Successful Edenization through education: suggestions for encouraging LTC staff to embrace the change of the Eden Alternative

Nursing Homes, March, 2004 by Jack L. Steiner, Cean Eppelheimer, Marla Devries

These seven steps are implemented within the Eden Alternative organization. In Michigan, BEAM provides additional motivation and support; in other states, these are provided by the EARCs. Effective January 1, 2004, BEAM has been assigned six more states in which to replicate this organizational training process: Indiana, Illinois, Wisconsin, Minnesota, Kansas, and Missouri.

The aim of the On-Site Training Model is not only to educate individuals on the Eden concepts, but also to better position the facility for a future of continued growth and success. The benefits of conducting the Eden Associate Training with at least 30 members from one organization include the development of relationships (the cornerstone of the Edenizing process) among staff, greater teamwork, and the ability to focus on concrete, rather than merely hypothetical, issues affecting the organization.

One of the principles the Eden Alternative teaches is that Edenization is a process, a journey that never ends. Celebrating successes along the way is an important ingredient in the process of change. Homes are therefore encouraged to record their Eden journey in a facility journal and to share their story with the community, family members, and residents.

Why the On-Site Training Model Works

It is helpful, when the day-to-day demands of the nursing home environment threaten to overshadow Edenization efforts, for staff to realize they are not alone. Using this model, an ample number of an organization's staff members have been "Eden educated" and can help keep the home focused on its Eden journey. In our state, BEAM provides continued support and encouragement to the organization, as well as being a conduit of best-practices ideas gathered from organizations around the state.

Indicators of Success

As with many developing systems, the Eden Alternative and BEAM have not yet developed sophisticated data collection processes. However, data gleaned from existing datacollection methods--such as the MDS, Medicare Compare, Quality Indicators, and internal human resources records--can be used to measure progress.

A reduction in staff turnover has emerged as a major benefit of Edenization. Administrators successfully implementing the Eden Alternative report staff stability approximately 6 to 10 months into the cultural transformation process. One Michigan facility reported an annual turnover reduction from 106% to 24% over a three-year period. (The statewide average of turnover for nursing home employees is about 69%.) Seven of the 30 Eden Registered Homes in Michigan have reported an average turnover reduction from 72% to as low as 9%, the average being 15% (visit www.mibeam.org for more details). Some Michigan nursing homes are saving in excess of $100,000 per year in reduced staff turnover costs.

As anyone in long-term care knows, a stable staff correlates with improved quality of care, which translates into greater customer (resident and family) satisfaction, as well as a reduction in recruitment costs. Additionally, a stable staff creates opportunities for staff members to develop ongoing relationships with residents.