Leadership

Successful organizational change starts with leadership. In complex long-term care environments, this commitment is particularly crucial given the number of internal and external variables affecting quality and outcomes. Even the most enthusiastic and passionate staff will struggle with implementation and sustainability of culture change without the support of leadership. According to business and long-term care expert, Bernie Dana, "Culture change is a byproduct of adopting a broad and disciplined approach to quality management and quality leadership."^*

Given that time and resources are often cited as barriers to culture change, the Getting Started process of learning, self-reflection, adopting new beliefs, planning and organizational assessment must be championed by leaders. It is these individuals that are charged with strategically developing implementation plans and allocating time and resource investment to culture change activities. The examples below further elucidate this involvement. 

Board Involvement: Example from Providence Mount St. Vincent, CCRC in Seattle, Washington

The Mount's Board, not only supports culture change activities, Board members take pride in encouraging ongoing work. Many Board members have personal experiences with The Mount and several Board members have family members residing in the community. Board members are deeply involved and interested in culture change and look forward to updates. Administrator, Tom Mitchell and Regional Administrator, Charlene Boyd report on culture change at Board Meetings. Programs supporting residents and employees such as sponsoring families and providing food bags for employees during holidays are examples of programs unanimously approved by the Board.

Nursing Home Administrator, Operations, Financial, Clinical Leadership: Example from Westminster Thurber, CCRC in Columbus, Ohio and AAHSA "Excellence in the Workplace" award winner

In 2004, the Leadership Team of Westminster Thurber set out to change the environment for those who live and work in the community. Led by Administrator Steve LeMoine, the team represents leaders from the full continuum of care, as well as crucial operational areas including Human Resources. To further the team's planning and implementation, tools and resources were supplied (books, group meetings, professional speakers, retreats, etc.) to grow the capabilities and skills of each member of the Leadership Team. The team practiced the principles of teamwork by developing teams to respond to all types of operational processes, such as HRT = Human Resource team that brought together the leadership to deal with employee issues, FAT = Financial action team, to review operational fiscal soundness, CAT = Capital action team, to review campus needs and strategically plan for the future goals of the community. The team rotates leadership responsibilities so each person has an opportunity to strengthen their leadership skills.   

ADDITIONAL FINDINGS FROM CASE STUDIES - A consistent finding in Pioneer Network case studies of culture change includes the importance that leaders place on modeling person-directed care practice for staff and elders. In fact, in studies of both The Mount and Westminster, over 60% of the leadership team used the word "modeling" as the predominant method of mentoring staff in culture change.

*Excerpt from August 2008 Provider Magazine article, "Investing in Culture Change: Long term care leaders speculate about why it works." Reprinted with permission from Provider Magazine. Access the full article here.

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