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Nursing Home Transformation Following Consumer Demand Bonnie S. Kantor, Sc.D Executive Director, Pioneer Network October 19, 2007
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2 Who here is aging? When did you start aging? And where have you always lived?
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3 Home Identity Connectedness Lived Space Privacy Power/Autonomy Safety Predictability Journeying Homelessness Non-Personhood Disconnectedness Meaningless Space Without boundaries Powerless/Dependence Insecurity/Uncertainty Placelessness Carboni (1990) Home vs. Homelessness
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4 Opportunities for Nursing Home Transformation Resident-centered Adaptations Improved quality of care and measurable Financial success Opportunity for practice, research and policy to view quality and efficiency as interconnected outcomes.
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5 THE PIONEER NETWORK Diversity of Stakeholders including: Providers State trade associations QIO community Consumers Medical community Aging network Regulators Universities and….
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6 STATE COALITIONS 36 Active, independent statewide coalitions; Diverse stakeholder involvement and structure; Always aligned with other statewide efforts; Enormous opportunities ahead.
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7 Key Questions What is Resident-Centered Care and why do we want it? Where are we now? What will it take to make it the norm?
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8 Resident-Centered Care: The Play Place: Medical Director’s Home Time: Middle of the night Date:August 2007 Action:and the phone rings…..
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9 Resident-Centered Care is the Integrated Practice of Health Care and Resident Support based on: A core set of values and beliefs; Each individual’s needs and desires; Creating home and community. (BINGO!)
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10 In Practical Terms, Culture Change and Resident-Centered Care Result In… Smaller living environments; Permanent work assignments and decision making closest to the residents; Flattened hierarchy; Dismantling daily routines and systems to allow freedom and choice.
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11 What We Know Is… It is possible to provide quality medical services and good personal care while allowing for resident choice. In fact…. Better clinical outcomes can be achieved; The range of clinical outcomes is broadened; Clinical concerns are uncovered earlier if not prevented all together.
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12 What Will It Take To Make Resident-Centered Care The Norm? And the Next Step…
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13 Where Are We Now? From debate to conversation; Critical mass of early adopters; Credible results confirming that it works; But the barriers remain persistent.
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14 Five Key Action Steps: Reframe the question and get rid of “the elephant;” Address leadership needs and engage new partners; Develop and disseminate core competencies and measurable markers; Ensure education and training in Resident-Center Care for all providers at all levels of training; And…
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15 Promote the “Business Case” Resident-centered Adaptations Improved quality of care and measurable Financial success Opportunity for practice, research and policy to view quality and efficiency as interconnected outcomes.
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16 Elliot (2007)
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17 Elliot (2007)
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19 How can you help? CMS/ Pioneer Network symposium: Creating Home in the Nursing Home: a national symposium on culture change and the environment requirements; Medicare and graduate medical education and training; Medicaid reimbursement opportunities.
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