Bethel Health Care Centre received a PEAK (Promoting Excellent Alternatives in Kansas) award in May 2007, during the Governor’s Council on Aging in Topeka. The Kansas Department on Aging annually recognizes the healthcare organizations that have taken steps to improve the quality of life for both residents and staff by changing the culture to increase resident control, empower frontline staff, enhance the home environment and increase community involvement.Bethel Health Care was one of nine Kansas care homes to receive a PEAK award, recognizing efforts to transition from the traditional institutional model of care to a more person-centered model.
Culture Change — A Journey
“Culture change” defines the reformation occurring throughout the healthcare industry to transition from a “medical model” of care to a “person-centered” model. Prominent for decades, the “medical model” was patterned after hospitals. To facilitate care by a nursing staff based from a large, centrally located nurses’ station, nursing homes were constructed with private and semi-private rooms along long hallways. Dining was in one large room, and meals were served from a central kitchen. Quality medical care was primary, managed by a director of nursing and licensed nursing staff. In many nursing homes, quality of life was secondary at best.
In presenting the PEAK award, Secretary on Aging Kathy Greenlee said, “The purpose of culture change is to focus as much on the quality of life as quality of care.”
At Bethel Health Care, the goal has always been to provide consistent, compassionate staff. All rooms are private. Staff and volunteers value residents by giving love, preserving dignity, understanding residents’ histories and personalities, and offering some individual choices. Culture change to become even more “person-centered” still required major changes for the facility, staff, and residents. Facility renovations created the physical “neighborhoods,” but changing the culture within them by increasing resident control and empowering frontline staff is a journey that will continue to require patience, encouragement, staff training and practice. The PEAK award application and subsequent evaluation of Bethel Health Care by a team from the Department on Aging recognized Bethel Health Care’s progress in four major areas of culture change.
Increase resident control
By increasing resident control, healthcare organizations recognize and respect the individuality of residents, encourage choices, and honor requests and decisions. At Bethel Health Care, every effort is made to accommodate resident requests and offer and encourage choices. New residents choose from several paint colors for their rooms and personalize with wallpaper borders, window treatments, wall hangings, furniture and bedspreads. These make rooms more like home and reflect a resident’s personality and history.
Spontaneous activities in each neighborhood are occurring more often as residents are encouraged to suggest what they would like to do – play a game, work on a puzzle, create a craft project, enjoy ice cream floats, or order pizza.
Opportunities are offered for residents to express concerns and preferences individually or at the monthly Resident Council meeting. A satisfaction survey is sent to a resident and/or family prior a care plan meeting. Family members are invited to a quarterly meeting to offer feedback to healthcare staff.
At Bethel Health Care, menu selections and alternates have always been offered. Residents look forward to meals and appreciate menu choices. Sometimes meals are ordered and brought in from a restaurant. Residents also enjoy eating out with family and friends or inviting them to eat in the new sunroom. Thanks to the renovations that added individual kitchens to each neighborhood, open breakfast is served from 7 to 9 a.m., made to order, hot and fresh. The aroma of bacon, eggs, pancakes and coffee wafts through each neighborhood. Residents are delighted!
Empower frontline staff
Consistency of staff teams for each neighborhood is one of the goals of culture change. Training and planning empowers frontline staff to make more decisions. Frontline staff members are the certified nurse aides who are directly involved with care and may know the residents best. They provide input about residents at care plan meetings. Teams also initiate activities and decorate the neighborhood each month. Dietary and nursing staff work together during open breakfast. Staff sets its schedules per request and trades schedules to meet personal needs.
A career-advancement plan is being developed.
Enhance the home environment
Enhancing the home environment creates the “place” for culture change. Fortunately, the foresight in planning and constructing health care in 1991 provided a great design for creating three “neighborhoods” because all rooms are private and there is a lounge area midway along each hall of 20 rooms.
The 2006 renovations included:
- Decentralizing the nurses’ station by placing a workstation in the lounge area and installing wireless pagers to decrease noise.
- Dedicating and renovating the Sunny Brook Neighborhood for residents who need memory support.
- Dividing the large dining room to provide a more intimate kitchen-dining-living area for Whispering Meadows and for Sunny Brook (Nature Trail’s was included in the Suderman Assisted Living construction).
- Adding a sunroom to Whispering Meadows to provide a private place for residents and their families.
Involve the community
At Bethel Health Care, community involvement through active, committed volunteers enriches the lives of residents. The Auxiliary contributes greatly to the quality of life for residents by its members’ service and gifts. More than 200 volunteers were invited to the annual volunteer reception. Many volunteer in health care, delivering and reading mail, assisting with activities, playing piano, presenting programs, leading Bible studies and more.
In addition, the activities department schedules intergenerational groups. Children and young people come to visit, play games, present programs or visit one-on-one with residents.
Congratulations to Administrator of Health Services Leigh Peck, Director of Nursing Melanie Florine, and the health care nursing staff, for the commitment to culture change that resulted in the PEAK award.
