As one of New Brunswick’s largest long-term care facilities, Loch Lomond Villa has been providing a safe, caring residential community for older adults since 1973. But as CEO Cindy Donovan points out, “Times have changed, levels of care have changed, needs of residents have changed, and we needed to change, too. We wanted a new and improved Loch Lomond Villa.”
A $30 million multi-phase expansion project that included a new resident home with four distinct “neighborhoods” provided the opportunity to plan for change. “Our goal was to transform our 40-year old culture into one that is truly focused on resident-centered care, making our facilities as comfortable and as homelike as possible,” Donovan explains. “It was all about deinstitutionalizing our environment. Strategically, we wanted our new homes to feel as though you’re walking into someone’s living room, and we kept that in mind throughout the whole process.”
Planetree: A Valuable Resource
To achieve their goals, they turned to one of the best resources in the world for helping healthcare organizations implement cultural change: Planetree, an internationally recognized leader in patient-centered care. Throughout the US, Canada, and Europe, Planetree has demonstrated that patient–centered care can be an empowering philosophy as well as a cost effective model, one which has been implemented in many types of healthcare settings including acute care, critical care, emergency departments, outpatient services, ambulatory care, community care centers, and long term care facilities.
“Planetree provided the framework that guided us toward how we were going to look and how we were going to get there,” says Donovan.
Dimensions of Care
The Planetree philosophy of putting the needs of the individual first includes 11 core dimensions of care, ranging from structures and functions to family involvement to food and nutrition. Attributes such as human interaction and relationship building, independence, dignity, respect, education, and communication are all part of the equation.
Jim Kinsey, Director, Planetree Member Experience, who worked closely with Donovan on the project, was impressed with her commitment and forethought. “She knew that it would take more than moving into a new building to change the way care was delivered. She and her executive team really did their homework to make sure they would have the authentic culture necessary to drive resident-centered care.”
The Planetree model addresses components of culture change as well as performance criteria for the organization. It differs from other patient/resident care models because it emphasizes educating staff, residents, and families and empowers them to be active partners in decision-making and in the care process overall.
The model includes training and leadership retreats for staff to help them understand and embrace the changes and prepare for new roles that would include more relationship building, ownership, and accountability. It encourages meaningful activities for residents in safe, healthy environments that support durability requirements, but are much more residential than institutional in feel.
Aligned Visions, Values
A starting point for Donovan and her team was the Planetree’s Organizational Assessment Tool, which clearly identified “what we were doing right and what needed to be worked on,” says Donovan. “It created a baseline from which we prioritized our work.”
For help with the physical transformation Donovan turned to Herman Miller dealership Chandler Office Environments, headquartered in Saint John, New Brunswick. Herman Miller Healthcare, the first manufacturer to become a member of the Planetree Visionary Design Network, and its human-centered design philosophy, aligned well with Loch Lomond Villa’s mission, vision, and values.
The Chandler team knew that Nemschoff, a Herman Miller Healthcare company, could provide most of the solutions for their interiors. “We have a wonderful partnership with Loch Lomond and we completely supported what they were trying to accomplish,” says Jamie Wright, division manager at Chandler Office Environments.
As Nemschoff Account Executive Karen Flock recalls, “Cindy [Donovan] felt very strongly that their new building be designed for people as homes, not as institutions. She’d say, ‘We’re like a family here,’ and she wanted the environment to reflect that. I really feel that her heartfelt attitude is what made this project such a success.”
Teamwork Was Helpful
Donovan is quick to credit the help she received from her staff, Chandler, and Nemschoff when it came time to making decisions. Perhaps most important—and very indicative of the Loch Lomond Villa philosophy—the residents also had a say in the design of their environment.
For example, Chandler provided plenty of Nemschoff chair samples for them to try; comfort, ease of getting in and out, and durability were all key factors considered.
“Staff safety is also an important issue, and Nemschoff seating is designed to ergonomically support caregivers as they’re helping people sit down or get up,” notes Chris Arbour, account manager at Chandler Office Environments.
Large Selection Of Materials
Donovan and her team were especially pleased with the large and beautiful selection of Nemschoff finishes and materials that met healthcare standards and approvals for quality, cleanability, and sanitation.
“In healthcare, we’re used to institutional furniture; we’re always putting plastic on couch cushions, which is not very nice for the residents and doesn’t do a whole lot for the ambience,” says Donovan. “But with Nemschoff we could pick warm, lovely colors in materials and finishes appropriate for the environment, and it doesn’t even look like healthcare furniture; it’s very homelike and appealing.“
She believes attention to such details plays a role in providing emotional support for people. “Soothing colors and comfortable, well-designed environments can help alleviate fear and anxiety that seniors sometimes have living in a place that’s unfamiliar; it helps them feel more at home.”
Although Donovan was somewhat restricted by budget she did have the freedom to determine how the money was spent, as long as she stayed within the “per bed” allowances. “There were times when I was challenged about the cost of a particular solution, but as I explained, we’re not going to get to do this again; this environment has to stand the test of time. And although you may spend more up front, in the long run you spend less because you reduce operating costs relating to replacement and/or repairs.”
“When it comes to 24/7 healthcare environments, long-lasting quality really is critical,” agrees Arbour.
Space Design Supports Goals
Other well-thought-out design elements helped create the type of resident-centered environment Donovan envisioned, such as:
- Common spaces encourage relationship building and interaction among staff and residents, including Celebration Lounges where a variety of activities and gatherings take place.
- Amenities such as a movie theatre, a baby grand piano, Internet café and computer stations, and a library provide a huge spectrum of activities and choices for how residents spend their time.
- Atriums, outside courtyards and walking areas, water fountains, a fishpond, and waterfalls encourage outdoor activities.
- Color-coded wayfinding and other visual cues in different “neighborhoods” help residents and visitors orient themselves.
- Windows provide plenty of natural light and views to the outside.
- Designated respite areas for staff, as well as showers and locker rooms, provide much-appreciated amenities.
- New tools and processes (such as tablet-type pads with touch screens for recording data) save staff time and eliminate redundant paperwork.
- State-of-the art technology, including a motorized ceiling lift, helps staff move residents more easily and safely in and out of bed.
- Decentralized and well-placed storage rooms and supply cabinets save steps and improve staff efficiency.
- Cameras let staff monitor residents from various places, improving safety, and LED screens keep visitors informed about various activities.
Working closely with staff throughout the process of change is also a critical part of the Planetree model. Just prior to move-in day, Donovan wanted the staff to “walk in the shoes” so to speak, of the residents who would be living in the new quarters. So she organized a sleepover for about 50 people. “We sat in the residents’ chairs, ate in their dining room, slept in their bedrooms, used the equipment, and lived in their surroundings. It was awesome!” she states.
Indeed, Kinsey believes Loch Lomond Villa has “really created a new template for long-term care in Canada.”
Donovan is clearly proud of the transformation. “The first things people notice when they walk in are all the beautiful colors and the inherent feeling of comfort and well-being,” she says.
“Through our efforts to change our culture to one that is truly resident-centered, we at Loch Lomond Villa see a future for elders where they are respected, included, valued, and cared for in a dignified way.”