Page 68 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
Advancing Resident Self-Determination
ways of communicating with providers into daily practice. The same holds true for all levels of nursing home staff – they must shift their mistrust of the survey process to a collaborative approach in which they share failures as well as success. In many cases, organizations that have established rigid policies and procedures will need to move toward a more organized process that focuses on embedding culture change principles into policies and practice. Federal and state policy makers, as well as nursing home corporations and individual facilities, will need to establish incentives to hold the regulators and providers accountable and to reward successful partnerships.
“Given the pivotal role that consumer advocates played in the creation of OBRA ’87 and their ongoing efforts to ensure consistent oversight and enforcement, this group’s buy in of smarter regulation is essential.”
“It is also essential that the most important stakeholders – nursing home residents and their families – assume responsibility for the success of this approach. Resident and family councils must weigh in on how partnerships should be structured and implemented. Consumers and their relatives need to receive culture change training together with surveyors and nursing home staff. To maximize the success of these collaborations, they must also be part of the facility-level teams that identify regulatory barriers, work to minimize these hurdles, and ensure the achievement of cultural transformation.” (Stone et al, 2009)
Kantor, in remarks to the Alliance for Health Reform and the Robert Wood Johnson Foundation, emphasizes the importance of state culture change coalitions in moving forward. She notes the important role of independent active groups with diverse stakeholder involvement, coordinating with other efforts to move culture change forward on the state level including effective partnerships with regulatory and technical consultation. She poses the fundamental question:
“So, what’s it going to take to make this resident-centered care the norm? What do we all have to do? First, it’s important to know that this is no longer a question. We have gone from debates to conversation. We all agree, the question is how.” (Kantor, 2007)
With the collaboration of researchers, academia and policy makers asking and answering the questions of “how” to the standards of their professions, pioneering states are demonstrating effective partnerships between regulatory and technical consultation. Pioneering providers are giving inspiration through a wide variety of approaches that successfully create home and resident-directed care. They are demonstrating that putting the person before the task and creating normalcy are indeed possible.
The Declaration of Interdependence, the Spirit of ’06 from the Pioneer Network, can guide us all toward effective partnerships in the exploration of “how.” The full document can be reviewed in Appendix G. In conclusion, it affirms:
In declaring our interdependence, we recognize that when we are united, we have endless possibilities; when we are partners, we build community; when we are proactive together, we reduce our fear of change, and when we cultivate the common ground, we grow individually and collectively. (Pioneer Network, 2006)
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