Small House Models: Texas SVH Culture Change

Britta Strickland, R.N., L.N.F.A.

Senior Vice President, Small House Development and OperationsTouchstone Communities

bstrickland@touchstone-communities.comwww.touchstone-communities.com

210.287.1262

What…… is our current state of delivering care to veterans?

… are we learning?

So What….

Now what….

… can we do?

What? = Situational Analysis

What is our current state of delivering care to veterans?

• Institutional (hospital model) care

• Better satisfaction than non SVH, but…

• Institutional (hospital model) care

…is it TRULY person centered care?

• Veterans may be more accepting of institutional care

- ranks and authority - basic training

- barracks - “sir, yes sir!”

So What? = Lessons Learned

So what are we learning?

• Long standing traditions

• Fear of change

• No clear roadmap for the future

• Fear of the implications of change, usually financial in nature

Now What? = Action Steps

Now what can we do?

• If you can’t build or rebuild

- Remove “brain barriers” and fear of change

- Stop institutional practices

Care plans at bedside

When making decisions ask, “ is what we are about to decide resident centered of staff centered?”

• Begin implementing “Neighborhood” or household practices

No staff rotations – it’s about relationships.

ALL staff members are assigned to a neighborhood - it’s about relationships, and not only with nursing personnel.

Small House Care

What it isn’t:

• Independent Living Cottages

• Just for domiciliary or AL residents

• It’s NOT about the house

Small House Care

What it is:

• Designed for frail or seemingly “healthy” skilled care residents

• Residents involved in decision making

• About elevating the bedside caregiver to a status that nears that of the residents’ status

• Trust and confidence in the Super-trained, empowered CNAs

• Leaders letting go – that’s a tough one!!

• Private room dignity

• Smells of home (bread baking, pot roast cooking, etc.)

• A wonderful model for State Veterans Homes, and so much more for residents!

Site Rendering

Site Plan – Tyler Texas

Small House Floor Plan

Typical Resident Room