For those gifts of human kindness, I will always be grateful!

Tomorrow I will be driving away from Uplands after ten years spent in this lovely part of the world with some of the best people on earth. As I prepare for that bittersweet drive away, I simply want to express to the staff and residents some of my personal thoughts at the end of this experience for me. Above all, I want to say thank you, sincerely, to all staff and residents who have made this experience one of the most fulfilling of my career.

When I arrived in December, 1998, I did so with one purpose in mind, that was to do all I could to serve the staff and residents. Several opportunities arose out of that goal. I completed my B.S., promoted to Director of HR, completed an A.I.T. and was given the challenge of culture change coordinator. Several chores were imbedded in the culture change role. We needed to rebuild the trust in one another. We needed an intense growth/education plan. More than anything, we needed a dream, a strategy to realize the dream, and the confidence that we can succeed in all that we do.

Some of these culture change chores have been accomplished, and some have only been started. But I assure you that there is a spirit in the Uplands community, at Wharton and among staff and residents, that this is a culture change on the move.

In these ten years I have enjoyed more true friendships and warm relationships than I ever would have expected. I have tried to give to Uplands, but at every turn I end up receiving more than I give. For those gifts of human kindness, I will always be grateful! Thank you for a wonderful experience.

Today's song
My Way - Elvis

(Dedicated to my mom)
http://www.youtube.com/watch?v=4HhAcvlCPb4

New Beginnings...

Tammie Underwood hands off the Administrative Mentor role to Maegan Wagner and begins learning Life Enhancement for her new Household Coordinator role. Household Coordinators, Tammie Underwood and Lee Skinner will share an office as we shift into the household teams. Maegan Wagner's first day is a payday, faced with learning all of our names.

Congratulations to Tammie Underwood and Maegan Wagner

for their new roles and beginnings!!!

(Lee Skinner & Tammie Underwood excited to get started with Life Enhancement training!)

(Maegan Wagner's 1st day on her own !)

Circles Everywhere!

The morning started with 15 staff members attending their Circles Everywhere! workshop by Barbara Everett (All staff are scheduled 4 hours 03/25-03/30).

The workshop is fundamental to a series of workshops that staff will attend monthly. Circles Everywhere! focuses on communication strategies that will help us give and receive radical loving and include:

• Understanding ourselves and our supervisors as coaches and servant leaders.


• The qualities of a good coach.


• What leadership looks like and the difference between management and leadership.


• Fundamentals of interpersonal communications


• The importance of listening


• Leveling


• Giving and Receiving feedback

Also, the workshop demonstrates the learning circle, community circle, team meeting model, and the stand-up or huddle meeting. The circle makes everyone equal. The rules of the circle help those who typically talk and have the most authority be quiet and listen. And, it encourages those who are typically shy or don't have much formal authority to speak up.

Staff and Resident Input are Vital to Our Success!

Today we held a staff in-service where we discussed upcoming training and new staff roles. Also, staff were informed that they would be asked at their "Circles Everywhere!" training this month how we might establish work teams in our current facility - keeping in mind the goal is to be in teams by the middle of May.

We spent a good 25 minutes answering staff questions regarding the household model including the organization restructure. The last 20 minutes were spent in breakout sessions where the dietary dept. had a learning circle about what may be more difficult in the new facility and how we may get through the difficulty; housekeeping and laundry had an open discussion about clarification of the new homemaker role and building logistics; nursing asked many questions including questions about the upcoming electronic chart system.

As we continue this journey we will be looking at every opportunity to conduct learning circles. Staff and resident input are vital to our success!

Administrative Office Open House Success!

Wharton's Administrative Office Open House, held in the lower level of Wharton Nursing Home today 1 - 3 p.m., was a success. Many families, residents, and staff attended showing their support as we accomplish one more critical step toward moving into Wharton Homes-tentatively scheduled for completion late fall 2009. Many commented on the fresh decor and then others admired the collage of Dr. May book pictures, but the big attraction was just looking out the back door and seeing the foundation outline for the first neighborhood that will be the home for 31 residents.

