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Image Slide 1. On each slide of this presentation in the background says ”Telling the Story- Dare to be different.” Different is then crossed out and the word “Extraordinary” is put in it’s place. Picture of a young boy. Image Slide 2 Picture of a baby sleeping.

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Image slide 1

Image Slide 1

On each slide of this presentation in the background says ”Telling the Story- Dare to be different.” Different is then crossed out and the word “Extraordinary” is put in it’s place.Picture of a young boy


Image slide 2 picture of a baby sleeping

Image Slide 2Picture of a baby sleeping


Looking beyond the routine toward the remarkable

Looking Beyond the Routinetoward theRemarkable!

Kenny Owings,

Regional Vice-President

On the bottom of each slide says ”Dare to be extraordinary”


Beyond the routine toward the remarkable

Beyond theRoutinetoward the Remarkable!

Jump Start

Your

Culture Change


The routine

The Routine

  • Rigid Routines where residents are expected to fit into facility schedule

  • Restricted Individuality

  • Restricted Options


The remarkable

The Remarkable!

Basic Values of Person Centered Care

  • Know Each Person

  • Put the Person before the Task


Telling the story

Telling The Story

Person Centered care means choices:

  • Fine dining

  • Spa bathing

  • Quality of Life

  • Neighborhoods


Telling the story1

Telling The Story

Fine Dining

  • Menu choices

  • Dessert cart

  • Salad Bar


Telling the story2

Telling The Story

Fine dining

  • Fine china

  • Linen table cloths and napkins


Telling the story images chef setting up the salad bar chef setting up the dessert cart

Telling The StoryImages: Chef setting up the salad bar & Chef setting up the dessert cart


Telling the story figure is a table setting with a menu on the table and candles

Telling The StoryFigure is a table setting with a menu on the table and candles


Telling the story figure is a 4 place table setting with fine china and napkins

Telling The StoryFigure is a 4 place table setting with fine china and napkins.


Telling the story figure is a elderly woman eating dinner

Telling The StoryFigure is a elderly woman eating dinner.


What this means to our residents is dining with

What this Means to Our Residents is Dining with

Dignity

Elegance

Independence

Variety / Choices


Image slide 1

Image slide 3Figure is a graph of P&M Healthcare Early Adopters Family satisfaction - fine dining. In year 2006 53.5 % were satisfied with Quality of dining experience. Year 2007 56% were satisfied with quality of dining and Texas was 55% satisfied with dining experience.


Enhanced bathing

Enhanced Bathing

  • Plush bath robes

  • Scented lotions

  • Relaxing massage

  • Soothing music


Telling the story figure is a picture of a locker room picture is of a basketball goal

Telling The StoryFigure is a picture of a locker room. Picture is of a basketball goal.


Telling the story picture is of a bathroom picture is of a shower room

Telling The StoryPicture is of a bathroom. Picture is of a shower room.


Image slide 4 picture of a woman in her bath robe in the bathroom

Image slide 4Picture of a woman in her bath robe in the bathroom.


Telling the story3

Telling The Story

Beauty salon


Telling the story4

Telling The Story

Beauty Salonvarious pictures of women in a beauty salon.


What this means to our residents is

What this Means to Our Residents is

ContinuityinServices,

Improved Self Image

Which leads to

Improved

Quality of Life


Telling the story picture of people smiling

Telling The StoryPicture of people smiling.

Quality of Life

  • Personal Quality of Life Specialist

  • Individual Attention

  • Frequent Family Communication

  • Consistent Service Delivery


Telling the story5

Telling The Story

Quality of Life

“The one thing I wanted for my 108th birthday was to ride in an airplane again. My friends here at Henderson Health & Rehab made my birthday wish come true” Cliff Hughes Picture of Cliff Hughes


Telling the story6

Telling The Story

Quality of Life

The bond that links your true family is not one of blood, but of respect and joy in each other’s life. Richard Bach. Pictures of elderly people enjoying themselves.


Telling the story7

Telling The Story

Quality of Life

“Ninety-Six years ago I learned to play piano by ear. In October I’ll be 101 and I play piano every afternoon!” Linnie Newsom Picture of Linnie Newsom playing the piano


Telling the story8

Telling The Story

Quality of Life

“Growing up I had 4 brothers, with my husband I had 3 sons and 4 grandsons. Here at Henderson Health & Rehab I feel like I have a house full of sisters to enjoy for the first time! Demetra Doss Picture of Demetra Doss


Telling the story9

Telling The Story

Quality of Life

Sarah Honneycutt

Sulphur Springs

Health and Rehabilitation

Beauty Pagent Winner

2007 – 2008 Picture of Sarah Honneycutt


Telling the story10

Telling The Story

Quality of Life

Of all the music that reached farthest into heaven, it is the beating of a loving heart. Henry Ward Picture of a elderly man


