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Live Blogging the Maryland Outreach Experience

News
by joe angelelli
Posted on Sat Sep 16, 2006 at 12:20:06 PM EST

The Maryland community forums continue this weekend. Today we're in Frederick, nearing the end of an engaging day involving about 40+ long-term care professionals, family members, advocates, and regulators -- thanks to Homewood at Crumland Farms for hosting us!

The attendees are meeting in groups right now, about to report out about what 5 things they can do to grow culture change in their community right now, with "grow" and "culture change" and "community" all defined by each group. I'm going to post them here in real time as the groups report out:
Group 1

1.Promote small regional family councils to support and maintain ongoing family councils -

2. Bring materials (books, videos) to organizations

3. Approach corporate level to initiate culture change.

4. Get from group physical data that supports culture change -- the business case; financial statistics about costs before and after.

5. Communicate to ALL of the staff within a given nursing home about what's possible with culture change.

6. (BONUS): Investigate grants to help organizations do this -- create templates for organizations to use.
Group 2

1. Appointment with LTC rehab services board (government board in county) to discuss culture change.

2. Take culture change material back to Maryland Occupational Therapy Board

3. Take information back to book club for community participation re: culture change.

4. Have GNAs (Geriatric Nursing Assistants) sit in on staff hiring interviews -- sit in and contribute to.

5. Continue transition of dining services throughout continuum of CCRC community -- from assisted living into skilled nursing -- to keep the same level of service across environments

Group 3

1. Incorporate culture change into the curriculum of nursing, social work, other allied professions -- build it into the system.

2. Involve developers in the culture change process/discussion

3. Illustrate the benefits of culture change to GNAs or others in entry-level positions -- why is it going to help them?

4. Use culture change as a way to adverstise in the commmunity -- tell your story

5. Incorporate individualized services and activities for persons with cognitive impairments.

Group 4

1. Educate a broad spectrum of decision makers about culture change --administrators, board members, etc.

2. Develop group discussions -- learning circles -- to generate ideas about can be done in each organization (include individuals from all parts of the organization)

3. Develop timeline and set goals -- short-term and long-term goals -- initiate small changes that can be done, like changing the language

4. Review what has been done, evaluate it, what worked, what didn't -- what can we do differently to make it work -- emphasize that it's a journey

5. Plan of action -- more specific to include steps we will take for each goal.

Group 5

1. Show film/DVD "A Tale of Transformation" -- get it out in bulk to different organizations -- write grant to make it happen.

2. Look at financial feasibility for household model -- commmunicate on the corporate level re: culture change.

3. Education to the regulatory agencies re: what households are and how they can operate within regulations

4. First steps -- consistent assignment

5. Communicate with "short-term" residents and organizations that support short-term residents about how to incorporate these principles into those practices

Group 6

1. Five meal concept from DVD -- start w/ continental breakfast and share the experience with family to involve them in process; do a cost comnparision re: different serving options -- individualized packets vs. serving in bulk

2. Staff patterns -- look at staff schedules; see how flexibility can be built into the system -- maybe full staff doesn't need to be there at 7am if residents are going to be sleeping later.

3. Crossing boundaries and learning -- get new hires cross-trained

4. Giving residents more flexibilty -- create activity areas where they can do more self-directed activities

5. Look into developing a bath-team with consistent staff for "spa" (and hot towels!)

Now in the comments section we invite those who have attended the other forums (or anyone else please!) to contribute their own action steps in the comment section below -- or just comment on what the Frederick groups have contributed!

< Minnesota Moves Forward | Good News in the Mail >



Outreach (none / 0)

My dad had the idea of having the video "A Tale of Transformation" run on one of the cable channels reserved for "Public, Educational, and Government use".  Although I'm not sure which channel would be the most appropriate forum, I thought it was a really good idea that would raise awareness of the needed changes among people with interest in being involved in public affairs.  It's also a strategy that could be used to develop grass-roots interest and awareness nationally, since cable systems across the country have a similar requirement to provide channels for public-interest use.


The scope of what has to be adjusted in a thoughtful manner is so broad it's intimidating, but as more people from different "industries" become aware and moved to participate in re-envisioning eldercare, the transformation should evolve naturally.  As Joe said today (I'm paraphrasing and hope I'm not putting words in his mouth), the current systems enable us to avoid facing and thinking about the experience of aging and our "third stage of life," and we just can't continue on that path.


