Mona Groves, local manager of Home Care Services, is pleased as punch - and with good reason. Groves spearheaded a team of local health care providers from Shorncliffe Residential Care Facility who won an award of merit this year in the workplace health innovation category of the Excellence in B.C. Healthcare Awards.
Groves explained the catalyst for the changes at Shorncliffe was a comment by a clerk in her office in May 2005.
"We have so many people off sick with WCB claims," the woman bemoaned.
And she was right; a whopping 42 per cent of workers had musculoskeletal injuries at that time. As of March 2008, with the implementation of the new philosophy of care, that number has been reduced to 16 per cent.
Groves gives much credit to a book by Moyra Jones, Gentle Care, changing experience of Alzheimer's disease in a positive way.
The answer to our dilemma was in that book, she said. The key was to take the care workers' focus from task to resident.
"We had to change our point of view to their point of view," Groves explained.
And to make the change successful, everyone had to buy into it.
The staff had to change the way they looked at their work. There had to be a culture change, Groves said.
One of the first things Groves did after poring over Jones' book night after night was to develop a philosophy. That helped to define what changes were needed at the home to make it a genuine home rather than a place where folks lived and were entertained.
By defining what the physical environment should look like, the team was able to find ways to make the residents feel at home and comfortable in their surroundings. The underlining principle was to make the unit warm and restful, provide safety and security to both residents and staff, support the losses and abilities of residents and provide opportunities for interaction and stimulation.
"How do you make every little thing you do with them meaningful?" was the question asked. By putting the heart in the institution was the short answer.This, the team felt, could be accomplished by providing brighter colours on the walls, cues to help the residents recognize their doors and other accessories to make each unit a genuine home.
The philosophy also addressed activities. The team realized through their studies that many of the people living in the home needed a "normal daily routine." Rather than large group activities that involved loud noise, the team turned ordinary activities that we all do every day, such as combing hair and reminiscing, into regular events.
And the caring of the residents turned the focus to the individual. The care became focused on each resident's needs rather than a rigid task-driven schedule.
Other elements of the philosophy included the care of families and friends of the residents, the way the staff cared for each other and the caring of the volunteers.
The team included a clinical care co-ordinator, registered nurses, practical nurses, long-term care aides, a dietitian, a geriatric nurse advisor, an occupational health and safety advisor, an occupational therapist, an activity worker and a rehabilitation assistant.
In addition to the vastly lowered incidence of injury by staff, there have been far fewer challenging incidents with residents since the advent of the new work protocol.
And the change has been sustained. Regular staff surveys and focus groups point to the ongoing success of the change.
"This whole thing was about Shorncliffe staff making the work environment better and safer," Groves said.
"They are the most caring staff I've ever run into. They really, really care for the residents. They love the residents. The kitchen staff do, the housekeeping staff do. I'm really proud of them all," she said.
