Perham Memorial Hospital and Home, Perham, Minnesota, celebrated a public grand opening of its new nursing home on Saturday, October 7, 2006, culminating a three-year, $14 million construction project and a transformation in resident care that has gained the Perham facility national attention.

In 2001, with 56% more revenue than the year before, and $400,000 in new equipment- including an in-house CT scan, and mobile Magnetic Resonance Imaging (MRI) - Perham Memorial poised itself to continue to meet the health care needs of the area as the new century unfolded, by building a new nursing home.

Developing a New Model of Care -- The Pilot

After hearing over and over, that the building is not the issue - attitude is the issue, the administration and staff decided to build a new model of care in the old building. They wanted to oust rigidity and schedules; they wanted EVERYONE cross-trained. Everyone was scared - could this work? After two years of talking and planning, a group of patients, staff, and the administration began a six-month pilot project by converting one 32-person unit into two "households" of 16 residents and assigning a permanent team of universally trained workers in each house. Each direct care employee was cross-trained and became responsible for housekeeping, laundry, dietary, and social activities. Each resident decided what time to get up in the morning. An open breakfast was available until 10 a.m. permitting residents a choice of when and what to eat. Bathing schedules were adapted to the residents' needs and desires rather than having a preset schedule.

Staff members managed their own work schedules, covering all shifts, weekends, and holidays. No one rotated to a new unit to care for people they didn't know and who didn't know them.

Response to Change

Amazing things began to happen. Although studies show that a significant percentage of nursing home residents are malnourished sixty-six percent of the Perham residents gained weight. The number of folks suffering falls plummeted. Call lights are answered faster than ever because all staff is trained to respond to the residents' needs and the use of call lights shrunk to near zero.  Read More...

Brenda Miller's daughter, Emily, was born prematurely at 26+ weeks, weighing 1 pound 5 ounces. Emily spent the first three months of her life in the Holden Neonatal Intensive Care Unit (NICU) in C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, Michigan. Emily, now 12, is a petite and physically robust softball player.

Brenda received invaluable support from others while her daughter was a patient in the Holden Neonatal Intensive Care Unit. She remembers that during a weekly family meeting one family told about their stay in the unit. Their son seemed to be very similar to Emily. Brenda credits this experience -- of hearing this family's story and seeing their thriving 3 year old son -- with helping her to be a better mother during Emily's stay in the Unit, helping her not to despair, and spurring her to eventually work in the hospital. Families of "graduates" of the Unit showed Brenda the potential for her child to grow and have a productive life, and resulted in Brenda's providing support to other families.

 In 1998, Brenda became the first volunteer Parent Representative of the newly established Holden Neonatal Intensive Care Unit Family-Centered Care Committee. Since January 2006, Brenda and a staff nurse have co-chaired the committee. Initially, Brenda worked on discrete projects such as writing the Committee's mission statement and goals, instituting the Parent Choice Visiting Plan which empowered parents to select who could or could not visit their baby in the unit, and instituting -- at regular time intervals -- meetings for caregivers and families rather than waiting for a medical crisis to occur. Ultimately, as a part of the FCC Committee, Brenda was able to effect major change. Read More..

The Institute for Family-Centered Care would like to thank our 2006-2007 Pinwheel Sponsors:

• Seattle Cancer Care Alliance - 3rd International Conference on Patient- and Family-Centered Care Sponsor
• Seattle Children's Hospital & Regional Medical Center - 3rd International Conference on Patient- and Family-Centered Care Sponsor
• University of Washington Medical Center - 3rd International Conference on Patient- and Family-Centered Care Sponsor
• University of Michigan Health Systems - Hospitals Moving Forward with Patient- and Family-Centered Care Fall Seminar '06 Sponsor
• Children's Hospital of Austin  
• Children's Medical Center Dallas  
• Dana-Farber Cancer Institute
• Hasbro Children's Hospital/Rhode Island Hospital  
• IWK Health Centre  
• Joe DiMaggio Children's Hospital at Memorial
• Lucille Packard Children's Hospital
• Maimonides Medical Center  
• Massachusetts General Hospital Cancer Center  
• MassGeneral Hospital for Children
• MCG Health System  
• Miami Children's Hospital  
• North York General Hospital  
• Rainbow Babies & Children's Hospital  
• Sunnybrook & Women's College Health Sciences Centre  
• The Children's Hospital of Philadelphia  
• The Hospital for Sick Children  
• University Medical Center  
  

Hospital Partners:

• Brigham and Women's Hospital  
• Children's Hospital Boston   
• Children's Hospital of Western Ontario/London Health Sciences Centre  
• Children's Hospital of Los Angeles  
• La Rabida Children's Hospital  
• Mission Hospitals - Asheville, NC  
• North Carolina Children's Hospital  
• Poudre Valley Hospital  
• Texas Children's Hospital  
• The Children's Hospital - Denver, CO

Corporate Supporters:

•  Kasian Architecture Interior Design  
•  KI  
•  SmithGroup

Corporate Friends:

•  Earl Swensson Associates

To learn more about our current 2006-2007 Pinwheel Sponsors, please visit the Pinwheel Sponsors Page. 

The Institute will be unveiling a new Pinwheel Sponsorship Program at the beginning of 2007 with even more benefits and recognition for sponsorship.  If you are interested in becoming a 2007-2008 Pinwheel Sponsor, please email Pinwheel Sponsorship Program.  There are still opportunities to exhibit and sponsor at the 3rd International Conferece on Patient- and Family-Centered Care, download the brochure for more information. 

Research has shown that patient and family involvement in their own health care improves outcomes and patient satisfaction.

1. Make a list of questions in advance of your medical appointment to ask about your condition and care options.
2. Ask a nurse or doctor to answer questions that you have before, during, and after your care experience.
3. Become educated about your health care insurance policy covered benefits.
4. Learn about scientific evidence and the most current treatment options related to your condition by reading credible articles or information on the Internet.
5. Practice telling doctors about your symptoms, and how you are feeling. Practice asking questions when you need more information.
6. Keep a notebook of current medications, specialists, and other relevant information to discuss with a doctor. If hospitalized, be sure to ask every time you are given a medicine what you are being given.
7. Bring an advocate/friend who can listen, take notes, and help ask questions. Remember that family members are there to support you; inform them when issues are too difficult for you to handle alone.
8. Be honest with yourself and your provider about your needs, expectations, and feelings about your care. Be specific about what treatments you want or do not want. If you are unsure, ask for time to think about your decision prior to signing consents forms, and speak to your physician about those uncertainties.
9. Keep communication open at all times.  Find out who to contact with questions when your main contact is unavailable. Make sure you have designated "power of medical decision making" in writing in the unlikely event that you cannot communicate those wishes - and give a copy to your doctor.
10. Ask for and review written discharge instructions for medications, return appointments, and information for follow-up and ongoing care.

For more information on patient- and family-centered care, please visit www.familycenteredcare.org. Adapted from Kaufman, J. (2006) Successful Transitions to Adult Health Care for Individuals with Special Health Care Needs. Institute for Family-Centered Care, Bethesda, MD.