Transcript Insert Session Title

Toward Building a
Sustainable
Long-Term Care
Workforce: LEAP
Jayne Schaefer, BA
Workforce Programs Manager
Mather LifeWays
Evanston, Illinois
Faculty Disclosure
Jayne Schaefer has disclosed
that she has no relevant
financial relationships.
Facility Demographics
Mather Pavilion
Evanston, Illinois
A long-term care community of 158 beds
5 Neighborhoods
2 Neighborhoods for Memory Support
3 Neighborhoods for intermediate and
Skilled Care
Type of Ownership – Non-Profit
Learning Objectives
By the end of the session, participants will be
able to:
 Understand the importance of implementing a
comprehensive education program for the development
of nurse managers and staff nurses
 Understand the importance of developing a career
mobility ladder for the continued development and
advancement of direct-care workers
 Measure impact of this program on staff retention rates
 Understand the impact of this program on resident care.
In the beginning…
The nursing staff identified the
following needs:
 Improve quality of work life
 Improve staff retention
 Improve care to residents
Nurses told us they wanted…
•
•
•
•
Better communication
Supportive managers
Appreciation for jobs well done
Respect from co-workers
CNAs told us they wanted…
 Provide affection and support to residents
and their families
 Care for residents in a team environment
 Have their knowledge and skills valued
by nurses
 Sharpen their assessment skills
Residents told us they
wanted…
 To know the staff
 To have the staff know them
 To develop positive relationships
with staff
 To be treated as individuals
Based on those requests,
we developed a program to…
educate
empower
retain nurses and CNAs
while nurturing their relationships with
residents
families
each other
LEAP






Develops staff leadership skills
Develops teamwork skills
Develops communication skills
Develops a peer-mentoring program
Develops a career ladder for direct-care workers
Puts the resident quality of life and well-being at
the center
LEAP: A Workforce
Initiative Program
1. Resident-centered approach to developing
and retaining qualified, effective nursing staff
2. Teaching methods based on adult
learning theory
3. Ongoing evaluation mechanisms to
track progress
4. Research-based evaluation mechanisms targeting
key staff and resident outcomes
5. Training that prepares staff to effect and
sustain change
LEAP Nurse Training
Program Description
Training
 six training sessions
 three hours per session
Curriculum Focus
 developing the nurse as a leader
 empowering the nurse as a role model in providing
care
 empowering the nurse to become a gerontological
clinical expert
 developing the nurse as a care team builder
LEAP CNA Training
Program Description
Training
 seven training sessions
 two and ½ hours per session
Curriculum Focus
 defining the CNA’s role in person-directed care
 developing CNA communication skills
 providing the skills for head-to-toe inspection
 providing clinical updates
 building care teams
 developing mentorship skills
Implementation
 Identification of nursing staff needs – 1999
 Pilot of the Workforce Initiative begins –
Nov. 2000
 100% of nurse managers and staff nurses attend the
six training sessions
 26 CNAs apply for training – 13 (50%) selected for
training
 Consistent Assignment Staff Model introduced – 2001
 Program philosophy incorporated in hiring process
and orientation
Measuring the Effectiveness
of the LEAP Program
 Survey developed to examine




Leadership effectiveness
Job satisfaction
Resident characteristics
Number of health deficiencies
 Staff retention data collected and analyzed
 Pre-workshop
 2-weeks post workshop
 6-months post-workshop
Measuring the Effectiveness
of the LEAP Program





CMS 5-start rating
Annual Turnover Statistics
Annual Resident and Family Survey
Annual Employee Satisfaction Survey
Illinois Department of Public Health Survey
Immediate Outcomes
Nurses reported:




Increase in positive communication
Improved listening skills
Staff encouragement
Greater receptivity to staff needs and
problems
 Effective dealing with staff issues
Immediate Outcomes
CNAs reported:
 Perceived leadership behaviors among
nursing staff improved
 Better relationships with supervisors
 Greater emphasis on work recognition
 Increased staff communication
 Greater opportunities for promotion
Immediate Outcomes
Association with
Resident Characteristics :




Decrease in number of health deficiencies
Fewer residents who were completely bedridden
Fewer residents with abnormal weight changes
Fewer residents with pressure ulcers
Sustained
Resident Outcomes
 Residents and their families
 95%-100% satisfaction rating with staff and
community
 Person-directed care positively impacts loved
ones
 Improved quality of life
Sustained Nurse Outcomes
 Nursing Staff
 Significant improvement in job satisfaction
 Significant improvement in work empowerment
 Increased work effectiveness allowing for greater
focus on resident needs
 Improved communication with CNA staff allowing
for better resident care
Nurse Turnover Rates
70%
60%
50%
National Nurse Turnover
Rate
Illinois Nurse Turnover Rate
40%
30%
Mather Pavilion Nurse
Turnover Rate
20%
10%
0%
1999
2001
2002
2004
2005
2007
2008
Sustained CNA Outcomes
 Empowered to work with residents
- calls family to report on resident’s care,
medication changes, clothing needs
 Trained as activities personnel allowing
customization of activities to meet
resident’s needs
 Expected to participate in resident care meetings
 Expected to serve on various committees
including QA committee
 Expected to act as mentors to newly hired staff
CNA Turnover Rates
120%
100%
80%
National CNA Turnover Rate
60%
Illinois CNA Turnover Rate
40%
Mather Pavilion CNA Turnover
Rate
20%
0%
1999
2001
2002
2004
2005
2007
2008
Sustained
Community Outcomes
 Reduced recruitment, hiring, and training
costs
 No registry staff
 Call offs handled internally
 Quality of service to resident improved
 Heath deficiencies decreased
 Resident satisfaction increased
 CMS 5-star rating
Summary
 This program impacts the long-term care workforce in many
ways:
- encourages collaboration and
communication among all staff;
- reduces staff turnover;
- increases resident satisfaction; and
- provides a positive financial impact.
 This program changes the way we deliver resident care. In
order to sustain LEAP we need:
- buy-in from the administration; and
- incorporation of the philosophy in the hiring practices,
orientation, training, and yearly reviews.
Questions?