“Best Practice”

© Imelda Maurer, cdp  June 2, 2015
ilmcdp@yahoo.com

Businessdictionary.com defines best practice as follows:  "A method or technique that has consistently shown results superior to those achieved with other means and that is used as a benchmark. Wikipedia’s definition adds this: “In addition, a ‘best’ practice can evolve to become better as improvements are discovered”

In a way the concept of transformative culture change within aging services organizations can be seen as a systemic ‘best practice’. The work of Sister Lucy, as a leader of Pennybyrn at Maryfield reflect this.  Pennybyrn is a continuing care retirement community near Greensboro, NC.  Although the “facility” had deficiency-free surveys as a matter of course, Sister Lucy felt that something just didn’t feel right. Along with some of her staff, she learned of the Household Model at an annual conference of the Pioneer Network.  Their organization was in the midst of major architectural renovations and the household model made perfect sense.  Pennybyrn moved from a good institution caring for elders to HOME!  still serving elders with the same clinical proficiency, but at HOME! not in an institution. 

The transformation at Pennybyrn was/is systemic because transformational culture change is not experienced just because certain programs or policies are part of the organizational life.  This transformation is the result of a shift of consciousness, a shift in thinking about aging and aging services, about organizational leadership and how it is exercised not just by someone or some few who hold a title, but from within the total circle of staff. A successful shift will result in a positive new way of life for staff and for residents.

Interestingly, even though transformational culture change cannot be equated with the presence of certain programs or policies, within those organizations moving toward culture change, certain “artifacts” are usually present.  Karen Schoeneman and Carmen Bowman developed the “Artifacts of Culture Change Tool” in 2006 which is available here.

This is a lengthy document, made so by the wealth of information it contains. In addition to providing the free-access tool (pages 22 – 31) it provides the rationale for including the various areas of nursing home life that make up the tool. There is also a section on topic-relevant research references and a general bibliography.

If you look at nothing else, study the tool.  It is not a government tool, or an enforcement tool. Finally, in the words of the authors, “The tool affords the opportunity for an individual home to gauge its progress and do its own benchmarking of where they are on a culture change journey.”

So there we are, back to where we began:  best practice as a benchmark and as part of a journey, an ongoing journey of transformational culture change, whose practices can evolve to become better as improvements are discovered