In this “Expert Opinion” interview, Senior Living Business Editor Jane Zarem talks with Elsie Norton about ACTS’ culture change initiative, the ACTS “Signature Experience.”

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Contact Information:
Elsie Norton, SVP of Quality Care
ACTS Retirement-Life Communities
7700 West Camino Real Boulevard, Suite 300
Boca Raton, FL 33433

Read the interview transcript:
Jane Zarem:
I’m speaking with Elsie Norton, Senior Vice President for Quality Care for ACTS Retirement Life Communities, which owns and operates 19 communities in six states and is the nation’s largest not-for-profit owner, operator and developer of CCRCs.
Elsie, you’re currently incorporating a culture change initiative called ACTS Signature Experience at each of your communities. How would you describe this new model and your overall culture change strategy?
Elsie Norton:
Well, ACTS Signature Experience is a person-directed approach to care and services. It really honors the individual and his or her needs, their desires and their routine. Much as a person’s signature is unique, we believe our care and service model should focus less on accomplishing tasks and meeting schedules and more on providing opportunities for residents to exercise choice and continue as much of their normal routine as possible. And this goes across the entire continuum of care.
Now, obviously, in a retirement community where we have independent living, assisted living and skilled care, I think our greatest opportunity for culture change is in the skilled care setting, where we’re transforming our medical model into more of a social or residential model. Our goal is really to work within the regulatory environment, but to give residents the freedoms to get up in the morning and go to bed at night when they want to, to provide flexible meal times and dining venues, have activities that promote all aspects of wellness and just to work with residents, staff and family members and really create home for the resident, no matter what the level of care.
Jane Zarem:
I see. And what part did your ACTS Gerontological Research Institute and your communities play in developing this new model?
Elsie Norton:
Well, the primary involvement of ACTS Gerontological Research Institute in our culture change efforts is to assist in measuring our success. You know, it’s one thing to say ACTS Signature Experience improves the quality of life for all residents. But it’s really quite another to bring an evidence base to support it. I’ll give you a couple of examples.
We opened our first ACTS Community, Fort Washington Estates, back in 1972. We had a very traditional medical model, skilled care center. Well, just last year we moved residents into a brand-new center that really embodies the residential model. So my staff at ACTS Gerontological Research Institute conducted a survey of the residents before the move, after the move and yet again several months later. And this is going to allow us to measure changes in the quality of life.
Now, once this data is compiled and it’s in process now, we’ll be analyzing that and we intend to publish these results so that we can share them not only internally, but with the industry as a whole.
And then, on a grander scale, we’ve entered into a partnership with a neighboring research institute that’s going to help us to identify barriers to culture change and identify how the physical environment, the job roles and even technology can influence quality of life outcomes in this type of a person-directed environment. So our goal is to perform this type of applied research and then share our findings so that we can help others to improve the lives of senior adults.
Now, the community leadership, and senior management I have to add, have worked together to establish what we believe to be a model community, if you will. In addition to retraining staff on person-directed care and services, we want to embrace culture change in new construction-which is actually easier-and work to retrofit the existing communities so that the physical plant can enable our efforts to provide better service offerings.
Now, that being said each community has developed a five-year plan that addresses both training and physical plant renovations. It could mean rebuilding a café in independent living into a bistro. It could be creating a country kitchen in assisted living or skilled care. Or it might just be changing a tub room into more of a spa. So every community has its own individual need.
Jane Zarem:
That sounds wonderful. How many of your 19 communities have already incorporated ACTS Signature Experience and what’s your timeline for completing the initiative?
Elsie Norton:
Well, since we just acquired our 19th community less than two weeks ago, we haven’t formally introduced ACTS Signature Experience in that community as of yet. It has, however, been incorporated into the fabric of all other 18 communities. We’ve completed formal training for the first third of these communities and we have the others all scheduled. We’ve also had three culture change coaches who are part of our staff who work directly with the community staff at all levels on a more informal basis.
So as to a timeline, actually, I have to tell you that we look at this more as a journey — a journey that will keep us constantly looking for new and better ways to improve the quality of life for our residents. Much like the reason that all the ACTS communities are accredited by CARF-CCAC, we believe that it’s really all about constantly trying to improve. So the residents of today and those of tomorrow, they all deserve the best quality of care and the quality of life. And I think we can do that.
Jane Zarem:
Well, that’s wonderful. I think you’re on the right track. Thank you very much, Elsie.
Elsie Norton:
You’re welcome.
Recorded June 6, 2008