Defining Culture Change: Times… They are changing.. For the better

Look around. In almost all aspects of our daily lives there are few constants. One apparent exception to this rule would be the inevitability of change. Particularly in healthcare, constant and on-going change seems to be a given. Many of us are benefiting from improvements in healthcare – ranging from physician services, access, technology, treatment regiments, medications, more home-like settings and overall caregiving provided within nursing and rehabilitation centers. Many skilled nursing/rehabilitation centers are experiencing transformational change.

The early baby boomers are causing the beginning of a demographic explosion among the population aged 65+. In NC, 2.3 million baby boomers (those born between 1946 and 1964) are now reaching retirement age. By the year 2030 about 25% of the state’s population will be over age 60. Numerous healthcare delivery options are available to seniors at home, in retirement communities and assisted living facilities as well as in skilled nursing and rehabilitation centers. Demographers now estimate that 2 out of 3 Americans will spend some time in a skilled nursing/ rehabilitation center. Furthermore, it’s estimated that at any given time, approximately 10% of the aged 65+ population resides in a skilled center. These statistics and trends create the real catalyst for culture change in skilled care. Culture change spans the gamut of the caregiving spectrum. That spectrum includes everything from the personal interactions and customer-service expected by residents and their families to the availability and use of technology to the new innovations being utilized in design and construction of new building and renovations alike. The entire manner in which healthcare, including skilled care, is provided is being examined. The driving goal is to achieve progress through a culture change that insists on transformational improvements expected by baby boomers. Great things are already occurring. The North Carolina Healthcare Facilities Association, representing over 400 of NC’s skilled nursing centers, helped spearhead this movement several years ago with an initiative called “The Journey to National Best.” As Chair for this transformational committee, I saw firsthand the personal and professional commitment demonstrated to breaking down previous barriers. Some of these include: regulatory, financial and perceptual issues. The opportunity to promote change for the better has challenges but the rewards for all make it worthwhile. Existing and new construction skilled rehabilitation and nursing centers are embracing culture change. Private rooms and showers, flat screen TV’s and shorter hallways creating more intimate ‘neighborhoods’ are tangible improvements. Utilizing computer technology for medical records and prescription drug ordering helps enhance efficiency and accuracy. Wireless computer access allows for on-the-go documentation by staff as well as WiFi connectivity for residents and visitors. This doesn’t sound much like the “nursing home of old” does it? Culture change is also reflected in the increasingly successful therapy programs in skilled rehabilitation centers. Exciting, effective and fun new technologies are now frequently found in these centers. The use of equipment and modalities previously reserved only for hospitals and acute settings is now becoming commonplace. More insurers are recognizing the quality outcomes from capable and well-trained therapists choosing skilled rehabilitation as their career place of choice. One of the most fun scenes within our local communities has been the excitement of residents playing Wii golf and bowling. The strengthening, endurance and improved range of motion are often hidden by the smiles and enthusiasm. Not all centers involved with culture change are brand-new. Many older locations have been renovated with computer rooms, fine dining rooms, movie screening rooms and specialized orthopedic and stroke rehabilitation treatments. The ‘Journey’ of culture change is gaining statewide and national momentum. The non-for-profit FutureCare of NC was founded with the purpose to support transformational research and training improvements in skilled care. Already several significant projects have been untaken. A Duke Foundation grant will research caregiver to caregiver communication. Workplace enhancements supported by the State of NC, Win a Step Up and NOVA are improving career paths. Nationally the American Health Care Association has developed higher quality awards. AHCA’s “Advancing Excellence” measures improved national clinical outcomes. “MyInnerView” collects national and local consumer data to compare consumer satisfaction. Yes, the times are a’ changing. And yes, I believe they continue to change for the better in the environments and caregiving in skilled rehabilitation centers across NC. That’s positive change in personalized care, the environment, technology, leadership, training and rehabilitation. This all adds up to providing better quality care. We remain committed to this “Journey to National Best.” Join us.

– Paul T. Babinski, LNHA, MBA/MHA, Vice President of Operations, Long Term Management Services, LLC Serving Liberty Nursing and Rehabilitation Centers. If you have questions or would like a tour of a skilled center in transformation, contact or access