Projects
See below additional examples of our work with federal and state government, foundations and other health organizations.
Who should participate? All staff from nursing homes in Michigan can benefit from attending: Administrators, Nurses, CNAs, Therapists, Social Workers, Activities, Dietary, and Housekeeping; as well as residents and their families.
What is required? Participation with WellbeingTREE is free.
Completed Sessions
(See the supporting materials below)
Bereavement and Grief Session Topics and Recordings:
- Session One: “There is Wisdom in the Building”
A discussion of strategies for staff and residents to support each other after a death. View a recording of session one - Session Two: “Caring for Yourself”
Recognizing signs of grief in yourself, teaching residents to recognize signs of grief in themselves, and applying strategies to respond to those signs. View a recording of session two - Session Three: “Caring for Others”
Assisting others when a death occurs. View a recording of session three - Session Four: “It’s Always Too Soon, Until It’s Too Late”
Communication is key to ensuring residents, families, and staff know their roles during these events. View a recording of session four - Session Five: “Memorials”
Memorials are for the living and a good way to honor staff and remember residents. View a recording of session five
Social Isolation and Loneliness Topics and Recordings:
- Session One: “Loneliness and Companionship”
Exploring the connection between social isolation and loneliness with our physical and mental health, addressing ways that can alleviate another's social isolation with care processes. View a recording of session one - Session Two: “Transforming Systems & Processes to Promote Connectedness”
Exploring ways that systems, processes, and practices can promote loneliness and isolation and can prevent finding desired companionship for residents. View a recording of session two - Session Three: "Empowering Resident Voice and Choice"
Delving into what empowerment means in the nursing home for both residents and staff and encouraging the use of observation and assessment to help homes identify practices that build empowerment. Valuable resources are shared that participants can use to carry their learning forward. View a recording of session three - Session Four: "Tackling Loneliness & Promoting Social Connection Among Nursing Home Residents"
Taking a deep dive into the definition of loneliness, we ask the question "How can nursing home residents feel so lonely when they are surrounded by others?" Examining risk factors that may increase the likelihood of loneliness and discussing health outcomes associated with loneliness. View a recording of session four - Session Five: "Effective Approaches for Reducing Loneliness in Nursing Home Residents"
Discussing strategies to mitigate social isolation and loneliness in nursing home residents including navigating family estrangement as well as using different types of technology and laughter therapy. View a recording of session five
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Altarum and the University of Michigan are teaming up to help primary care providers effectively manage pain in older adults.
When prescribing opioids to older adults, it is important to balance pain relief and quality of life with the risk of opioid dependency. The ROMPO (Reframing Optimal Management of Pain and Opioids in Older Adults) project goal is to respond to the unique challenges providers face when caring for older (age 60+) patients who use opioids through a comprehensive educational program.
Implementing ROMPO into your practice will help reduce your older adult patients’ use of opioids while addressing pain in a more effective and sustainable manner.
Benefits of Participating
- Improve outcomes for older adult patients experiencing pain
- Learn to measure and document your patients’ pain using the PEG as part of a comprehensive approach to improving functionality and well-being
- Incorporate an ambulatory pain order set into patients’ charts for easy access to medication and referral orders, as well as clinical decision support
- Learn shared decision-making strategies to help empower older adults to become active participants in their medical care
- Access prescriber support and clinician resources
- Work with a dedicated Practice Facilitator who will provide customized technical assistance for your practice
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- Earn free Continuing Medical Education (CME) and Maintenance of Certification (MOC) credits – up to 20, depending on eligibility
- Participating practices earn up to $1000 in incentive payments after submission of data at three time points.
Eligible Providers Must:
Specialize in Internal Medicine, Family Medicine, or Geriatrics, and care for patients aged 60 and over.
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Designed to transform hospital-like institutions that approach elders as medical patients into communities, nursing home comprehensive culture change initiatives are the definition of radical change. Staff are trained and coached to not only provide medical and supportive services, but also on how to consistently prioritize resident choice and quality of life. Although over the last four decades significant work to develop approaches that foster a person-centered model of care have been designed, little has been done to measure the effectiveness or standardize different culture change protocols.
Altarum’s Delivery Systems Transformation team is committed to implementing, evaluating, and advocating for best practices that ensure quality of life in old age. To advance the work on person-centered care we developed the Systems Change Tracking ToolSM (SCTT). A uniquely purpose-designed QI instrument that allows all members of the nursing home staff, from administrators through care aides and household staff to track their accomplishments and challenges implementing person-centered care over time. By completing and reflecting on the SCTT regularly, staff understand more clearly where they are moving the needle on person-centeredness and how they can make culture change a reality for their residents.
The need for more person-centeredness in the nursing home sector has become starkly clear during the COVID-19 pandemic. Nursing homes nationwide struggled not only to curb high rates of morbidity and mortality, but also with significant resident decline and premature death directly traceable to social isolation and loneliness. As residences where 1.3 million elders live their final years, those in public health are called to refine and amplify practices and protocols that can be used to enhance residents’ quality of life. With the further benefit of making the job of care aides more rewarding.
How the Systems Change Tracking Tool Works
As culture change training proceeds, the SCTT assesses changes that occur in the residential long-term care setting by measuring staff-led shifts in person-centered practices and protocols using 58 items. To ensure its cogency and usefulness, the SCTT underwent cognitive testing and an iterative review process by long-term care, culture change, and survey methodology experts. Importantly, the tool’s instructions acknowledge that not all changes discussed in the instrument will happen quickly—and some may not happen at all.
The SCTT features questions that are grouped into six domains, as established by the Holistic Approach to Transformational Change (HATCh) theoretical model.
The six HATCh domains1,2 are:
- Care Practices Continuous improvement of clinical and non-clinical care (for example, consistent staffing among residents)
- Workplace Practices Endeavors that affect residents through their impact on staff (for example, access to information about resident preferences)
- Environment Creating a home environment that is comfortable and comforting to the residents that live there (promoting feelings of home and comfort)
- Family/Community Resident activities to benefit personal and social interactions; opportunities to engage residents (for example, being able to listen to music of their choice or dine at a local restaurant)
- Leadership Developing culture change among all staff levels, including offering skill-building trainings for direct care staff and inclusive decision making for care plans
- Stakeholders Institutional and regulatory factors that influence culture change; working with stakeholders so these are in harmony with what residents need
Completed quarterly, the tool has four possible responses options: the home has a plan for implementation; the home has a plan that is partially implemented; the home has a plan that is fully implemented; or the home has no plan for implementation.
Working with Altarum to Measure Nursing Home Culture Change Using the Systems Change Tracking Tool
The SCTT tool is publicly available and free to use. We invite anyone who is interested in learning more about how we implemented the SCTT protocol in our own on-going comprehensive culture change initiatives to reach out. We would be pleased to discuss how other organizations might use the tool for their own purposes including for Quality Assurance and Performance Improvement (QAPI) projects. We believe this tool can be a valuable asset in advancing best practices in eldercare nationwide.
If you are interested in using the tool please contact us!
- White-Chu, et al. (2009). Beyond the medical model: the culture change revolution in long-term care. Journal of the American Medical Directors Association, 10(6), 370–378. https://doi.org/10.1016/j.jamda.2009.04.004
- Healthcentric Advisors. (2015). Holistic Approach to Transformational Change®. Retrieved from https://www.youtube.com/watch?v=DtRnzz4ztbk&feature=youtu.be
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