I want to thank Patricia Rogers for teaming with me through the project and her dietary dept (the pastries were spectacular!), Jennifer Bryant for helping out in so many ways, Joy Taylor for her administrative support, Nancy Himell for her support and the beautiful flowers, Robin Gray for giving me the freedom to be creative, and all the staff members for believing in the vision!!!

Jessica Norris and Lisa Norris, Clinical Mentors enjoying their fresh, new offices.

Wharton Families and Residents Attend A Wharton Homes and Eden Presentation

Over 70 Wharton families and residents attended the Wharton Homes and Eden Presentation Friday, February 13th. Buzz and Sharon Bair presented the ten Eden Principles, including two poems by Darlene Austin. I followed, presenting how the Eden Principles would be implemented through the new organization structure. Robin Gray concluded the meeting with a construction update and answering questions.

All Staff Attend Radical Loving Care Workshop

All staff is scheduled to attend a, "Radical Loving Care" workshop for two hours either February 4th or 5th .

Administrative Office Relocated

Several administrative offices relocated to the lower level of Wharton. Before we relocated, we remodeled with fresh decor including warm paint colors and carpet. Also, we revamped Buxton Lounge adding French doors. Buxton will be used as training and meeting space and as a general multi-purpose room. The space may be reserved through the business office.

All are invited to the Administrative Office Open House

February 27th 1 - 3 p.m.

Offices: Robin Gray-Mentor, Tammy Wagner-Community Mentor, Patricia Rogers-Dining Services Mentor, Sharon Blankenship-Clinical Records Mentor, Lisa Norris-Clinical Mentor, Jessie Norris-Clinical Mentor

Busy, Busy, Busy

Eight members of leadership finished a 1 1/2 day Baptist Healing Trust "Radical Loving Care" workshop today. The leadership team that completed a similar training in September of last year will join today's workshop attendees in April to discover ways to reach out to staff members and residents to achieve goals produced from the workshops.

The technology action team met with Epic Technology today to discuss nurse call/phone system solutions. We are looking to implement a flexible, comprehensive, mobile nurse call solution that will improve communication without the audible distractions. There were many solutions, but the one that allows the nurse call system to alarm through an analog phone that caregivers and nurses would carry really peaked our interest.

Also, today I presented the organization structure to Fletcher staff members and residents. Staff and residents had great questions, particularly how the Village volunteers will be involved.

Introducing the Household Coordinator Team

Household Coordinators will be working hard this year with a long list of training to prepare for their new roles and responsibilities. To prepare for all the changes, the team has WIG (wildly important goal) meetings weekly. The three goals are 1. KSA's (Knowledge, Skill, and Abilities) 2. Aligning Systems (policies/procedures) 3. Creating household teams. The idea is that these goals are so important and if we don't accomplish these three goals, nothing else matters. The Household Coordinators identify a goal to accomplish each week from the BIG 3 that is S.M.A.R.T. (specific, measurable/mission oriented, achievable, realistic, and timely).

Lee Skinner, Sherry Knox, Tammie Underwood, Kay Brown

Eden Alternative Assessment

The Eden Alternative Registered Home Assessment is a tool to evaluate the Eden Alternative Journey. Since the Eden philosophy compares culture change to the needs of a garden, the levels of achievement are as follows:

Levels of Achievement Score
Warming the Soil 40-80
Planting the Seed 81-152
Tending the Garden 153-204
Harvesting the Crop 205-265
Master Gardener 266

The initial Eden Assessment was completed January 2008 with Wharton Nursing Home scoring 119 and Fletcher Assisted Living scoring 114.

A follow-up Eden Assessment was completed January 2009 with Wharton Nursing Home scoring 108 and Fletcher Assisted Living scoring 142.

· Raising Management to Leadership

The Eden follow-up assessment identified that we improved raising management to leadership by 4% at Wharton Nursing Home and 11% at Fletcher Assisted Living.

Merry Christmas and Happy New Year!

Wharton Homes Organization Structure

Today staff members met in small groups to learn about Wharton Homes' organization structure. Overall the responses were very positive-one staff member responded, "I finally see light at the end of tunnel and it is all starting to come together." The new org. structure focuses on balancing the social/life with medical/clinical needs and a serve and support leadership style. Each staff member is scheduled an "individual development plan" meeting to discuss where they see themselves contributing in the homes and outline any training needs.

