The Pioneer Network has launched an online version of its popular Artifacts of Culture Change tool.
The web-based evaluation tool allows long-term care providers to measure how successfully they have implemented culture change in their facilities.
The tool helps providers determine whether they have introduced culture change in a sustainable way, as well as how far along they have already progressed in their culture-change journey.
“The artifacts tool is not only a wonderful way to measure change progress, it also offers ideas about opportunities for change an organization may not have been aware of,” said Susan Misiorski, PHI National Director of Training and Organizational Development.
Scoring Points for Culture Change
The web-based tool measures a facility’s culture-change progress in six categories:
- Care Practice Artifacts — What are the facility’s policies on person-directed dining, bathing practices, etc.?
- Environment Artifacts — Do residents have ample space and privacy? Does the facility include amenities such as Internet access and outdoor areas? Does it reflect “home”?
- Family and Community Artifacts — What is the facility’s visiting policy? How are families involved and welcomed?
- Leadership Artifacts — Are residents given the opportunity to voice their opinions to staff members?
- Workplace Practice Artifacts — Are CNAs allowed to set their own schedules and work consistently with the same residents? Are they given the opportunity for advancement via a career ladder?
- Staffing Outcomes and Occupancy — How long do workers remain with the facility? What is the staff turnover rate over the last 12 months?
At the end of the evaluation, facilities are awarded a point total based on their responses, with a maximum score of 580 points.
Providers can use the evaluation tool as often as they want, free of charge. The Pioneer Network recommends quarterly “tune-ups,” but stresses, “It’s your choice.”
Updating the Evaluation Tool
The new online evaluation tool is an update of the paper-based Artifacts of Culture Change, which the Pioneer Network debuted in 2006. The Web-based version incorporates interpretive guidelines issued in 2009 by the Centers for Medicare & Medicaid Services (CMS).
According to the Pioneer Network, the evaluation tool “represents the first national database of implementation activities ever collected.”
The Pioneer Network used funding from The Commonwealth Fund to build the online version of Artifacts of Culture Change.
– by Matthew Ozga
Many, many thanks to our Pioneering friends Karen Schoeneman at CMS and Carmen Bowman of Educatering for co-writing the artifacts tool and making it so generously available!!
In true culture change, the person is central, not peripheral, and everyone else wants to know who she is, what she wants and needs to live a good life and does everything with and for that person in the context of a relationship. Relationship precedes, accompanies and follows every service rendered.
A guiding tool,developed by founding members of the Pioneer Network took the form of Values and Principles. These held the belief, for one example alone, that each person grows. In true culture change, encouraging growth requires that each person is known – her life stories, thoughts, feelings, wishes, significant relationships, talents, triumphs, losses – and these cannot be reduced to “an opportunity to voice an opinion to staff members,” that being the only pale reference to residents in the entire tool.
It is of concern that culture change is increasingly described in outer, superficial terms – advocating amenities which, while nice, aren’t the main focus. In a study that appeared in the August 2009 issue of The Gerontologist, the example provided to describe Person Centered Care actually described staff-centered care. I would suggest that in addition to the PN’s Values and Principles, that providers turn to Carter Williams’ early paper “Relationship is the Heart of Care” as a useful resource to nurture and guide current culture change efforts.