We need to start late and end early since many participants will be driving an hour or more to attend.

Please keep in mind that these conferences basically have 2 purposes,

1. Spread the word about Culture Change
   
2. Bring family members and family councils into the culture change process as equal players

Think of this as preparing for a traveling road show.

We can do this several ways.  Joe, can you email a copy of your PowerPoint presentation to at least a few of us?  It won't give us your words but it will give the basics.  Can you send me a copy of the DVD and the Getting Started packet?

Carol, can you email your PowerPoint program to a few of us or would you prefer that we try to set up a meeting during the last half of May where you could do it for us?  If we do that, we can also have a face-to-face planning meeting.  I can try for time at Holy Trinity for that if we want to do it.

Sept 9 & 10--Waldorf/Washington
Sept. 16th & 17th--Cumberland/Frederick
Sept. 30--Columbia
Nov. 18 & 19.--Elkton/Salisbury

Sept 9 -- Waldorf
   Presenters: Joe, Carol, Sandee
   Crew:  Kate, Bob, Dianne
Sept. 10-Washington
   Presenters: Joe, Carol, Sandee
   Crew:  Kate, Bob, Clare
Sept. 16--Cumberland
   Presenters:  Joe, Carol, Sandee
   Crew:  Kate, Bob, Otto
Sept. 17 --Frederick
   Presenters:  Joe, Carol, Sandee
   Crew:  Kate, Bob, Otto
Sept. 30--Columbia
   Presenters:  Joe/understudy, Carol, Sandee
   Crew:  Kate, Bob, Sharon
Nov. 18 .--Elkton
   Presenters:  Joe/understudy, Carol, Sandee
   Crew:  Kate, Bob, Sharon, Pat
Nov. 19 --Salisbury
   Presenters:  Joe/understudy, Carol, Sandee
   Crew:  Kate Bob, Clare, Margie

And that brings us to who will volunteer to be understudy for Joe?  From past mini-conferences, I know that can't be me.  Just doing the intro and the transitions will be pushing it.  I always end up juggling trying to handle all the issues that come up at these things.

The framework should come from the content of the conferences,  from the projection of the pilot project, and from our vision of the perfect outcome future long-term care in DC/MD/DE.  

We won't spend a lot of time on this until we get the mechanics of the conferences and the pilot project worked out but, as we go through the process, keep it in mind and post any thoughts you may have here.  We'll go back and pick them up as soon as we have the time (or can coerce someone into organizing it).

Thank you, thank you, thank you!!  You scheduled the conference in Columbia on a Saturday, where more people will attend.  This is going to be the biggest conference of all of them in terms of the potential people we invite.  Love it!!

Bob

Over the weekend I will summarize what Kate has contributed in the comments above and place them in the main body of the thread.  

CULTURE CHANGE PROJECT

PURPOSE:

*To bring the concept of Culture Change to the attention of the general public in all parts of Maryland.
*To make family members and family councils an integral and equal part of the movement.

OBJECTIVE 1:  CULTURE CHANGE CONFERENCES

PURPOSE:

*To bring solid, factual information on culture change to residents, family members, family councils, local and state elected officials, ombudsmen, AAA personnel, long-term care facility staff and administrations, and the general public.

*To send a message regarding the imperative of including family members and family councils as an integral key player in the success of this transformation.  

*To make the general public familiar with or more familiar with Voices for Quality Care, The Pioneer Network, and other partnering groups as sources of information and assistance in this process.

PLAN:

*Provide conferences in locations making all parts of Maryland within a 540-moile radius of a conference.  Include Delaware in radiuses.

*Develop one agenda for all conferences.  Use different speakers if necessary and/or train in place.

*Since these will be regional conferences, we can probably expect a smaller audience--less than 60 people at each.   Churches/ nursing homes/ large assisted living facilities/ CCRCs/ public facilities are possible places to hold these conferences without renting space.

*Grants are available for this kind of activity as are gifts from other organizations if we get moving on them soon enough to receive them before we need to hold the conferences.  We will plan these conferences in the initial phases, however, as if we must do them with Voices resources only.

