A new era in residential care

How do we go about changing residential care from an institutionalized medical model of care to a social model where first and foremost we create a home and community that our residents would want to live in?

Simple. We megamorphosis it.

Providence Health Care continues its comprehensive planning to renew PHC’s residential homes with a clear vision focused on creating a home and community our residents would want to live in. PHC embarked on a monumental culture shift in moving towards this vision of shifting from an institutionalised model to a social model of care through a process they named “Megamorphosis.”

“This has just launched our new beginning in residential care at PHC.”

Megamorphosis is a high intensity two weeks of rapid PDSA cycling (Plan-Do-Study-Act) of concurrent testable ideas. These ideas had been unearthed through the human centered-design process in Residential Care for Me, which used a wide scale of engagement of residents, families and staff.

The key part of the project is planning for modern, new homes on PHC’s St. Vincent’s: Heather site at 33rd Avenue and Heather Street in Vancouver, providing an opportunity to design and build something innovative and substantive from the ground up — a mini-community on the campus with diverse amenities and services.

“Although PHC staff, medical staff and volunteers continue to provide exceptional and compassionate care to our residents and tenants, PHC’s homes are old, and, with four beds per room, our bed stock needs urgent replacement,” says Jo-Ann Tait, program director, Elder Care and Palliative Services. “But our need is more than just to replace old buildings or old beds. We have to reimagine the way we provide care, the way we design our homes, our care models and the way we interact with and address the numerous social and health care needs of our residents.”

A new era in residential care

Jo-Ann says the business case for the redevelopment planning process is currently reviewing the future operational budget requirements for the campus, exploring how potential partners could be involved, and having conversations with the City of Vancouver regarding longer-term community planning and community engagement issues.

While the new campus won’t be ready for a few years, the planning and piloting of new ideas and enhanced care settings need to be done now. These new ideas were identified over the past two years first through the “Residential Care for Me” initiative and are now being prototyped in PHC residential care settings through the Megamorphosis initiative.

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“Throughout these initiatives, we’ve involved staff, residents, families and partners such as Tapestry Foundation for Health Care – and it’s really paid off,” says Jo-Ann. “As an example, the Tapestry Foundation, which is now amalgamated with St. Paul’s Foundation,  approved funding of a $2.01 million renovation to the north neighbourhoods of Holy Family Hospital residence. It’s an investment that helps make our new thinking real; it will help us try out and refine the approach to the social models of care we want for the future.”

The generous donation to improve Holy Family neighbourhoods will:

  • Create and test the household model of our future; it will look at designing a specific space as a household for 10 to 12 residents, with as many private rooms as possible, a living area and kitchen area, etc.
  • Increase the number of wheelchair accessible toilets.
  • Increase the freedom of movement on the Holy Family lands by creating a larger secure outdoor space beyond the patio (e.g., into the tree and grass area north of the residence).

Let the transformation begin

The Megamorphosis initiative is looking at implementing and sustaining the following learnings:

  • Emotional connections matter most
  • Residents direct each moment
  • Home is a feeling not a place

Youville Residence and St. Vincent’s: Brock Fahrni have undertaken the work required to support and ready staff for testing and sustaining ideas to transform our culture.

To date, the evaluative outcomes demonstrate significant shifts in emotional connections and our implementation of over 50 testable ideas — many of which were either staff suggested, or resident and family driven have yielded a positive impact on the lives of the residents.

In short: the future looks bright for residential care at Providence Health, a sentiment perfectly captured by Jo-Ann following the completion of the first Megamorphosis exercise: “Oh, this is far from the end, my friends; this has just launched our new beginning in residential care at PHC.”

Look for every residential home to experience their own Megamorphosis throughout 2017.

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