Page 15 - Tale of Transformation

How to Progress
From the Institutional to the Transformational Stage
in Physical Environment
The most important concept to convey at this point is to create home. Some resistance to this vision of home is expressed by organizations that have a high number of short stay residents.
What if you have a high percentage of short stay residents? If your organization serves a high number of short stay residents, you can still focus on the components of home which are appealing to everyone. Remember author, Maya Angelou’s words: “I long, as does every human being, to be at home wherever I find myself.” So explore together – what is home? What does it mean? Why does it bring us solace? We would want these life satisfactions and expectations wherever we are - whether we live in our own house or are temporarily staying somewhere while we rehab.
Establish Teams with Staff, Residents, Families. Take the common threads that your team discovers in these discussions about home and what it means; and begin to study your Physical Environment – is it conducive to home or the qualities of home?
Perhaps have teams tackle different questions. You might establish a Privacy Team, or a team to focus on Pleasant Spaces, and so on. Provide the team with adequate resources and links. Be sure residents and/or their families are on each team. Doable changes with satisfying outcomes are possible. Below are some examples:
• The Cedars in McPherson, KS worked on their bathrooms. Teams of staff and residents with a $250 spending limit per bathroom created a ‘refuge’ - pleasant spaces that catered to a sense of well-being.
• At Pennybyrn at Maryfield, High Point, NC, the staff of one hallway decided to create a ‘breakfast club’ in a solarium near their hall. Residents delighted in the made to order breakfast accomplished by caregivers and kitchen staff working together on the project.
• Beverly Health and Rehabilitation Center in Superior, WI transformed the tiniest hallway space of their lobby that had housed a copy machine. With a bit of ‘trading spaces’ attitude and fun they found furniture to shape a pleasant spot to read or visit.
• A team in a subacute unit designed a new spa, complete with thick towels and terry robes.
Establish parameters. The most important thing in this early stage of team work is to assure that the team’s results can succeed. Consequently, the parameters provided by the Steering Team become of paramount importance. They should include: regulations (the decisions made must reflect all relevant regs); financial restrictions (examples: must be accomplished with no additional funds; or must be accomplished within $150); territorial respect (example: each hall may only make decisions affecting the common areas within their hall); and high involvement (example: the team must include residents). Think long and hard as a Steering Team when establishing these Action Teams. What are your desired outcomes of this team’s work and what are the parameters they should operate within.
ATTRIBUTES STAGE 2
Decision Making
• Group process is used but its impact is more symbolic than contributory
• Administrator makes final decision on any plans
Staffing
• defined by the department
• nursing staff are permanently assigned • some self scheduling by is allowed
Physical Environment
• Less institutional, more homelike
• Resident rooms , common areas are personalized • Institutional clutter is removed
• Residents have more choices at mealtime
Organizational Design
• Department heads are more involved in daily life with residents
• Department heads participate as members on
leadership teams with other staff on the unit level
Leadership
• Members grow in their ability to involve others in
critical thinking and decision-making
• Team leadership emerges
• Natural leaders emerge
• Preceptor training and leadership training programs are offered
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