TASK FORCE
ON
PERSON CENTERED CARE
September 2021
Pilgrim Place is a stand-alone, non-profit CCRC, founded in 1915 in Claremont, CA. Our Health Services Center (HSC) has been in operation as a duly certified 62 bed skilled nursing facility since 1980. At HSC, we are responsible for providing a safe and comfortable residence for those in need of short-stay rehabilitation therapy and/or skilled nursing services. HSC is also the permanent home to the majority of our residents who require ongoing skilled nursing services. HSC serves residents from the community-at-large as well as, eventually, for many of the 300+ active retiree “Pilgrims” who live here. Since 2008, the Pilgrim independent living residents have been passionately engaged in advocating for person-centered care to be the norm across the Pilgrim Place campus. However, this program was never fully realized nor sustained due to the absence of structured systems and turnover of key staff including administrative leadership. Many gains that had been made to improve the quality of daily life have diminished. We need help to retrain and sustain the essential enduring heart of person-centered care -- the nursing staff and administrators at our Health Services Center.
We know elderly people can live with dignity in a facility which intentionally creates a culture of neighborhood and Home; one in which the interests and needs of residents are tended to in a personal way; one in which collaboration and team work is the mode among residents and staff; one in which the capacities of residents are honored and relationships with others are valued; one in which professionals are trained to consider the "person first" and where this is the tone of the whole facility.
Person-centered care requires nurses who focus on human relationships, as well as medical tasks. Our Board of Directors has written salary increases and a higher HSC nurse/patient ratio into the budget, but we still have difficulty keeping positions filled. Turnover in front line staff is high and retired Pilgrim leaders (who continue to drive this initiative) pass on. Our earlier efforts at change never became anchored in clearly changed roles and relationships among all HSC stakeholders: nurses and their assistants, housekeepers, dining and maintenance staff, administrators, and present and future residents with their families and friends.
For the past 18 months, a new Task Force composed of Pilgrims, nursing staff, and HSC administrators has been meeting monthly to revitalize our initial 2009 efforts toward culture change. Now we are ready for professional guidance to create a comprehensive and fully person-centered system of staff recruitment, development and support that will endure in our surprisingly fluid skilled nursing situation. We are proposing a $79,490 two-year grant, to contract with Action Pact to provide intensive “train-the-trainers” orientations in person-centered care, e-Learning short courses available on nurses’ phones that can be required of all staff (including registry visitors), and ongoing consultations to guide and support our administrative leaders to make the necessary structural changes that will sustain our efforts over time and through internal change.
For our residents, we want the Health Services Center to become a heart that pumps culture change across the campus -- not its end-of-life backwater. For our nurses, we are primed to make real changes to increase their job satisfaction. Once this grant succeeds, we envision HSC as a “magnet school” that provides internships in person-centered care that will attract students who choose to continue working here in that spirit. We want to make the Health Services Center a Home where residents and staff can mutually learn from and honor who they really are and who they hope to be.