Wharton Homes Roles

Mentor: a licensed administrator who has the overall responsibility for ensuring that the nursing home is operated and functions in a manner that reflects the vision and values of the community.

• Medical Mentor: a medical physician who provides mentoring and coaching to team members who provides medical care to residents. Medical Mentor is the Medical Director.
• Clinical Mentor: a registered nurse who provides mentoring and coaching to team members who provide clinical care to residents and is responsible for the coordination of the MDS process for residents living in the household. Clinical mentor is the Director of Nursing.
• Dining Services Mentor: a licensed dietitian or certified dietary manager who mentors and coaches dining services, and homemakers who are responsible for the dining experience for residents within each household in a community.
• Dining Services: an individual responsible for services associated with dining including, preparation and serving of food to the household and cleaning the kitchen.
• Clinical Records Mentor/Central Supply: an individual responsible for maintaining clinical records and coordinating central supply for households.
• Administrative Mentor: an individual responsible for clerical, computer maintenance and office management support.

Community Mentor: a licensed administrator who provides mentoring and coaching to household coordinators who coordinate the activities of a household team to residents.

• Household Coordinator: an individual selected to coordinate the activities of a household team. The household coordinator is responsible for collaborating with residents and team members to ensure quality services to residents and to facilitate household activities that meet the goals set by the residents and team members. The household coordinator provides opportunities for each team member to develop leadership skills that can be used both within and outside the household team.
  · Environmental Services Mentor: an individual who serves as the mentor and coach to the household housekeeping/laundry guides and other team members to assist them to meet the needs of residents. Leads and coaches members of the environmental services team to ensure that the physical environment in community buildings and the grounds are safe and useable for residents, visitors and staff.
  · Life Enhancement Mentor: an individual responsible for mentoring and coaching team members in the households to ensure that each resident has the opportunity to participate in activities and events that are meaningful. This individual fulfills the regulatory requirement for an activities director.
  · Social Services Mentor: a social worker (licensed preferred) who serves as the mentor and coach to household social service guides and other team members to assist them to meet the needs of residents.
• Household Nurse: a licensed nurse (registered nurse or licensed practical/vocational nurse) assigned to a household team who is responsible for the delivery of nursing services to residents during a specified time frame.
• Caregiver: a certified nurse aide who is responsible for providing medical and physical care to the residents of the household to meet their daily needs and enable them to function at the highest possible level.
• Homemaker: an individual who has completed the homemaker and courses and is responsible for preparing and serving food to residents, performing housekeeping and laundry activities for the residents and the household.
  
  Extended Family Members: Individuals assigned to households to assist and celebrate with residents and staff as needed (ex. CFO, Director of Development, HR, Administrative Mentor, Clinical Records Mentor).

Artists and angels discovered at Wharton Nursing Home

http://www.crossville-chronicle.com/archivesearch/local_story_339160215.html

By Jennifer Bryant / Chronicle contributor

Wharton Homes Values

• We value person-directed care focusing on each individual’s unique personality and how they wish to live each day.
• We value “Radical Loving Care” where staff members are encouraged to create sacred encounters by meeting human need with loving care.
• We value the Eden Alternative™ Principles that describe the plagues and antidotes of long-term care.
• We value residents, families, and staff as integral team members working together to create a fulfilling and meaningful life for all.
• We value self-led teams that decide among themselves the most appropriate individual and team responses to the needs and desires closest to the residents.
• We value “home” as related to each individual heart’s desire, and strive to enable the choices and quality of life elders enjoyed in their own homes. Each resident is respected as an individual and shares decision making.
• We value community, where members live, work, and socialize; where they are actively engaged and determine for themselves how to give and receive within their friendships, household, neighborhood, city, state, and country.
• We value growth in training (skills) and education (knowledge) as both means and ends. By deeply investing in staff, residents, and family growth, we further community, enhance possibilities of individual fulfillment, and set an implicit standard that guides our behavior as an organization.

Eye on the Ball!

