Sign Up For Email Updates   Submit

Research Resources in Culture Change

This list contains only a small fraction of the culture change research base and currently does not provide categorization by topic or theory. Please check back in the coming months as we continue to develop a comprehensive listing of links and resources to describe and inventory research in culture change. To contribute resources, become part of our research network or to share your story, contact Amy Elliot at suggestions@pioneernetwork.net.

Resources from the Pioneer Network Conference Intensive "Meeting at the Crossroads of Research and Practice"
A compiled list of resources discussed at the intensive (links are provided to the resources when available). Resources and papers may also be listed under other headings on this page or other pages on this website.

Envisioning your future in a nursing home by Margaret Calkins, PhD

Practical Strategies to Transform Nursing Home Environment: Towards a Better Quality of Life
By Lois Cutler and Rosalie Kane

Culture Change in Nursing Homes: How Far Have We Come? Findings From The Commonwealth Fund 2007 National Survey of Nursing Homes
by Michelle M. Doty, PhD, Mary Jane Koren, MD, MPH, and Elizabeth L. Sturla, MPH and supported by The Commonwealth Fund

Culture Change in a For-Profit Nursing Home Chain: An Evaluation
by Les Grant, PhD and supported by The Commonwealth Fund

A Stage Model of Culture Change in Nursing Homes
Developed by Les Grant and LaVrene Norton is a stage model of culture change in nursing homes. This tool assesses the degree of culture change from an organizational development perspective in the four stages of Stage I - Institutional model, Stage II - Transformational model, Stage III - Neighborhood model and Stage IV - Household model, describing the organizational status of Decision Making, Staff Roles, Physical Environment, Organizational Design and Leadership Practices in each

Resident Outcomes in Small-House Nursing Homes: A Longitudinal Evaluation of the Initial Green House Program
by Rosalie A. Kane, PhD, Terry Y. Lum, PhD, Lois J. Cutler, PhD

Advancing Culture Change in Florida Nursing Homes: An Issue Brief
by Annette Kelly and the Florida Pioneer Network

Research in Culture Change in Nursing Homes
by Christine Mueller
 
Eden Alternative: The Texas Project
by Sandy Ransom, Institute for Quality Improvement in Long Term Health Care. IQILTHC Series
Report 2000-4, May 2000

Evaluation of the Wellspring Model for Improving Nursing Home Quality
by Robyn I. Stone, Susan C. Reinhard, Barbara Bowers, David Zimmerman, Charles D. Phillips, Catherine Hawes, Jean A. Fielding, and Nora Jacobson

Websites:

Artifacts of Culture Change

Colorado Foundation for Medical Care (CFMC)

Design on a Dollar

The Eden Alternative

Ideas Institute
Free, searchable library focusing on environments and aging

NHRegsPlus
This searchable website serves as a one-stop location to examine and compare the content of state regulations related to nursing homes, the processes of regulation and exceptions to regulations within a state, recent state changes, innovative nursing-home designs and programs that were accomplished within existing regulations, and innovative state regulatory initiatives

Promoting Excellent Alternatives in Kansas Nursing Homes (PEAK)

University of Wisconsin - Wisconsin Clinical Resource Center (WCRC)



Creating Home Symposium Papers (available for pdf. download)

Envisioning your future in a nursing home by Margaret Calkins, PhD

The Environmental Side of the Culture Change Movement: Identifying Barriers and Potential Solutions to furthering Innovation in Nursing Homes by Carmen S. Bowman, MHS 

Household Models for Nursing Home Environments by Gauis Nelson

Lighting: Partner in Quality Care Environments by Elizabeth Brawley

Nothing is Traditional about Environments in a Traditional Nursing Home by Lois J. Cutler, PhD
 
Creating Home in a Nursing Home: Fantasy or Reality by Margaret Calkins, PhD


Documents & Links

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.

Person-Centered Care For Nursing Home Residents: The Culture-Change Movement
Health Affairs highlights culture change in nursing homes with an online article entitled, "Person-Centered Care For Nursing Home Residents: The Culture-Change Movement." Mary Jane Koren, M.D., M.P.H., the assistant vice president of the Frail Elders Program at The Commonwealth Fund, authors this compelling discussion of culture change adoption, awareness and the potential for policy interventions to promote deep systemic change. 

