Building a Solid Foundation for Culture Change in LTC · Building a Solid Foundation for Culture Change in LTC: ... Appreciative Inquiry ... and team members to share in the ritual

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Building a Solid Foundation for Culture Change in LTC:Working Together to Put LIVING First

Culture Change Exchange | May 11-12, 2016Josie d’Avernas, Susan Brown, Hilary Dunn, Christy Parsons

Workshop objectives

1. Introduce the culture change concept

2. Explore your organization’s readiness for culture change

3. Assess your organization’s current environment

4. Hear about one organization’s successful culture change journey

5. Learn about resources available to support you in your own individualized culture change journey

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Culture change requires

• personal transformation

• operational transformation

• environmental transformation

• societal transformation

Ownership and empowerment

OLD CULTURE NEW CULTURE

“I need to get buy-in of my staff”

“We all need to take ownership, we all

have a role to play”

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BHAG …it all started with a Big Hairy Audacious Goal…

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Take time to build a solid foundation

• Start with a small group of learning partners

• Learn about culture change from others

– Pioneer Network

– Eden Alternative

– Other LTC organizations engaged in culture change

• “Warm the soil” with enablers

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Learning partners…

…have an agreement to share:• Thoughts• Experiences• Changes that will inevitably

happen

…have a relationship that is founded on:• Intellectual rigor• Courage to share intimately• Mutual support and

encouragement

EXERCISE: Your learning partners

• Who will you invite as your initial learning partner(s)?

• What strengths does each individual bring to the partnership?

Reflection questionsGuidebook (page 13)

Take a few moments to consider the following reflection questions and record your answers on

the handout provided.

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Clarify organizational

values and strengths

Collaborative leadership

Command and control leaders

Consensus leaders

Collaborative leaders

LEVEL OF MEMBER ENGAGEMENT

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EXERCISE: The importance of collaboration

“When leaders in long-term care implement change without true collaboration, there is no culture change.”

Worksheet: The role of collaboration and authentic participation in culture changeAppendix 4 (page 15)

Discuss the following statement with people sitting near to you. We will then ask for some

ideas to be shared with the larger group.

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Awareness-Raising Event

Culture change is not about implementing a single vision of a new culture, but co-creating a new culture together.

In 2009, an awareness-raising event engaged 140 leaders and direct support team members to:

• learn about the culture change movement;

• learn strategies for meaningful group discussion and collaboration;

• discuss strengths and identify challenges/opportunities for improvement; and

• collaboratively decide whether or not to embark on a culture change journey.

Institutional vs. Social

INSTITUTIONAL MODEL OF CARE SOCIAL MODEL OF LIVING

Focus on care Focus on living (and care)

Scheduled routines Flexible routines

Team members rotate Team members assist same residents

Decisions for residents Decisions with residents

Environment = workplace Environment = home

Structured activities Planned, flexible, and spontaneous activities

Hierarchical departments Collaborative teams

Team members care for residents Mutual relationships

Us and them Community

(Adapted from Fagan, 2003)

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EXERCISE: Collaborative organizational assessment

Handout: Collaborative Organizational Assessment handoutAppendix 5 (page 23)

Take a few minutes to complete the collaborative organizational assessment on the handout provided. When you have finished the

assessment, discuss the following questions with someone sitting near you.

“In what domain did you score lowest or highest and why?”

“What is your organization’s area of greatest strength and area of greatest need for improvement?”

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Will we embark on this journey together?

YES!

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Traditional vs. Appreciative approach

vs.

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Appreciative Inquiry

Traditional problem solving Appreciative inquiry

Focus on “what’s wrong” Focus on “what works”

Identification of problemsAppreciating and valuing the best

of “what is”

Search for root causes of failure/decay

Search for root causes of success

Fix the past Create the future

Obstacles treated as barriersObstacles treated as ramps into

new territory

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The positive core is made up of those qualities, attributes,

strengths, and assets that already exist within the organization,

all of which will take us into the future, provide continuity, and

act as a source of pride and confidence for each village member.