One resident commented, "November is almost over and there is nothing on the green wall path for the month." It is amazing to see the months tick away. While it may seem like we haven't been working on our path, we have spent the month of November researching three different electronic health records providers, ironing out the details of Wharton Homes new organization structure for presentation to all staff, and developing the first draft of the Wharton Homes policies/procedures and job descriptions. Never fear, the month did not end without some construction pictures up on the green wall path, and I'm sure those winter months of Dec.-Feb. will be jam packed with culture change accomplishments and successes. We still have our eye on the ball!

The harder you work, the luckier you get!

The State survey strain over the past couple of weeks has taken its toll on staff, residents, and families. Thanks to all of you for your support and prayers. My personal prayer is that Wharton Homes continue its vision...

"To create a warm and secure home that nurtures the human spirit"

Today's song.. Calling All Angels - Train

http://www.youtube.com/watch?v=pAKF3_hCSNs

Employee Questionnaire

We are participating in an employee study conducted by Baptist healing Trust in conjunction with the Center for Nonprofit Management (both in Nashville). We at Uplands, will not have any access to nor will we receive any employee's specific answers to the questions. Employee responses to this important survey will only be combined with those from others in a report format. It's from honest and frank responses that we can best understand and improve our performance. The surveys are tentatively scheduled to be distributed to staff December 4th.

It's great to be back!

While I was on vacation last week, the State was in and surveyed the nursing home and I hate I missed the learning opportunity. Listening to the team today, it definitely seems that the feedback from the State supports our culture change shift to balance the social/life household model with the medical/clinical side of nursing homes.

Momentum is High!

You can feel it in the air...

Wow! Between the construction site sounds of large equipment moving earth and trees being extracted and the buzz in the nursing home of the upcoming announcements of change in organization structure and training/development, the new Wharton Homes momentum is at an all time high.

The more than 30 staff questions posted on the green hallway such as "How many jobs will there be?" and "How will it be decided what staff goes in what home?" etc. and the Communication Board showing the Coming Soon Training & Development listing 1. C.N.A. Training, 2. Dietary Safety & Sanitary Training, 3. Housekeeping & Laundry Training, 4. Circles Everywhere!, etc. is creating quite the curiosity about the upcoming changes that is expected to be communicated to all staff in November.

I am leaving for an Eastern Caribbean Cruise on Saturday and already I can't wait to get back and share all the upcoming news with staff, residents & families and see the progress on the construction site!

Uplands Board of Directors are introduced to "Radical Loving Care"

Cathy Self, VP of The Baptist Healing Trust gave a two-hour presentation to the Board today on the concepts of Radical Loving Care. It was very exciting to watch the members of the Board be intrigued, curious, and supportive of a truly radical concept in the healthcare industry that is so heavily mandated by regulations and ideology of professionalism. Where do lines exists between showing love, being professional and meeting regulations?-were just a couple of questions from the Board. Cathy explained that "Radical Loving Care" does not mean we abandon the high expectation of competency, but that "Radical Loving Care" expects both high competency and high compassion. I want to thank Cathy and the Board for the deep inspiration during those two hours!

Communication, Communication, Communication

With so much going on... construction, organization restructure, and up-coming training, we know communication will be key to our success. We painted the 120 hall at Wharton a bright green to create a focal point of communication. One side of the hall has a path divided by seasons to inform staff, residents, and families of our progress on our move into Wharton Homes. The other side of the hall will showcase Q & A, training schedules, news articles, etc. Also, we will have informal and formal meetings, including learning circles, to discuss and communicate all that will be going on during this very exciting next 13 months!

Paperless? Wharton looks at an electronic health record system.

With the excitement of Wharton Homes construction starting yesterday, it only makes sense to look at pairing our state of the art social-model nursing home with high technology! Momentum Healthware showed the department heads a look into the future with a paperless-electronic health record world and a real time tracking system. We have lots of questions and will be looking for comparable systems to get an idea of what will work for us.

First Cottage Moved

The first cottage at Uplands was moved today to make room for the new Wharton Homes.

