Culture change living toolkit

What is Culture Change?

Culture change is a process

The process is based on re-examining values, beliefs, attitudes, behaviors and approaches that are embedded within an organization and to work on improving them for everyone involved.  

The philosophy behind our process.

What is Culture Change fact sheet (PDF)

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Culture change uses Appreciative Inquiry

The PiDC Alliance Culture Change process centers on Appreciative InquiryThe Appreciative Inquiry process works by:

  1. focusing on what is working well in your group or organization
  2. building on those successful aspects in other parts of the organization. 

The goal is to repeat and expand on positive processes in other parts of the group or organization to meet goals that have been agreed upon through collaboration.                                                                                                                                                   

The Partnerships in Dementia Care (PiDC) Alliance has modified the traditional 4 step Culture Change process created by Cooperider and others and uses a five phase process which involves transforming or enhancing the current culture of a group or organization through innovation, discovery and contact with others.

This toolkit will guide you through the five phases of the process to effect culture change in your own group or organization.

Appreciative Inquiry fact sheet (PDF)

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Culture change is collaborative

Culture change is about team members working together to identify what is working well within their group or organization, and creating a vision for the future. Then, the group works together in visioning, decision making and strategic planning to reach that vision.

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Culture change requires empowerment, dedication and leadership

Culture change can be challenging because it asks team members and the whole group or organization to consider shifting or disrupting assumptions about how and why the organization functions as it does. In order for successful culture change to work, members of the culture change team have to be empowered to think and act in ways that challenge and build on traditional ways of operation while supporting the shared vision.

Culture change cannot be successful without broad involvement, strong leadership, trusting relationships, and a clear understanding of the current realities and future goals of a group of organization. We call these relationships Authentic Partnerships.

Effective culture change often has one or more champions within an organization who are committed to the process. These individuals do not need to be the highest ranking individuals in a group.

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Culture change does not end

The process of culture change is ongoing. There will always be ‘something else’ that a group or organization can work on. As time goes on, your group will become skilled at identifying new avenues that inspire innovation, transformation and growth.

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Culture change in the long-term care (LTC) context

Culture Change in a LTC context involves collaborative work to transform programs and services which make up the current care culture in a LTC facility. M.K. Chapin has written extensively on what LTC Culture Change might address and transform:

Culture Change in long-term care is a longitudinal, systemic, holistic process of transforming a long-term care organization (people, culture, beliefs, actions) and its physical surroundings, from being embedded in a traditional institutional medical model of philosophy to operating as a holistic therapeutic community based upon resident centered care and dignified workplace practices (Chapin, 2010, p. 192).

According to Chapin, these transformations are aimed at psycho-social, organizational and physical environments. The goal is to create a LTC facility that works simultaneously on three levels as:

  1. “a healthy, positive, enjoyable workplace,
  2. a loving, supportive home…and
  3. a thriving community that meets resident-identified, physical, social, emotional and spiritual needs as well as facilitating a high quality of life for all individuals involved” (ibid).

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What is the toolkit?

The toolkit is a constantly updated resource related to the PiDC Alliance Culture Change process. Groups who are starting the Culture Change process often report that getting organized can be very challenging. Individuals and groups interested in starting the process can feel overwhelmed or unsure of where to begin (Chapin, 2010: 187). There have also been calls for documented processes that others might follow on their culture change journeys. The toolkit has been created to help visualize and plan the process.

The tools, resources and media created throughout this research project are a valuable resource for any group or institution going through the culture change process. Please use the toolkit as a resource for your own journey.  

There are two major components to the toolkit:

  1. Narrative description of our process. Learn about our five phase Appreciative Inquiry process and the ideas underlying the Culture Change process. Understand ‘why’ the process unfolds as it does and what makes it successful.
  1. Sample activities, teaching and learning exercises, handouts and organizational tools. You can consult, use and modify these for the needs of your own group or organization’s Culture Change process. These are linked throughout the toolkit.

As the members of the PiDC Alliance research team and Culture Change Coalitions work together through the process of culture change, they will continue to contribute to this tool kit as an evolving resource.

Five Phases 

Phase 1 Dawn...our work begins

Phase 2 Discovery...appreciating the best of what is

Phase 3 Dream...imagining what could be

Phase 4 Design...what should be

Phase 5 Delivery...what will be

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Who is the toolkit for?

Anyone interested in culture change within their group or organization can benefit from the resources and tools contained within this toolkit. These might groups might include:

  • Long-Term Care organizations
  • Community Home Health Care groups
  • Groups serving a client base which includes individuals with Alzheimer’s or a related dementia

The exercises include ways to learn about and include persons with dementia in the culture change process.

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How should the toolkit be used?

The toolkit is not meant to be followed precisely. You will see, as you read through the toolkit and plan your own Culture Change journey that some exercises and activities may be relevant to the needs and interests of your group or organization, and others less so. 

Feel free to select, use and modify the activities and exercise suggestions and tools to fit your group or organization.

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What are the exercises and activities for?

Each of the exercises and activities has been designed to help groups move through each of the five distinct phases of the Culture Change process using Appreciative Inquiry

We have found that over the course of our culture change research, each exercise is also meant to teach a skill, or to work on strengthening one of the 5 enablers of Authentic Partnerships.


Chapin, M. K. (2010). The language of change: finding words to define culture change in long-term care. Journal of Aging, Humanities, and the Arts: Official Journal of the Gerontological Society of America4(3), 185-199.

Dupuis, S.L., McAiney, C.A., Fortune, D. B., Ploeg, J., & de Witt, L. (2014). Theoretical foundations guiding culture change: The work of the Partnerships in Dementia Care Alliance. Dementia Online First, January 13, 2014. Available from Sage Journals Online

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