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Leeway: Designing and Implementing a Community Living Model, New Haven, CT

January 2017
EDAC Advocate Firm Project

HoodenPyleGil (HPG) and CAMA


Firm's role on the project:  Planning, Programming, Architecture, Design, Interiors

 


 

EBD Goal 

To support personalized positive change for individuals living with multiple chronic diseases by transforming the way care management services are delivered and how health and wellness services are integrated in the community.
 

Overview 

Leeway, a respected nursing home pioneer in New Haven, CT and other stakeholders are working together to create a Community Living Model that will provide health services to individuals living with multiple chronic illnesses. Leeway facilities and support services include skilled nursing facilities, residential care housing, supportive housing, and independent living. The company was recently awarded a grant by the Connecticut Department of Social Services (DSS) to diversify its services. This project aligns with existing city and community efforts as well as state efforts to support an individual’s capacity to thrive and flourish within the City of New Haven. The project emphasizes personal empowerment through health literacy and coaching and prepares individuals to successfully return to the community after hospitalization by extending multidisciplinary care management services.
 

Challenge 

The challenge is to decrease hospital discharges to nursing facilities by 1.5 percent and to contribute to the statewide goal of transitioning 8,000 people from nursing facilities to the community by 2020. This challenge shifts the care and support individuals receive at two distinct points in the medical intervention continuum. The first is at the point of discharge from the hospital. The second is in the daily life of the individual and the health and well-being options provided to them as well as the transfer of information to access these services. Additional challenges include broadening and building relationships across siloes, working with partner organizations to contribute to their ongoing initiatives, avoiding duplicative services and support, and achieving system-level change.

The first step in addressing these challenges has been to pose a question to the community: “What could the time between medical interventions look like so that it is filled with a supportive, reliable, and loving social network; healthy options that support the mind, body, and spirit to thrive; and a safe place to call home?” The goal is that the community, stakeholders, and partner organizations will address this challenge together by increasing choices for the individual while expanding the existing continuum of long-term care services and support.
 

Solution 

The team addressed the challenge at all levels and through all stages of the project. One key objective is to develop Places of Dynamic Services that encourage healthy living through personal growth as well as foster security. 

The vision is to design and build a Place of Well-Being that serves as a onestop shop for individuals with multiple chronic illnesses.

The premise is that stakeholders can accomplish more by building on collective strengths. To support this view, “Appreciative Inquiry” is the methodology utilized that recognizes the full worth of something or someone and discovers possible solutions through questions. Appreciative Inquiry is strengths-based, artful in its search, collaborative, inclusive, and generative. The methodology moves through four phases from discovery to dream to design and finally to destiny. 
 

Results 

During initial interviews, participants shared stories of what aspects were working well. The main questions revolved around the strengths of each partner organization, their well-being, the community and connections, and the dream of a Place of Well-Being. The strengths of Leeway were identified through the voices of staff, residents, alumni, and case managers. Individuals who live with multiple chronic illnesses in the community were then interviewed. Powerful themes emerged, including that an individual with multiple chronic illnesses could be any one of us, and how would we want to be treated? It’s important to be seen and accepted for who one is and to have a sense of belonging; this is the key to receiving dignified treatment and compassionate care.

A living storybook was developed to record the changes and steps taken, questions asked/to be asked, sticky problems, and successes along the way. Vignettes and photographs are scattered throughout. The storybook represents the collective voice of individuals, organizations, and the community.