Culture Change in Long-Term Care-Post COVID-19: Adapting to a New Reality Using Established Ideas and Systems.

The response to the COVID-19 pandemic in long-term care (LTC) has threatened to undo efforts to transform the culture of care from institutionalized to de-institutionalized models characterized by an orientation towards person- and relationship-centred care. Given the pandemic's persistence, the sustainability of culture-change efforts has come under scrutiny. Drawing on seven culture-change models implemented in Canada, we identify organizational prerequisites, facilitatory mechanisms, and frontline changes relevant to culture change that can strengthen the COVID-19 pandemic response in LTC homes. We contend that a reversal to institutionalized care models to achieve public health goals of limiting COVID-19 and other infectious disease outbreaks is detrimental to LTC residents, their families, and staff. Culture change and infection control need not be antithetical. Both strategies share common goals and approaches that can be integrated as LTC practitioners consider ongoing interventions to improve residents' quality of life, while ensuring the well-being of staff and residents' families.

Cultural Changes and Willingness to Change in Indigenous People of Penglipuran Bali Tourism Village During the Covid-19 Pandemic

As economic drivers (especially in rural communities), touristic villages have faced a very difficult situation during the COVID-19 pandemic. The sluggish tourism industry has greatly impacted the income of rural communities that depend on tourists who visit them. This study aims to understand and explore how the Penglipuran tourism village community survives amid the sluggish tourism industry due to the COVID-19 pandemic. The unit of analysis in this study was the Penglipuran Bali tourism village community, which is included in the Top 100 World Sustainable Destinations. This case study used a qualitative approach to both data collection and data analysis. Observations and semi-structured interviews were used to obtain information. The study results found that the indigenous people of the Penglipuran tourism village are willing to change and are adaptive to cultural changes to use technology without eliminating traditional norms to survive in sluggish tourism. The habit can be seen in the activities of indigenous people who return to farming and raising livestock as well as utilizing social media and e -commerce in marketing tourism villages' products, including local handicrafts.

Finding Comfort in Discomfort Reflecting on Stories Told.

INTRODUCTION: The 2022 Presidential Address for the Association for Academic Surgery was focused on better understanding the personal and professional challenges faced by surgeons during the COVID-19 pandemic. METHODS: As part of this work, we embarked on a listening tour, inviting surgeons from all over the country to tell us their stories. This led to forming a panel of five selected participants based on how their stories crosscut many of the most prevalent themes during those conversations. Here, we present thematic excerpts of the 2022 presidential panel, intending to capture that moment and challenge surgeons to contribute to an ever-evolving movement that pushes us to unpack some of our greatest areas of discomfort. RESULTS: We found that, in many ways, the COVID-19 pandemic brought into focus what many surgeons from marginalized groups have historically struggled with. Dominant themes from these conversations included the role of surgery in informing identity, the tensions between personal and professional identity, the consequences of maintaining medicine as an apolitical space, and reflections on initiatives to address inequities. Panelists also reflected on the hope that these conversations are part of a movement that leads to sustained change rather than a passing moment. CONCLUSIONS: The primary goal of this work was to center voices and experiences in a way that challenges us to become comfortable with topics that often cause discomfort, validate experiences, and foster a community that allows us to rethink what and whom we value in surgery. We hope this work serves as a guide to having these conversations in other institutions.

