Building empowered staff teams to increase culture change practices in Illinois nursing homes

"Culture change" is the common name given to the national movement for the transformation of older adult services from a provider-driven model with custodial approaches to care, to one focused on providing individual choice and self-determination. An organization's ability to implement culture change practices is dependent upon 1) retention of qualified staff, 2) a culture of person-centered relationships between staff members and between staff and residents, and 3) information and resources needed to implement culture change practices. The BEST CARE II Program (Building Empowered Staff Teams and Creating Affirmative Relationships for Excellence), funded by IDPH, focuses on providing nursing home staff with training to support them in implementing culture change practices. The training is delivered in a highly interactive one-day workshop held throughout Illinois. Participants are provided with implementation materials that comprise a toolkit for easy replication and individualization. Evaluation: Surveys were conducted at baseline, 6-months post-workshop and 12-months post-workshop to assess changes in 1) work empowerment, 2) organizational culture, 3) job satisfaction, and 4) culture change practices implemented in participant organizations. These culture change practices included: 1) holding regular community meetings; 2) having CNAs consistently work with the residents of the same unit; 3) having CNAs attend resident care conferences; 4) utilizing self-scheduling for nursing staff; 5) implementing recognition programs for staff; and 6) having a career ladder program for CNAs. Results: The evaluation includes participants at baseline (n=239), 6-month post-program (n=133), and 12-month post-program (n=55) surveys. Statistically significant improvements were found in the four areas evaluated.