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Artifacts of Culture Change

How to Use

Pioneer Network is host to this web-based version of the Artifacts of Culture Change. By registering and completing the Artifacts of Culture Change, providers are able to input, score and store their data online. Providers will be able to access current and historical data and are encouraged to:
  • Complete the tool at a minimum of twice a year. Quarterly updating is recommended, because for many homes, organizational reporting occurs quarterly. Adding Artifacts to a quarterly reporting schedule can also help to better analyze incremental changes in benchmark reporting;
  • Create high involvement of staff, family and residents in completing the tool and solicit feedback from varying perspectives (visit Tips for additional guidance);
  • Although assessments of responses can be approximates (e.g. responders do not need to count every adaptive handle), providers are encouraged to provide close approximate estimates to ensure the best possible measurements of longitudinal change.

New users should click "Register Now" from the Welcome tab and complete the information on the registration screen. All new accounts require activation, and new users will receive an e-mail with activation instructions after completing registration.

After activation, new users can log into the Artifacts of Culture Change and begin the ACC Tool by clicking on the links to each section. Important notes:

  • ACC sections do not need to be completed in sequence. Simply click on the link to a section to access that portion of ACC.
  • Users do not need to complete all responses in one sitting. Users can log in and log out as many times as necessary to complete the ACC tool.
  • Users will need to complete answers for individual sections in one sitting and should always save answers. Even if a user is planning to log out without completing the entire ACC tool, it is important to always click the "Save Answers" button at the bottom of each section. If all responses are not complete, the system will prompt for required fields.
  • The Artifacts of Culture Change is not complete until the user clicks "Submit" on the ACC Summary screen. At that time, data will be stored and users will no longer be able to alter responses.

Upon log in, existing users can view past and current ACC submissions under "Your ACC History" on the ACC Summary screen.

  • Click on past submissions (submission data will highlight in yellow) to access ACC summary results. Additionally, users can click on ACC sections to review individual responses or print the ACC tool with answers. Past, submitted ACC tool entries cannot be altered.   
  • Quarterly completion of the Artifacts is encouraged. Existing users should click the "Update our ACC" button on the ACC Summary screen to report these changes. You will not need to retake or complete a blank ACC. The most recently submitted ACC forms the basis for this new "update." Carefully review each section, record changes to data, and click the "Save Section" button at the bottom of each screen. Once review and changes are complete, click "Submit" on the ACC Summary screen to store the new data.

Each provider will only be able to access an organization's individually stored data and will not be able to view Artifacts responses of peers. However, the online collection of consistent and measurable variables facilitates the use of data in the aggregate to report on culture change implementation measures and benchmark data for homes in multi-organizational chains. Visit Reports for more information on this benchmark reporting.

 The Artifacts of Culture Change Downloadable Version - A blank version of the tool for download.

 The Development of the Artifacts of Culture Change Tool - This is the full report written for CMS who funded the project explaining rationale for the tool, how the tool was developed including the point scale selected, and a large Source Information table which gives backup for each item such as where that practice can be located around the country and any research found supporting items.

 The Artifacts of Culture Change Privacy Policy

 Vol.1, No 1 Artifacts of Culture Change Benchmark Reports, 4/1/10-3/31/11

 Colorado Culture Change Collaborative (CCCC) Grant Project Summary - This document summarizes an almost one year project funded by the Colorado Culture Change Accountability Board CMP Grants and managed by Carmen Bowman of Edu-Catering. The summary goes into great detail about the project which sought to work with 20 nursing homes who voluntarily chose three culture change practices as identified by the Artifacts of Culture Change measurement tool. Homes agreed to meet as teams every other week to implement the three practices and share their story at the end of the project. They also completed the Artifacts tool at the beginning and end of the project. An increase in points, approximately a total of 15 for three practices (at 5 points each) was anticipated. However, the average point increase of 47 points was shocking and showed the value of joining such a project, a little support and mostly the power of making a commitment. The Artifacts tool also proved to do accomplish one of its identified goals by co-developers Karen Schoeneman of CMS and Bowman of Edu-Catering to serve as an educational tool. Many teams stated that the Artifacts tool opened their eyes to all that could be and that "it was the right thing to do" to incorporate more of the represented culture change practices for the residents they serve. Learn more about Edu-Catering and Artifacts initiatives here: http://www.edu-catering.com/artifacts_of_culture_change

 Colorado Culture Change Coalition (CCCC) Technical Assistance Project Report of Year One 2012

Colorado Culture Change Coalition (CCCC) Technical Assistance Project Report of Year Two

Colorado Culture Change Coalition (CCCC) Assisted Living Technical Assistance Project 2014

Arkansas Culture Change Project Summary - Through the work of Arkansas Foundation for Medical Care's AR Innovative Performance Program (AIPP) a quality improvement program was implemented to teach nursing facility and assisted living facility staff processes to implement culture change and individualized person-centered care. This report summarize the projects results.

Florida Pioneer Network: Advancing Culture Change in Florida Nursing Homes - Advancing Culture Change in Florida Nursing Homes was developed out of the exploration of culture change practices in 40 Florida nursing homes over 18 months in 2008-2009, using the Artifacts of Culture Change as a group interview tool. The project elicited both barriers and facilitators of culture change practices. Results are documented in this brief.

Artifacts of Culture Change DVD - Available through HaveAGoodLife.com, this DVD features a presentation by Carmen Bowman with in-depth discussion of Artifacts questions and implementation.

Just in Time Toolkits (Resources, Regulations and Results) - Creating and sustaining change isn't easy. While some adopters are like master chefs sprinkling various methods into the mix, others prefer "recipes for change" to support implementation. In reality, the most successful changes will vary by setting, organization, leadership, staff and the elders affected. There is no one recipe, but we have identified wonderful ingredients that can help cater an experience just right for you. That's the essence of the Just in Time Toolkits – RESOURCES, REGULATIONS, RESULTS. We highlight wonderful implementation resources,  identify relevant regulations and point you to results to help you find just the right path.  Toolkits address environmental, dining and staffing transformations.

Missouri Department of Health and Senior Services Letter of Support

The Artifacts of Culture Change was developed for public use by the Centers for Medicare & Medicaid Services and Edu-Catering, LLP. For more information on the development of the tool contact Karen Schoeneman or Carmen Bowman. Pioneer Network does not claim any rights to the Artifacts of Culture Change. Alterations to content are made with the consent of the developers.