The 2nd Pioneer Institute is off to a great start today in Chicago. I've been attending the Getting Started pathway led by Sue Misiorski and Joanne Rader.

I've had some good conversations with folks active in the Illinois Pioneer Coalition. I will be adding Illinois to the list of states over to the left there soon.



I'm particularly impressed by the within-Illinois regional coalitions that are active around the state. The Southwestern Illinois Pioneer Coalition for Culture Change has its own website.

Update [2005-8-1 15:12:41 by joe angelelli]: The second half of Sue & Joanne's Getting Started pathway produced some great discussions about learning circles and how they allow more voices to be heard.

Joanne showed a clip from Almost Home that featured a nurse talking about the convenience of a med cart and how putting the meds in a locked medicine cabinet in each resident's room is not practical. The participants then met in small groups to model a learning circle and discuss ways to address the med cart.

During the follow-up discussions several points emerged:

Revolution & Evolution -- It's not an either/or question, it's both.

This afternoon Steve and LaVrene handed out an oversized copy of the "Norton-Shields Change Matrix for Progession to Households," a worksheet that (based on my discussions with attendees over break) really crystalized what the morning and early afternoon discussions were building toward.

They had some good points about what it takes for people to be ready to consider the question of "what steps should we take?" One can't simply plop down the Change Matrix in front of someone and expect them to locate themselves. The morning work of connecting with the heart and soul was critical for laying the groundwork for understanding with the mind.

They also made the distinction between "improving upon the base of what is" versus "changing what is."

Steve said, "Revolution means we're going to reframe, reshape, and completely rebuild on new assumptions of how elders live." He spoke about "living out" the framework for change, about the need to "evolve it" to its full potential.

LaVrene noted how leaders need to internalize the shared sentiment that "we're going to go all the way with the change." "We're not just going to involve family members -- family members are going to be integrally involved. We're not just going to do away with hierarchy -- we're going to create self-led teams.

LaVrene noted that "culture change is not about just changing bathing schedules and doing little interventions in dining, it's got to be about making home.

Lots of good learning happening in the Rose City today. Now it's off to a reception by the newly formed Oregon Coalition called:

MOVE: Making Oregon Vital for Elders

I'm in Portland "live blogging" the first ever Pioneer Institute.

Nearly 200 people from around the Northwest were treated to an inspiring welcoming talk by Steve Shields of Meadowlark Hills. Steve called this culture change work "revolutionary, then evolutionary" and to me that phrase captures so much of what we're trying to do within long-term care settings and in the broader community (and on-line!)

It's an insight that some find a little unsettling - that this is not about "improvement" in classical terms. It's more radical -- but not in a political sense. It's radical in terms of the assumptions it makes about how leaders must fundamentally change their own mindset before any deep change can happen.

So I'm left wondering, how do we "not settle" for a limited improvement mindset and instead make it truly transformational change? Any insights from the QIO folks out there?

I'm off to attend Steve & LaVrene Norton's session on leadership.

Update [2005-7-12 15:22:43 by joe angelelli]: I just had lunch with QIO folks from Oregon, California, & Minnesota. They're really doing some great stuff.

Update [2005-7-12 15:22:43 by joe angelelli]: I had intended to float from Institute Pathway to Institute Pathway (there are five), but I'm learning so much from Steve & LaVrene that I'm staying in this session for the remainder of the day. Tomorrow I will visit the other Pathways and describe each of them to give whomever might be visiting a sense of what's going on...

The five Pathways are: