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J Am Med Dir Assoc. 2009 Jul;10(6):370-8. doi: 10.1016/j.jamda.2009.04.004.

Beyond the medical model: the culture change revolution in long-term care.

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Hebrew Senior Life/Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, USA.


Culture change in long-term care facilities involves a shift in philosophy and practice from an overemphasis on safety, uniformity, and medical issues toward resident-directed, consumer-driven health promotion and quality of life. Fundamental to this shift is a focus on the importance of the relationships between residents and direct care staff. This review presents and discusses the key elements of culture change, including workforce redesign, resident-centered care, leadership, and the implementation process and evaluation. A case report describes how medical staff can participate in this grassroots movement and help foster the social, cultural, programmatic, and physical changes that can alter the culture of long-term care one home at a time.

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[Indexed for MEDLINE]

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