Dining Practices for Residents with Dementia: Case Studies of Four European Nursing Homes
Authors: International Association of Homes and Services for the Ageing and LeadingAge Center for Applied Research
Publication: 2013
A report from the International Association of Homes and Services for the Ageing (IAHSA) and LeadingAge Center for Applied Research examined how 4 European nursing homes took steps to improve the dining and nutritional experience of residents with dementia. In carrying out their programs, the nursing homes  provided person-centered care, offered mealtime flexibility, monitored residents with dining-related issues, relied on multidisciplinary teams, and tapped nontraditional workers. Sodexo Institute for Quality of Daily Life, a research partner of IAHSA, funded the project.

State Investment in Culture Change Toolkit 
Author: Center for Applied Research
Publication: 2009
The State Investment in Culture Change Toolkit is designed to help states initiate or expand culture change efforts in nursing homes. The Culture Change Toolkit is a collection of programs and activities that 7 states created to support culture change initiatives in nursing homes. The materials were collected from a case study supported by  The Commonwealth Fund. The goal is to provide other states with this information, so they can learn from these experiences, and to create a network among state governments and other key organizations.

The Culture Change Toolkit organizes the descriptions of the initiatives into 3 areas:

  • Workforce Improvement Initiatives
  • Person-Centered Care Initiatives
  • Continuous Quality Improvement Initiatives.

The profiled initiatives include a description to enhance awareness of the range of approaches and specific interventions that have been developed through state investments.

State Investments in Culture Change
Author: Bryant, N., Stone, R.I., and Barbarotta, L.
Publication Date: 2009
The report summarizes the findings of a 7-state case study that documented and examined the extent to which and in what ways states have engaged in promoting, encouraging and supporting culture change activities in nursing homes. The report describes the categories and magnitude of the financial and non-financial investments made by each state, with examples of specific activities. The article concludes with several cross-cutting themes that emerged from the case studies and highlights implications for policy and practice as well as lessons learned.

Supporting Culture Change: Working Toward Smarter State Nursing Home Regulation
Auhor: Stone, R., Bryant, N., and Barbarotta, L. 
Publication Date: 2009
A new model of nursing home regulation is where the states and federal government strike a balance between the traditional regulatory approach to weed out substandard facilities and a partnership model aimed at promoting high performance. This issue brief highlights the importance of how such a model is structured, as well as the need to adequately train and educate regulatory staff and providers about culture change. Regulators, providers, consumer groups, residents, and their families also will need to commit to the principles of person-centered care to ensure the success of the new collaborative approach.

Process Evaluation of Implementation of Lutheran Wellspring Alliance of the Carolinas
Author: Bryant, N., Heineman, J., and Stone, R.I.
Publication Date: 2009
The final report summarizes the findings, including a description of Wellspring in the Carolinas, how well the model was implemented and the changes among staff, residents and families.

Translating Research into Practice: Speeding the Adoption of Innovative Health Care Programs
Author: Bradley, E.H., Webster, T.R., Baker, D., Schlesinger, M., Inouye, S.K., Barth, M.C., Lapane, K.L., Lipson, D., Stone, R., and Koren, M.J.
Publication Date: 2004
For this study, the authors conducted case studies of four varied clinical programs to learn key factors influencing the diffusion and adoption of evidence-based innovations in health care. They found that they success and speed of the adoption/diffusion process depend on the roles of senior management and clinical leadership, the generation of credible supportive data, an infrastructure dedicated to translating the innovation from research into practice, the extent to which changes in organizational culture are required and the amount of coordination needed aross departments or disciplines. The translational process also depends on the characteristics and resources of the adopting organization and the degree to which people believe that the innovation responds to immediate and significant pressures in their environment.

Selecting a Model or Choosing Your Own Culture
Author: Stone, R.I.
Publication Date: 2003
In this article, the author reviews the practical issues related to implementing culture change in nursing homes. She discusses the merits of model replication and highlights the barriers to creating and sustaining culture change in nursing homes. She describes the various dimensions of culture that must be changed, including the approach to clinical training and practice, the nature of management and job design, the approach to caring and the characteristics of the residential environment. The author then identifies the major elements required to maximize the potential for nursing homes to create and sustain culture change.

Evaluation of the Wellspring Model for Improving Nursing Home Quality
Author: Stone, R.I., with Reinhard, S.C., Bowers, B., Zimmerman, D., Phillips, C.D., Hawes, C., Fielding, J.A. and Jacobson, N.
Publication Date: 2003
The purpose of the project was to evaluate the Wellspring model of nursing home quality improvement. In a 15-month study, a team of researchers led by research and policy experts at LeadingAge Center for Applied Research conducted qualitative and quantitative analyses to better understand the underpinnings and impacts of the Wellspring model.

Long-Term Care for the Elderly with Disabilities: Current Policy, Emerging Trends and Implications for the 21st Century
Author: Stone, R.I.
Publication Date: 2000
Policy makers today face three significant questions concerning aging services: (1) Who should pay for long-term care and how? (2) How should services to elders with disabilities and their families be designed and who should deliver them? (3) How can the labor force delivering that care be recruited, trained and maintained? For long-term care policy makers in the United States, this is the triple knot. Each of these three strands demand equal attention if sound, appropriate policy is to be developed. This paper describes the current status of the three key dimensions of
long-term care policy-financing, delivery and workforce-and identifies some of the major demographic and policy trends that will affect the demand for, and supply of, long-term care in the future.