_ Form a Steering Team to decide what issues need to be tackled first. The best Steering Team will include both formal and informal leaders. Formal leaders are your department heads and others in leadership positions. Informal leaders are those who influence others, even though they may not be in positions of authority.

_ Create a Vision

_ Work to accomplish High Involvement (participation from residents, their families, and staff in all departments, shifts and positions).

_ Develop permanent Care Teams that can grow into Neighborhoods.

_ Engage staff, families and residents in helping to realize residents' Daily Pleasures.

_ Broaden the Leadership Team from Department Heads to include informal leadership (see above).

_ Use a Team Meeting Model to conduct all meetings.

_ Create Study Teams (that will have Steering Team representation) to study innovations in various areas (perhaps dining, creating home, bathing, person-centered rather than behaviorally managed dementia care, etc).

_ Encourage each team to look at what they can do in the short term and what they will need to move toward more slowly. For example, implement a Bathing Team that would review "Bathing Without a Battle" by Joanne Rader and determine how all staff would receive the relevant training. Then, establish a bath team in each neighborhood to begin to fix up each individual bath room.

_ Read Learning Circle article: Power of the Circle by LaVrene Norton and begin to use Learning Circles before and after in-services, as team-builders, as ways to change the climate in the early stages of culture change.

_ Carefully examine the Values of the Pioneer Network and the Principles of the Eden Alternative. Ask yourself how they are similar and how they are different. Where do they overlap? How do we articulate our own values and principles?

_ Pull out your policy and procedure manuals and look through them. Hold each policy up to the light of the principles and values, and write in the margin beside them which ideas they reflect. Perhaps they reflect a person centered culture of care, perhaps they don't. Do they reflect management caring for staff as management would have staff care for elders? If so, great! If not, what can be changed? Create Common Ground and High Involvement as you work through this exercise.