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Assessing Organizational Culture with PHI

July 19, 2012

“For organizations to truly embrace culture transformation, you have to be willing to stand in front of your peers and your staff and be vulnerable,” said Kelly Gasior, the Vice President of Strategy and Housing Operations of Trinity Senior Living Communities (TSLC). TSLC, a faith-based senior living organization, is one of a growing number of long-term care and senior housing companies that are engaged in culture transformation. Trinity’s culture-change model, Sanctuary, embraces person-centered principles aligned with its Catholic mission and Trinity’s heritage of effectively helping elders live full lives with a true sense of dignity. But TSLC’s leaders know that culture change is a journey, one that requires constant reflection, analysis, and a willingness to honestly and continuously assess the situation. That’s why, earlier this year, they contracted with PHI to perform a full organizational evaluation of the implementation of culture change and the Sanctuary model.

TSLC provides person-centered care to more than 35,000 elders in dozens of communities in Michigan, Iowa, Indiana, and Maryland. Elders have the option of living independently in apartments (with or without regular assistance), or in specialized nursing-care environments. PHI’s evaluation focused on Trinity’s 13 skilled nursing care facilities as well as its corporate home office in Livonia, Michigan.

Cean Eppelheimer and Kathy McCollett, Organizational Change Consultants from the PHI Coaching & Consulting Services team, began the assessment by asking each of the 13 sites to look inward. They requested that each Trinity nursing home complete a self-assessment detailing specific Sanctuary model characteristics as well as other artifacts and indicators of culture transformation. The self-assessment results can be used on an ongoing basis by TSLC to measure Sanctuary progress.

Next, Eppelheimer and McCollett traveled to each site for an in-person visit. Using the self-assessment results as a framework, they held focus groups at each of the 13 nursing care sites, talking to frontline staff (including direct-care workers), administrators, supervisors (such as nurses), department heads, and elders. They also interviewed Trinity’s executive leaders at the Livonia home office. The process involved many hours of questions, answers, and note-taking. “Cean and Kathy made a fantastic team,” said Gasior, one of the executive leaders interviewed during this step of the process. The entire assessment process was tailored to the TSLC Sanctuary culture, as focus group questions were crafted specifically to reflect the elements of the Sanctuary model and the Trinity heritage.

After the visits, Eppelheimer and McCollett synthesized their findings into reports — one for each of the 14 sites evaluated. The site reports were presented to each nursing home via conference call. The reports highlighted their strengths and opportunities and offered recommendations for each home and the corporate office. Finally, all 14 individual reports were compiled into one master report and delivered to the Executive Management Group at the Livonia office. Drawing on their years of experience in the field of organizational change, Eppelheimer and McCollett suggested 10 steps that TSLC could take to deepen their implementation of the Sanctuary culture. “It’s a truly thorough report that we can use and implement,” Gasior said.

Although they’ve only had the full PHI evaluation in their hands for about a month, TSLC executive leaders say that it has already produced positive change within the organization. The assessment process “drew our eyes back to [Trinity’s] positive aspects, allowing us to play to our strengths and improve on our weaknesses,” Gasior said.

For example, the reports have highlighted the fact that Trinity’s executive leadership must consciously work to maintain strong communication ties with one another, which can be difficult in a multi-state, multi-function organization such as TSLC, Gasior noted. “We need to shore up those communication gaps and just spend time together — something we haven’t done in a long, long time,” she added. To that end, Trinity’s leaders have followed up on one of the 10 suggestions and schedule a leadership retreat, to be conducted by PHI in early fall.

“Being evaluated is not always easy or fun,” Gasior said, comparing it to a doctor’s visit. But ultimately the experience was “eye-opening in a positive way,” she said. The challenge now is implementing the entire range of suggestions. That will take time and energy, Gasior said. There is no “silver bullet” in any of PHI’s reports, no magical fix that will make Trinity run as perfectly as possible. Trinity has a lot of “hard work” ahead of it, Gasior said. But, thanks to PHI, Trinity has a much clearer idea of how it should proceed with its culture change journey.

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