Article on Culture Change Featured in AIA Design for Aging Knowledge Community Newsletter

The Only Constant Is (Culture) Change

By Steve Leone, AIA, LEED AP

The only constant is change, continuing change, inevitable change that is the dominant factor in society today. No sensible decision can be made any longer without taking into account not only the world as it is, but the world as it will be. – Isaac Asimov

Change is inevitable, change is constant. We all accept that concept until of course, we are inconvenienced by it. We complain about the hectic pace of the modern world while simultaneously making appointments, playing games, sending messages and making calls, on a hand-sized electronic device. We may be down-right offended by the lewd antics of today’s entertainers yet feel comforted by an old tune by that gyrating, oddly groomed foursome from Liverpool. And just as we think we’re working at the top of our game, dedicated, efficient, effective, we’re presented with new regulations and new software that will undoubtedly land some of us in the training room, outside for a cigarette or out the door altogether.

Culture change implies, no requires, a deep, philosophical, organizational change that replaces the way we do everything. As with any organization attempting to implement culture change, there will be those who will support, roll up their sleeves and blossom as true leaders and change agents. Others are likely to kick and scream but give in and learn to adjust.  Some just won’t make it and leave. It’s not for the weak at heart.

In the long-term care space, the Pioneer Network is largely credited with organizing a collective of leaders focused on radically changing the culture of aging. Formed in 1997, the Pioneer Network advocates for person-directed care, a more humane consumer-driven model that embraces self-determination. This is in sharp contrast to the institutional, provider-driven models which evolved from the acute-care models of old.

Nothing About Me Without Me; is a phrase that for me, best summarizes the goal of person-directed or person-centered care.

Above all, culture change requires strong and unwavering leadership. That leadership, that will need to be methodical and patient, nurturing and decisive, understanding yet ready to make hard and sometimes uncomfortable decisions. Such is the leadership at Assisi House in Aston, Pennsylvania.

At Assisi House, the Sisters of St. Francis of Philadelphia, house and care for their fellow sisters in a facility that supports independent living, assisted living, skilled nursing and memory care.  Now retired from their rigorous vocations as teachers, nurses, administrators, etc., the sisters at Assisi House continue to carry out their Franciscan ideals through prayerful service to one another, their community, and their world. Advancing their commitment to person-centered care, leadership and staff have challenged their long-standing approach and effectively begun their journey towards true culture change.

As a preamble to any structural changes to its facility, Spiezle Group orchestrated a series of workshops, interviews and presentations with a multi-disciplinary team, which set organizational expectations and developed an action plan for change. Upon completion of this phase and acceptance by the Sisters of the action plan, Phase II was initiated which included renovations to the facility.

The guiding principle for Assisi House was that all renovations work towards the goal of removing the hallmarks of traditional care-centered, medical model environments. Primary targets for renovation/repositioning include the removal of central nurses stations, opening central space for greater social activities and redefining an otherwise non-descript space to accommodate smaller better defined social programs. This phase of the renovation work is now underway and will be completed by mid 2014.