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 Discussion Topic Culture Change

Before starting this forum, please read Chapter 16.

In this forum, what is your understanding of culture change and why do you think it is important in long-term care organizations? Also, think about some barriers to successful culture change in an organization.

At least 275 words

 The Continuum of Care: This week material is to read chapter 15 and chapter 16.

Course Materials (Available in the Content area of the course): Pratt. J. Long-Term Care- Managing Across the Continuum. 4th edition. Jones and Bartlett ISBN: 978-1-284-05459-0. 

Long-Term Care: Managing Across the Continuum, Fourth Edition

John R. Pratt

CHAPTER FIFTEEN: LEADERSHIP IN LONG-TERM CARE

CHAPTER HIGHLIGHTS

Introduction – ONE of the most important building blocks in the foundation of successful long-term care delivery.

Leadership – the art of getting others to want to do something that you are convinced should be done.

Leaders: Who are they? There are several myths about leaders, including:

· Are leaders born – it is a set of skills that can be learned by nearly anyone.

· Leaders are prescient visionaries – They cannot predict the future, but are prepared to deal with it.

· Leaders are charismatic, possess a special gift – they have charm and appeal that arouse loyalty, but, it is not something special that only a few have.

· Leadership is associated with a superior position – not all managers are leaders.

· Leadership is a matter of control – leaders enable rather than controlling.

· Leaders are remote and distant – they are seen as approachable by their followers.

Common Characteristics of Leaders

· Honest – sincere, genuine.

· Forward-Looking – have a sense of direction and a concern for the future of the organization.

· Inspiring – make followers believe they can do things they had previously thought they could not.

· Competent – competent in their professions and in management.

Leadership Skills – there are several skills necessary to successful leadership in long-term care management.

Influencing Others:

· Skill: Managing Power/Influence – understanding kinds of power and how to use it.

· Position Power – power one has because of the position held.

· Coercive Power 

· Reward Power 

· Legitimate Power 

· Connection Power 

· Personal Power – power that comes from one’s own personality and experience.

· Expert Power 

· Information Power 

· Referent Power 

· Skill: Motivation – understanding what motivates each person and how to use it.

· Skill: Communication – knowing how to make others understand what the leader wants.

Providing Direction:

· Skill: Strategic Thinking – being able to see the big picture.

· Skill: Planning – a formal process of organizational planning.

· Skill: Managing Change – recognizing change and using it proactively.

· Skill: Decision-Making – having the courage to make decisions.

Getting Voluntary Acceptance:

· Skill: Enabling – facilitating subordinate performance.

· Skill: Providing Feedback – letting subordinates know how they are doing, and how to improve.

· Skill: Problem-Solving – recognizing problems, collecting information and making decisions.

· Skill: Conflict Resolution – understanding and dealing with two or more divergent interests.

· Skill: Negotiation – creating win-win situations.

· Skill: Mentoring – coaching and developing others.

· Skill: Team-Building – creating working teams out of groups of individuals.

· Skill: Managing Stress – understanding the causes of stress in the leader and subordinates and managing it.

Gaining & Improving Leadership Skills – ways to acquire or improve leadership skills.

· Recognize the Need for Improvement – improvement cannot take plce without recognition of the need for it.

· Assess Current Skills – involves self-analysis and use of formal analysis tools.

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© 2015 Jones and Bartlett Publishers, LLC

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Long-Term Care: Managing Across the Continuum, Fourth Edition

John R. Pratt

CHAPTER SIXTEEN: CULTURE CHANGE IN LONG-TERM CARE

CHAPTER HIGHLIGHTS

Introduction – the term “culture change” is used in two separate, but closely related, ways. The two ways in which it “culture change” is used herein are as follows:

· As it applies to long-term care consumers (particularly nursing home residents).

· As it relates to changing organizational (corporate) culture in long-term care and other businesses, and its impact on the organizations’ employees.

What is Culture Change? – the common name given to the national movement for the transformation of older adult services, based on person-directed values and practices where the voices of elders and those working with them are considered and respected.

Benefits of Culture Change

· Resident benefits – reduces loneliness, helplessness and boredom; improves physical and mental health (e.g. reduces depression and behavioral problems); reduces unanticipated weight loss, reduces mortality, etc.

· Staffing benefits – reduces employee turnover, eliminates temporary agency staffing and mandatory overtime, reduces workers’ compensation claims/costs, etc.

· Additional benefits – significantly improves employee, resident, and family satisfaction; increases involvement with the outside community including children, students, clubs, and religious organizations, etc.

Culture Change Programs:

· The Eden Alternative

· The Wellspring Model

· The Green House Project

· The Pioneer Network

Components of Culture Change:

· Decision-Making

· Leadership

· Staff Roles

· The Physical Environment

· Organizational Design

Other Aspects of Culture Change:

· Creating a Sense of Community

· Amenities

· Transportation

· Social media

Organizational Culture:

· The collection of self-sustaining patterns of behaving, feeling, thinking, and believing, the patterns that determine how things are done.

