Susan Misiorski

PHI’s Director of Organizational Culture Change, Susan Misiorski, recently participated in a groundbreaking expert panel to discuss the nurse’s role in culture change.

Leaders from the nation’s leading long-term care, aging, and nursing organizations gathered in New York City in late October at the invitation of the Hartford Institute for Geriatric Nursing and NYU College of Nursing in collaboration with the Coalition of Geriatric Nursing Organizations (CGNO) and the Pioneer Network, a national organization whose purpose is to serve and advance the culture change movement.

Participants identified ways to involve nurses in culture change initiatives and the research needed to develop and test the effects of culture change initiatives on resident care, quality of life outcomes, and workforce issues. The purpose of the gathering was, in part, draft a white paper on their findings.

Because it is so difficult to cover for nurses on the floor while they participate in change committee meetings, many long-term care facilities have created change plans without adequate nurse involvement, said Misiorski. The end result is that—to a large extent—culture change has been happening around the nurses, but not with the nurses.

Long-term care leaders have identified a need to bridge this gap in nursing involvement. Since nurses provide support and leadership to direct-care workers, the role of the nurse in culture change will directly impact the experience of the direct-care worker, said Misiorski.

“The general conversation centered around how nurses could bring their clinical and leadership expertise to advance person-centered care,” she said.

The culture-change movement seeks to end the “one size fits all” approach to resident care in nursing homes and promotes more flexible policies to ensure the comfort and dignity of all residents. It began in 1997, based on evidence showing that nursing-home residents lacked a voice in their health-care goals and that their quality of life was being sacrificed to institutional control.

The ongoing movement, said Misiorski, aims to ensure that all individuals receiving long-term services are able to direct their care. It also advocates for elders to enjoy the full benefits of home regardless of where they live.

Misiorski is the author of Getting Started: A Pioneering Approach to Culture Change in Long-Term Care Organizations and, as a PHI consultant, supports organizations in implementing person-directed care.

A white paper summarizing the findings of the panel discussion is to be released in early 2009.