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Customized learning, culture change

January 12, 2012
by Joanne L. Smikle
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A comprehensive approach to staff education and organizational development

If your company only educates to fulfill mandatory licensure requirements, you are missing potential opportunities to grow staff which can dramatically impact the perceptions of long-term care and deliver on the promises of culture change. It is more than just paying lip-service to person-centered care (PCC). Culture change requires all staff to have a deep awareness and keen understanding of what PCC really means.

Raising the bar and developing that type of talent requires a different approach to staff education and organizational learning overall. Moving to a comprehensive approach requires realigning resources so that they are consistent with the organization’s mission and vision.

First, comprehensive development encompasses the entire organization—from senior managers to the frontline employee. This is more than creating snappy propaganda about culture change. Every employee must have the competencies required to create sustainable change throughout the enterprise.

Second, becoming a learning organization is essential to culture change. Simply checking the boxes on mandated training is not enough. The focus must be on creating a culture that values professional development. Those are the hallmarks of learning organizations and integral to culture change.

The third assumption is that the organization creates alignment between its core values and the tenets of the culture change it wishes to adopt.


Culture change is more than spa baths, breakfast bars, bathing on demand and huge capital improvements to facilities. Real change begins in the minds and hearts of LTC professionals. It is about putting the person first in person-centered care. The corporate mission must revolve around the facility’s residents—the top of the priorities pyramid. While the margin is critical to corporate survival, it cannot be the most compelling performance driver. According to Jeb King, director of Learning and Organizational Development for Maryland-based Encore Healthcare, LLC, “A company that succeeds in altering its culture will have well-articulated values.” Begin the process of inculcating employees with those values at orientation. Continue the process through discussions, training and structured education throughout an employee’s tenure.

As we consider what person-centered care really means, those who deliver care must become more important in the equation. The organization’s mission, vision and core values must emphasize an environment that is as affirming for care recipients as it is for care providers. This shift cannot just be in words. It must be in thought and deed as well. Dissatisfied caregivers have little chance of fulfilling the mandates of a mission that revolves around higher levels of care and concern for residents.

Understanding culture change requires an understanding of the fundamentals of sustainable change. It is not as simple as modernizing an old, tired building. Instead, it is about teaching the people in the building new ways of approaching the business of long-term care. Invite all employees to become actively engaged in devising new approaches to all aspects of care. The most effective innovations are simple and focused. They do not all originate at the management level; they can be spawned anywhere in the organization.

The real LTC culture change creates a collaborative internal culture that fosters high levels of employee engagement, creativity and collaboration as well as external collaboration with regulators, families and other stakeholders. This type of transformation gets to the nucleus of how long-term care operates. It requires a different set of competencies at the most senior leadership levels. These leaders must become innovators, meaning that they feel a personal responsibility not just for spawning new ideas, but for encouraging that same behavior from others.

These leaders grasp the importance of ongoing professional development for every employee. They do not use staff development simply as a tool for delivering mandated licensure courses.


A comprehensive approach to staff development is inherently linked to organizational development. It addresses how the company will meet the mandates of its mission through its human capital. The process begins with defining the strategic intent of culture change in the organization. Begin by determining where the organization wants to be. This enables the company to begin with the end in mind. If it is on a transformative path, begin defining what the transformation is going to look like and how that will translate into mission, vision and values. Goals, objectives and a clear statement of strategic intent are formulated at this initial stage.

Next, thoroughly analyze the organization’s long- and short-term developmental needs in light of its transformational goals and objectives. This needs assessment must include qualitative data gathering (focus groups, interviews and other structured discussion groups), as well as a quantitative method (survey). The analysis must measure needs of each category of employees, from managers to direct care staff to ancillary services to senior executives.

Once the needs are clearly defined, begin strategic planning to meet those needs. Create Individual Development Plans (IDPs) for each job category. These customized developmental maps reflect the competencies required to transform the company. They detail the education, training and developmental experiences required to correctly position each job category for success in the organization as it evolves.




Great article on culture change while the challenge is daunting the journey begins with a single step. Reorienting the organization from reacting to mandated performance thresholds to operational excellence repositions the organization to a proactive approach in expanding market share, improved reimbursement and regulatory compliance, higher satisfaction, and reduced liability exposure. Managements perception often is there isn't enough time in addition to ongoing duties. As you state so eloquently leadership must model and articulate the need to balance the daily routines with long term strategies. Keep up the great work Joanne.