Teresian House

Challenges and Lessons Learned

• Change doesn't happen overnight and leadership must stay the course.  -
  According to a Resident Care Coordinator, "No matter the challenges, we never turned back." To avoid slipping back into old habits, Teresian House staff emphasize openness and communication. Care teams meet weekly, monthly neighborhood meetings bring together residents and staff, other operational areas such as environmental services meet regularly, and culture change specific groups such as the "SPRING" team involve staff from all areas of the organization. 
  
  
• Implementation is an investment and, although relationships and engagement are tangible and observable outcomes for staff and residents, return on investment is tricky to measure.  -Transformations to neighborhoods mean a loss of efficiencies in some areas and improvements in others. For example, Teresian House lost the efficiencies of a large centralized dining area but gained efficiencies from global inter-disciplinary teams. In another example, the current structure required hiring more social workers, but Teresian House experienced large savings in laundry. "Overall, expenses are budget neutral, and we are attracting incremental revenues from the high quality of culture change." - Mike DelBrocco, CFO
  
  
• Surveyors can be challenging at first. - Initially, the Health Department was not onboard with resident centered care. "They thought they loved the idea until they came in for survey, because it wasn't controlled enough. They couldn't believe that residents had access to coffee. Now, they are much better. The new Interpretive Guidelines will help." - Registered Nurse
  
  
• Initial turnover should be expected in the beginning. - "Some of the social workers at the time just didn't buy into it. They refused to do laundry or empty a dishwasher. The ones we have now really love it." - Resident Care Coordinator
  
  
• It helps to love your leader. - The mutual respect between Sister Pauline and the staff of Teresian House was evident throughout the case study.  "If she wasn't doing this, it wouldn't have worked. She was driven."
  
  
• Innovate, Innovate, Innovate - From Tele-Medicine to Dancing with the Residents, Teresian House embraces change with new programs and goals each year.

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