A national movement calling to improve the culture in nursing homes to embrace and support the social aspects (resident choice, respect and empowerment) and the healthcare mission is believed to positively impact both quality of care and quality of life. However, little is known from research on the actual impact of resident-centered cultures on these outcomes.

Researchers at the University of Pennsylvania, School of Nursing, compared the characteristics of organizational culture in nursing homes engaged in culture change activities with those providing conventional care. Barriers and enablers to changing organizational culture and actions for program enhancement are reported here. Examples of barriers were high turnover of administrators and care givers and excluding nurses from culture change activities. Examples of enablers were a critical mass of "change champions" and shared values and goals at the various levels of the organization.

The program enhancements recommended were the following: Involve all levels of staff, residents, and community in culture change activities. Align incentives and rewards with the new cultural values. Empower individual homes to make decisions and implement change at the local level. Provide incentives to the staff for the integration of the desired cultural values into everyday life in the facility.