Green House Blog

Green House Model Fidelity Tool Ensures Sustainability

The Green House (GH) model is a valuable investment of time and resources, and can yield incredible results.  As the only evidence based culture change initiative, it has been proven, and together with Green House adopters around the country, there is a responsibility to protect it.   The Model Enrichment Resource & Integrity Tool (MERIT) was developed in response to insights gained through research.  It is used as a tool to assess model integrity across all Green House homes.

MERIT Assessments

The term MERIT  (Model Enrichment Resource and Integrity Tool) is used to describe the GH model integrity process. However, MERIT is an umbrella term for several GH evaluation and assessment tools.

 MERIT Staff Assessment

  • The MERIT Staff Assessment is designed to evaluate the application of the core values of Real Home, Meaningful Life, and Empowered Staff in Green House homes. The MERIT Staff Assessment launched in 2015 and has been administered to open Green House homes in 2015 and 2016. It is used to measure how model fidelity manifests in practice.

MERIT Organizational Outcomes Assessment (new for 2017)

  • This tool gathers quality outcomes from Green House organizations including key clinical and financial indicators. These clinical and financial benchmarks will provide a valuable comparison to the MERIT Staff Assessment data, and parallels an organization’s data collection through its QI and QM processes.

MERIT Staff Assessment for Legacy Homes (new for 2017)

  • This online tool assesses the application of The Green House core values in a legacy environment. Green House organizations interested in assessing the level of alignment to the core values in their legacy environment and understanding the level of cultural transformation across the organization may contract with GHP for the delivery of the assessment tool. Participation is voluntary. The administration of this assessment tool follows the same process as the GH MERIT Staff Assessment.

More Information

The Green House model is based on three fundamental core values: Meaningful Life, Empowered Staff, and Real Home.  These values play an important role in successfully implementing and sustaining the integrity of the Green House model, as evidenced by:

  • Consistent care delivery and shared goals among Green House adopters
  • The most comprehensive approach to holistic culture change grounded in elder-centered values and essential practices
  • Standards that protect the integrity of The Green House brand and investment of organizations who have committed to the model
  • On-going opportunities for Green House peer support and accountability
  • Impact on a national scale with emphasis on research and growth of the model

The design and administration of the MERIT online assessment and database management process is managed by the Center for Social Research (CSR) at Calvin College in Grand Rapids, Michigan.  CSR conducts social-scientific research on behalf of Calvin faculty and a wide array of local, national, and international organizations.  Each year, the tool evolves and is refined.

 

 

 

 

Portrait of a Green House Leader, Terry Rogers

Terry Rogers, President & CEO of Episcopal Foundation of Jefferson County, in Birmingham, AL was recently highlighted in The Green House Project‘s Leadership webinar series. His organization includes, St. Martin’s in the Pines, a continuing care retirement community and home care service in Birmingham, with nine Green House cottages.

terry and elderTerry’s inspiration for a career in health came from observing his mother as caregiver to family members and neighbors, graduate from nursing school, and enter the home health profession. After graduating from The University of Alabama at Birmingham, Terry began his healthcare administration career in business and operations positions with home health agencies, hospitals, and the Episcopal Foundation of Jefferson County, where he has served as President & CEO since 2000. In addition, he serves as a member of the Community Advisory Committee for the University of Alabama Comprehensive Center on Healthy Aging, the National Public Policy Congress, the Budget and Finance Committee, and the Business Strategy Council for LeadingAge, in addition to his service as member of the Green House Project Peer Network Steering Committee.

Terry began his career with St. Martin’s with a formal long range planning effort aimed at redeveloping the campus and replacing the skilled nursing building. His colleague, Linda Robertson, an Eden Alternative Associate, directed him towards the work of The Green House Project in Tupelo, Mississippi. After attending a workshop in Tupelo, he returned to Birmingham to inform the board about this innovative model of care and identify what a new nursing home may look like on their campus. Terry describes that seeing truly is believing; the enthusiasm for the model carried throughout the board and to the broader community and together they were committed to developing the first Green House homes in Alabama. He attributes this success to formally engaging with The Green House Project team to aid in the collaborative design process of their multi-story Green House homes and assist in overcoming regulatory hurdles by training state regulators about the Green House model.

st. martins_ shovelsDuring the development process, Terry notes that “we had a steep hill to climb” but felt confident given the robust training opportunities provided by The Green House Project team and the value of being associated with the model given the research supporting its success. He continues to be an advocate for the model integrity process and the importance of the Green House trademark as a method of accountability throughout the Peer Network to ensure the original guiding principles are instilled in every community. “We didn’t get into The Green House model because it was easy, we got into this because it was the right thing. Changing in the right way is why we’re having the outcomes we’re having. If we start letting “the right way” be diluted, the outcomes are going to change… we think The Green House model works and we want to do it in the right way and we want everyone in the Peer Network to do it the right way as well.”

At St. Martin’s, continuing team education is key in maintaining the integrity of the model and helps leadership “keep it fresh.” Terry describes that continuing assessment and evaluation creates an opportunity for leaders to revisit the beginnings of why they started and to continually engage in action plans for improvements. As the “keepers of the philosophy”, leaders must problem solve, motivate, and coach their teams through consistent messaging of the model. Since opening, St. Martin’s aims to serve as a role model and brand ambassador to encourage and invigorate The Green House model into future organizations and help them throughout their journey.

Upon opening, Terry observed the model’s financial success as a result of the shift in operational cost structure and the flattened hierarchy that creates a “middle management shake-up.” Furthermore, adding Green House cottages into the St. Martin’s continuum of care created a competitive advantage that drives demand at all levels of care, resulting in a corresponding increase in their assisted living and independent living occupancy of approximately 5%. This influx of revenue allows St. Martin’s to promote the community giveback component of their mission to ensure that Elders have the opportunity to live in their cottages regardless of their payor status.

In terms of quality of care, Terry describes that “there’s a little bit of magic taking place” in their Green House cottages that yields better outcomes. Specifically, their 100% occupancy rate, higher family satisfaction survey scores, and positive clinical outcomes are a result of better, deeper knowing in their Green House homes. The Green House principles “just makes sense.” Despite the Green House model’s success at St. Martin’s, Terry notes that they can always do better and are constantly seeking improvements. He is pleased to be a part of the Peer Network and associated with other courageous change agents that are never satisfied in knowing all they need to know in caring for elders.

A lifelong resident of Birmingham, Terry loves fishing, Crimson Tide football (Roll Tide!), participating in barbecue competitions, and spending as much time as possible by the lake with his family. He is presenting at the 2015 Annual Meeting with Green House Project team members Susan Frazier and Marla DeVries on the Model Enrichment Resource and Integrity Tool (MERIT) and the research that supports this process for sustainability.  To hear the full interview>>