Page 204 - In Pursuit of the Sunbeam.indd

Design Process Flushes Out Lingering Resistance or Lack of Clarity
When you start designing households, you likely will discover where resistance to change and lack of clarity still lurk within the organization. To enable the design team to help translate your vision into physical dimensions and space relationships, you need to communicate how you imagine life taking shape in the Household Model. This is where discrepancies between desired goals and resistors to change rise to the surface.
As with any transformation, there may be lingering resistance to specific changes in the physical environment. This provides a window into the mindsets of participating stakeholders. Though most may by now be behind the overall concept, some might not understand how the decentralized, “small is better” design will allow them to get their work done. Some still believe assembly line methodologies are surely most efficient. They may think assembling food trays in a central kitchen must be faster than making food to order in the household kitchen and wonder, “How will we be able to get it all done?!”
As leaders, we know a full understanding of change doesn’t come in one gust of wind. We may be able to internalize the grand philosophy of creating home and resident-directed service and make it our own. Most of us, however, discover the full implications of deep change only in increments, sometimes one situation at a time.
For example, imagine a nurse who is excited about resident-directed service and changing the physical environment as advocated in the Household Model. He may envision his own mother moving into one of the houses and finds comfort knowing things will be different for her. The nurse may even be a powerful force in the organizational change process and eagerly interact with the design team. This same nurse, however, may be a product of traditional training and professional indoctrination. As one highly trained and qualified to provide skilled nursing care, his perspective on equipping resident rooms is unwittingly limited to the old way of doing things. He may adamantly oppose the notion of placing a medicine cabinet in each resident’s room because he is convinced distribution is most efficient from a centralized med cart. Also, he makes a passionate case that decentralized distribution will result in more medication errors. Of course, the decentralized approach has proven to work very well while protecting residents’ privacy, but it is not yet within the experience of this nurse.
Or think of the activities staff. They want to keep their large activity closet to store seasonal decorations, and dedicated wall space to put up a large bulletin board for announcements. Obviously, they have not yet fully
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