Feminist perspectives on disaster, pandemics, and intimate partner violence

The COVID-19 pandemic brought international awareness to the likelihood of increased abuse of those in abusive intimate partner relationships because of the forced confinement with their abusers (Bettinger-Lopez and Bro, A double pandemic: domestic violence in the age of COVID 19, Council on Foreign Relations. https://www.cfr.org/in-brief/double-pandemic-domestic-violence-age-covid-19, 2020). While this awareness was much discussed, assistance to survivors of abuse was limited because survivors often could not reach out for help, nor could advocates wishing to offer assistance safely reach in to advise them (Taub, A new Covid-19 crisis: domestic abuse rises worldwide. https://www.nytimes.com/2020/04/06/world/coronavirus-domestic-violence.html, 2020). The ever-present influence of the abuser prevented or limited the delivery of effective aid in many cases (Taub, A new Covid-19 crisis: domestic abuse rises worldwide. https://www.nytimes.com/2020/04/06/world/coronavirus-domestic-violence.html, 2020). But this was not the first disaster to place those experiencing intimate partner abuse at greater risk. Other disasters have in various ways increased women's safety risks both during and after crisis. Other crises routinely resulted in increased abuse of survivors in intimate partner relationships including sexual and other assault by intimate partners (Rao 2020;Sohrabizadeh Prehosp Disaster Med, 31(4):407-412. https://www.ncbi.nlm.nih.gov/pubmed/27212204, 2016). This chapter briefly identifies some forms of abuse experienced by women outside of the home during times of crisis and their connection to intimate partner abuse. Then, the impact of COVID-19 on intimate partner survivors will be explored and some of their experiences described. Gaps and flaws in nations' approaches to gender violence are often highlighted during and after disasters. Lack of planning to protect survivors of intimate partner violence and other highly vulnerable populations during crises was exacerbated by the additional dangers brought by COVID-19. Primarily, the heightened dangers resulted from stay-at-home orders, which made services for abused partners more difficult to obtain and highlighted the possibility of unintended consequences resulting from policies designed to protect the public as a whole (Godin 2020). This chapter concludes by considering what has been lacking in strategic disaster planning, including what lessons have been learned thus far through the COVID-19 experience. Recommendations for effective disaster planning to protect survivors of intimate partner abuse, while also protecting other vulnerable populations, are suggested. This information is presented with the caution that as of this writing the global pandemic continues to limit access to hard data. Long-term analysis of the implications of the pandemic on Intimate Partner Violence (IPV) survivors awaits the passage of time. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Decent work in care homes: lessons and implications of the pandemic experience from Scotland

Purpose: The purpose of this paper is to identify lessons and implications on the theme of decent work in social care. This has long been highlighted as integral to improving social care for the elderly. The COVID-19 pandemic experience reveals lessons and implications about the systemic absence of decent work in one place, Scotland, in care homes. The main lesson and implication is a need for change beyond the focus on levels of pay and systemic advocacy of decent work as it is conventionally understood. Design/methodology/approach: Data was collected using qualitative, semi-structured interviews with 20 care workers in care homes.[AQ4] A range of care system institutional stakeholders was also interviewed. A range of care system institutional stakeholders was also interviewed. Findings: Decent work in social care may only be progressed to the extent that a culture change is achieved, transcending the institutional stasis about who owns and engages with progressing decent work. Research limitations/implications: This is a study in one place, Scotland, with a small sample of frontline care workers in care homes and representatives from a range of institutions. Practical implications: Effective culture change for decent work in care homes needs to be a higher research priority. More explicit culture policies can be a mechanism by which overall decent work and system change may be catalysed and sustainably secured together. Explicit culture change is here set out with respect to operational, institutional and national domains. Social implications: There needs to be social policy and political support for situating decent work to be part of a broader culture change around care work with the elderly. A culture-oriented change plan as well as new resourcing and structures can together ensure that the nadir of the pandemic experience was a historical turning point towards transformation rather than being just another low point in a recurring cycle. Originality/value: The situating of systemic decent work progress within a broader culture change, and modelling that culture change, are original contributions. © 2022, Emerald Publishing Limited.

The Influence of Hofstede's Cultural Dimensions on Attitude Towards Change and Innovation in Oganizations

As the COVID-19 pandemic has radically changed the business landscape in the last years, some organizations were able to adapt to the new environment and continue to function, some thrived, seeing unmatched growth, while others disappeared forever. Even before the COVID-19 pandemic, adaptability had already been deemed to be an important organizational capability, which ensured an organization stayed relevant in the market. With the pandemic, the ability to adapt has become essential to the organizations' survival. Additionally, a large body of research was dedicated to the importance of innovation, which has been shown to have a positive impact on organizations' competitiveness, growth and overall results. While adaptability is a response to the changes in the external environment of an organization, innovation consists in the change being generated inside the organization. Thus, an organization reacts to change by being adaptable and generates change by being innovative. Given that both capabilities are of importance to an organization's success, this paper performs a literature review of the factors influencing the organizations' adaptability and innovativeness, specifically the cultural factors, based on the well-established Hofstede Cultural Model. The results show that both adaptability and innovativeness are influenced by the cultural dimensions in different ways. However, not all cultural dimensions can be influenced to the same extent, some being more malleable than others. This means that organizations must aim to influence the most malleable cultural dimensions in order to increase their adaptability and innovativeness, to improve their overall performance.

