Since 2015, we’ve been making life better for residents, families, staff, and others by providing coaching and training services that improve care, safety, and quality of life in long-term care communities.

Long-term care facilities are complex environments that are known as home to residents, workplaces to staff, and everything in between for families, potential residents, vendors, and others. Our philosophy is that excellent person-centered care comes from excellent teamwork, communication, and practices.

Over several years, we developed a simple, easy-to-use, and comprehensive way to manage the complexity of daily life in long-term care facilities. The LiveWell Method™ is a validated approach that uses a practice-based framework for organizing, tracking, measuring, and improving daily operations in long-term care, hospital, and other complex healthcare settings.

When communities use the LiveWell Method ™, they have better staff retention, fewer staff absences, and fewer workplace injuries. They also have fewer falls and medication errors. Staff have higher morale. They have a voice, are able to make a difference, and are better at caring for older adults and people with disabilities.

Communities that use the LiveWell Method also save up to $150,000 per year in administrative costs by retaining staff and reducing falls and medication errors.

The LiveWell Method ™ is the State of Oregon’s endorsed Quality Assurance and Performance Improvement (QAPI) method. It is grounded in local and global best practices, based on Lean Thinking and Human-Centered Design, and available to long-term care communities anywhere in the world.

From Pilot to Proven

The LiveWell Method was developed and piloted by The Malden Collective (TMC) with the State of Oregon over a four-year period from 2015-2018. Funding was made possible through grants provided by the Quality Care Fund of the Department of Human Services/Aging and People with Disabilities. In 2019, the State embarked on a multi-year expansion of LiveWell to provide training, remote learning, coaching, and peer learning opportunities to staff working in long-term care facilities.

The LiveWell Method™ provides simple ways to improve teamwork, communication, resident wellness and safety, measurement and tracking, and organization of the workplace. It uses visual management tools and key daily practices such as the huddle, community quality board updates, and resident observation. The LiveWell Method™ is a form of Lean Management adapted to the unique needs of long-term care communities.

LiveWell is often seen as a culture change program. But it is not a traditional culture change program. It is “bottom-up and top-enabled.” It starts with the people doing the work. It engages and empowers individuals, creating a more democratic and transparent workplace. This is how the LiveWell Method creates great work environments that staff want to work in.

The LiveWell Method has also been implemented in more than ten skilled nursing communities in San Mateo County, CA. The Health Plan of San Mateo used LiveWell to improve quality and reduce costs. The program resulted in a new pay-for-performance strategy.


Being tasked with specific items to accomplish week to week helps us understand and get the tools created; having high expectations challenged us in a good way to be better.
— AL/RCF Staff Person

A Record of Improving Care

The LiveWell Method is rooted in the innovative workforce training programs developed by the NHS Institute for Innovation and Improvement. Facing budgetary pressures and people living longer with chronic illnesses, NHS England had to find new ways to improve the quality of care delivered by different segments of the healthcare workforce. They did this by developing a series of unique empowerment methodologies based on the best practices of Lean thinking.

Under the leadership of Barbara Kohnen Adriance, CareOregon, a Medicaid-managed care organization, imported and later adapted NHS England’s Releasing Time to Care program for hospitals in Oregon and throughout the country.

In 2015, Oregon’s Aging and People with Disabilities office of the Department of Human Services provided seed funding to test, develop, and pilot a new program. The LiveWell Method is based on the same principles underlying NHS England’s programs: empowerment, participation, transparency, accountability, and relevance to the specific culture of each care environment. The LiveWell Method was developed by Barbara Kohnen Adriance’s team at CareOregon and tested in fifty communities in Oregon between 2015-2018.

Data from the pilot showed substantial improvements in falls, medication errors, and a reduction of over-prescription of antipsychotic and antibiotic medications—in addition to staff engagement and a reduction in turnover.

The Malden Collective recognizes the invaluable input and support provided during the LiveWell pilot period by the following individuals: Linda Kirschbaum, Fred Steele, Keren Brown Wilson, Lisa Maynard, Kim Hutchinson, David Thurber, Diana White, Suanne Jackson, Ana Potter, Margaret Cervenka, Lisa McKerlick, Judy Ha, Lucia Lindell, Jennifer Pratt, and Lisa Miller.