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Susan Misiorski

PHI National Director of Training and Organizational Development Susan Misiorski will lead a seminar entitled “Change Management: Leading through Resistance” at the 2011 LeadingAge Annual Meeting & IAHSA Global Aging Conference in Washington, DC.

Misiorski’s seminar will take place on October 18 from 3:30 PM–5:00 PM.

“Change Management: Leading through Resistance” is a part of the “Leadership and Strategy” track; participants will:

• examine the three different levels of resistance commonly associated with organizational change.
• discuss how to successfully overcome resistance from board, staff, consumers, and family members.
• acquire coaching techniques that can be used to effectively lead teams through change initiatives.

Misiorski, the founding president of the Pioneer Network Board of Directors, manages PHI’s organizational development work with nursing homes and home care agencies across the country.

She has been instrumental in helping client organizations understand that there is no single “starting place” when it comes to culture change.

– by Deane Beebe

The National Fire Protection Association (NFPA) has revised its Life Safety Code handbook to include provisions in the health care occupancy rules that support making nursing homes more home-like environments.

Four proposals recommended by the Pioneer Network to “create home in the nursing home” have been included in the 2012 edition of the NFPA 101^® Life Safety Code^®, according to a statement by the national culture-change organization.

The proposals that have been adopted, with some restrictions and providing that certain criteria are met, are:

• Kitchens serving no more than 30 residents will be permitted to be open to the corridor and other spaces, and either residential or commercial stoves or cooktops may be used.
• Furniture may be provided in corridors.
• Combustible decorations will be permitted in resident rooms, corridors, on doors, and in common space.
• Gas or electric fireplaces will be allowed to be used in smoke compartments that contain sleeping rooms, but not within individual sleeping rooms.

The Pioneer Network plans to advocate for the federal Centers for Medicare and Medicaid Services (CMS) to also accept these revisions, followed by states.

New Dining Practice Standards

Additionally, the Pioneer Network has proposed new Dining Practice Standards (1.4 MB pdf) that “support individualized care and self-directed living” for people living in nursing homes.

The proposed food and dining standards, such as individualized nutrition approaches and a diabetic/calorie-controlled diet, “reflect evidence-based research available to-date as well as current thinking which is in some cases in advance of research,” a press statement from the group explains.

The Dining Practices Standards have already been agreed to by 12 national clinical standard setting organizations, including the American Association of Long Term Care Nursing and National Association of Directors of Nursing Administration in Long Term Care.

The Pioneer Network is planning to submit the Dining Practices Standards to CMS as well as to the U.S. Food and Drug Administration, Centers for Disease Control, and the long-term care community, and anticipates that CMS “will refer to these new agreed-upon standards of practice within [their] long-term care interpretive guidance where they fit.”

– by Deane Beebe

In the July issue of the PHI Training & Organizational Development Services (TOD) newsletter, Kathy McCollett, a PHI organizational change specialist, gives new meaning to “informed consent,” using the language of culture change.

Meanwhile, Renya Larson, a specialist with PHI’s Training & Organizational Development team, discusses why teamwork matters.

Visit the PHI Training & Organizational Development Services site to read past newsletter posts and to subscribe.

– by Deane Beebe

Logo of 2011 Pioneer Network National Conference

The Pioneer Network‘s annual conference will take place August 1-4 in St. Charles, Missouri, and will feature several sessions led by PHI experts.

Susan Misiorski, the national director of the PHI Training and Organizational Development Services team, and Kate Waldo, PHI organizational culture change specialist, will help guide day-long presentations during the four-day event.

PHI’s Cean Eppelheimer and Kathy McCollett will also present a 90-minute session on how to be an approachable leader.

According to the Pioneer Network’s website, the conference is the “only national conference devoted solely to culture change.”

Initiating Culture Change

Along with Joanne Rader of Rader Consulting, Misiorski will co-lead “Getting Started,” a day-long intensive session designed to help leaders of care facilities take the first steps toward culture change.

Misiorski and Rader will dispense practical advice to formal and informal leaders across care settings who are interested in de-institutionalizing services and individualizing care.

“For the last decade, the Pioneer Network conference has presented a great annual opportunity to spread the word about culture change,” said Misiorski, the founding president of the Pioneer Network’s board of directors.

“I hope that attendees will come away inspired to start their own culture-change journey — or, if they are already on the road to culture change, I hope they will redouble their efforts to implement organizational change,” she added.

Focus on LGBT Elders

Meanwhile, Waldo will co-lead a day-long intensive session entitled “Creating an Environment of Safety and Inclusion for LGBT Older Adults.”

During the session, Waldo and Hilary Meyer, the director of the National Resource Center on LGBT Aging, will present a curriculum designed to help staff, administrators, and volunteers at aging network organizations to provide better care for their LGBT residents.

