October 6, 2014 // 12:36 PM

Serving People Around the World

Written by Scott Miller

True to its mission, Garden Spot Village enriches the lives of those older adults who call its Lancaster County campus “home.” The organization also benefits many whom it will never meet—perhaps many more who haven’t even begun to think about their post career years—by sharing its knowledge and insights into person-centered care. From hosting educational visits for peer groups to helping shape policy, Garden Spot Village makes contributions to the "senior" services industry that have a positive impact on skilled nursing across the country and around the world.

Garden Spot Village made a successful transition to the innovative person-centered household model of skilled care in 2005. In the years since, hundreds of peer organizations have visited the campus’s skilled care households to learn how to make that transition.

Last year, visitors included representatives from several retirement communities. In anticipation of building a skilled care facility with eight households, Lake Erie College of Osteopathic Medicine (LECOM) sent its nursing home administrator to Garden Spot Village. She spent three days in the households, learning about culture change and person-centered care from team members and residents.

Opening doors to culture change

“More and more organizations across the country are moving to the household model. It is quickly becoming the standard for new construction, and many organizations are looking for ways to renovate their institutional nursing homes into the household model,” says Steve Lindsey, CEO at Garden Spot Village.

The potential pitfall is that some may see the household model as merely a cosmetic change. In reality, making the household model work requires a culture change. If the organization continues to operate in an institutional manner, without becoming person-centered, the resulting disconnect can lead to problems. Garden Spot Village helps peer organizations understand the culture change that is necessary by inviting them to see the households in action.

The visitors usually meet with members of the leadership team and then tour the households, with lots of opportunities to get answers to their questions. Most groups spend half a day or so.
“We have encouraged guests to have a meal in the household, so that they get to see the household in operation and interact with the elders in the household at that time,” Lindsey says.

Ideally, visitors can spend some time with their counterparts in similar job roles—for example, nurses can talk with nurses in the household, nursing assistants meet with other nursing assistants, and dietary staff can talk with a homemaker.

“We are really open and honest in our sharing,” says Becky Weber, Nursing Home Administrator at Garden Spot Village. Team members talk freely with visitors about the challenges they faced, what they learned and what they would do differently—and the fact that they are still on the journey. They share contact information so visitors can continue the dialog.

Sharing insights and shaping standards

Garden Spot Village has hosted tours for continuing care retirement communities and nursing homes from across the United States and from several other countries, including Canada, Mexico, Great Britain, Ireland, China, Iceland, the Netherlands and Argentina. They learn about Garden Spot Village from architects, consultants or professional associations such as Action Pact, the Pennsylvania Culture Change Coalition or the Pioneer Network. They learn through word-of-mouth referrals from others who have visited Garden Spot Village, or they have heard Lindsey, Weber or other team members speak at state, regional or national conferences and have wanted to learn more.

In addition to speaking and hosting tours, Garden Spot Village team members serve the industry in other ways. When the Facility Guidelines Institute (FGI) began the process of updating its guidelines for design and construction of healthcare facilities and nursing homes, LeadingAge—an association of not-for-profit senior services—asked Lindsey to serve as their representative. As such, he joined a multidisciplinary team of more than 200 experts from the federal, state and private sectors to develop the updated standards for 2014.

“The participation of individuals with such a wide range of expertise helps make the document one that truly reflects a variety of clinical, administrative, engineering and design concerns and that is indeed based on interdisciplinary consensus,” Lindsey says. “I was fortunate to work on a subcommittee of very dedicated professionals who believe in the value of the household model and worked collaboratively to ensure it was held up as the new standard. Having operational experience in the household model was extremely beneficial as we developed the code language for the guidelines.”

With this year’s edition of the Guidelines for Design and Construction, FGI will publish two standards—one for hospitals and outpatient facilities and one for residential healthcare and related support facilities. The FGI website notes that the rise of person-centered care drove the decision for a separate document because “the philosophical approach to residential care is fundamentally different….”

The consensus is developed through a public process that includes three meetings of the full committee over a two-year period. FGI released the 2014 guidelines for publication early this year, and soon the committee will begin working on updates for 2018. As the industry moves forward with developing and refining services for the growing population of people ages 62 and better, the Garden Spot Village team remains ready to serve in whatever capacity they can to help enrich the lives of older adults.


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