Page 43 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
DEEP ORGANIZATIONAL CHANGE
managers. This team of leaders continues to work together and with their household team to make dining a special time for our residents while achieving all the clinical care requirements.
We began our journey with the goal of taking our effort as deep as it could go. We continue to this day to grow, to learn from each other, and to look for ways to provide better care and better quality of life. The empowered teams and individuals implement ideas and experiences faster than any one person can keep up with, but each is done with the resident in mind, and the standards of excellence that each person is committed to.
The degree that dining can be made special for the residents is only limited by commitment, creativity and a willingness to do the ‘hard thing.’ Our program took a significant jump forward when our Dining Services Mentor, a chef by training and experience who was new to healthcare and Pennybyrn at the time, began to consider the plan to cook breakfast in the houses and then have cooked food delivered for other meals and put in warming trays. He questioned “why would we do that, so much more is possible.” The plan that he proposed, worked through with the teams, and then eventually implemented was to cook or prepare the meals in each household---all three meals!! It was his insight and the commitment of the entire team that took the vision and ultimate reality to heights that previously hadn’t even been considered. The quality of life for residents and clinical outcomes related to dining were impacted significantly by this. The message is one of not only thinking outside the box, but get rid of the box, and don’t get a new one. (Newman, 2010)
These dining system changes create an environment with the pleasantness of home -- from sitting at the kitchen table having a cup of coffee while the homemaker works in the kitchen, to staff engaged in meaningful table talk and stimulating real conversation among the residents, to having content for conversation bubbling out of community circles done through the PersonFirst® initiative.
It is for certain that deep-seated culture change is a challenge. To be most successful on the journey, it is important to include and provide education for all – staff, residents, family members, family and resident councils, ombudsmen and other concerned and involved community groups.
DEEP ORGANIZATIONAL CHANGE – FROM A REGISTERED DIETITIAN’S PERSONAL PERSPECTIVE
Specific to the deep organizational change at Lenawee county Medical Care Facility and the professional transformation of their clinical dietitian chronicled in One Nursing Home’s Tale of Transformation:
Two Weeks Before Move-In: Hopeful But Skeptical
Suzanne Hiltner was intrigued by the prospect of working in a ‘cutting edge’ culture change organization when she applied for a position at Lenawee. But as the day approaches for moving into neighborhoods, she grows anxious. As Clinical Dietitian, her responsibilities have typically revolved around nutritional needs assessments, quality assurance and inventories. She has worked at the nursing home for less than two years and never in a leadership role with staff outside her department. But now she is about to wade into the broader stream of
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