The curriculum achieves those goals by:

• Teaching participants about LGBT older adults — their culture, their needs, their concerns.
• Identifying best practices to help LGBT elders feel safe and included in their aging networks.
• Identifying health disparities between LGBT and non-LGBT elders.
• Reviewing policy and practice areas to consider how to increase inclusiveness and safety for LGBT older adults.

Other Sessions

“Getting Started” and “Creating an Environment of Safety and Inclusion for LGBT Older Adults” are two of 13 all-day intensive sessions that conference-goers can choose to attend during the conference’s second day.

The topics of other intensive sessions include implementing culture change in a physically traditional facility; administering dining assistance for people with dementia; and sustaining culture change over the long term.

Shorter sessions and workshops will also be held throughout the event.

A full list of the intensive sessions can be found on the Pioneer Network’s website, along with a full conference schedule and registration information.

– by Matthew Ozga

Three brief stories on direct care:

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Pioneer Network Extends Early Bird Registration

The registration deadline for the Pioneer Network‘s 2011 National Conference has been extended until Tuesday, June 7.

This year’s conference will take place in St. Charles, Missouri, from August 1-4.

The Pioneer Network is a leader in the culture change (pdf) movement and an advocate for person-directed care.

Effective June 27, Peter Reed, Ph.D., M.P.H., will take the helm as the organization’s new executive director.

Visit the Pioneer Network website to learn more about the conference and to register.

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Fund Created for Nursing Home Employees Hit by Tornado

The Missouri Health Care Association (MHCA) has established a charitable fund and grant program to help employees and their families who suffered damage from the devastating tornado that ripped through Joplin, Missouri, on May 22.

At least 10 nursing home residents and one employee were killed in the tornado, and three Joplin nursing homes are no longer habitable, according to McKnight’s Long-Term Care News.

More information on the fund and information on how to donate is available on at the MHCA website.

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Consumer Voice Publishes New Guide on Choice and Advocacy

The National Consumer Voice for Quality Long-Term Care launched Piecing Together Quality Long-Term Care: A Consumer’s Guide to Choices and Advocacy, a national guide intended to:

• educate older adults and people with disabilities about options for long-term services and supports;
• empower consumers to become self-advocates for quality long-term care; and
• provide information and resources to assist people currently living in nursing homes to move back into the community.

The Consumer Voice has also created a document to assist groups that want to develop state-specific guides. Kansas, North Carolina, and Virginia have already published guides for consumers in their states.

– by Deane Beebe

The newest additions to PHI’s National Clearinghouse on the Direct Care Workforce:

Economic Contribution of Nursing Facilities — This February 2011 brief from the Alliance for Quality Nursing Home Care explains the economic significance of nursing facilities in the U.S. For example, the brief notes that $138 billion was spent on nursing facility care in 2008 alone. The brief also explains the negative impact that the economic recession has had on nursing facilities. Specifically, nursing facilities have had to grapple with a tightened credit market as well as cuts to or freezes on Medicaid payment rates.

Generations, Winter 2010-11 issue — This issue of Generations contains multiple articles that are pertinent to the direct-care workforce, including articles authored or co-authored by PHI experts.

In “Caregivers on the Front Line: Building a Better Direct-Care Workforce,” PHI National Policy Research Director Dorie Seavey gives a general overview of the workforce. Meanwhile, in “Federal and State Policy Strategies for Developing a Quality Eldercare Workforce,” members and staff of the Eldercare Workforce Alliance — including PHI President Steven Dawson — explain how the Affordable Care Act will benefit the eldercare workforce.

Other articles from the issue include:

• The Changing Face of Long-Term Care and How a New Immigrant Workforce Will Shape Its Future — This article explains the important role that immigrants and ethnic and racial minorities play in the direct-care workforce. The author examines several pressing issues facing the long-term services sector as the U.S. minority population expands over the next several decades, including the potential exploitation of immigrant direct-care workers.
• A Vision for the Future: New Care Delivery Models Can Play a Vital Role in Building Tomorrow’s Eldercare Workforce — This article details the increasingly important role that direct-care workers will play in the nation’s long-term care services and supports sector following the implementation of health reform provisions such as the CLASS Act. The article also provides a brief overview of the direct-care workforce. The authors are deputy assistant secretaries at the Department of Health and Human Services (HHS).
• Reinventing Management Practices in Long-Term Care: How Cultural Evolution Can Affect Workforce Recruitment and Retention — This article analyzes the extent to which the Better Jobs Better Care initiative succeeded in introducing elements of culture change into the management practices of long-term care providers. The authors write that incremental culture change — making gradual, visible changes to a long-term care facility — can be better at fostering sustainable culture change than a more radical, wholesale approach. As a result of these visible changes, workers feel more valued, and are more likely to stay.

PHI’s National Clearinghouse on the Direct Care Workforce is a national online library for people in search of solutions to the direct-care staffing crisis in long-term care. It houses over 1,000 articles, reports, issue briefs, and fact sheets on the direct-care workforce.

– by Matthew Ozga