The Challenge of Translating Culture Change.
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Institute of Medicine, Committee on Nursing Home Regulation. (1986).Improving the quality of care in nursing homes. Washington, DC: National Academy Press.Kaplan, R. L. (2011). Analyzing the impact of the new health care reform legislation on older Americans. Elder Law Journal, 18, 213–245. Kapp, M. B. (2013). Nursing home culture change: Legal apprehensions and opportunities. The Gerontologist, 53, 718–726. doi:10.1093/geront/ gns131Konetzka, R. T., Park, J., Ellis, R., & Abbo, E. (2013). Malpractice litiga-tion and nursing home quality of care. Health Services Research, 48(6 Pt 1), 1920–1938. doi:10.1111/1475–6773.12072Li, Y., Spector, W. D., Glance, L. G., & Mukamel, D. B. (2012). State “tech-nical assistance programs” for nursing home quality improvement: Variations and potential implications. Journal of Aging and Social Policy, 24, 349–367. doi:10.1080/08959420.2012.735157Mead, R. (2013, May 20). The sense of an ending. New Yorker, 89, 92. Mendelson, M. A. (1974). Tender loving greed. New York: AlfredA. Knopf.Miller, S. C., Looze, J., Shield, R., Clark, M. A., Lepore, M., Tyler, D., … Mor, V. (2014). Culture change practice in U.S. nursing homes: Prevalence and variation by state medicaid reimbursement policies.The Gerontologist, 54, 434–445. doi:10.1093/geront/gnt020 Mukamel, D. B., Weimer, D. L., Harrington, C., Spector, W. D., Ladd,H., & Li, Y. (2012). The effect of state regulatory stringency onnursing home quality. Health Services Research, 47, 1791–1813.doi:10.1111/j.1475-6773.2012.01459.xNelson, B., & Grassley, C. (2014, April 2). Letter to Marilyn Tavenner, Administrator of CMS. Washington, DC.Noelker, L. S., & Browdie, R. (2014). Sidney Katz, MD: A new paradigm for chronic illness and long-term care. The Gerontologist, 54, 13–20.doi:10.1093/geront/gnt086Office of Management and Budget (OMB). (2014). RIN Data. Retrieved from /public/do/eAgendaViewRule?publd=201404 &RIN=0938-AG81O’Reilly, J. T., & Van Tassel, K. (2014). Litigating the nursing home case (2nd ed). Chicago: American Bar Association Publishing. Plakane, B. (2012). Quality assurance policies and indicators for long-term care in the European Union, Country Report. Latvia: SSRN. Retrieved from /abstract=2033098Roth, G. (2013). Policy and regulation of long-term care—Exploration of an uncultivated field. Latvia: SSRN. Retrieved from / abstract=2205111Stevenson, D. G., Spittal, M. J., & Studdert, D. M. (2013). Does litiga-tion increase or decrease health care quality? A national study of negligence claims against nursing homes. Medical Care, 51, 430–436.doi:10.1097/MLR.0b013e3182881cccU.S. Department of Health and Human Services, Office of Inspector General. (2013). Skilled nursing facilities often fail to meet care plan-ning and discharge requirements, OIE-02-02-00201 Retrieved from /oei/reports/oei-02-09-00201.pdf.U.S. Department of Health and Human Services, Office of Inspector General. (2014a). Adverse events in skilled nursing facilities: National incidence among Medicare b eneficiaries, OIE-06-11-00370 Retrieved from /oei/reports/oei-06-11-00370.pdf.U.S. Department of Health and Human Services, Office of Inspector General. (2014b). Compendium of priority recommendations.Retrieved from /reports-and-publications/compen-dium/files/compendium2014.pdfZimmerman, S., Shier, V., & Saliba, D. (2014). Transforming nursing home culture: Evidence for practice and policy. The Gerontologist, 54(Suppl. 1), S1–S5. doi:10.1093/geront/gnt161The Challenge of TranslaTing CulTure ChangeElaine T. Jurkowski (2013). Implementing Culture Change in Long-Term Care: Benchmarks and Strategies for Management and Practice. Springer Publishing Co., New York, 298 pp., $70.00 (paper).It is perhaps not an exaggeration to state that all nursing home administrators, direc-tors of nursing, and long-term care researchers have heard the term “culture change.” It is pro-moted by the Advancing Excellence in America’s Nursing Home Campaign—in which more than 60% of nursing homes have registered (Advancing Excellence in America’s Nursing Homes, 2014)—as well as by the American Health Care Association (AHCA), the National Association Directors of Nursing Administration in Long Term Care (NADONA/LTC), and numer-ous other organizations. In an online search for books and research articles about “nursing home culture change,” as of July 2014, Amazon. com listed 117 books, and PubMed 259 articles. Consequently, a new book on the topic of culture change in long-term care sets high expectations and faces competition, especially if it intends to make a novel contribution.Jurkowski’s book, Implementing Culture Change in Long-Term Care: Benchmarks and Strategies for Management and Practice, creates its niche by listing the culture change benchmarks presented in the Artifacts of Culture Change Tool (Bowman, 2006) and setting out to provide guid-ance to put those benchmarks into practice. The Artifacts tool creates a weighted score based on 79 “artifacts” representing culture change. Artifacts are listed under six categories: (a) care practices (14 items, 70 points; e.g., baked goods are baked on resident living areas); (b) environ-ment (27 items, 320 points; e.g., no traditional nurses’ stations); (c) family and community (6 items, 30 