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CHAPTER 11
FUTURE PULL Understanding the Culture in Culture Change by LaVrene Norton
taining the information from them. Of course, these are good practices and skill sets you should already start to develop. Again, learning circles are an excellent format for guiding small group self assessment discussions.
There are pitfalls to self-assessment. (Perhaps the first is that you may not be capable and honest enough with yourself to accurately judge your ability to self as- sess. Or is your decision to self-assess a product of self delusion, more evidence of the gap between the myth and reality in your organization?) Power issues in your organization are another argument for assessment by an external observer: Staff and residents often will not share as openly in the presence of formal leaders as they will with an objective facilitator.
How questions are constructed can determine whether you move forward with positive energy toward a compelling vision of the future or become mired in the old antagonisms and politics of the past. Questions that focus on what is wrong with the organization may result in pointing blame. Instead, construct your ques- tions to ask responders how they want the future to be so they can more easily express their honest desires.
Do not ask questions that may seem intended to benefit or support the vision of a particular individual or group. It is probably best to use an anonymous sur- vey tool like those used in annual staff satisfaction sur- veys. If an outside consultant creates your annual staff satisfaction survey, consider asking him or her to build in specific question areas that are objective and measur- able for exploring issues of culture change. You want the survey to identify the key drivers and restrainers to your transformative vision. If this is a vision that your organization has formally determined, what might get in the way of it happening? What does the organization absolutely have to address, fix, or improve to be able to achieve the vision? And equally important, what strengths and qualities are alive and well that will drive the organization toward the vision?
ASSESSMENT TOOLS
For its clients transitioning to the Household Mod- el, Action Pact has developed a list of self-assessment questions for each discipline within the long-term care organization. However, other self-assessment tools
have been developed by leaders in culture change and are easily accessible to anyone. Following are three ex- amples:

Change Tool” was created for the Centers for Medicare & Medicaid Services (CMS) by CMS project officer Karen Schoene- man and consultant Carmen S. Bowman of Edu-Catering. The tool lists 79 examples of concrete changes homes have made in their culture that distinguishes them from tradi- tional facilities. Those changes are in care and workplace practices, leadership, physi- cal environment, efforts to facilitate family and community involvement, and observ- able outcomes (such as greater staff reten- tion). Individual nursing homes can use the 79 examples as benchmarks to gauge their current culture.

developed an interactive web version of “The Artifacts of Culture Change” so that longterm care organizations can input and score their data online. Both it and the CMS “Development of the Artifacts of Cul- ture Change Tool” are available at www. pioneernetwork.net.

the levels of optimism, trust, and generos- ity across the organization—and thus its readiness to undertake change—with spe- cific questionnaires directed at residents, family members, and staff. These surveys are available for free downloading from the “Resources” section on the Eden Alterna- tive web site (www.edenalt.org).

point, you will probably want to supple- ment them with a list of your own ques- tions that address your organization’s spe- cific issues.
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