Arkansas Coalition for Nursing Home Excellence

Major Activities This Year

• Through the work of the AR Innovative Performance Program (AIPP) a quality improvement program was implemented to teach nursing facility and assisted living facility staff processes to implement culture change and individualized person-centered care. We selected a group of nursing homes and assisted living facilities to work intensively on culture change implementation in their homes.  Our group was made up of 29 homes across the state. On a monthly basis, we held a conference call called the Communication Connection for the group of culture change homes.  The State Survey Agency Director, Carol Shockley, joined in the monthly conference calls to answer regulatory concerns raised by homes.  Many of the homes were apprehensive to make changes for fear of the regulatory repercussions.  Carol encouraged the homes to come up with a plan of what they would like to accomplish and submit the plan to AIPP.  AIPP would bring the idea to the State Surveyor Agency for guidance on how to accomplish the change while maintaining compliance.  We found that if we brainstormed these types of issues, we could come up with an appropriate way to make the change and remain in compliance.  During the pilot period, the homes that were surveyed did not experience any compliance issues regarding the changes that were made.  In fact, we had a very positive experience with the surveyors and many were excited to see the changes that were being made.
• The AIPP Culture Change Quality Specialist (CCQS) conducted onsite consultation visits with  an average of 8 nursing homes per month.  The onsite encouragement was extremely beneficial to the homes and allowed the CCQS to share ideas and practices from one home to another.  These onsite consultations continued through the end of the year.
• The AIPP needed a way to roll out information, not only to our culture change group, but to the entire State.  We created a blog called www.arkansasculturechange.com.   We are linking our blog to other blogs that will provide resources and guidance.   Our blog was featured on Bill Thomas' Changing Aging blog on multiple occasions.  
• On February 24 - 25, 2011, AIPP hosted a Statewide 2 day Culture Change Workshop featuring G. Allen Power, MD.  The topic of this seminar was Dementia Beyond Drugs.  This workshop was attended by people from across all healthcare settings.  There were 252 participants representing 91 organizations as well as 53 surveyors.
• On June 9, 2011 AIPP hosted a celebratory Statewide Culture Change workshop featuring Dr. Bryan K. Williams, Customer Service Training Consultant. His presentation urged participants to view residents and families as valued customers. There were 139 participants representing 49 organizations at the workshop. Following the half day training seminar, we held a barbeque luncheon for our culture change homes to celebrate their commitment to the project.
• AIPP was designated as the Advancing Excellence LANE for the state of Arkansas.  The advisory group of stakeholders for the AE campaign met quarterly.  An overview of the AE campaign was presented during all training presentations.  The campaign was featured on the July monthly conference call.  
• Members of the AIPP team attended the Pioneer Conference in St. Charles, MO.
• In November 2011, AIPP held a State wide culture change training seminar featuring Mary Tellis-Nayak on the topic of Caregiver Satisfaction = Resident Satisfaction.  There were 145 participants in this workshop.  We featured a culture change best practice panel discussion consisting of representatives from Arkansas nursing homes who have truly implemented culture change practices.
• The culture change homes were encouraged to complete the Artifacts of Culture Change and then to repeat it again 6 months later.  The group of homes showed an average overall increase of approximately 50 points when they completed it the second time.
• AIPP developed a CD training tool called "Basic Blueprint for Implementing Culture Change" that was sent to all nursing homes in the state which suggested best practices and other relevant information based on the experiences of our group.  The contents of this CD tool can be viewed on our website at www.aipp.afmc.org  
• The initial group of homes will become mentors to the next selected group of homes.  They will continue to be invited to participate in small group culture change training opportunities.  We will continue to provide onsite consultation visits on a less frequent basis.  We will encourage the upcoming group of culture change homes to get acquainted with this group and to utilize their successes and lessons learned.