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COACH’S CORNER: Following the Michigan Model of Collaboration

March 30, 2015

Recently I had the opportunity to be on a keynote team at Michigan’s semi-annual Joint Provider Surveyor Training (JPST) in Grand Rapids. Over 800 individuals gathered in the spirit of collaboration for person-centered living in long-term care. Michigan’s JPST process is truly a model for the nation, demonstrating what’s possible when people work together toward a shared goal.

Across the country, relationships between the regulators that survey nursing homes and the providers who operate these homes have long been strained. It is the job of the surveyor to identify deficient practices — or areas where the nursing home is not in compliance with the regulations that govern licensure. The system is designed to focus on the negative, and we have all heard stories of homes that have worked hard to implement person-centered culture change only to result in a deficiency on their survey. Over the course of time, this dynamic has contributed to tense relationships between providers and regulators, as well as a widespread perception that the regulations are a barrier to implementation of person-centered culture change.

Kudos to Michigan for tackling this perception regarding regulatory barriers to culture change! Just last year Michigan completed a four-year, multi-stakeholder effort called One Vision: Moving Forward that produced nine regulatory clarifications and one best practice guide on topics Michigan providers named as barriers.

The JPST conference design models collaboration from start to finish. The planning team consists of providers and regulators, and each session is facilitated by providers that are demonstrating success with the topic being shared, a regulator, and another local or national stakeholder with expertise. There is time for questions and answers and all attendees are hearing the same message about how to implement person-centered practice changes while sustaining compliance. There is no question this collaborative model is opening the doors for change in the state of Michigan.

It really is “all about relationships,” and Michigan is taking bold steps to minimize tension and build the relationship between regulators and providers on the way towards their shared goal of quality. Working against each other leads to fear that impedes risk-taking, which ultimately denies residents the quality of life that is otherwise possible. Michigan’s collaborative efforts are demonstrating that culture change is possible not only for resident care, but in the historically challenging relationships between providers and regulators.

— by Susan Misiorski, PHI National Director of Coaching & Consulting Services

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