Key Change Series Part 1 - Revolutionizing Care Through Music: A Theory of Change
Innovative leaders in health and social care are always looking for evidence-based, scalable solutions that can meaningfully improve care. Music care is a transformative approach that’s making measurable, sustainable change in care settings.
Several years ago, the Room 217 Foundation developed a Theory of Change (ToC), a framework designed to document how a program works, why it works, and the impact it creates. ToC is a concept rooted in program evaluation from the 1990s. The value of ToC lies in its structured approach to making complex change programs clearer, more accountable, and more effective.
Room 217 had already created logic models for our various programs. ToC took us deeper—helping us think through not just the program’s activities, but the underlying assumptions, the necessary conditions for success, and the long-term benefits for all involved. Our basic assumption was simple: Music can be a powerful agent of change within a caring community. Through our research in 82 long-term care homes and 84 hospices in Canada, we saw firsthand the effects of music. Music improved people’s moods, changed the atmosphere, fostered hope, and built a sense of community among caregivers and patients alike.
The ToC process allowed us to ask: How can we measure and sustain these effects on a broader scale? This question led to the creation of MUSIC CARE CERTIFY (MCC)—a quality improvement program that integrates music into the culture of care organizations, turning music into a core, measurable component of care.
There have been clear advantages to developing a ToC. Leveraging a comprehensive program rationale has clarified our assumptions, assessed the merits of our standardized quality improvement program, and explained the activities and processes that contribute to change. We have established a shareable vision of the program and identified enablers and barriers to success we can explain to others.
We discovered that ToC design methodologies vary. Yet each method typically addresses several key areas which include:
- Identifying a problem or opportunity that requires a program response, the root causes and effects of the problem and who is affected
- Scoping the objectives of a program solution and the foreseen impact
- Naming stakeholders who would likely be a part of the solution
- Enumerating measures of success
- Listing assumptions about why, in our case, we think MUSIC CARE CERTIFY will work.
The visual metaphor we used to guide our ToC was a tree. We placed the causes of the problem at the roots, the effects as branches, and then focused on the leaves and fruit as the solutions. The imagery helped us map out how music could grow within a care environment, eventually becoming a deeply embedded part of the care culture, a visible and lasting solution.
Through this process, we became even more convinced of music’s role in solving the quality of life issues that so often affect caring communities. By integrating music care systematically and sustainably—through the components of MCC—we provide a realistic, scalable solution that’s both affordable and replicable.
Imagine care settings where music is integrated into the culture, where quality of life improvements are not just hoped for, but proven. This is the future we’re building—one where music becomes a key player in revolutionizing care.
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