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Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Commercial Market Place and Nursing Home Transformation:,Following Consumer Demand,Bonnie S.Kantor,Sc.D,Executive Director,Pioneer Network,1,Opportunities for Nursing Home Transformation,Resident-centered,Adaptations,Improved quality,of care and,measurable,Financial success,Opportunity for practice,research and policy to view quality and efficiency as interconnected outcomes.,2,Who here is aging?,When did you start aging?,And where have you always lived?,3,Home,Identity,Connectedness,Lived Space,Privacy,Power/Autonomy,Safety Predictability,Journeying,Homelessness,Non-Personhood,Disconnectedness,Meaningless Space,Without boundaries,Powerless/Dependence,Insecurity/Uncertainty,Placelessness,Carboni(1990),Home vs.Homelessness,4,Culture Change,Renewal,of Personal Transformation,Re-organizing,the work,Renovating,the Physical Environment to Create Home,5,Pioneer Network Founding Principles,Know each person,Community is the antidote to institutionalization,Practice self-examination,searching for new creativity and opportunities for doing better,Relationship is the fundamental building block of a transformed culture,6,Pioneer Network Founding Principles,Risk Taking is a normal part of life,Put person before task,All elders are entitled to self-determination wherever they live,Recognize that culture change and transformation are not destinations but a journey,always a work in progress,7,Our Vision,A culture of aging that is life-affirming,satisfying,humane and meaningful.,8,A clear understanding of the elder:,Where are you from?,What is your personal history?,What is your preferred typical day?,Who do you want to be in the future?,9,“Quality is not a program;it is an outcome that evolves from organizational culture focused on the customer and organizational excellence,AAHSA 2005,10,Person Directed Practices,(Begins somewhere between Consideration of the Person and Persons Choice),Degree of Person-Directedness,Staff Directed,(agency scheduled routines/staffing dictate care provision),Consideration of Individual,(Seek persons input and tailor some aspects),Individual Choice,(Offers choices of food,waking,bathing etc.),Individual Control,(have right of refusal and right to take risks),Person Directed,(Individual has primacy-determines own schedules,activities,meals,and caregivers),Developed by the Lewin Group,Person Directed Practices Overlap with Varying Degrees of Choice and Autonomy,11,Are the values of choice,respect,and self-determination implemented here?,The Question Consumers WILL Ask is,12,What Culture Change Is,A,bout:,Honoring individuality of residents and staff,Creating“home,Person vs.task focus,Creating a new way of being and thinking related to aging.,Creating responsive systems.,13,Paradigm Change,INSTITUTIONAL,medical,“treatments,task focus,“float staff,staff make decisions,structured activities,PERSON-DIRECTED,social/holistic,nurture spirit,care matches needs,consistent assignments,residents make decisions,spontaneous activities,14,Paradigm Change(cont.),INSTITUTIONAL,schedule for convenience of staff/administration,facility“belongs to staff,sense of isolation and loneliness,departmental focus,PERSON-DIRECTED,schedule adjusted for resident and staff needs,facility is residents home,sense of belonging and community,team approach,15,Opportunities for Nursing Home Transformation,Resident-centered,Adaptations,Improved quality,of care and,measurable,Financial success,Opportunity for practice,research and policy to view quality and efficiency as interconnected outcomes.,16,Research on Outcomes Associated with Network Participation,In the first empirical,comprehensive study of the Pioneer Network,research examined if“early adopter participants achieved financial and quality outcomes that were significantly different from outcomes of non-participant homes.*,CMS provided data from 1996(pre-participation in the network timeframe)and 2003(participating in the network for at least one year).,*Source:Elliot,et al.(2007),17,Quality of Care Results,Findings comparing quality of care outcomes of homes participating in the network to analogous control homes denote that early adopter homes achieved statistically significant improvement in quality of care over control homes.,In a multivariate analysis of all homes certified by CMS in 2003,coefficient estimates indicate that length of time participating with the network positively affected quality of care.,*Source:Elliot,et al.(2007),18,Efficiency Results,This research also evaluated the effects of Pioneer Network participation on the per bed net income and operating margins of early adopter homes versus analogous control homes and produced the following findings:,Overall,homes participating in the Pioneer Network displayed statistically significant improvement in per bed net income and operating margin from 1996 to 2003 when compared to controls.,*Sourc
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