GEOGRAPHIC LOCATIONS:

1.  Cumberland
   
2.  Frederick
   
3.  Washington DC--The Washington Home
   
4.  Columbia
   
5.  Waldorf
   
6.  Elkton
   
7.  Salisbury

9:30-10:00 AM          Coffee & sign-up
10:00-11:00 AM:          Culture Change on the National Scene
            Joe Angelleli
11:15-12:15:        Culture Change on the Local Scene
            Carol Benner
12:15-1:45 PM:        Lunch  & The 4 Phases of Transition
2:00-3:30 PM:        Culture Change on the Personal Scene
            Sandra Merrigan-Harrison   

PROPOSED DATES:

Sept 9  (Saturday) --Waldorf
Sept 10 (Sunday)   --Washington
Sept 16 (Saturday) --Cumberland
Sept 17 (Sunday)   --Frederick
Sept 30 (Saturday) --Columbia
Nov. 18 (Saturday) --Elkton
Nov. 19 (Sunday)   --Salisbury

BUDGET:

    Rough estimate.      6 hotel rooms per conference is the max.  In most instances we won't need that many.
            That is 3 for presenters and 3 for organizers.  

        Mileage rate is business rate for Sept-Dec of 2005 for the IRS.  Between Jan and
Sept. of '05 it was 40¢ per mile.  Private vehicle for govt. use for '06 is 44.5¢/mile.  I
used a distance from Washington DC to wherever as the basic distance just to have an idea of how far people might have to travel.

The actual expenses to do this well will be approximately $15,000 if we average 40 participants at each conference and $20,000 if we average 80 participants.

For 7 Conferences:

Hotel rooms    $3,000.00     
Mileage    $1,148.10     
Food  (40)(80)    $4,200.00    $8,400.00
Hand-outs (40)(80)    $1,920.00    $3,840.00
Space rental    $1,200      
Publicity    $1,400      

Total    $12,868.10    $18,988.10

POSSIBLE FUNDING SOURCES
    AARP-funded most of conference in VA
    SEIU
    OHCQ
    Delmarva  (QIO)
    Commonwealth Fund

    We will also put out the donations jar so we may collect some funds from one conference
    to fund the next one.

PARTNERS & ASSISTS
    The Pioneer Exchange
    The Pioneer Network
    Delmarva

OBJECTIVE II:  THE PILOT:

At this time, most of the emphasis and resources in the Culture Change movement are directed toward
industry associations, corporations,  individual facilities, staff, licensing agencies, QIOs, and
ombudsman. The ways each of those groups participates in projects has been and is being documented.  Guidelines, educational materials, pitfalls, suggestion, and cautions have been and are being developed.   You'll notice that residents, family members, and family councils are not on those lists.  We think they should be there, in alphabetical order, along with all the others.  Unfortunately, since there has been little resident/family participation to date, there is little in the literature or elsewhere to use as a guideline for the inclusion of residents, family members, and family councils as equal participants in this process.

PURPOSE:

* To develop working models of family council participation in Culture Change projects that can be used
  by QIOs, Culture Change organizations, and long-term care facilities in Maryland and in other states.
    *To document the benefits of full family participation as well as to identify any pitfalls of that
  participation and explore remedies for them
*To make family participation an integral part of the Culture Change process in the   Washington/Maryland/Delaware area.

PLAN:
    *Five nursing homes will be selected for the pilot.
        *Requirements:
            *Nursing homes must have a functioning family council with a reasonable
  working relationship with the administrator of the facility
            *The facility must either currently have embarked on a Culture Change journey
              or plan to begin one.
            *Both the facility and the Family Council must agree that the Family Council
              will work with the facility as an equal partner with residents, staff, and the
              administration for the duration of the project.
            *Both the family council and the nursing home must commit to seeing the
             project through with good intent
            *Both the family council and the facility must agree to share their
  experiences in Culture Change so far as the family council/facility partnership
  is concerned with the other facilities in the pilot program
*Both the family councils and the facilities must agree to share their joint
  experiences in a documented format to be shared with other facilities and
  organizations involved in Culture Change
*An escape hatch will be provided
    *Community mediator?

*The Pioneer Exchange will provide:
*A total of 10 copies of their Getting Started program.
            *Two will go to each facility, one to the family council and one to the facility
itself
        *A private space on the Pioneer Exchange web site for sharing ideas, successes, concerns,
        remedies, and general comments and observations between the 5 groups

ANTICIPATED EXPENSES: None

Some of the organizations we need to contact are listed below.  If someone has agreed to work on them, the name is listed.  If you want to work on one of the unassigned organizations, just post a note here letting people know you are doing that so we don't have 3 people all contacting the same organization.  If you have other organizations to add, post them in a reply and let's have a discussion and a consensus on whether or not to include them..

