect this to person-centered care practices

Answer 1

Ans) The Culture Change Movement:

-The ultimate vision of culture change is to improve the lives of residents and staff by centering facilities' philosophies, organizational structures, environmental designs, and care around practices that support residents' needs and preferences.
- Institution-centered versus person-centered culture.
-Principles of culture change
-Nursing home culture change competencies for nurses.

Institution-Centered Culture:

-schedules and routines are designed by the institution and staff, and residents must comply
-focus is on tasks that need to be accomplished
-rotation of staff among units occurs
-decision-making is centralized with little involvement of staff or residents and families
-there is a hospital environment
-structured activities are provided to all residents
-there is little opportunity for socialization
-organization exists for employees rather than residents
-there is little respect for privacy or individual routines

Person-Centered Culture:
-emphasis is on relationships between staff and residents
-individualized plans of care that are based on residents' needs, usual patterns, and desires
-staff members have consistent assignments and know the residents' preferences and uniqueness
-decision-making is as close to that of the resident as possible
-staff members are involved in decisions and plans of care
-Environment is homelike
-meaningful activities and opportunities for socialization are available around the clock
-there is a sense of community and belonging "lile family"
-there is involvement of the community-children, pets, plants, outings

Principles of Culture Change:
-care and activities are directed by the residents
-the environment and care pracitices support a homelike atmosphere
-relationship amoing staff and residents are supported and fostered
-increased attention to respect of staff and the value of caring are promoted
-staff is empowered to respond to the residents' need and desires
-the organizational hierarchy is flattened to support collaborative decision-making for staff
-comprehensive and continuous quality improvement underscores all activities and decisions to sustain a person-directed organizational culture.

Nursing Home Culture Change Competencies for Nurses
-models, teaches, and utilizies effective communication skills such as active listening, giving meaningful feedback, communicating ideas clearly, addressing emotional behaviors, resolving conflict, and understanding the role of diversity in communications
-creates systems and adapts daily routines and "person-directed" care practices to accommodate resident preferences
-views self as part of team, not always the leader
-evaluates the degree to which person-directed care practices exist in the care team and identifies and addressed barriers to person-directed care
-views the care setting as the residents' home and works to create attitudes of home
-create a system to maintain consistency of caregivers for residents
-exhibits leadership characterisitics/abilities to promote resident-directed care
-role models person-directed care
-problem solves complex medical/psychosocial situations related to resident choice and risk
-facilitates team members, including residents and families, in shared problem solving, devision-making, and planning.