Beyond the medical model: the culture change revolution in long-term care.
Culture change in long-term care facilities involves a shift in philosophy and practice from an overemphasis on safety, uniformity, and medical issues toward resident-directed, consumer-driven health promotion and quality of life. Fundamental to this shift is a focus on the importance of the relationships between residents and direct care staff. This review presents and discusses the key elements of culture change, including workforce redesign, resident-centered care, leadership, and the implementation process and evaluation. A case report describes how medical staff can participate in this grassroots movement and help foster the social, cultural, programmatic, and physical changes that can alter the culture of long-term care one home at a time.
White-Chu
E Foy
EF
Hebrew Senior Life/Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, USA. ewhitech@bidmc.harvard.edu
Graves
William J
WJ
Godfrey
Sandra M
SM
Bonner
Alice
A
Sloane
Philip
P
D007857:Leadership; D008404:Massachusetts; D008962:Models, Theoretical; D009735:Nursing Homes / Q000458:organization & administration*; D019982:Organizational Case Studies; D015279:Organizational Culture; D011787:Quality of Health Care