points; e.g., regularly scheduled intergen-erational programming); (d) leadership (5 items, 25 points; e.g., residents or family members serve on committees); (e) workplace practices (14 items, 70 points; e.g., a paid volunteer coordinator is on890 The Gerontologist at Xiamen University on April 19, 2015 /Downloaded fromstaff); and (f) outcomes (13 items, 65 points; e.g., longevity of the director of nursing). An impor-tant caveat regarding the Artifacts tool, however, and as noted by Jurkowski, is that it has not been psychometrically evaluated, nor is there evidence regarding its validity, reliability, and scoring algo-rithm (Zimmerman et al., in press). Thus, the Artifacts may be viewed by the research commu-nity as a weak standard around which to organ-ize this book. Also, the Artifacts is but one of a number of available tools related to culture change (California F oundation for Medical Care, 2006), and its developers expressly note that it is meant to add to the available tools, not replace them. At the same time, the Artifacts has been embraced by many providers and advocates, and so practical instruction in achieving its benchmarks is certain to be welcomed.Part II of this book presents the Artifacts and text intended to offer practical instruction to pro-mote culture change implementation. In some cases, the text is helpful (e.g., an example and photograph of an altimeter clock in the room of a former pilot to illustrate personalization), but in others it is less so. For example, text to support the benchmarks related to using aromatherapy, mak-ing extra lighting available, having outdoor walk-ing/wheeling paths, using a buddy system, and other sections do not provide the detailed instruc-tion that could truly benefit a reader. That said, Part II also includes discussion of topics ranging from person-centered care to social engagement, leadership practices, measurement of staff turno-ver, and others, and so may help a reader better understand the relevance of the benchmarks.The book also includes introductory chapters to “establish a context for shaping long-term care settings” and final chapters presenting “tools and resources to facilitate the change process.” These headings constitute important bookends for a “how to” book about culture change, recognizing as they do that individuals and settings differ and that culture change does not occur in a vacuum. Jurkowski is to be credited for recognizing the breadth of the matter of culture change and also for striving to make this information digestible to a wide audience. Indeed, that challenge is at times a tall order, as individuals new to the field of aging may need more information than is provided to (for example) understand what is meant by say-ing “asset transfer is critical” and “the fallacy of asset transfer,” or why it is “ironic” that 5% of the population resides in nursing homes. Of note, there are also some points of error—or at least argument—throughout the book, including dis-tinctions made regarding types of long-term care settings and philosophical paradigms relevant to long-term care.Jurkowski is to be commended for promoting culture change in long-term care. This is an effort that has achieved traction but has a long way to go, because implementation is hindered by a lack of definitive outcome data (Shier, Khodyakov, Cohen, Zimmerman, & Saliba, 2014) and by chal-lenges related to norms, expectations, and adap-tive leadership (Corazzini et al., 2014). The aim to improve the culture of nursing homes continues to be a vision for the future, as Jurkowski rightly notes.Sheryl Zimmerman, PhDKenan Distinguished Professor University of North Carolina at Chapel Hill Co-Director, Program on Aging, Disability and Long-Term Care Cecil G. Sheps Center for Health Services Research 725 Martin Luther King Jr. Boulevard Chapel Hill, NC 27599-7590 E-mail: Sheryl_ Zimmerman@Lauren W. Cohen, MAAssociate Director, Collaborative Studies ofLong-Term Care University of North Carolinaat Chapel Hill Program on Aging, Disability and Long-Term Care Cecil G. Sheps Center for Health Services Research 725 Martin Luther King Jr. Boulevard Chapel Hill, NC 27599-7590 E-mail: lauren_cohen@ReferencesAdvancing Excellence in America’s Nursing Homes. (2014). Retrieved July 7, 2014, from https:///Bowman, C. S. (2006). Development of the Artifacts of Culture Change Tool. Retrieved July 7, 2014, from /Data/Documents/artifacts.pdfCalifornia F oundation for Medical Care. (2006). Measuring Culture Change: Literature Review. Retrieved July 7, 2014, from http://www./files/nh/MCC%20Lit%20Review.pdfCorazzini, K., Twersky, J., White, H. K., Buhr, G. T., McConnell, E. S., Weiner, M., & Colón-Emeric, C. S. (2014). Implementing culture change in nursing homes: An adaptive leadership framework. The Gerontologist. Advance online publication.Shier, V., Khodyakov, D., Cohen, L. W., Zimmerman, S., & Saliba, D.(2014). What does the evidence really say about culture change in nursing homes? The Gerontologist, 54 (Suppl. 1), 6–16. Zimmerman, S., Allen, J., Cohen, L. W., Pinkowitz, J., Reed, D., Coffey, W.O., … Sloane, P. D. (in press). A measure of person-centered practices in assisted living. Journal of the American Medical Directors Association. doi: 10.1093/geront/gnu086Vol. 54, No. 5, 2014 891 at Xiamen University on April 19, 2015 /Downloaded from。