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52 In Pursuit of the Sunbeam: A Practical Guide to Transformation from Institution to Household How do you do it at home?
How should we do it here?
The Norton-Shields Change Matrix For Progression to Households
The Study of the Matrix
Making the deep and lasting change called for in the Household Model is difficult and complex. Undoing and unlearning is concurrent with redoing, relearning and making new discoveries. Following Prochaska’s lead, the authors developed the Norton-Shields Matrix to help guide the change agent through the varied stages and processes required to make the dramatic and profound changes needed in birthing the Household Model within his or her organization.
Linear progression in any profound change is rare. Our Matrix of change allows for a progression that one can understand in multiple ways. If you look at the columns from left to right you will see the stages of change from different vantage points of the organization (personal, leadership, organization, environment). Looking down each column will give you an idea of what the stages of change look like from the different vantage points. These stages are based on J.O Prochaska’s Stages of Change.
The Matrix can also be used to see an over-all chronology, beginning with an individual who is aware only of the traditional model of nursing home care, and moving to full participation of the facility’s residents and staff within the Household Model. Start at the top left, work your way down the column, move to the top of the next column, work your way down, etc. Imagine the path of a sine wave. You will see the progression from the first inkling things must change, to becoming a leader, to inspiring others to lead, to full collaboration in redesigning the organization. Finally, the self-led team of staff works with residents to design and create the living environment, and all are acknowledged and rewarded with continuous opportunity to learn and grow.
The total transformation begins with individual transformation. It is important to ground yourself in the need for personal change as you enter into the world introduced in the Matrix. Most start someplace else, which usually ends in frustration, failure, or mitigated success. We must start with ourselves, look and act within. Only then can we effectively look and act outwardly along the pathway of change. The individual becomes a leader and instigates opportunities for others to experience the personal transformation and become leaders themselves. These self- aware leaders form steering and action teams committed to bringing