DiscoveryPrimary Aim:

To discover an organization’s positive core

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Our Positive Core

Strengths & Contributions

Our Ideal Future

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The Dream cycle…

… occurs when the best of “what is” has been identified

… asks people to create life-giving images of their future

… is grounded in the organization’s history and strengths.

DreamPrimary Aim:

To expand or extend people’s sense of what is possible

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EXERCISE: Your ideal future

Based on Guided Imagery exerciseStep 6, Action 6.2 (page 66)

Take a few moments to write down the key ideas that came up during your imagining of an

ideal future.

1. What is happening? What do you see, feel, sense, or hear?2. What do you think would need to happen in order for this change to come about?”3. What is one thing that we can do today to support this vision?

To view a shorter version of the Dream video played during this workshop, visit:

https://www.youtube.com/watch?v=39IbGommlJU&list=PLHjCxNW-AgfFGkcvoX6lwf90W1qFRB6Z_&index=13

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Team members identified common themes that emerged from these performances and actionable ideas that would accelerate our journey toward a more ideal future.

Opportunity areas

Flexible dining Flexible living

Meaningful activities Cross-functional teams

Diversity Research and innovation

Resident empowerment Authentic relationships

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Aspiration statements articulate the desired organizational

qualities, processes, and systems to help guide the organization to

its higher purpose by challenging common assumptions or

routines, and suggesting desired possibilities for the organization

and its people.

DesignPrimary Aim:

To develop operational goals and actions to guide us in working

toward “what could be”

Aspiration Statements: Characteristics

Aspiration statements should be:

1. Provocative: Does it stretch, challenge, or interrupt the status

quo?

2. Grounded: Are examples available that illustrate the ideal as a

real possibility? Is it grounded in the organization’s collective history?

3. Desired: Do you want it as a preferred future?

4. Affirmative: Is it stated in bold and positive terms?

5. Participative: Does it engage and include people in decision-

making about the destiny of their own lives?

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Aspiration Statements: Flexible Dining

Key points for Schlegel Villages’ “Flexible Dining” Aspiration Statement:

• Industry leaders

• Honour resident choice of mealtime, food and company

• Always room for family, friends and team members

• Dining is an important ritual

• Homemade dishes and fresh-baked goods

• Comfortable environment

• Individual preferences

• Dignity and respect

Our villages are celebrated as industry leaders for our flexible dining program.

Our flexible dining honours the residents’ abilities to make choices regarding all aspects of dining including mealtimes and food choices.

Our flexible dining invites the broader community to the table, ensuring plenty of room for families, friends, visitors, and team members to share in the ritual of eating together.

Our homemade and fresh baked meals are tailored to honour individual preferences, and our dining services are offered with care and dignity, ensuring a comfortable and enjoyable experience for each person.

Aspiration Statements: Flexible Dining

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Village teams were encouraged to think about some possible goals

and actions that could help them achieve their newly realized

aspirations as well as to consider how to include village members

in the actual process of developing goals and actions.

DestinyPrimary Aim:

To engage participants in planning how to enact and

sustain the aspirations.

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Broaden engagement, keep momentum going

• Advisory Teams

• Culture change Roadshow

• Conversation Cafes

• Reflection interviews and retreat

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2009 2011 2013 2015

4.7 6.7 7.4 7.7

So How Have We Fared on Our Journey?

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Questions?

To order additional guidebooks or to inquire about coaching support, please contact:

Kate Ducak

Culture Change Project Officer

519.904.0660 ext. 4107

[email protected]

For more information about this workshop, please contact:

Josie d’Avernas

Vice President

Schlegel-UW Research Institute for Aging

[email protected] X 4103

Susan Brown

Research Coordinator

Schlegel-UW Research Institute for Aging

[email protected] X 4105