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Anna Ortigara
Anna Ortigara
Q: How successful has growth been under the five-year Robert Wood Johnson Foundation grant?

A: Right now, 34 projects are in the process, 14 are in operation. Our goal is 50 opened projects by November 2010. We should be fine. Things look good. We'll have more cumulative research data by fall.

Q: What's been most eye-opening?

A: People usually think about small homes and elder-directed care with the Green House Project, but what's just as important, almost radical, is that direct care staff is truly working in an empowered role. Self-directed work teams are working. That's big.

Q: What do you mean?

A: Direct care staff never would have been trusted or been viewed as capable of running the care of a home before. CNAs get an additional 120 hours of education to become care team partners.

Q: But you use fewer nurses, right?

A: There are people who think we got rid of all of them, but not at all. It's better nurse staffing ratios than other (care) models, by far. 

Q: Any special challenges so far?

A: All the projects are battling “institutional creep.” It's so easy to backslide and say, “We do things ‘this way' because it's ‘most efficient.'”

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