Decent work in care homes: lessons and implications of the pandemic experience from Scotland

Purpose: The purpose of this paper is to identify lessons and implications on the theme of decent work in social care. This has long been highlighted as integral to improving social care for the elderly. The COVID-19 pandemic experience reveals lessons and implications about the systemic absence of decent work in one place, Scotland, in care homes. The main lesson and implication is a need for change beyond the focus on levels of pay and systemic advocacy of decent work as it is conventionally understood. Design/methodology/approach: Data was collected using qualitative, semi-structured interviews with 20 care workers in care homes.[AQ4] A range of care system institutional stakeholders was also interviewed. A range of care system institutional stakeholders was also interviewed. Findings: Decent work in social care may only be progressed to the extent that a culture change is achieved, transcending the institutional stasis about who owns and engages with progressing decent work. Research limitations/implications: This is a study in one place, Scotland, with a small sample of frontline care workers in care homes and representatives from a range of institutions. Practical implications: Effective culture change for decent work in care homes needs to be a higher research priority. More explicit culture policies can be a mechanism by which overall decent work and system change may be catalysed and sustainably secured together. Explicit culture change is here set out with respect to operational, institutional and national domains. Social implications: There needs to be social policy and political support for situating decent work to be part of a broader culture change around care work with the elderly. A culture-oriented change plan as well as new resourcing and structures can together ensure that the nadir of the pandemic experience was a historical turning point towards transformation rather than being just another low point in a recurring cycle. Originality/value: The situating of systemic decent work progress within a broader culture change, and modelling that culture change, are original contributions. © 2022, Emerald Publishing Limited.

Separate and Unequal: A Time to Reimagine Dementia.

The rapid emergence of COVID-19 has had far-reaching effects across all sectors of health and social care, but none more so than for residential long-term care homes. Mortality rates of older people with dementia in residential long-term care homes have been exponentially higher than the general public. Morbidity rates are also higher in these homes with the effects of government-imposed COVID-19 public health directives (e.g., strict social distancing), which have led most residential long-term care homes to adopt strict 'no visitor' and lockdown policies out of concern for their residents' physical safety. This tragic toll of the COVID-19 pandemic highlights profound stigma-related inequities. Societal assumptions that people living with dementia have no purpose or meaning and perpetuate a deep pernicious fear of, and disregard for, persons with dementia. This has enabled discriminatory practices such as segregation and confinement to residential long-term care settings that are sorely understaffed and lack a supportive, relational, and enriching environment. With a sense of moral urgency to address this crisis, we forged alliances across the globe to form Reimagining Dementia: A Creative Coalition for Justice. We are committed to shifting the culture of dementia care from centralized control, safety, isolation, and punitive interventions to a culture of inclusion, creativity, justice, and respect. Drawing on the emancipatory power of the imagination with the arts (e.g., theatre, improvisation, music), and grounded in authentic partnerships with persons living with dementia, we aim to advance this culture shift through education, advocacy, and innovation at every level of society.

Integrating Workforce Health Into Employer Diversity, Equity and Inclusion Efforts.

Our collective experience with COVID-19 and Black Lives Matter has heightened awareness of deeply embedded racial and socioeconomic disparities in American businesses. This time, perhaps, sustained change is within reach. As organizations advance diversity, equity and inclusion (DEI) initiatives, an often overlooked focus of is the health status of employees and their families, where equitable access to high-value health benefits offerings should be available to all. This commentary provides guidance for employers to expand their DEI initiatives to include employee and family health and well-being as a central outcome measure. Employers should ensure that DEI efforts incorporate equitable benefits design, and objectively assess benefit design impact on healthcare utilization and cost. Additionally, employers must appreciate the workplace as a significant determinant of health-for lower income workers, in particular-with review of policies and practices to mitigate any discriminatory negative health or well-being impact. Further, race and ethnicity data should be incorporated in health benefits data analysis to understand more clearly the differential outcomes of health management offerings on these different sub-populations. Finally, social needs data should be incorporated into strategic benefits planning to better understand gaps and opportunities to foster greater benefits equity. The provided recommendations can support employer goals of achieving greater equity and value in workforce health, measurably contributing to business success.

Social Capital in the Response to COVID-19.

Social capital provides a number of benefits during crisis scenarios, and high social capital communities respond more efficaciously than those with low social capital. With this in mind, we argue that the response to and recovery from the COVID-19 pandemic may be hampered in many American communities by deficiencies or disruptions in social capital brought about by physical distancing. Drawing on evidence from past crises, we recommend individuals, communities, and government institutions work to strengthen and expand social networks. A failure to do so will exact a toll in terms of human morbidity and mortality and exacerbate the current disaster.