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Positive Outcomes of Culture Change

Clinical Outcomes

Early to Mid-Implementation Signs of Quality of Care Impact: In real world implementation, quality of life impact will likely be evident before formal quality of care indicators reveal significant change. However, residents may rate clinical care higher (due to improvements in their overall experience). In addition, as the quality indicator most correlated with person-directed principles and care, use of restraints should decline. Improvements in weight loss, falls, agitation, pressure ulcers, and time in a bed or chair are also potential areas of impact.  Of course, the level of clinical improvement depends predominantly on the organization's performance pre-implementation as well as the support of clinical leadership (Medical Directors and Directors of Nursing) for person-directed care.

Pioneer Network continually tracks clinical outcomes of adopters and finds consistent, positive results. Below are longitudinal examples. 



Aside from the substantial benefits to residents from these reductions, there are obvious cost implications as well. AHRQ estimates that the average pressure ulcer-related hospital stay extends to between 13 and 14 days and costs between $16,755 and $20,430, depending on medical circumstances.




Culture change is a process not a program – quality of life, a decreased  % of time spent in a bed or chair and fewer restraints are inherent in this person-centered process. Although quality programs such as Advancing Excellence are making great strides in reducing these outcomes nationally, adopter homes have achieved these outcomes for over 10 years.



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