Youville’s Megamorphosis in action
Submitted by Jo-Ann Tait, program director Elder Care and Palliative Services
The Residential Care for Me team started their first two week (eleven day) Megamorphosis last week at Youville's Marguerite Place. After four weeks of pre-work focusing on Compassion Matters, Language Matters and Pain Matters, staff were ready to begin the high intensity two week period. The Centre for Practitioner Renewal supported the team through weekly pre-work sessions that brought the entire interdisciplinary care team together, and continued to support the staff through these Megamorphosis weeks.
“We’ve been in our cocoon stage,” said Joseph Sun, Nurse Educator at Youville and Parkview. “Before Megamorphosis we were all individual caterpillars working very hard every day. We were given this gift of understanding compassion and the work we do by being able to look inwards and take stock of who we are and what purpose we serve, and we were supported by the leaders to emerge out of our cocoons when we were ready. By the time Megamorphosis started, we were butterflies now ready to take flight.”
Based on resident, family and staff insights gathered during the human centered design process, the Megamorphosis is focusing on the three stories: emotional connections matter most; residents direct each moment; and home is a feeling – not just a place.
Priorities outlined for Wednesday, February 15
The Megamorphosis work began with open team meetings with residents, family and staff prioritizing the top 32 testable ideas that had been identified as areas that needed focus. Testable ideas included: creating a Buddy Program for residents; making staff space invisible; filling public spaces with colours, textures and interactive items; and ensuring that everyone knows the three things that bring every resident peace, comfort and joy.
Leaders from throughout PHC have been highly involved in taking on the 32 testable ideas and working with the residents, staff and families to build connections by seeing life through their eyes and starting to shift the feel of an institutionalized place into one of comfort where people can relax.
Staff have organized their time around having Megamorphosis discussions focused on quality of life and care of the residents from the moment they began their day at 0700 huddle. Staff then re-connect at 1145 with the greater team to share ideas that have been tried with specific residents and identify areas of needed support, then gather again at 1400 for an hour of intense brainstorming and evaluation of testable ideas. “For those familiar with PDSA cycles and the Institute for Health Care Improvement Breakthrough Series, this was taking the same process and replicating many, many multiple PDSAs all at the same time. It's been organized chaos,” explained Robena Sirett, co-lead of the Megamorphosis Residential Care for Me process.
Items to encourage rummaging
“If you were to walk onto Marguerite Place at Youville, you will first feel the difference. There is a different energy –one that is lighter, fun and actually more vibrant,” says Kim Smith, Site Leader and Manager at Youville. The usually spotless dining tables now have balls of yarn, hats and purses scattered on them; assorted scarves hang on hooks and there are bins of flowers and toys in the hallways. To the uninitiated this may look like clutter, but these items are for encouraging rummaging among residents – to keep them engaged using familiar objects and items that they identify with and react to, along with other people as they engage with what is now around them.
Each branch will hold a photo of a resident and list what brings them joy
Tree-shaped wall decals are another new addition to Marguerite Place. The branches will soon hold photos of residents with a description of a few things that bring them comfort and joy. “Often information like this is housed in charts and in professional notes that not many have a chance to read – especially care staff and other family members. This is our way of sharing information that we can all be aware of and use as we interact with the people we serve and visit,” Kim explains.
Juliet Batke, Quality Improvement Specialist, has been making buttons for staff to wear with their names on them that can be personalized with coloured pens and stickers. The buttons help make sure that members of the Marguerite Place community are all known to each other, as well as to new residents, family members and visitors.
Mr. Chand, a handy Marguerite Place resident, has been busy sanding and painting sheets of plywood that will be affixed to hallway walls and have items attached to them for residents to interact with.
Mr. Chand hard at work
Coming up in Megamorphosis week two, a room on Youville’s 6th floor will be transformed into a Treasure Room where residents can “shop” and select clothing, accessories and household items for their rooms from a selection of goods donated by staff. The number of residents who move into our residential care homes with no clothes and nothing for their rooms is quite surprising. Care aides have quietly bought things for residents over the years, especially for those in greatest need. With the creation of the Treasure Room, staff hope that residents can feel empowered to select items, at their own pace, and re-create their new home at Youville.
RCA Gemma modeling an interactive apron
While the formal evaluation of Megamorphosis is still taking shape, the informal evaluation through resident reactions has been the single most important daily measure. One resident stated, “It’s getting good here again.”
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