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Provider Tools, Articles and Links

Tools for Change

Vol.1, No 1 Artifacts of Culture Change Benchmark Reports, 4/1/10-3/31/11

Vol.1, No 2  Positive Outcomes of Culture Change: The Case for Adoption

MDS 3.0 as an Engine for High Quality Individualized Care

MDS 3.0 Resident Assessment and Care Screening Form

Business Case for Adoption

An Editorial and Technical Brief on The Household Model Business Case
Steve Shields, a foremost and leading expert in the field, and David Slack author this definitive work establishing financial feasibility of the household model with financial data on staffing and operations budget by house size, financial analysis of optimum number of houses in a project, and the other key ingredients necessary to establish your own household model business plan.

Quality Partners of Rhode Island Staff Stability Toolkit
This toolkit incorporates experiences and lessons learned in over 400 nursing homes. It is designed to serve as a resource for homes just getting started with efforts to reverse turnover as well as employers who have already started to address recruitment and retention and need further assistance in a specific area.

Investing in Culture Change - Long term care leaders speculate about why it works
by David Farrell and Amy Elliot.

UNC Institute on Aging Better Jobs Better Care Online Turnover Calculations
Turnover Calculator by long-term care provider type.

Additional Business Case for Adoption Resources

Organizational Readiness and Assessment

Low Cost
Practical Strategies to Transform Nursing Home Environments
Prepared for Quality Partners Nursing Home QIO Support Center by Lois J. Cutler and Rosalie A. Kane

Artifacts of Culture Change

Eden Alternative Warmth Surveys: These surveys measure the qualities of organizational warmth (optimism, trust and generosity) against those of cold organizations (pessimism, cynicism and stinginess). Initiating culture change happens best when the organizational temperature is warm and change will tend to consume that warmth. It is important for leaders to have a method to assess the overall organizational temperature to assure that those within the organization are ready to take on and sustain the changes that are made.

"Provider Readiness Assessment Tool" developed for the NC NOVA Partner Team by the Institute for the Future of Aging Services

Staff Assessment Person-Directed Care 
Developed by Better Jobs Better Care

ACT WorkKeys Occupational Profile Report For the Entry Level Direct Care Worker across Aging Services
Better Jobs Better Care produced this occupational Profile for entry level Direct Care Workers in response to four complementary and overarching needs in the long term care field.

How to try this
John A. Hartford Foundation initiative to translate the evidence-based geriatric assessment tools in the Try This Assessment Series into cost-free, web-based resources.


Long-Term Care Improvement Guide
Developed by Planetree in partnership with Picker Institute, the Long-Term Care Improvement Guide was created in 2010 to propel long-term care communities in their improvement efforts.  Informed by focus groups with residents and staff, executive interviews, and a series of site visits to organizations with well-established resident-centered cultures, the Guide features more than 250 concrete strategies for actualizing a resident-directed, relationship-centered approach and demonstrates how culture change makes an impact on operational, clinical and financial outcomes.  The featured strategies apply to Independent, Assisted Living, Short-term Rehabilitation and Nursing Home environments and are not specific to any one culture change model.  The Guide is designed to supports beginner to advanced resident-centered culture, with a self-assessment tool to help organizations prioritize initiatives and decide where to start and stretch goals that challenge sites to take change efforts to even greater heights.  Beyond a compendium of practices, the Guide also examines a defined process for engaging all stakeholders in creating, implementing and anchoring a community vision for change.  A myths and facts section dispels many common misconceptions about resident-centered care.  Features a foreword by Bonnie Kantor, Executive Director of Pioneer Network, and Commentary by Dr. Bill Thomas.

The Path to Mastery: The Art of Creating a Caring Community – The Path to Mastery is a comprehensive resource guide developed by The Eden Alternative to assist any organization on their culture change journey. It is divided into four Milestones with steps that lay the foundation for the next Milestone along the Path to Mastery. Each Milestone is organized into three types of transformation: Personal, Organizational, and Physical. All three transformations must be attained to achieve lasting culture change.  The Path to Mastery will not only define where an organization is on the path to culture change, but it will also provide a clear course for the future. It provides direction and purpose along with references to resources to help accomplish each step along the path.

