Breakout Sessions

The Workforce Crisis in Long-Term Care:
Proven Tools to Help Meet the Challenge

Thursday, September 18, 2008

Retention Specialist
Cornell Institute for Translational Research on Aging
The hallmark of this model is the designation of a staff person from a facility as the Retention Specialist. This individual receives tools and ongoing support to conduct a needs assessment, institute retention programs and evaluate their success. The retention specialist takes a leadership role in developing and sustaining a core of caring committed staff and acts as a retention advocate. Outcomes indicate that the retention specialist position is related to a reduction in turnover. Development of an online toolkit is in process.

Win A Step Up
University of North Carolina Institute on Aging in partnership with the North Carolina Department of Health and Human Services

Win A Step Up is a workforce development intervention aimed at improving the working situation of nursing assistants in nursing homes. This program is a successful facility-based quality and retention-enhancing training program for frontline supervisors and direct care workers in nursing homes. Components of the program include: (1) Coaching Supervision Train the Trainer certification for facility staff; (2) instruction for frontline supervisors in the coaching style of supervision; (3) instruction of nursing assistants using a 30 hour curriculum focusing on clinical and interpersonal skills: (4) program evaluation and other research activities related to the long-term care workforce.

Growing Roots and Pathways to Leadership: Peer Mentoring
Foundation for Long Term Care
Peer mentoring is an approach that addresses the troubling turnover rate of direct care staff in nursing homes. “Growing Strong Roots” is an award winning peer-mentoring program for CNAs designed to improve the orientation process, and the quality of care by teaching the value of caring and reinforcing critical skills and behaviors. In addition the program uses exemplary aides as role models. Pathways to Leadership is a recently completed program which combines the orientation process and the quality of care goals of the CNA training into an expanded training for charge nurses. Included in this program is training to improve management leadership and communication skills, especially as they relate to dementia care. A goal of both programs is to improve care for residents with dementia by improving retention rates of charge nurses and the CNAs they supervise.

12 Steps: Creating a Culture of Retention In Home and Community-Based Long-Term Care Services
PHI (formerly, Paraprofessional Healthcare Institute)
All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing quality care. The 12 steps provide guidance to agencies in developing excellent recruitment, selection and retention practices – the three key elements necessary to successfully manage long-term care organizations. It is based on building a system to support recruitment and retention initiatives, including reviewing and enhancing orientation, providing support services, mentoring, supervision coaching, training, worker participation in decision making, and management leadership and oversight. A work book describing the 12 steps can be purchased from PHI.

Powerful Tools for Caregivers: One County’s Story
Legacy Health System  
Eighty percent of caregiving is provided by family and friends. Supporting this informal workforce will help to negate or delay the need for care services provided by the professional long-term care workforce. Powerful Tools for Caregiving (a Legacy Health System Program) is a six-week psycho-educational program for family and friends who are caring for older adults and disabled individuals. The course provides informal caregivers with the skills, confidence and information to better care for themselves while caring for others. In post class surveys, participants report feeling less anger, guilt and depression. They also report improved communication skills, an increased ability to cope with the difficult challenges of caregiving and better self-care. Information about local community resources for caregivers is provided as an integral and important component of this program and results in participants more readily accessing community resources.