Design from Within

1. Design from Within Deb Fournier RN-BC, MSB, NHA Maureen Carland RN, BSN, NHA Evan Carroll AIA, LEED, BD+C, Principle

2. Our Objectives • Identify principles of person directed design • Describe the resident architect's experiences and the application of these experiences to the community • Examine the formation and role of advisory counsels for guiding project development

3. What Typically & Historically has Happened • Decision making by owner or architect • Even small decisions made away from the user • Management makes decisions

4. How and Whythis Needs to Change Baby Boomers are Coming! The next generations wants more choices

5. Outline An administrator’s perspective: Why and how an architect came to MVH 2. An architect’s perspectives: Evan’s experiences 3. Lessons learned from Evan’s visit and applications at MVH 4. Another example: Principles of resident directed design in a large renovation project at St. Mary’s

6. What happenedat Maine Veterans’Home • Evan Carroll • Architect, Graduate of Roger Williams University • Raised in Maine • Passionate for designing for aging population

7. How did this Happen? Living Through Learning program at UNE Marilyn Gugliucci, Director of Geriatrics

8. How we prepared • Previous Med students • Faux medical conditions • Positive results

9. The best laid plans… • Uneasiness • Unprepared staff

10. Communication • Rationale and learning goals • Concerns and anxieties • Careful planning • Discussion

11. Outline An administrator’s perspective: Why and how an architect came to MVH 2. An architect’s perspectives: Evan’s experiences 3. Lessons learned from Evan’s visit and applications at MVH 4. Another example: Principles of resident directed design in a large renovation project at St. Mary’s

12. Living in a Veterans’ Home • Why have this experience? • How did I prepare? • What was it like? • What did I learn?

13. Why have this experience? • People • Paradigms are shifting • Empathy • New solutions

14. How did I prepare? • Journal • Packing • Self coaching

16. HOME safe comfortable familiar secure

19. What was it Like? • Arrival • Having a roommate • Dependence • Shift Changes • Smiles

20. What was it Like? • Settling In • Staff • Socializing • Visitors • Becoming a household

21. What was it like? Two Stories: The Luau Rose

22. What was it like? • A rewarding experience: • The relationships • Growing old is a part of life • Love can overflow • Designers, residents, families and staff must work together

23. What did I Learn? • Kinds of Care • My two different roommates • Memory/Long Term Care Rehabilitation • Build friendships vs. Protect self • Settle-In vs. Wait to leave • Home vs. Hotel • Dependence vs. Hope for Independence

24. What did I Learn? • Senses • Sounds of home • Smells of home • Sights of home • Textures of home

25. What did I learn? Spaces in a Home Space - to be alone

26. What did I learn? Spaces in a Home Space - to chat

27. What did I learn? Spaces in a Home Space - to walk

28. What did I learn? Spaces in a Home Space - for a group

29. Spaces for things What did I learn? • Identity • Ownership

30. Spaces for things What did I learn? Ledges & Shelves

31. Spaces for things What did I learn? Frame Rail

32. Spaces for things What did I learn? Window Dressings

33. Spaces for things What did I learn? Bedding and Rugs

34. Spaces for things What did I learn? Shadow Box

35. Views and Safety What did I learn?

37. Outline An administrator’s perspective: Why and how an architect came to MVH 2. An architect’s perspectives: Evan’s experiences 3. Lessons learned from Evan’s visit and applications at MVH 4. Another example: Principles of resident directed design in a large renovation project at St. Mary’s

38. Now that we Know Small Projects • Cafe • MVH Multi-Purpose Room Remodel • MVH Room Remodel

39. Now that we know • Jake’s Cafe

40. Now that we Know New Menu

41. Now that we know Multi purpose room • Residents choose finishes • Residents choose window treatments

42. Now that we Know Room Remodel • Mock Room • Resident interviews and surveys • Focus groups • Staff Surveys

43. Outline 1. An administrator’s perspective: Why and how an architect came to MVH 2. An architect’s perspectives: Evan’s experiences 3. Lessons learned from Evan’s visit and applications at MVH 4. Another example: Principles of resident directed design in a large renovation project at St. Mary’s

44. An Administrator’s Journey • What are our key stakeholders telling us? • Expectations have changed • Privacy is important • Desire to be included in making decisions that affect them • They are individuals and not just patients • Trust comes from: • Honest communication • Prompt response • Reliable and competent care

45. Preparing the Culture • Decision to adopt the principles of patient and family centered care. • Changed the wording to patient, resident, and family centered care • Researched PRFCC models and tools • Provided education to Board, Leadership, & Employees • Identified this transition as a corporate goal • Shared stories of patient, resident, and family experiences

46. Principles of Patient, Resident, & Family Centered Care Dignity and Respect Information Sharing Participation Collaboration Reprinted with permission from the Institute for Patient- and Family-Centered Care: www.ipfcc.org."

47. www.ipfcc.org Patient, Resident, & Family Advisory Councils Who: Former patients, residents, and family members What: Serve as advisors to administration and staff

48. Patient, Resident, & Family Advisory Councils Why: Provides an effective mechanism for stakeholder inputs. Results in more efficient planning. How: Careful selection of skilled facilitator • Criteria to identify potential council members • Initial educational session to introduce roll of advisory councils and principles of PRFCC • Ask for membership on the council

49. Advisory Council Charter for St. Mary’s Rehab Center • Serve as Advisors for: • 2.3 million dollar renovation project • Healing environment • Evidence based design for seniors • Guide program transition from traditional skilled care to rehab center of excellence • Deliverables: • Customer satisfaction 96% recommend • Return to home rate 90% • 3 year CARF accreditation

50. Renovation Learnings • Use of mock rooms • Getting around the bed • Swing versus pocket doors • Width of bariatric bathroom entrance • Location of head of bed • Put a picture here?