Implementing Change in Long-Term Care: A Practical Guide to Transformation
By Barbara Bowers, Ph.D., R.N., Kim Nolet, B.S., Tonya Roberts, B.S., R.N., and Sarah Esmond, M.S., of the University Wisconsin–Milwaukee School of Nursing, is a manual created with Commonwealth Fund support that is designed to help nursing home staff put what they know or have learned into action in order to improve quality of care and quality of life for residents and staff.

Providence Mount St. Vincent Case Study
Pioneer Network Case Study (Click here to visit webpage)

The Learning Circle in Culture Change: Why Use It?
by Bill Keane. This document compiles expert perspectives on learning circles including characteristics, purpose and outcomes.

The Learning Circle
Developed by Action Pact, Inc.

Advancing Excellence in America's Nursing Homes
The Advancing Excellence in America's Nursing Home Campaign is a major initiative of the Advancing Excellence in Long Term Care Collaborative. The Collaborative assists all stakeholders of long-term care supports and services to achieve the highest practicable level of physical, mental and psycho-social well-being for all individuals receiving long term care services.

The Cultural Evolution Leadership Series
Part One:  Testing New Strategies To Drive Performance
Part Two:  Culture Change Or Parish: The Business Case
Part Three:  Strategic Investments In Person-Centered Care

Bathing Without a Battle
Access to award winning materials on bathing persons with Alzheimer's disease

AHRQ Innovations Exchange: Nursing Home "Neighborhoods" Emphasize Dignity and Independence, Leading to Improvements in Resident Health and Quality of Life and Lower Employee Turnover
Profile of Providence Mount St. Vincent

PHI provides a full range of consulting and training services to help you assess your existing culture, plan for change, and implement new organizational structures, leadership and staff roles, and individualized caregiving practices.  The website contains resources to support your culture change efforts.

Coaching Supervision: Introductory skills for supervisors in home and residential care

This curriculum by PHI introduces supervisors (including nurses, department managers and leadership) of long term care employees to the skills they need to effectively help staff solve problems and improve work performance. The 7 modules are designed to be taught over two days, and train supervisors in four key skills: Active Listening; Self-Management; Self-Awareness, and Presenting the Problem. The curriculum includes learning objectives, activities, questions for discussion, and all necessary handouts. This curriculum is available in both English and Spanish. In addition, a training DVD provides examples of the demonstration role plays (performed by professional actors) and instructions for incorporating these demonstrations into the curriculum.

Better Jobs Better Care (BJBC) Tools to Reduce Direct Care Worker Turnover
Long-term care providers can now benefit from the tools, resources and findings from the Better Jobs Better Care (BJBC) grantees in new resources including: a Catalogue of Tools and Resources, a Video featuring BJBC providers and Robyn Stone, a Research Report outlining key research findings and what they mean to providers, and a Special Issue of The Gerontologist.

Action Pact, Inc. 
Action Pact, Inc. is a company of trainers, consultants and educators who assist nursing homes and other elder care organizations in becoming resident-directed. They work with clients to redesign the way the organization itself functions, moving from traditional top-down management towards a collaborative effort of self-governing teams.

B & F Consulting
B & F Consulting helps providers with the "how" of change by walking people through how to bring staff together, examine daily operations, and systematically reframe and re-organize the day-to-day of nursing home life. B & F customizes services to meet provider needs, whether it be stabilizing staffing, initiating or re-energizing culture change, or building systems to support quality improvement. B & F helps providers build skills and systems to support inclusive leadership, supportive workplace practices and resident-centered caregiving.

Edu-Catering: Catering Education for Compliance and Culture Change
Edu-Catering caters education for compliance and culture change to the long-term care continuum via consultation, training at conferences, all-day workshops and webinars for national and state long term care associations, state culture change coalitions, state survey agencies, joint provider/surveyor trainings and state QIOs, and by hosting the monthly web talk show for Action Pact Conversations with Carmen.

THE GREEN HOUSE® Project assists organizations explore the financial feasibility and successfully implement all aspects of The Green House model of deep nursing home transformation.  Their goal is to successfully replicate the model's research demonstrated quality improvements within cost neutral operations at each site. GHP is a partnership between Bill Thomas, The Robert Wood Johnson Foundation, and NCB Capital Impact.

Additional Implementation

Reports and Resource Libraries

PHI National Clearinghouse on the Direct Care Workforce
Free, searchable library focusing on direct care workers

Ideas Institute
Free, searchable library focusing on environments and aging  

Additional Reports and Resource Libraries