Objectives of this workshop

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 you own individualized culture change journey

What is culture change in LTC?

In the most general terms, culture change is a shift from an institutional model of care to a social model of living; a shift in

focus from providing care to supporting living.

We must still provide excellent care, but without making it the central focus. Culture change calls us to put living first.

BHAG – It all started with a Big Hairy Audacious Goal

Culture change takes:

- personal transformation-organizational transformation

-societal transformation

Culture change requires supportive:

- physical environments- leadership practices

-staffing design - vocabulary

Culture change requires Ownership & Empowerment

Old Culture

• “I need to get buy-in from my staff.”

New Culture

• “the staff team takes ownership.”

• Ownership only comes from having a part in shaping the plan.

• Empowerment = Authority, Resources, Information, Accountability

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

– Transformational and serving leadership training

– Excellence in resident-centred care training

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.

Collaborative Organizational Assessment

• Take a minute to individually complete the assessment below, rating your home or organization on each of the 9 domains (1 being more institutional; 10 being more social).

• With your table, share 1 learning that resulted from the assessment. In what domain did you score lowest or highest and why?

Things that Disturb Us

Examples:

• Opting for a quick fix instead of trying to understand the underlying causes of personal expressions

• Team members focus on completing tasks with a lack of resident interaction due to time constraints

• Instead of supporting residents in decision-making, team members make decisions

• Rigid mealtimes due to kitchen routines, Ministry standards, and structured schedule for team members

Will we embark on this journey together?

YES!

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”

Sear 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

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

Positive questions would help us discover and better understand:

(1) Our positive core

(2) Our individual and collective strengths and contributions

(3) Our images for an ideal future

Discovery Discussion

Our Positive Core

Strengths & Contributions

Our Ideal Future

The Dream cycle…

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

… asks community members to create life-giving images for their future.

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

DreamPrimary Aim:

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

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

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”

Opportunity areas

Feedback

In 5 years, what we most aspire to in terms of flexible dining is…

Is the statement provocative? Is it grounded in our organization’s collective history? Does it represent the desired future? Is it affirmative, stated in bold and positive terms? Is it participative, engaging members of the community in decision-making about the destiny of their own lives?

Aspiration Statements

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.

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.

Village Advisory Teams

Village Culture Change Events

Operational Reflection

Broaden Engagement, Keep Momentum Going

Village Advisory Teams

• Village Advisory Teams

– Acts as an informed and wise council, offering collaborative input to help guide the Village leadership team in resident-centred decision-making

– Comprised of representative residents, family members, and team members from all levels, departments, neighbourhoods, and shifts

• Support Advisory Team

– Acts as an informed and wise council, offering collaborative input to help continue the organization’s momentum with the culture change journey

– Comprised of two representatives from each Village

Village Culture Change Events

Conversation Cafes

Celebrating Success and Where Do We Go From Here

Operational Reflection

• A time to collaboratively reflect on our roots, our process, our participation, our aspirations, our challenges, our progress, our questions, and our learnings, with a view to future growth and thriving.

Collaborative Organizational Assessment

2009 2011 2013 2015

4.7 6.7 7.4 7.7

So How Have We Fared on Our Journey?

Working Together to Put LIVING First – Our Journey Thus Far

Guidebook and Coaching

• Guidebook tells our story (114 pages)

• Appendices provide resources and worksheets (109 pages)

• Coaching packages are available to break the work into more manageable chunks– Learning about culture change (1 day with 2 coaches)

– Preparing for your culture change journey (3-5 days over 3-6 months)

– Holding an Appreciative Inquiry Summit (5-7 days over 2-3 months)

– Broadening Engagement and Sustaining Momentum (3-5 days over 12 months)

• Coaches are from RIA and Schlegel Villages and have direct experience in culture change

To order a guidebook or to inquire about coaching support contact Josie d’Avernas

Questions?

Jos ie d ’Avernas

Schlegel Centre for Learning , Research and

Innovat ion in Long Term Care

250 Laurelwood Drive

Water loo, ON

N2J 0E2

P h o n e : ( 5 1 9 ) 9 0 4 - 0 6 6 0 x 4 1 0 3

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