Barriers to Change
1) Exclusion of nurses to culture change activity (While nursing assistants were not mentioned here, I’m inclined to believe they were also excluded.)
2) Perceived corporate emphasis on regulatory compliance and the "bottom line” (money)
3) High turnover of administrators and caregivers
Promoters of Change
1) A critical mass of "change champions"
2) Shared values and goals
3) Resident/family participation
4) Empowerment at the facility level
Clearly, changing nursing homes successfully involves input
from all levels of staff, residents, and community. Incentives encouraging achievement of new and shared goals are also effective.
You can read more details about this study here.
You can view this video on the importance of inclusiveness in culture change proceedings.