Creating an Environment of Leadership to Achieve and Sustain Culture Change in Nursing Homes

Sunday, November 1, 2009

Gena B. Edmiston, BSN
Nursing Home, Denali Center/Fairbanks Memorial Hospital, Fairbanks, AK

Learning Objective 1: The learner will be able to describe the essential behaviors of leadership.

Learning Objective 2: The learner will be able to describe how the essential behaviors of leadership apply to nurses at the "staff" level.

Keeping the Resident at the center of all care and decisions is the essence of the Culture Change movement in nursing homes.  The goal is worthy but difficult to achieve when driven from above in a hierarchical organization.  Culture Change is accelerated when those most directly responsible for team leadership, wing nurses, understand their role in communicating and behaving in a manner consistent with the organization’s values and vision. Those who lead teams of Certified Nursing Assistants (most often licensed practical nurses) rarely receive education in team leadership, and rarely participate in the creation and actualization of organizational vision.

The focus of this project was to bring Leadership education to staff nurses that they might develop an identity as “leader”, and then behave in ways consistent with leadership concepts.  We adopted the Kouzes and Posner “Leadership Challenge” model and tailored it to speak to the role of the nursing team leader.  In doing so, our nursing home grew more effective teams, as measured by the Nursing Home Culture of Safety Tool, and achieved staff retention rates that far exceed national norms.  This poster will highlight the activities of this leadership project and describe both with quantitative and qualitative data the outcomes achieved.  The content of this poster is appropriate for nursing home Directors of Nursing, Actvities Directors, Administrators, and other Leadership Professionals interested in culture change.