A comparison of leadership vs. renovation in changing staff values.

The authors compared the effects of the staff's perceptions of the culture in a LTC facility pre and post-intervention(s). One unit had significant architectural modification (physical intervention). On the second unit, efforts were directed toward culture change through management modification (social intervention through goal setting and role modeling). Lastly, both were compared to a third control unit where there was no planned change. On the unit with the social intervention model there was an attempt to support a "neighborhood" sense for residents and staff that would encourage residents to become more self-directed and self-sufficient rather than remain in the passive "good patient" role. Significant staff training resources and time were devoted to this effort. On the second unit, the architectural renovation sought to provide a distinctly home-like open, and relaxed atmosphere with a large, well-equipped day room. This encouraged closer resident and staff interactions and included a staff workstation that was part of the day room. On a third control unit, no changes were made.