09/29-09/30 Busy Week with Contract Signing & Leadership Retreat

09/29/08 Merit Construction, Inc. of Knoxville signed the contract for Wharton Homes construction. The construction begins the week of October 6th with an expected completion date of late fall 2009. http://www.meritconstruction.com/

09/29-09/30 Baptist Healing Trust Leadership Retreat




The leadership team met offsite at the Palace Theatre in Crossville to learn about Radical Loving Care. Cathy Self, VP of BHT presented the concept of Radical Loving Care by asking the group to define "Radical" and what "Radical Loving Care" would look like, feel like, and smell like. Cathy defined the four relationships that make up the environment we work in: Self-Self, Caregiver-Caregiver, Caregiver-Leader, and Caregiver-Resident. She explained that like a bottle of wine where the first glass is the best and the last bit of the wine at the bottom, "the dregs", are bitter, we have to pay attention to our self’s in our mind, body, and spirit so we are always giving our best, not our "dregs".

We spent the last two hours of Monday at Laughing Bodies Yoga with Rebecca Dennis where we again learned that you have to take care of yourself first. Rebecca began the class by asking each person their name, what medical problems they had, and what they thought when Tammy (me) told them they were going to yoga. The group had many medical issues including pain and many responses to the yoga, but most of the responses were pretty positive. The group stretched and calmed the mind through poses and meditation. At the end of the session, Robin Gray said she had never felt more relaxed and several others felt no pain. The session was great and many of us are thinking about signing up for classes.http://www.laughingbodies.com/

Visit to Shorehaven Homes of Oconomowoc, WI

Shorehaven Homes moved from an institutional nursing home with long halls and big nurses’ stations into 11households three years ago. Each household is the home for 15 residents.

The Choreography of Culture Change

09/21-09/26
I am in Milwaukee, WI this week attending a workshop-"The Choreography of Culture Change" through Culture Change Now! This week-long experience is structured to give us the knowledge needed to think through organizational change; and the skills necessary to design and facilitate meaningful change processes. The book "In Pursuit of the Sunbeam" by Steve Shields and LaVrene Norton is used as part of the training in addition to the training guide "The Choreography of Culture Change". Being the first day I can already tell this is a genuine turning point in understanding how to better serve Uplands in its culture change journey.
http://www.culturechangenow.com/

Catch-up..

09/04/08 Wharton Homes Construction bids are opened.

Get Ready for a Wild Ride!
08/21 & 08/22 Wharton Leadership Retreat
Thanks to the trailblazing by Live Oak, The Eden Alternative, The Mount and others, there are lots of examples within the industry today to help guide nursing homes on their culture change journey. There is no “cookie-cutter” model that fits everyone-every home must decide for itself what mix of elements will work best in its own unique environment. After all there is no place like home.

Nonetheless, there is a replicable process for creating a shared vision and moving forward as an organization to create more home-like environment. The process includes six phases: the study circle, the design team, skills assessment and development, team development, implementation, and evaluation.

The phases of culture change by Action Pact, Inc.

Wharton’s leadership team went on a two-day leadership retreat, including whitewater rafting on the Ocoee, low ropes course, and other obstacle races, to better understand that although the next year is going to feel like a wild whitewater rafting ride, with teamwork and continuous communication we will create a warm and secure home that nurtures the human spirit!

Kay Brown, Robin Gray, Patricia Rogers, Sharon Blankenship, Tammy Wagner, Sherry Knox, Lee Skinner, Tammie Underwood, Lisa Norris

07/26/08 Uplands receives $35, 033 Baptist Healing Trust Grant, Spring 2008. This grant will allow the Uplands teams to receive training on the concepts of Radical Loving Care as they move to a new model of care for their residents. Managers will model an open-hearted leadership style in which they care for their staff as they wish their staff to care for the elders and use a "serve and support" rather than a "command and control" style of management. http://www.baptisthealingtrust.org/grants/recipients.php

http://www.crossville-chronicle.com/archivesearch/local_story_262163624.html

07/09/08 Wharton Care Center's construction plans are approved by the State of TN.

05/31/08 Uplands Retirement Village joins the Eden Alternative registry http://www.edenalt.org/

05/09/08 Official Wharton Care Center groundbreaking
http://www.crossville-chronicle.com/archivesearch/local_story_142070844.html

Ready, Set, Scribe...

The journey to move from a traditional "medical model" nursing home to a "social model" nursing home began over a year ago, however this blog will help document the journey beginning with the official Wharton Homes ground breaking, May 9, 2008. So let it begin...