MD Office of Health Care Quality--Kate Ricks--grant request for partnering and $10,000 sent April 18

AARP DC:  Partner & funds:  Sandee Merrigan-Harrison

AARP MD:  Partner & funds:  Clare Whitbeck

AARP DE:  Partner & funds:  Pat Englehardt/Sandy Dole

United Senoirs of MD:  Partner:  Clare Whitbeck

MD Dept. of Aging:  Partner:  Clare Whitbeck

SEIU:  Partner & funds:  Kate Ricks:  Initial contact with MD legislative person:  April 17 (We'll want to also contact the national office)

Multiple Sclerosis Society:

Alzheimer's Association:

The ALS Association

The Arthritis Foundation

How about the licensing agencies and Depts. of Aging in DC and Delaware?  Others?

MD Office of Health Care Quality--Kate Ricks--grant request for partnering and $10,000 sent April 18

AARP DC:  Partner & funds:  Sandee Merrigan-Harrison

AARP MD:  Partner & funds:  Clare Whitbeck

AARP DE:  Partner & funds:  Pat Englehardt/Sandy Dole

United Senoirs of MD:  Partner:  Clare Whitbeck

MD Dept. of Aging:  Partner:  Clare Whitbeck

SEIU:  Partner & funds:  Kate Ricks:  Initial contact with MD legislative person:  April 17 (We'll want to also contact the national office)

Multiple Sclerosis Society: Sharon Christie

Alzheimer's Association:  Sharon Christie

The ALS Association:  Sharon Christie

The Arthritis Foundation:  Sharon Christie

We need to identify the people in this category who will be attending each conference.  Then, with their permission, I suggest that we give them a different colored name tag and make an announcement that they are available for questions, etc.  This will make it easier for attendees to get their questions answered and to enter into discussions on points that are of interest to them.

As you know, we planned and organized the conferences from a widely scattered geographical base.  Our primary contacts were the Pioneer Exchange and email.  We have never been fortunate enough to have all of the Planning Committee members in the same place at the same time and likely won't.  Still, we were able to come up with what we felt was a good program.  We are learning now as we move from one conference to the next that flexibility in that plan and continual "tweaking" are essential.  

Our program has a keynote speaker (Joe at all conferences except Columbia, Karen Schoeneman at the Columbia conference) giving an overview of what Culture Change is and what's happening around the country.  The second speaker (Carol Benner) focuses in more on how this impacts the individual resident and on what is happening around the state of Maryland.   We show the DVD "The 4 Phases of Transition" during lunch making a morning full of information that we are giving to our attendees.  We've also added an innovative "non-scientific" scientific survey on the most important elements of "quality care" that Carol will share with you in another message.

The afternoon session has evolved into a time when our attendees, in discussion groups, give back to us and to each other.  This is perhaps the most exciting part of the day, the part where the rubber meets the road to use a cliché.  This is Culture Change happening.  In this afternoon session, our attendees take us from theory to practice, from vision to reality.  Each of these groups is composed of individuals from all the various parts of long-term care working together in the same space and time.  Within them are the people who have the answers to all of our Culture Change questions.  We just need to keep the talk going long enough for them to find those answers.  And, to listen carefully so that we hear them when they do.

We are discussion what kinds of things can we do next week to grow culture in our communities. The participants say:

1. Change the bathing experience. Get towel warmers and personalize the bathing experience.
   
2. Get a webcam for resident computers to improve communication between families and residents.
   
3. Mailboxes and shadowboxes really bring home the point that a resident's room is HOME.
   
4. A serenity is a grea idea too.
   
5. Educate staff that the reasons we have our jobs is because of the residents and we need to care for them.

1. Stop doing things for staff convenience
   
2. Stop rotating staff through different units and initiate consistent assignment.

We also had a side discussion about HIPAA and how it is often used an excuse for not doing something. FOr example, is putting a shadow box or a picture of a resident outside a resident's room a HIPAA violation?)

Back to the central theme here --

3. Stop the "It's not my job" mentality and get some teamwork going.
   
4.  Stop using chemical and physical restraints.
   
5. Stop using alarms to keep residents in beds and chairs.

That's it for today. It was a small group, but certainly valuable. The folks at the Salisbury Nursing Home were most hospitable and fed us the same lunch as the residents had. We had several residents come in and out of our meeting and participate. Mary Rogers from the Delaware QIO was there and spoke about activities from the Delaware perspective. We also had participants from the Delaware provider community and ombudsman office. And, Sandy Dole was there too and gave a presentation. We missed Joe Angelleli,one of our usual morning speakers, but Kate did a dynamite substitution.

Thanks to everyone!
Six down and one more to go in Elkton Maryland!

Carol Benner