1. Culture Change in Nursing Homes: The Case For A National Demonstration
Anne Montgomery
Deputy Director
Altarum Institute

2. Senate Special Committee on Aging: Nov. 30, 2011

3. “Hand in Hand” Toolkit (2013): CMS

4. Institute of Medicine (2008) “Retooling For An Aging America” Recommendations
Payers should promote and reward the dissemination of those models of care for older adults that have been shown to be effective and efficient.
Congress and foundations should significantly increase support for research and demonstration programs that:
promote the development of new models of care for older adults in areas where few models are currently being tested, such as prevention, long-term care, and palliative care.

5. STAFFING: MULTIPLE CHALLENGES, MULTIPLE OPPORTUNITIES

6. “You never change things by fighting the existing reality.
On Building New Models
“You never change things by fighting the existing reality.
To change something, build a new model that makes the existing model obsolete.”
-- R. Buckminster Fuller

7. Culture Change in Nursing Homes: Key Elements
Leadership and governance buy-in and commitment to culture change, including training and an ongoing support structure (e.g., a collaborative of ongoing interaction and shared learning, and/or coaching and mentoring arrangements) for Administrator/Executive Director and other leaders;
Evaluation of existing operational culture and setting of facility goals based on initial evaluation and baseline outcomes;
Assignment of an internal culture change champion, leader or designee who is charged with moving the organization forward and holding it accountable to realize agreed-on goals, and having access to “culture change” experts and an implementation structure that includes on-site assessments and feedback;
Education, support/communication and mentoring staff programs;

8. Culture Change in Nursing Homes: Key Elements (2)
Interdisciplinary teams working collaboratively to implement person-centered care practices;
satisfaction, staff engagement (i.e., commitment and motivation) and retention, infections, use of antipsychotics, falls, pressure ulcers, hospitalizations and readmissions;
Shared learning and collaboration with other facilities implementing culture change practices;
Involvement of residents and family members, as possible, in a range of processes (e.g., workshops, team discussions on quality of care and quality of life, learning circles and formal councils).

9. Pedal to the Medal: Let’s Move!

10. Women Comprise the Majority of the U. S
Women Comprise the Majority of the U.S. Population of Older Adults and Are the Dominant Population in Nursing Homes
Blue Nudes, Henri Matisse, 1952