A Manual for Community-Based Participatory Research
The Center for Excellence in Assisted Living (CEAL) and the Cecil G. Sheps Center for Health Services Research/University of North Carolina at Chapel Hill (UNC) produced this first-of-its-kind manual to improving practices and informing policies in assisted living communities through the use of a collaborative method of research – community-based participatory research (CBPR). The two-year project (2006 – 2008) was funded by AHRQ.

Improving Quality of Life In Nursing Homes Through Structured Resident Interviews
The study tests the hypothesis that quality of life of nursing home residents can be improved by customizing the care they receive based on their individual preferences. Funding was provided by the Commonwealth Fund and the University of Pittsburgh Institute on Aging.

Pragmatic Innovations in Long-Term Care Conference: Developing a Research Agenda
Access to Consumer Report, Research Report, Final Conference Report and Policy Fact Sheet

Culture Change in Nursing Homes: How Far Have We Come? Findings From The Commonwealth Fund 2007 National Survey of Nursing Homes
by Michelle M. Doty, PhD, Mary Jane Koren, MD, MPH, and Elizabeth L. Sturla, MPH and supported by The Commonwealth Fund

Resident Outcomes in Small-House Nursing Homes: A Longitudinal Evaluation of the Initial Green House Program
by Rosalie A. Kane, PhD, Terry Y. Lum, PhD, Lois J. Cutler, PhD, et

Culture Change in a For-Profit Nursing Home Chain: An Evaluation
by Les Grant, PhD and supported by The Commonwealth Fund

Better Jobs for Better Care (BJBC) Research Report
This report outlines key BJBC research findings and what they mean to long-term care providers.

A Labor Management Partnership for Person-Centered Care in Nursing Homes: A Case Study
by Walter Leutz, PhD, Christine Bishop, PhD and Lisa Dodson, PhD

Transformative Nursing Homes Experience Positive Regulatory Quality and Financial Outcomes
Pioneer Network Brief

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

Additional Links


Abstracts

The Physician's Role in Long-Term Care Culture Change
Author/Journal: Robert Stall MD JAMDA (Journal of the American Medical Directors Association) 2009 10(8):  587-588

Resident Choice and the Survey Process: The Need for Standardized Observation and Transparency
by John Schnelle, PhD, Rosanna Bertrand, PhD, Donna Hurd, MSN, Alan White, PhD, David Squires, BS, Marvin Feuerberg, PhD, Kelly Hickey, BS and Sandra F. Simmons, PhD

Bathing Of Older Adults with Dementia: Easing the unnecessarily unpleasant aspects of assisted bathing
by Joanne Rader MN, RN, Ann Louise Barrick PhD, Beverly Hoeffer DNSc, RN, Philip D. Sloane MD, MPH, Darlene McKenzie PhD, RN, Karen Amann Talerico PhD, RN, Johanna Uriri Glover PhD, RN; AJN, American Journal of Nursing. 106(4):40-48, April 2006

The Nursing Home Culture-Change Movement: Recent Past, Present, and Future Directions for Research
by Anna N. Rahman, MSW and John F. Schnelle, PhD; Gerontologist 2008 48: 142-148

Definition, Measurement, and Correlates of Quality of Life in Nursing Homes: Toward a Reasonable Practice, Research, and Policy Agenda
by Rosalie Kane, PhD; Gerontologist 2003 43: 28-36

Evaluating the Quality of Life of Long-Term Care Residents With Dementia
by Philip D. Sloane, MD, MPH, Sheryl Zimmerman PhD, Christianna S. Williams, PhD, Peter S. Reed, PhD, Karminder S. Gill MSPH, and John S. Preisser, PhD; Gerontologist 2005 (Special Issue) 45: 37-49

Additional Abstracts


Special Issues

Research in Gerontological Nursing Special Issue

Multiple articles and authors, July 2008 1 (3) 

Gerontologist Special Issue I
Multiple articles and authors, 2005, 45 (1) 

Journal of Social Work in Long-Term Care
Multiple articles and authors, 2003 2 (3/4)