What this means to our residents is1

What this Means to Our Residents is

Individual Attention

Family Involvement

Consistency

in Service Delivery


Image slide 1

Image Slide 5P&M Healthcare Early Adopters Family Satisfaction - Quality of Life. Graph shows 7 different Quality of life standards and shows the differences between 2006, 2007, and Texas: First is "Respectfulness of staff", year 2006 68%, year 2007 73% and Texas 74% satisfied. Second "Care (Concern) of staff" year 2006 65%, year 2007 68% and Texas 67% satisfied. Third is "Resident- to- Staff Friendships, year 2006 68%, year 2007 75% and Texas 70% Satisfied. Fourth is "Resident to Resident Friendships" year 2006 69%, year 2007 70% and Texas 70% Satisfied. Fifth is "Choice/Preferences year 2006 61%, year 2007 63% and Texas 65% satisfied. Sixth is "Respect for Privacy" year 2006 63%, year 2007 68% and Texas 68% satisfied. Last is "Responsiveness of Management, year 2006 61%, year 2007 67% and Texas 62% satisfied.


Clinical practice guidelines

Clinical Practice Guidelines

Quality of Life

Date:Review Date:Revision Date:

Policy

It is the policy of this facility to conduct Quality of Life Rounds and Interviews of both resident and family to promote the highest mental, physical

and psychosocial well being of the persons living with us.

Fundamental Information

Procedure

  • Department Heads will be assigned rooms. This Department Head will become the Quality of Life Specialist for these assigned rooms.

  • Rounds will be preformed each morning prior to the Stand-Up meeting.

  • Resident Interview Form and Quality of Life Rounds form will be completed during the morning rounds.

  • Quality of Life Specialists will report to the attendees the results of their rounds.

  • Any areas of concern will be addressed at the meeting and plans will be made to correct if not already corrected during the rounds.

  • Appropriate Department Head will take notes and make a plan to correct/prevent future occurrences.

  • Appropriate Department Head will take notes and make a plan to correct/prevent future occurrences.

  • The forms will be completed and turned in to the Administrator at the end of the week.

  • Administrator will maintain a notebook for these Quality of Life Rounds and interview forms.

  • The Family Interviews will be conducted monthly and as needed.

  • Results of these rounds and interviews will be reported to the QA QI Committee.

    Documentation

    Quality of life Rounds form

    Resident Interview Form

    Family Interview Form


Quality of life resident assessment

Quality of Life – Resident Assessment

1. How do you enjoy spending your time? ___________________________________

_______________________________________________________________________

2. Would you like to continue to pursue those interests? ______________________

a. in a group setting or individually? __________________________________

b. (ask general questions r/t the answer they give). ______________________

_______________________________________________________________________

_______________________________________________________________________

3. What type of work did you do? __________________________________________

4. Would you like to continue doing those type of things? _____________________

_______________________________________________________________________

5. What do you consider to be the 3 most significant accomplishments of your life?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

6. If you could do anything here, what would it be? ___________________________

_______________________________________________________________________

7. We offer the following activities (hand them a calendar)…Would you enjoy

participating in any of these group activities?________________________________

Quality of Life – Resident Assessment

  • How do you enjoy spending your time?

  • Would you like to continue to pursue those interests?

    a. in a group setting or individuallyb. (ask general questions r/t the answer they give). 3. What type of work did you do?

    4. Would you like to continue doing those type of things?

    5. What do you consider to be the 3 most significant accomplishments of your life?

    6. If you could do anything here, what would it be? 7. We offer the following activities (hand them a calendar)…Would you enjoy

    participating in any of these group activities?


Family contact form

Family Contact Form

Name of Resident: ___________________

Name of Family Member:____________

Your Name: _______________________ Date: ____________

QuestionsResponseAction Taken & Date

1. Do you have any concerns about ________________________ ____________________________________

the quality of care for your Loved _________________________ ____________________________________

one?

2. Is there anything I can do to make _______________________ ____________________________________

your Loved One feel more “at Home”? ______________________ ____________________________________

3. (Ask at least one NEW personal question

about their Loved One… such as: favorite

color, food, hobby, animal, music, flower,

movie, sport, drink, holiday, scent,

time of day, etc.) ______________________ ____________________________________

4. Is there anything that you would like

to ask me? ______________________ ____________________________________

Name of Resident:

Name of Family Member:

Your Name:

Date:

Questions

Response

Action Taken & Date

1. Do you have any concerns about the quality of care for your Loved one?

2. Is there anything I can do to make your Loved One feel more “at Home”?

3. (Ask at least one NEW personal questionabout their Loved One… such as: favoritecolor, food, hobby, animal, music, flower, movie, sport, drink, holiday, scent, time of day, etc.)

