GOEDE PRAKTIJK BONNE PRATIQUE GOOD PRACTICES

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GOEDE PRAKTIJK / BONNE PRATIQUE / GOOD
PRACTICES Changes in organisational culture at
OCMW Leuven DREAMING, DARING, DOING Tony
Hulst, on behalf of all OCMW employees

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Contents Introduction Initial
situation Basic conditions Mission
1st wave focus on 4 resident-oriented values
2nd wave focus on 4 resident-oriented
values Steering and support measures 3rd
wave focus on residents perceptions 4th
wave focus on our organisational system
5th wave Strengths Turning points
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Introduction to our OCMW As a major city with
approximately 90,000 inhabitants Leuven has a
relatively big OCMW (Public Center for Social
Welfare). The Institutions department of
this OCMW ensures residential care to about 542
elderly people, currently spread over four rest
and nursing centers. Out of a total of 1,019
about 400 staff members were from the beginning
involved.
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• Initial situation
• Firmly established patterns of behaviour, splits
  between staff members, miscommunication in all
  his appearances
• Lack of support for the developed quality system
• Application of resident-oriented values ?
• Managerial style is not always optimal
• Presence of basic conditions
• Unanimous call with enriching proposals for
  approach
• Freedom to execute the whole project on a basis
  of trust,
• motivation, constructive cooperation and
  support
• Openness with regard to the dynamics of the
  proposed
• approach

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• Mission
• To select a number of very concrete and practical
  applications of each of the user-oriented values,
  imposed by law, and to implement them in our
  daily attitudes and behavioural patterns.
  Further, these applications must be
• supported to the largest possible extent by
  all staff
• members
• recognisable, feasible and directly applicable
• minimum applications but also somewhat
  ambitious
• known by everyone and enforceable
• continuously embedded in our way of working
• process- and job-related, as part of our
  quality system

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• List of resident-oriented values and selection
• Privacy (with regard to the residents personal
  privacy)
• Dignity
• Autonomy
• Sense of security
• Participation
• Right to complain (as an individual right)
• Integration (with regard to social relations,
  family relations, no set visiting hours)
• Freedom of choice
• - Self-development
• - Information
• - Hominess
• - Fundamental entertaining attitude

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First wave (focus on Privacy, Dignity, Autonomy
and Sense of security) Step 1 (April - May
2005) Every fortnight, all staff members
received a letter containing a resident-oriented
value We asked them to write down (at least)
one personal and feasible application or best
practice per value They were obliged to reply,
even without adding an example Anonymous
submission and processing were guaranteed In
all, we received 3,000 to 4,000 concrete examples
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• Step 2 (June)
• Classifying and collecting all proposals
• Step 3 (September)
• Step-by-step evaluation undertaken by pilot
  groups of line staff
• revision and possible supplementing of
  proposals
• indication of what do we wish?, what do we
  have to do?
• and what is a key priority area / special
  action item?
• Step 4 (September)
• Final selection by line staff and management of
  the department
• Result our key priority areas or so-called
  Twelve Works
• Step 5 (October - November 2005)
• First general training session 285 staff
  members received training

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Extract from list of applications concerning
Sense of security
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(No Transcript)
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• SMK 1 - PRIVACY (with regard to the residents
  personal privacy)
• Room
• We always tell the resident what we are going to
  do and explain the nursing care we are going to
  give
• (it is our residents right to benefit from your
  full attention to him)
• Room
• We respect his room
• we knock on the door before entering, even if the
  door is open
• we wait for an answer if the condition of the
  resident allows it
• (6 concrete items)
• Room
• We cover our resident in a respectable way if we
  undress, wash, nurse, examine him or give him
  treatment
• according to the situation
• we close the door
• (and/or) lower the roll-down shutter
• (and/or) close the curtain or the curtain in
  between

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Step 6 Each residential and nursing center
can select one additional key priority area per
resident-oriented value. Together they form their
own Four-leaved Clover Each site defines and
organizes autonomously the way of selection Step
7 (January 2006) Presentation of the project by
a team of line staff members to the Joint Special
Committee Step 8 (January 2006) A calendar
with the Twelve Works another key priority
area every fortnight Step 9 (October
2006) Public poster with the Twelve Works and
the Four-leaved Clover
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Second wave (focus on Participation, Right to
complain, Integration and Freedom of choice)
Smooth timing - Core activities of the
First wave May November 2005 - Start of the
Second wave (letters) parallel to the start of
the first training session Response again we
received 3 to 4,000 suggestions Steps
identical democratic selection process Second
general training moment - Evaluation of the
implementation of the first Twelve Works -
Familiarisation with own Four-leaved Clover -
Familiarisation with the new series of Twelve
Works - Empathy exercise of staff
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• Steering and support
• Fixed agenda items of main consultative bodies
  
• Realisation of information moments for
  volunteers and
• kitchen staff (wzc Ed. Remy on 28-4, 22-6
  and 29-06-06)
• Fixed item during performance and evaluation
  interviews
• Annual catch-up sessions
• Selection and realisation of Quick Wins
  (source the
• /- 8,000 submitted proposals)
• Organisation of the first Audits of head
  nurses (18-05-06 and 30-11-06) with the
  special challenge of
• ABSOLUTELY avoiding negative remarks

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Extract from checklist of our head nurses audit
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• Third wave
• (focus on perceptions of residents)
• Resident survey apart from a survey into the
  general
• satisfaction of our residents, one page
  consisted of concrete
• reformulations of our key priority areas
• Realisation in January April 2007 in our four
  residential and
• nursing centers
• The Instituut voor de Overheid (Public
  Management Institute), connected to our
  university, served as scientifique touchstone
• Neutral trainees ensured the field work and
  provided
• adequate help
• Response 243 out of approximately 542
  residents
• Realisation of a third general training session
  at this level as a first try towards analysis
  and improvements

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Questions Your satisfaction about our
behaviour
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• e.g. question 1 staff members knock on my
  door, even if the door is open
• e.g. question 10 staff members ask my opinion
  in order to know what I want
  
• (answercategories from left to right always,
  mostly, sometimes, never)

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• Fourth wave
• Focus on
• introduction to our renewed computerized
  documentsystem
• his efficiency and effectivity by means of
  pleasant and
• practical exercises
• Start pilot project early 2009
• Fifth wave
• Focus on
• outcomes of the planned survey of staff ?
• better defined or a new set of key priority
  areas ?
• innovative ideas ?

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• Our strengths
• Political and administrative management
  commitment
• Climate of cooperation it is a project we are
  all involved in !
• Open and positive approach systematically
  avoiding, discussing
• and eliminating threats and obstacles
• Calling upon an external trainer who has won
  confidence of staff
• The modalities of the project, with its
  roll-out planning,
• the continuous process of stimuli and its
  open end
• Integrated approach, with reference to the
  impact on the various
• EFQM/CAF criteria

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• Some turning points in our organisational culture
• Reception of 7 to 8,000 personal best
  practices of our line staff
• Final selection of key priority areas
• Presentation of the project by line staff to the
  top
• Positive character of organised internal audits
• Full transparency with regard to the project
• The public advertisement of our key priority
  areas
• The outcomes of our resident survey !

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• Further information ?
• Concepts and examples are available from
• quality coordinator OCMW Leuven
• tony.hulst_at_ocmw-leuven.be
• BEAPP trainer Thomas Creten (external)
• BEAPP_at_telenet.be of tel
  03.644.76.25
• A detailed description of the project is
  available in VVSG/Politeia
• Praktijkboek Kwaliteitszorg in
  Welzijnsvoorzieningen
• (Practice book for Quality Assurance in Social
  Care Facilities)

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