I was an attendee at the conference today and would just like to thank Homewood, Voices for Quality Care, OHCQ, and the speakers for providing this conference and the whole series to the stakeholders in Maryland who are aware that we are stakeholders.  (We all have much that is important to us at stake.)  I hope that the communication provided today and the communications that result from it quickly bring benefit to our families and communities.


by LeanneinMaryland on Sat Sep 16, 2006 at 06:57:23 PM EST
Thanks Leanne (none / 0)

Great idea -- there are also local "health" programs on public TV that folks could approach about going on to show clips of the DVD and have a discussion about it.

Thanks for the keeping the conversation going here! The crew is up in Cumberland now, and we will be "live blogging" from there later today...


by joe angelelli on Sun Sep 17, 2006 at 04:55:13 AM EST
[ Parent ]
Maryland Culture from Cumberland! (none / 0)

Here we are again - from about 100 miles west of where we were yesterday! A smaller crowd, but an equal amount of excitement and enthusiasm. We have two groups today, and here are our action plans:

Group 1

  1. Tell our story and invite the media.

  2. Educate the community by holding a seminar and inviting church, civic groups.

  3. Start with small changes and educate resident and family councils. Ask for their suggestions for how to make life better for the residents.

  4. Involve residents and families in actual culture change.

  5. Involve culture change and person centered care in CNA curriculum.

Group 2

  1. To find community partnerships -- churches and or individuals and bring together - and create a culture with broader sense of community.

  2. Create a newsletter that would go to family and staff so everyone would know what is happening, including activities and birthdays.

  3. Continue learning process of culture change. Have it ongoing and continuous.

  4. More positive media coverage.

  5. Educate nursing homes and set short and long term goals. Work with partners to again broaden sense of community.

We miss you Joe! And congratulations!!!!

The Cumberland Crew


by CarolBenner on Sun Sep 17, 2006 at 11:32:59 AM EST
Thanks Joe! (none / 0)

I attended the conference in Frederick and everyone's contributions helped strengthen my commitment to culture change at my facility. Can you make available the PowerPoint slides you used to explain Culture Change? It would be a help in educating our staff about Culture Change.
Thanks,
Mary Sue

by mscochran on Tue Sep 19, 2006 at 12:22:00 PM EST
Presentations from the Conferences (none / 0)

Hi Mary Sue --
We're planning on putting all of the presentations on the Voices for Quality of Care website at the end of October. If there is anything you need sooner, let us know and we'll get it for you!
Carol

by CarolBenner on Sat Sep 30, 2006 at 03:25:01 PM EST
[ Parent ]
More from Maryland - The Columbia Experience! (none / 0)

Hi Friends! Voices for Quality Care held its fifth Culture Change Conference in Columbia, Maryland today. We had the largest crowd yet with over 50 participants! In the afternoon, we did usual exercise and talked about what things we need to do in order to get the culture change movement going in our communities. We had a great discussion and some new ideas emerged. Unfortunately we couldn't do any live blogging because we were in the basement of an old building and couldn't get a have a signal. So, I'm posting a little later. Nevertheless, here is what out groups came up with.

Group 1

  1. Stop the rigid scheduling and stop saying " It's not my job."
  2. Stop whining, moaning and groaning unless you have a solution
  3. Stop denying that a problem exists

Group 2
1. Stop rigid schedules including bathing, dressing medication, toileting;
This has resulted in activities starting late because many residents are still in the middle of activities of daily living.

Group 3
1.    Make the nursing home more like home by encouraging the staff to wear regular clothing
2.    Unlock dining rooms and give residents access to food 24 hours a day
3.    Get the managers out of their offices and have them walk around the nursing home
4.    Do whatever it takes to reduce tunover

Group 4

  1. Be less accepting of what managers say - when he or she says no, challenge the manager and try to engage him or her in a dialogue
  2. Let all residents participate in activities if they want
  3. Stop "clumping" all residents together for activities. Have individualized activities

Group 5
  1. Stop "allowing" and start "empowering"
  2. Stop the concept of "my resident" and "your resident"
  3. Stop making "blanket" policies and start treating people like individuals

Group 6
  1. If a 90 year old with diabetes wants a candybar, let him have it!
  2. Strengthen relationships with advocates
  3. Increase volunteerism
  4. Show less outward signs of medical activities
  5. Have more spontaneous activities
  6. Pay more attention to staff

We're done for today, but have many new thoughts and ideas! There are two more seminars, one in Salisbury and one in Elkton. Both are in Maryland. Please join us!

Be well everyone,
Carol Benner
Consultant, Delmarva Foundation (QIO for Maryland and the District)


by CarolBenner on Sat Sep 30, 2006 at 03:22:22 PM EST
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