Artifacts of Culture Change

Reports

ARTIFACTS BENCHMARK REPORTS: 4/01/2010 - 03/31/2011

*Only organizations with confirmed provider numbers are included in benchmark reports. For homes that completed multiple surveys, the most recent survey scores were utilized in compiling statistics.

EXECUTIVE SUMMARY

TOTALS
Homes completing the Artifacts of Culture Change average 241 total points (42% implementation rate) - TABLE A.

Care Practice and Family & Community measures represent the highest implementation rate at 50% - (TABLE A). Note: Outcome measures are not included in implementation and discussed below.

The Environment section averages the lowest implementation rate (32%) due in large part to low completion rates of measures worth more points in this section including Measure #15 - Households with an average score of 7 out of 100 points. This is further illustrated by the left hand distribution of scores in GRAPH C.

OUTCOMES
Homes completing the Artifacts of Culture Change report relatively stable outcome measures (74% in TABLE A). This is further illustrated by the right hand distribution of scores in GRAPH G. It is unclear whether stability is a predecessor to change or as a result of change. Scoring seems to indicate that homes completing the Artifacts have high scores prior to transformations.

83% of homes report no (zero) use of agency staff for Nurses or CNA positions
80% have had only 1 Administrator (zero turnover) in the past 12 months and 40% report that the Administrator has been with the home for 5+ years.
75% have had only 1 DON (zero turnover) in the past 12 months and 35% report that the DON has been with the home for 5+ years.

MEASURES

What measures are homes FULLY implementing? Homes report 100% implementation of more minor environmental transformations such as an extra lighting source, policy supports (residents can decorate their own rooms), and some process changes such as activities led by other departments. - TABLE B

What measures are homes PARTIALLY implementing? Core culture change elements included in The Centers for Medicare & Medicaid Services Interpretive Guidelines such as choice of waking time, and choice of bath/shower times are reported as occurring for SOME as opposed to all residents by the many homes. - TABLE C (Click here to view the CMS Interpretive Guidelines referenced above)

What measures are homes NOT implementing? Most homes completing the Artifacts do not have Households and still utilize traditional nurses stations. Residents are not able to bring pets into the homes. Staff still wear uniforms and do not have career ladder opportunities. - TABLE D

TABLE A - Artifacts Average Totals by Section

TABLE B: Top 15 Measures by Number of Surveys Reporting 100% Implementation (Maximum Points Awarded)

TABLE C: Top 15 Measures by Number of Survey Reporting Partial Implementation (Partial Points Awarded)

TABLE D: Top 15 Measures by Number of Surveys Reporting NO Implementation (Zero Points Awarded)

TABLE E: AVERAGE PER QUESTION SCORE

Download this information in Tools for Change: Vol.1, No 1 Artifacts of Culture Change Benchmark Reports, 4/1/10-3/31/11

To express interest or sign-up for longitudinal peer and benchmark reporting, please contact Amy Elliot at amy.elliot@pioneernetwork.net.

The Artifacts of Culture Change Downloadable Version - A blank version of the tool for download.

The Development of the Artifacts of Culture Change Tool - This is the full report written for CMS who funded the project explaining rationale for the tool, how the tool was developed including the point scale selected, and a large Source Information table which gives backup for each item such as where that practice can be located around the country and any research found supporting items.

The Artifacts of Culture Change Privacy Policy

Vol.1, No 1 Artifacts of Culture Change Benchmark Reports, 4/1/10-3/31/11

Colorado Culture Change Collaborative Grant Project Summary - This document summarizes an almost one year project funded by the Colorado Culture Change Accountability Board CMP Grants and managed by Carmen Bowman of Edu-Catering. The summary goes into great detail about the project which sought to work with 20 nursing homes who voluntarily chose three culture change practices as identified by the Artifacts of Culture Change measurement tool. Homes agreed to meet as teams every other week to implement the three practices and share their story at the end of the project. They also completed the Artifacts tool at the beginning and end of the project. An increase in points, approximately a total of 15 for three practices (at 5 points each) was anticipated. However, the average point increase of 47 points was shocking and showed the value of joining such a project, a little support and mostly the power of making a commitment. The Artifacts tool also proved to do accomplish one of its identified goals by co-developers Karen Schoeneman of CMS and Bowman of Edu-Catering to serve as an educational tool. Many teams stated that the Artifacts tool opened their eyes to all that could be and that "it was the right thing to do" to incorporate more of the represented culture change practices for the residents they serve.

Arkansas Culture Change Project Summary - Through the work of Arkansas Foundation for Medical Care's AR Innovative Performance Program (AIPP) a quality improvement program was implemented to teach nursing facility and assisted living facility staff processes to implement culture change and individualized person-centered care. This report summarize the projects results.

Florida Pioneer Network: Advancing Culture Change in Florida Nursing Homes - Advancing Culture Change in Florida Nursing Homes was developed out of the exploration of culture change practices in 40 Florida nursing homes over 18 months in 2008-2009, using the Artifacts of Culture Change as a group interview tool. The project elicited both barriers and facilitators of culture change practices. Results are documented in this brief.