Resource Library

We are here to help you every step of the way

Whether you are just getting started or you have been on the culture change journey for some time, here are resources, developed by leading experts to help you implement organizational culture change and person-directed care.

Donate

Pioneer Network believes that we have an opportunity to make the world a better place for today’s elders — and at the same time, we can create a new way to age for ourselves.

Donate Now
Artifacts of Culture Change

Artifacts of Culture Change

The CMS Artifacts of Culture Change is a tool for providers to assess readiness, implementation and sustainability of person-directed care.

  • See All Artifacts of Culture Change Resources

    Artifacts of Culture Change

    The CMS Artifacts of Culture Change is a tool for providers to assess readiness, implementation and sustainability of person-directed care. The Artifacts of Culture Change tool fills the purpose of collecting the major concrete changes homes have made to care and workplace practices, policies and schedules, increased resident autonomy, and improved environment. It results from study of what providers and researchers have deemed significant things that are changed and are different in culture changing homes compared to other homes.

    Read More
Care Planning

Care Planning

Person-directed care planning is a process of collaborating with elders to honor their choices.

  • See All Care Planning Resources

    A Process for Care Planning for Resident Choice

    A tool to support long term care communities in honoring residents’ choices that influence quality of care and quality of life, while mitigating potential risks associated with those choices

    Read More

    Storyboard Communication Map for Engaging Staff in Individualizing Care

    A companion to the Engaging Staff in Individualizing Care Starter Toolkit

    Read More
Culture Change Basics

Culture Change Basics

Understanding the basic principles of person-directed care is the first step in making an informed decision, asking the right questions and moving forward with implementation.

  • See All Culture Change Basics Resources

    Continuum of a Person-Directed Culture

    Illustrates the differences between staff directed and person-directed culture. Examples show how the continuum applies to specific practices

    Read More

    Foundational Organizational Practices

    Part of Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    National Culture Change Related Organizations

    A list and information about national organizations that can help your organization with its culture change journey.

    Read More

    Nurse Competencies

    Ten competencies deemed most relevant and critical for nurses to be successful in creating and sustaining person-directed care, useful in identifying specific skills needed by nurses working in culture change settings

    Read More

    The Language of Culture Change

    Words matter and these papers address the importance of language in creating a culture of aging that is life affirming, humane and meaningful

    Read More

    The Learning Circle: Action Pact

    The Learning Circle is built upon the idea that everyone sitting around the circle has something to contribute and something to learn

    Read More

    The Learning Circle: Why Use it?

    The Learning Circle is built upon the idea that everyone sitting around the circle has something to contribute and something to learn

    Read More

    The Power of Language to Create Culture

    Words matter and these papers address the importance of language in creating a culture of aging that is life affirming, humane and meaningful

    Read More

    Values Card

    Values of Pioneer Network

    Read More
Dining

Dining

Find resources here for transforming the dining experience using leadership, assessments, and resident input.

  • See All Dining Resources

    Dining Memory and Food for Thought

    Ideas from neuroscience, psychology and literature that can be used as tools to help build alternate approaches to choice and dining in nursing homes

    Read More

    Dining Practice Standards

    Nationally agreed upon food and dining standards of practice support individualized care and self-directed living versus traditional diagnosis-focused treatment for people living in nursing homes

    Read More

    Enhancing the Quality of Nursing Home Dining Assistance

    Findings of the Agency for Health Research and Quality study of Paid Feeding Assistant programs

    Read More

    Flexible Dining Starter Exercise

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Flexible Dining Tipsheet

    Part of Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Food, Pharmacy and Culture Change: A Recipe for Success

    The role of the consultant pharmacist in concert with the interdisciplinary team in identifying drug-food interactions, determining what education to provide the elder

    Read More

    Home Style Dining Interventions in Nursing Homes: Implications for Practice

    An overview of meal service in nursing homes, reasons for implementing home style dining, outcomes of home style dining intervention, and implementation challenges and recommendations

    Read More

    Just in Time Toolkit – Dining

    These toolkits highlight helpful implementation resources, identify relevant regulations and point providers to results to help them find just the right path for their organization in each of three areas, environment change, dining transformations and staffing transformations

    Read More

    New Dining Practice Standards Toolkit

    Medical evidence from recent research studies has demonstrated that restrictive diets for older individuals in long term care are of little benefit, and in fact can be detrimental. These diets often cause residents to reject their meals, leading to weight loss. Restricting sugar, salt, or fat make little difference in blood sugar, blood pressure, or cholesterol in the older person. Research evidence shows that a liberalized, regular diet for most residents can enhance quality of life as well as contribute to maintenance of health.

