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Caregivers Corner
May, 2000
A Mission of Change
"The nursing home industry has been under what some would call 'excessive' scrutiny and negative reinforcement with mandates by President Clinton and HCFA to improve the quality of care in our facilities. These mandates are dictated in the same breath that has tumbled payments to these facilities by 17-30%. The current system for improving the quality of care in place at the state and federal levels is not meeting the desired outcome. "Scrutiny has caused more fear and trepidation for the facilities which, in turn, are forced to maintain an equal or higher level of scrutiny toward staff completing their duties; this, in an industry with average turnover rates above 60%. Add to this, a mandated requirement to report to two state agencies and the State Police any allegations of 'rough care' or 'harsh words' that may be considered a criminal offense. Employees in our facilities are scared and unsure of themselves. Many feel the risks are not worth the pay. "This 'Culture Change' movement does one very proactive thing to ease this concern - it promotes the training and knowledge of frontline caregivers, providing more reassurances and comfort that they do know what they're doing and that they are true professionals. When any person masters their trade, you tend to notice the quality in their craft. There is no reason this precept cannot pertain to our troubled industry." -- Chris Bailey, MHA, NHA |
Interest generated by a December 1999 symposium sponsored by Pennsylvania Auditor General Casey's Office gave birth to the Pennsylvania Culture Change Coalition. Since then all of the provider associations across the Commonwealth, as well as other interested organizations, have been invited to attend monthly meetings through which the Coalition has adopted the following goals:
- Provide a statewide network of culture change resources for providers and other stakeholders.
- Involve all appropriate organizations, individuals, governmental departments and professional associations in the advancement of its mission.
- Identify systemic issues that undermine improved care delivery, then develop and implement strategies to correct them.
- Promote the values, principles and practices of the culture change movement as the new performance standard throughout Pennsylvania, through the identification of best practice models of care and facility management.
Coalition members affirm the following principles that are central to creating a loving, life-affirming environment in which residents and caregivers can thrive:
 | Appreciating the uniqueness and value of each individual |
| Providing opportunities to exercise choice and control in daily life |
| Treating those who give and receive care with dignity and respect |
| Empowering the community through self-examination, seeking and sharing feedback, and a willingness to search for better ways |
| Creating home environments where loneliness, helplessness and boredom are replaced by meaningful companionship, variety and spontaneity |
| Recognizing the potential for growth and development at all stages of life |
The new culture to which Coalition members aspire may take many forms. For some organizations it may involve a flattening of the management hierarchy or a focus on developing and empowering frontline workers to accept greater responsibility. Others will seek greater inclusion of frontline workers in identifying and helping to address customer and workplace issues. Yet others may move toward increasing primary care assignments to strengthen the relationship and nurturing bond between caregivers and residents.
For more information on the work of the Coalition or to be added to the Coalition's distribution list Contact the Institute.