Modeling and Measuring Nursing Home Reform: Workbook and DVD

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A DVD and accompanying workbook, "A Tale of Transformation: Four Stages Tell the Story," offer learning points and inspiration for teams working to change the culture of nursing homes. These resources are designed to work hand in hand with the Culture Change Staging Tool, with which nursing homes can chart their progress in moving from the institutional model through to the transformational model, neighborhood model, and finally to the household model of resident-centered care.

Organization: Action Pact, Inc.

Target Populations: Nursing home administrators, directors of nursing and other nursing home staff, long-term care researchers; nursing home residents

T he Issue: The "culture change" movement in long-term care aims to transform nursing homes into environments where each elder can live enjoy privacy, choice, and a sense of purpose. Proponents of "culture change" recommend replacing hospital-like units with households of small groups of residents and permanently assigned staff. In addition, they seek to improve training of nursing home staff, giving them a voice in how their job is performed and valuing their contribution to the organization.

The Intervention: A DVD and accompanying workbook, A Tale of Transformation: Four Stages Tell the Story, offer learning points and inspiration for teams working to change the culture of nursing homes. These resources are designed to work hand in hand with the Culture Change Staging Tool, with which nursing homes can chart their progress through the following stages:

  • Stage One—The institutional model organized around a traditional nursing unit.
  • Stage Two—The transformational model, where awareness of culture change spreads among direct-care workers and administrative staff.
  • Stage Three—The neighborhood model, where traditional units are broken into smaller functional areas, and more choice is given to residents.
  • Stage Four—The household model, where residents live in self-contained living units and staff work in self-directed teams that are permanently assigned to a given household.

This tool is based on a conceptual model of culture change created by Leslie A. Grant, Ph.D., of University of Minnesota and LaVrene Norton, M.S.W., of Action Pact, Inc. The model was created by eliciting expert advice and pilot testing in more than 30 nursing homes across the country. The workbook serves as a guide to the hour-long video, pointing to particular sections for viewing and then offering discussion starters and activities to follow. Nursing home teams might choose to work through the full video and workbook, or invite staff members to focus on segments that are relevant to their work. The video vividly illustrates how the daily lives of residents and staff improve as homes move through the stages of culture change.

For Further Information: To order the DVD and workbook, visit the Action Pact Web site. Contact: LaVrene Norton, M.S.W., of Action Pact, Inc..

April 2006


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