    Read More

    Pathway to Transforming Dining

    Promising practices to de-institutionalize the dining experience

    Read More

    Promising Practices in Dining

    Innovative examples of how providers are changing their dining practices so that it is a more dignified, pleasurable experience

    Read More

    Survey Interpretation of Regulations

    Potential regulatory and survey issues related to food and dining innovations

    Read More

    The Deep Seated Issue of Choice

    Addresses the issue of resident self-determination through a focus on the dining experience

    Read More

    The Food and Dining Side of the Culture Change Movement: Dining Symposium Background Paper

    Provides the history of the culture change movement as it pertains to the physical environment, a summary of current research into building design issues and innovations, and a review of relevant federal long term care and Life Safety Code regulations for nursing homes

    Read More

    The Role of the Physician Order

    The role of the physician in enabling nursing homes to liberalize diets which allows for resident choice

    Read More
Getting Started Toolkits

Getting Started Toolkits

These resources highlight effective implementation resources, identify relevant regulations and point you to results to help you find just the right path.

  • See All Getting Started Toolkits Resources

    A Free Starter Toolkit for Engaging Staff in Individualizing Care

    This is the free Pioneer Network Starter Toolkit

    Read More

    A Good Welcome Starter Exercise

    This is part of Step Two of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    A Good Welcome Tipsheet

    This is part of Step Two of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Consistent Assignment Starter Exercise

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Consistent Assignment Tipsheet

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Engaging Staff in Individualizing Care Communication Map

    Pioneer Network is pleased to share this Communication Map for Engaging Staff in Individualizing Care. It illustrates how communication infrastructure is essential for effective care delivery to ensure positive resident and staff experiences.

    Read More

    Engaging Staff in Individualizing Care: An Implementation Handbook

    This Handbook provides how-to information for implementing four foundational organizational practices for individualizing care, preventing avoidable declines and maximizing good outcomes: consistent assignment, shift huddles, QI closest to the residents and involving consistently assigned CNAs in care plan meetings.

    Read More

    Flexible Dining Starter Exercise

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Flexible Dining Tip Sheet

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Getting Started

    Pioneer Network partnered with PHI to produce this powerful tool for organizations that are beginning the process of de-institutionalizing services and individualizing care. It is a resource filled with training modules, exercises and tools for individuals at all levels of an organization.

    Read More

    Huddles Starter Exercise

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Huddles Tipsheet

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Individualizing Mornings Starter Exercise

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Individualizing Mornings Tip sheet

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Individualizing Night Time Starter Exercise

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Individualizing Night Time Tip Sheet

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Involving CNAs in Planning Exercise

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Involving CNAs in Planning Tipsheet

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Just in Time Toolkit – Dining

    These toolkits highlight helpful implementation resources, identify relevant regulations and point providers to results to help them find just the right path for their organization in each of three areas, environment change, dining transformations and staffing transformations

    Read More

    Just in Time Toolkit – Environment

    These toolkits highlight helpful implementation resources, identify relevant regulations and point providers to results to help them find just the right path for their organization in each of three areas, environment change, dining transformations and staffing transformations

    Read More

    Just in Time Toolkit – Staffing

    These toolkits highlight helpful implementation resources, identify relevant regulations and point providers to results to help them find just the right path for their organization in each of three areas, environment change, dining transformations and staffing transformations

    Read More

    More than Meds Toolkit

    This toolkit provide resources, tools and lessons learned from the “More than Meds” project to help nursing homes become better places to live and work.

    Read More

    Promoting Mobility Starter Exercise

    This is part of Step Two of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Promoting Mobility Tipsheet

    This is part of Step Two of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    QI Huddles Starter Exercise

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    QI Huddles Tipsheet

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Quick Org Self-Assessment

    This is part of Step One of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Reducing Antipsychotic Medications Starter Exercise

    This is part of Step Three of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Reducing Antipsychotic Medications Tip Sheet

    This is part of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Selecting and Prioritizing Changes

    Adds tools to the original Getting Started toolkit for selecting and prioritizing changes in practices related to the living, working, and caregiving environment

    Read More

    Side-by-Side Communication Map for Engaging Staff in Individualizing Care

    A companion to the Engaging Staff in Individualizing Care Starter Toolkit

    Read More

    Step One: Introduction to Four Organizational Practices

    This is part of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Step Three: Individualizing Care Practices Introduction

    This is part of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    Step Two: Clinical Practices Introduction

    This is part of the Starter Toolkit for Engaging Staff in Individualizing Care

    Read More

    The First 24 Hours – An Unfolding Case In PDC

    The goal of this unfolding case is to illustrate systems to support person-directed care for a resident’s first 24 hours in a nursing home, critical to integrating choices into a new resident’s daily life and plan of care

    Read More
Measuring Outcomes & Quality Improvement

Measuring Outcomes & Quality Improvement

Culture change is an ongoing journey that requires step by step improvement efforts.  Learn what others have done and find resources for your own implementation.

