Measuring Culture Change

Background & Purpose

Many nursing homes across the country have joined a movement toward person-centered, individualized care. This movement, known as nursing home culture change, focuses on implementing a holistic approach to care moving away from an institutional model and toward a social model where the nursing home resident is central to living and care decision processes. CMS awarded the Measuring Culture Change (MCC) special study to the Colorado Foundation for Medical Care (CFMC). This project had two primary purposes: (1) developing a mechanism to distinguish nursing homes that have successfully implemented culture change from those with partial or no implementation, and (2) providing an evaluation of outcome-based performance of these nursing homes to identify quantitative differences between homes that have successfully implemented culture change and homes that have not.

Main Project Tasks

The CFMC project team accomplished eight major tasks during the project:

Reviewed relevant literature
Convened an expert panel to provide input on key culture change practices and constructs, as well as a set of metrics to measure culture change practices
Identified or develop a mechanism to measure culture change
Recruited known culture change nursing homes
Implemented the culture change measurement mechanism
Analyzed project data
Conducted more in-depth validation activities
Produced a project report on findings
Published project results, as appropriate

Period of Performance

June 2006 – July 2008

Resources

The Colorado Foundation for Medical Care (CFMC), the Medicare quality improvement organization for Colorado, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS Policy.