4. Is there anything that you would like to ask me?


Image slide 1

Quality of Life RoundsFigure is a quality of life rounds worksheet. This worksheet would be something that the staff would fill out to verify that.


Image slide 1

Telling The StoryFigure is a slide that says titled Neighborhoods. Magnolia Lane, Weeping Willow Drive, Redbud BLVD. Live Oak Street. At the bottom of the slide it says: Companionship and Comaraderie.


Image slide 1

Telling The StorySlide is several pictures of the inside of facility. There are couches and tables in a nice sitting area.


Telling the story11

Telling The Story

Quality of life

Decorated with our Resident’s Interests in mind. Figure shows a room decorated with Elvis pictures and records hung on the walls.


Telling the story figure is two pictures showing computers and a game room for residents

Telling The StoryFigure is two pictures showing computers and a game room for residents.


Telling the story figure is of a picture of a living room setting

Telling The StoryFigure is of a picture of a living room setting.


Image slide 1

Telling The StoryFigure is a picture of a sitting room with couches, coffee tables, end tables, lamps and nice plants.


Telling the story figure is of a elderly woman and a younger woman looking at a picture

Telling The Storyfigure is of a elderly woman and a younger woman looking at a picture.


What this means to our residents

What this Means to Our Residents…

This feels like

HOME!


Image slide 1

Image Slide 6Figure is of P&M Healthcare Early Adopters Family Satisfaction graph. The graph shows the difference between 2006, 2007, and the texas average. In year 2006 59.5%, year 2007 65% and Texas 64% satisfied.


What this means to our residents is2

What this Means to Our Residents is

Safety & Independence

with

Professional Services

And

Measured Outcomes


Image slide 1

Image Slide 7P & M Healthcare First Adopters Average Monthly CNA Turnover Graph; The graph shows the differences between 2005 and 2007. January 2005 9%, January 2007 10%; February 2005 7%, February 2007 8%; March 2005 18% March 2007 7%; April 2005 11%, April 2007 11%; May 2005 13%, May 2007 14%; June 2005 9%, June 2007 13%; July 2005 13%, July 2007 11%; August 2005 14%, August 2007 11%; September 2005 13%, September 2007 7%; October 2005 15%; November 2005 10%; December 2005 7%.


Image slide 1

Image Slide 8Employee Satisfaction Graph; Respectfulness of staff Texas 65% P & M Healthcare 82%; Overall Satisfaction Texas 55%, P & M Healthcare 70%; Recommendation for job Texas 55%, P & M Healthcare 70%; Recommendation for Job Texas 60%, P & M Healthcare 75%; and Adequacy of equipment/supplies Texas 55%, P & M Healthcare 58%.


Image slide 1

Image Slide 9Employee Satisfaction graph. Fairness of evaluations Texas 58%, P & M Healthcare 70%; Safety of workplace Texas 62%, P & M Healthcare 70%; Appreciation of supervisor Texas 55%, P & M Healthcare 70%; Care (concern) of Supervisor Texas 60%, P & M Healthcare 75%; Sense of accomplishment Texas 70%, P & M Healthcare 80%.


Image slide 1

Image Slide 10Employee Satisfaction Graph; Quality of Family-related training Texas 50%, P & M Healthcare 58%; Quality of resident-related training Texas 55%, P & M Healthcare 58%; Quality of Orientation Texas 58%, P & M Healthcare 60%; Quality of teamwork Texas 54%, P & M Healthcare 62%; Quality of in-sevice education Texas 62%, P & M Healthcare 65%; Communication by supervisor Texas 59%, P & M Healthcare 65%.


Image slide 1

Image Slide 11Employee Satisfaction Graph; Average Texas 55%, P & M Healthcare 65%; Assistance with job stress Texas 42%, P & M Healthcare 48%; Comparison of pay Texas 38%, P & M Healthcare 50%; Attentiveness of management Texas 45%, P & M Healthcare 52%; Staff-to staff communication Texas 48%, P & M Healthcare 52%; Care (Concern) of management Texas 48%, P & M Healthcare 55%.


Image slide 1

Image Slide 12Enhanced QM score trends: Pain graph shows the percent of residents at year and quarter. There are the KO's IPG average, Texas average and the US Average between 2003 quarter 3 and 2007 quarter 3.


Image slide 1

Image Slide 13Enhanced QM score trends: Restraints graph shows the percent of residents at year and quater. There are the KO's IPG average, Texas average and the US Average between 2003 quarter 3 and 2007 quarter 3.


