Page 46 - Tale of Transformation

Artifacts of Culture Change Categories and Items
communication, began to interact with them. “This progress challenged their assumptions about what is possible. They began to act differently, responding to the elders in a more individualized way and helping them to make choices. They shared their perceptions with co-workers and family members, many of whom expanded their expectations and changed the way they related to the elders” (Barkan, 2002).
Workplace Practice Artifacts
Having consistent staff work with the same residents, self-scheduling, career ladders, on-site child day care, awards, sending non-managerial staff to outside training and cross-training all contribute to improving the work culture for staff. In the Eaton Beyond ‘Unloving Care’ study of high and low quality homes, said one DON at a high quality Quaker facility, “’I take care of my staff, and they take care of the patients. If I treat them badly, they will treat the patients badly’” (Eaton, 2000).
Overwhelmingly, consistent staff is a hallmark of a changed culture. When the same staff care for the same residents, that is when relationships form, staff get to know residents needs and preferences, and staff pick up on resident changes in condition (CMS satellite broadcast, 2002, Misorski). Consistent staffing correlates to low turnover and nurses prefer it (Eaton, 2001). From the Kane study, those facilities determined to have high quality of life implemented permanent CNA staffing. Similarly, self-scheduling has been found to resolve scheduling issues and results in staff being more responsible to each other and to their residents (Eaton, 2001).
As a means to make it clear to employees that a home is committed to transforming into a culture of person- centered care, some homes are including in their employee performance evaluations competencies that reflect a transformed culture. One such home is Pennybyrn at Mayfield in North Carolina, whose performance evaluation covers the areas of Team Builder, Person Centered Relationships, Initiative, Willingness to Grow, Critical Thinking-to- Action and Judgment.
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