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State Investment in Culture Change in Long Term Care

State Investment in Culture Change in Long Term Care . Natasha Bryant, MA Academy Health Annual Research Meeting June 8, 2008. Overview. Introduction Methodology Findings and Themes Summary and Significance . Introduction. Project Purpose and Importance. Grant: Commonwealth Fund

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State Investment in Culture Change in Long Term Care

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  1. State Investment in Culture Change in Long Term Care Natasha Bryant, MA Academy Health Annual Research Meeting June 8, 2008

  2. Overview • Introduction • Methodology • Findings and Themes • Summary and Significance

  3. Introduction

  4. Project Purpose and Importance • Grant: Commonwealth Fund • Purpose – State role in promotion of culture change • State can be a major player and catalyst of change

  5. Three Inter-Related Areas of Activity Continuous Quality Improvement Person-Centered Care Workforce Improvement

  6. Research Questions • What motivated each state to invest in culture change? • Who were the major drivers? • What were the financial and non-financial investments? • What were the specific activities supported by the state? • What were some of the major crosscutting themes?

  7. Methodology

  8. Selection of Case Study States • Sample: selection of states • Case study states • Georgia • Kansas • Massachusetts • Michigan • North Carolina • Oregon • Vermont

  9. Data Collection Activities • Telephone interviews • Review of secondary documents • Site visits • Stakeholder meeting

  10. Findings and Themes

  11. State Motivation • States reactive rather than proactive • Long-term care workforce crisis • Awareness and knowledge of culture change models • Reaction to negative press

  12. Types of Magnitude of State Investments • CMP dollars • Legislative funding • Medicaid • Discretionary grants • In-kind time

  13. Approaches to Culture Change and Initiatives • Workforce improvement • Person-centered care • Continuous quality improvement

  14. Themes • Degree of coordination/integration across initiatives • Regulatory barriers • Importance of relationship building across stakeholders • Uncertainty about funding • Relative lack of legislative champions

  15. Summary and Significance

  16. Summary • State can have a major role in influence to adopt and expand culture change in nursing homes • Three strategic objectives of culture change: • Person-centered care • Workforce improvement • Continuous quality improvement

  17. Significance • Enhance awareness of state policy and program staff • Guidance • Providers, consumers and workers better understand initiatives that have been successful and how they can advocate

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