· The workplace environment formulated from the interaction of the employees in the workplace. It is defined by all of the life experiences, strengths, weaknesses, education, upbringing, and so forth of the employees.

Characteristics: of Successful Organizational Culture:

1.
Respect for all individuals, including employees, residents, and visitors.

2.
Responsiveness to questions.

3.
Freedom from blame.

4.
Honesty.

5.
Respect for scientific evidence.

Changing the Culture – any culture can be changed and is probably changing most of the time.

Implementing Cultural Change

· Change Takes Time – do not expect it to happen quickly.

· Provide Resources – it will not happen without commitment of people, funds, time.

· Change Opportunities – recognize opportunities to create change (e.g., change of administration).

Role of the Leader – every organization needs a leader to implement beneficial change.

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Chapter 15

Leadership in
Long-Term Care

Learning Objectives

1. Discuss the role of leadership in
long-term care

2. Identify the components of leadership

Identify the characteristics of successful leaders

4. Identify and understand the skills needed by successful leaders

5. Understand how to gain or improve leaderships skills

Leadership

“Leadership appears to be the art of getting others to want to do something that you are convinced should be done.”

– Vance Packard

The Pyramid Climbers

Components of Leadership

1. Influencing others (getting others to do something)

2. Providing direction (something you are convinced should be done)

3. Getting voluntary acceptance (getting them to want to do it)

Leaders: Who Are They?

Myths and misunderstandings:

Are they born or created?

Prescient visionaries

Charismatic, special gift

Superior position

Matter of control

Remote and distant

Common Characteristics
of Leaders

Honest

Forward-looking

Inspiring

Competent

Leadership Skills

Three categories:

Influencing others

Providing direction

Getting voluntary acceptance

Influencing Others

Skills:

Managing power and influence

Motivation

Communication

Managing Power & Influence

Types of power:

Position

Coercive  

Reward  

Legitimate  

Connection  

Managing Power & Influence continued

Types of power (continued):

Personal

Expert   

Information  

Referent   

Providing Direction

Skills:

Strategic thinking

Planning

Managing change

Decision making

Getting Voluntary Acceptance

Skills:

Enabling

Providing feedback

Problem solving

Conflict resolution

Getting Voluntary Acceptance continued

Skills (continued):

Negotiation

Mentoring

Team building

Managing stress

Gaining & Improving
Leadership Skills

Recognize need for improvement

Assess current skills

Summary

Leadership is critical in any organization. This is particularly true with the fast-paced nature of long-term care organizations. It is a field that is undergoing nearly continual transformation. It is a situation crying out for leadership. If providers are to be competitive, they need leaders who can carry them to the next level of success.

Chapter 16

Culture Change in
Long-Term Care

Learning Objectives

1. Understand the nature of culture change

2. Identify the benefits of culture change

3. Understand the role of culture change in
long-term care

4. Identify the components of culture change and
how it is implemented

5. Understand the difference between resident-centered culture change and organizational culture change

Culture Change

Two ways in which “culture change” is used are as follows:

As it applies to long-term care consumers (particularly nursing home residents)

As it relates to changing organizational (corporate) culture in long-term care

What Is Culture Change?

The common name given to the national movement for the transformation of older adult services, based on person-directed values and practices where the voices of elders and those working with them are considered and respected.

Benefits of Culture Change

Resident benefits:

Reduces loneliness, helplessness, and boredom

Improves physical and mental health
(e.g. reduces depression and behavioral problems)

Reduces unanticipated weight loss

Reduces mortality

Benefits of Culture Change continued

Staffing benefits:

Reduces employee turnover

Eliminates temporary agency staffing
and mandatory overtime

Reduces workers’ compensation
claims/costs

Benefits of Culture Change continued..

Additional benefits:

Significantly improves employee, resident, and family satisfaction

Increases involvement with the outside community including children, students, clubs, and religious organizations

Culture Change Programs

The Eden Alternative

The Wellspring Model

The Green House Project

The Pioneer Network

Components of Culture Change

Decision making

Leadership

Staff roles

The physical environment

Organizational design

Other Aspects of Culture Change

Creating a sense of community

Amenities

Transportation

Social media

Organizational Culture

The collection of self-sustaining patterns of behaving, feeling, thinking, and believing; the patterns that determine how things are done

The workplace environment formulated from the interaction of the employees in the workplace

Characteristics of Successful Organizational Culture

1. Respect for all individuals, including employees, residents, and visitors

2. Responsiveness to questions

3. Freedom from blame

4. Honesty

5. Respect for scientific evidence

Changing the Culture

To implement organizational cultural change:

Understand that change takes time

The organization usually needs to
provide resources

Recognize change opportunities

Role of the Leader in
Cultural Change

A leader is necessary:

To motivate team members

To be a visible role model

To explain what is acceptable
and desired

Summary

There are two ways in which culture change is used in long-term care:

As it applies to long-term care consumers

As it relates to changing organizational (corporate) culture

Both have been recognized as critical to success for a long-term care provider.