Image slide 1

Image Slide 14P & M Early adopters acquired pressure ulcers graph. on left side of graph is from 0 to .03 and on the bottom of the graph is from 2005 Q1 to 2007 Q3. 2005 Q1 .026, 2005 Q2 .02, 2005 Q3 .024, 2005 Q4 .023, 2006 Q1 .014, 2006 Q2 .018, 2006 Q3 .019, 2006 Q4 .016, 2007 Q1 .012, 2007 Q2 .007, 2007 Q3 .003


Image slide 1

Image Slide 15P & M Healthcare early adopters Average daily census graph. year 2005 residents 825 and in year 2007 residents 858.


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Image Slide 16Homes Net Operating Income graph. On the left side shows the amount of dollars. Home AB year 2005 $80,000 and year 2007 $780,000; Home BR year 2005 $400.000 and year 2007 $620,000; Home CM year 2005 $300,000 and year 2007 $1,100,000; Home DG year 2005 $250,000 and year 2007 $500,000; Home EC year 2005 $250,000 and year 2007 $450,000; Home FW year 2005 $100,000 and year 2007 $450,000; Home GP year 2005 -$50,000 and year 2007 $550,000


Image slide 1

Image Slide 17P & M Healthcare Early Adopters Annual Net Operating Income graph. year 2005 $1,400,000 and in year 2007 $4,500,000


Image slide 1

Image Slide 18P & M Healthcare Artifacts of Culture Change Assessment graph; shows subtotal scores and potential points; Care Practices subtotal score 50 and potential points 60; Environment subtotal score 80 and potential points 325; Family and community subtotal score 10 and potential points 30; Leadership subtotal scores 20 and potential points 25; Workplace Practice subtotal scores 50 and potential points 60; outcomes subtotal scores 50 and potential points 55.


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Image Slide 19P & M Healthcare tools of culture change score card graph; N. Texas region total and potential points; Care practices total 60 and potential points 70; Environment total 55 and potential points 85; Family and Community total 15 and potential points 20; Leadership total 15 and potential points 20; Workplace practice total 25 and potential points 30; Outcomes total 25 and potential points 50; Bonus total 20 and potential points 30.


Image slide 1

Image Slide 20Figure is the Culture Change Progress Report; This report has 18 different topics and are rated on a scale from 1.0 to 4.2. The Highest Modal Stage is 4.1- Intermediate Household.


Image slide 21

Image Slide 21

Strengths

  • Alternative meal service is provided at breakfast, lunch and dinner.

  • Leadership team has representation from all units, neighborhoods, or households.

  • Residents are offered extensive choices.

  • Residents are offered moderate choices.

    Residents can make special food requests.

  • Neighborhood amenities are provided.

  • Residents are offered limited choices.

  • Tray line service is eliminated on at least one meal.

  • Staff are aware of culture change initiative

  • Staff assignments are consistent.

Opportunities

  • Staff are working in traditional departmental roles.

  • Staff opportunities to work in self-directed teams are limited.

  • Household amenities are limited.

  • Multidisciplinary teams have limited decision making authority.

  • Staff are not organized into multidisciplinary teams.

  • Leadership team is not doing things extending beyond departmental roles.

  • Frontline staff show limited resident-directed behaviors.

  • Frontline staff show limited informal leadership behaviors.


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Image Slide 22P & M Healthcare Early Adopters State Survey Data graph; Graph shows the Deficiencies per each facilities; facility AB year 2005 Deficiencies 13. Year 2007 Deficiencies 4; Facility BR year 2005 Deficiencies 23, year 2007 Deficiencies 9; Facility CM year 2005 Deficiencies 6, year 2007 Deficiencies 3; Facility DG year 2005 Deficiencies 6, year 2007 Deficiencies 1; Facility EC year 2005 Deficiencies 11, year 2007 Deficiencies 3; Facility FW year 2005 Deficiencies 5, year 2007 Deficiencies 5; Facility GP year 2005 Deficiencies 8, year 2007 Deficiencies 3.


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Image Slide 23P & M Healthcare Early Adopters Complaint Survey Data graph. Graph shows number of surveys to homes. Graph shows number of surveys to homes. Home AB year 2005 surveys 11; Home BR year 2005 surveys 24, year 2007 surveys 3; Home CM year 2005 surveys 17, year 2007 surveys 3; Home DG year 2005 surveys 10, year 2007 surveys 3; Home EC year 2005 surveys 11, year 2007 surveys 2, Home FW Year 2005 surveys 7, Year 2007 surveys 3; Home GP Year 2005 Surveys 29, year 2007 surveys 4.


Rvp tips to jump start your culture change

RVP TIPS to Jump Start your Culture Change

  • Designate a Culture Change/ Quality of Life Specialist at the Regional Level

  • Programming should address Culture Change for Associates as well as Residents

  • Meetings/Conference calls should incorporate expectations for Culture Change

  • Recognition should center around Culture Change

  • Weekly Leadership Tips to tie in Culture Change

  • Share Success stories and make them as visual as possible

  • Walk the Talk


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