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The Foundations of Culture Change: Underlying Principles

Culture Change is bigger than any one theory or model. Cultural Transformation is more than just a collection of things to do in a home. Instead, the best way to view Culture Change is as a foundational philosophy that underlies our desire to improve the quality of life for our residents and the staff who provide care for them.

The philosophy of Cultural Transformation can best be summed up in two statements:

  • "Making our homes places where people want to live, versus places where they go to die."
  • "Making our homes places where people want to go to work, versus places where they have to go to work."

To reemphasize this point, Culture Change is not merely a set of things we do or policies that we change. Instead it is a global way of thinking about the work we do and how we provide care to the people who live in our homes. You have many choices about what specific plan you will follow to change the culture of your community. No matter what model(s) of care you choose, it is the foundational principles that underlie your commitment which are most important.

The Institute's 5 Core Principles of Culture Change

Principles that we believe are vital to your Cultural Transformation efforts are summarized below. These principles are all important and apply equally well to the residents who live in our communities and the workers who devote their lives to providing care. These principles are interconnected and shape the overall feel and atmosphere of the home.

Emphasis on Respect -- Each member of your community regardless of role in the home (resident, frontline worker, nurse, groundskeeper, etc.) has the right to voice views, ideas, and opinions without fear of ridicule or recrimination. Each person's views should be incorporated into discussions before decisions are made.

Emphasis on Empowerment -- All members of the community, regardless of role in the home, need to feel as though they make a difference. All are recognized as valued, contributing members of the community. Each member is entitled to information and resources that foster critical thought. Residents and workers have decision-making authority over things that impact them, while at the same time respecting more global organizational and regulatory constraints.

Emphasis on Choice -- Residents and workers in long term care communities should be given a range of options that reflect personal preference. Having residents and/or workers buy into management directed policies is not choice. Residents have the right to make choices regarding their day-to-day lives without penalty. Workers are given the flexibility to make choices regarding the work they are responsible for in the home without penalty. Choices should be made with consideration of global organizational and regulatory policies and procedures.

Emphasis on Relationships -- Relationship building should be an ongoing activity within each home. This includes strengthening the bonds among residents, among workers (at all levels), and between residents and workers.

Emphasis on Community -- A primary goal of Culture Change is the ability of homes to evolve from a hospital-like environment to a true community. The phrase, "Would I do this in my own home?" should never be far from your thoughts. Along with medical care, residents' social, emotional, spiritual, cognitive, and cultural needs should receive equal attention. Staff should be viewed as complete individuals versus the more traditional view of identifying workers with the tasks they perform.

When embarking on your Culture Change journey, keep these principles in mind. Use these principles as a touchstone for deciding if you are on track. If your ideas to change the culture of your home include respect (for residents and staff), empowerment (for residents and staff), choice, an emphasis on relationships, and a commitment to making your long term care community more homelike, then you have succeeded. Most of all, remember that...

Culture Change Begins with You!