  • See All Measuring Outcomes & Quality Improvement Resources

    Culture Change Case Studies

    Each case study highlights culture change from pre-transformation to implementation while focusing on the resulting impact and returns for residents, staff and organizations

    Read More

    Development of Artifacts of Culture Change

    A report on the development of the Artifacts of Culture Change tool

    Read More

    Positive Outcomes of Culture Change

    Describes the positive outcomes of culture change adoption

    Read More

    Transformative Nursing Homes Experience Positive Quality and Financial Outcomes

    An issue brief summarizing the findings of a study of early culture change adopters

    Read More
Physical Environment

Physical Environment

Changing the existing physical environment of a nursing home in ways that improve residents' quality of life and without major expenditures is possible with these tools.

  • See All Physical Environment Resources

    Creating Home in a Nursing Home: Fantasy or Reality

    Explores ways nursing homes can be designed to reflect house and operated to reflect home

    Read More

    Creating Home in a Nursing Home: Fantasy or Reality (Power Point)

    Illustrates ways nursing homes can be designed to reflect house and operated to reflect home

    Read More

    Creating Home in the Nursing Home Environment

    Explores ways in which nursing homes can be designed to reflect house and operated to reflect a home

    Read More

    Design on a Dollar

    The Design on a Dollar journey provides easy “how-to” instructions and tips to make environmental changes cost-effective while involving your whole community

    Read More

    Household Models for Nursing Home Environments

    Provides information about the household model vs. the traditional institutional nursing home

    Read More

    Household Models for Nursing Home Environments (Power Point)

    Illustrates the household model vs. the traditional institutional nursing home

    Read More

    Just in Time Toolkit – Environment

    These toolkits highlight helpful implementation resources, identify relevant regulations and point providers to results to help them find just the right path for their organization in each of three areas, environment change, dining transformations and staffing transformations

    Read More

    Lighting: Partner in Quality Care Environments

    Describes the importance of adequate lighting in senior living environments

    Read More

    Lighting: Partner in Quality Care Environments (Power Point)

    Demonstrates the importance of adequate lighting in senior living environments

    Read More

    Low Cost Strategies to Transform Nursing Home Environments: Towards Better Quality of Life

    Describes low cost ways that a nursing home’s physical environment can be transformed to create home for the people that live there

    Read More

    Nursing Homes as Places to Live Now and in the Future

    Discusses the physical environment of the traditional institutional nursing home and makes recommendations for change

    Read More

    Nursing Homes as Places to Live Now and in the Future (Power Point)

    Illustrates the physical environment of the traditional institutional nursing home and makes recommendation for change

    Read More

    Private vs Shared Bedrooms

    Illustrates the case for private vs. shared bedrooms

    Read More

    The Environmental Side of the Culture Change Movement: Symposium Background

    Provides the history of the culture change movement as it pertains to the physical environment, a summary of current research into building design issues and innovations, and a review of relevant federal long term care and Life Safety Code regulations for nursing homes

    Read More
Policies & Regulations

Policies & Regulations

Stay up to date with the new polices and regulations that impact culture change practices.

  • See All Policies & Regulations Resources

    2012 Life Safety Code

    Four new culture change proposals accepted into the 2012 edition of the Life Safety code.

    Read More

    CMS Guidance for Laws and Regulations for Nursing Home

    Resources from CMS to teach yourself and your staff the latest information to help you meet the CMS Conditions of Participation.

    Read More

    CMS Survey and Certification Letter 2016

    The Department of Health and Human Services along with the Centers for Medicare & Medicaid Services published a Reform of Requirements for Long-Term Care Facilities on October 4, 2016.

    Read More

    Federal Register Containing the CMS Final Rules

    Federal Register Containing the 2016 CMS Final Rules for long term care

    Read More

    Final Rule to Reform Requirements for Long Term Care (Slides)

    2016 Final Rule to Reform Requirements for Long Term Care Presentation (Slides)

    Read More

    Notes from CMS Final Rule 2016

    Notes from CMS Final Rule Document Pertinent to Culture Change and Person-directed Care

    Read More