INNOVATIVE PRACTICES: Incorporating Person-Centered Care in Ombudsman Training,

INNOVATIVE PRACTICES: Incorporating Person-Centered Care in Ombudsman Training,

INNOVATIVE PRACTICES: Incorporating Person-Centered Care in Ombudsman Training, Complaint Investigation and Advocacy WEBINAR OCTOBER 24, 2012 Overview of Webinar Ombudsman Role and Culture Change Applying Person-Centered Care Principles to LTCO Work & Role Innovative Practices from State Programs

What Why How Application & Implementation in Your Program Summary & Closing Overview of Topic

Previous Work, Background LTCO Training and Resources on Culture Change practices, since 1995 2011 - 2012: Focused on Person Centered Care, Culture Change Principles Consistent with Ombudsman Role and Practice Application to Individual Advocacy Ombudsmen, OBRA and Culture Change Older Americans Act

Support community efforts to improve long-term care Advocate for quality care and rights of residents at the individual and systemic level Resolve problems by representing the interest of the resident Act on residents behalf in response to action or inaction by

providers, public agencies and others that may adversely affect the resident Culture Change Provide information to residents, families and providers regarding culture change and resident-directed care Promote resident-directed care and culture change during

complaint resolution Collaborate with others for widespread change and promote culture change as systems advocacy Ombudsmen, OBRA and Culture Change OBRA Right to the highest practicable physical, mental, and psychosocial

well-being of each resident Right to be treated with consideration, respect and dignity Right to self-determination and choice Culture Change/ Pioneer Principle Respond to spirit, as well as mind and body

Know each person Relationship is the fundamental building block of a transformed culture All elders are entitled to self-determination wherever they live Complaints and Culture Change Complaint Culture Change

Practice D-26: Dignity, Know each person, put respect- staff attitudes the person before the task Build relationships (Guardian Angel Program)

Create neighborhoods Involve residents in hiring Involve residents in training Overview of Topic 2012 - 2013: Focus on Incorporating Culture Change Principles into

Ombudsman Training Complaint Investigation Ongoing Advocacy, Systems Approaches Applying Principles: LTCO Work, Role Application Scenario #1 Brentwood Manor: PCC goal, CC Coalition Hickory Hills: No time for Advancing Excellence or CC Complaints regarding resident participation in care planning in both facilities

Respondent: Sherry Culp, Executive Director, Nursing Home Ombudsman Agency of the Bluegrass Application Scenario #1 1. What do you do? 3. What statements would you make as you work on this issue with the facility and in talking with the resident? 4.

In resolving this complaint, do you do anything differently than you do with Brentwood Manor? If so, what and why? If not, why not? 7. How do you ensure that residents and families in both facilities see you as their ally?

Application Scenario #2 LTCO working diligently on CC, encouraging providers to participate in Advancing Excellence Campaign, consumer education CC Coalition gaining momentum LTCO has a leadership role LTCOP has newsletter article about good provider practices, featuring a provider Other activities Respondent: Shannon Gimbel, LTCOP Manager, Denver, Colorado

Application Scenario #2 1. What is your response to allegations you are focusing on the fun things not on resident advocacy and the tough cases? 3. How do you respond to the allegations regarding a conflict of interest with your LTCO role? Rationale?

Evidence? Application #3 1. What LTCO actions, statements, or materials, may be interpreted as being proprovider? 2. What ticklers may prompt you to ask if you are becoming too aligned with providers perspectives in problem resolution? Application #3

What LTCO actions, statements, or materials, may be interpreted as being pro-provider? Socializing with facility staff outside of the facility, hugging staff Criticizing residents/families Trying to lower a residents expectations of the facility Participating in work groups with providers, being silent to avoid being viewed as negative Participating in care plan meetings upon staff request without asking the resident Spending more time with staff than with residents Volunteer LTCO becomes resident, then continues as a volunteer in that facility after discharge

Application #3 What ticklers may prompt you to ask if you are becoming too aligned with providers perspectives in problem resolution? Innovative Ombudsman Practices Selected State Examples Alabama: Karen Guice, Lead Ombudsman, Jefferson County LTCOP

Texas Your Program/State Innovative Practices: Texas Revised LTCO Curriculum to infuse resident direction throughout Includes a chapter on resident direction Why? LTCO practice: what does the resident want?

Revised training to include culture change Could do more to infuse giving residents control, option to speak for themselves LTCO step up only when residents signal a need Innovative Practices: Texas Results? LTCO can help talk the talk and walk the walk, role models for providers

The LTCOP confronted issue: Easier to be paternalistic and fix peoples problems without them; Better to give residents control Today, staff and volunteers describe their work differently than in the past. More confident that the steps LTCO take are the right ones because they are driven by the person

Finding more partners in provider community who share the LTCO views Innovative Practices: Your Program 1. What youre doing, why, and how including training ombudsmen and the role of the LTCOP? 2. How are person-centered care or culture change principles applied to daily LTCO

work? Application, Implementation: Your Program 1. New ideas or application points that you will use in your work. 2. How will you share the info with other LTCO? In Closing Seize daily opportunities to incorporate

Culture Change principles and encourage resident-directed care in: LTCO training Complaint resolution process Systemic advocacy Program leadership Resource allocation

Remain sensitive to potential perceptions of conflict of interest in your role or the LTCO Programs integrity as a resident advocate. Culture Change: Philosophy and Practice Culture change is a complete change in philosophy and practice creating a residentdirected approach to all aspects of life in longterm care Culture change includes changing how Ombudsmen communicate with residents, families and providers

Supporting resident-directed care is important and meaningful at every level including collaboration in coalitions and daily advocacy Resources The National Long-Term Care Ombudsman Resource Center (NORC) www.ltcombudsman.org The National Consumer Voice for Quality Long-Term Care www.theconsumervoice.org Pioneer Network www.pioneernetwork.net Advancing Excellence in Americas Nursing Homes www.nhqualitycampaign.org

CMS (Centers for Medicare & Medicaid Services) www.cms.gov CMS: Four Part Series- From Institutionalized to Individualized Care (archived webcasts) http://surveyortraining.cms.hhs.gov Quality Partners of Rhode Island www.riqualitypartners.org PHI National www.phinational.org YOU! Please share your success and activities with NORC. The National Long-Term Care Ombudsman Resource Center (NORC) www.ltcombudsman.org The National Consumer Voice for Quality Long-Term Care (formerly NCCNHR)

http://www.theconsumervoice.org/ This presentation was supported, in part, by a grant from the Administration on Aging, Department of Health and Human Services.

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