By Geralyn Magan
Travel back in time to 2008, when the LTSS Center published a report on practical workforce solutions that still apply today.
The year was 2008. The LeadingAge Institute for the Future of Aging Services (IFAS) at the American Association of Homes and Services for the Aging (AAHSA) was just finishing up work on a four-year, $15.5 million research demonstration program called Better Jobs Better Care (BJBC), funded by the Robert Wood Johnson Foundation and the Atlantic Philanthropies.
Much has changed over the past 13 years. AAHSA became LeadingAge. IFAS became the LeadingAge LTSS Center @UMass Boston. But the workforce challenges that spurred the BJBC demonstration remain. And findings from the research project remain relevant to LeadingAge members working to strengthen the long-term services and supports (LTSS) workforce in 2021.
SOLUTIONS YOU CAN USE
Solutions You Can Use: Transforming the Long-Term Care Workforce, published in 2008, is based on major findings from the eight grantees that used BJBC grants to test new workforce-strengthening approaches. The report outlines what researchers learned and explains what those findings mean, on a practical level, to providers of aging services.
The report presents 47 research findings and their implications in 13 topic areas. Here are a few examples:
Attracting Older Workers
Older workers said they are more interested in working as activity aides, medication assistants, or rehabilitation aides than as direct care professionals. These limited positions in nursing homes are often given as “perks” to frontline caregivers with seniority.
What does this mean to you? Consider ways to restructure jobs to appeal to older workers. Focus recruitment efforts for older workers on the positions of most interest to them. This
finding also highlights the importance of offering specialized training and career lattices.
Wages and Benefits
Nursing assistants were significantly more likely to say they intend to stay in their jobs when they saw their pay, benefits, and advancement opportunities as good.
What does this mean to you? Competitive wages and benefits are critical to the retention of direct care professionals.
Supervisor Training
Good basic supervision was the most important factor affecting the intent of nursing assistants to stay on the job. Yet almost half (49%) of direct care supervisors reported that they had not received any formal education on supervision. Among supervisors who had received formal training on supervision, only 13% felt they were well prepared to supervise.
What does this mean? Provide supervisors with formal supervisory training. Include leadership and supervisory training as a key element of workforce development. Training must focus on “coaching” rather than “command and control.”
Job Satisfaction
Organizations with higher job satisfaction had lower turnover rates. These organizations were more likely to use recruitment and retention best practices.
What does this mean to you? Implement best practices for increasing job satisfaction and reducing turnover. Provide supervisory, coaching, and peer-to-peer communication training to support camaraderie and team building.
Career Enhancement
The majority (55%) of direct care professionals did not want to be a frontline caregiver in three years. Of those who wanted to leave direct care work, almost half wanted to advance their careers by becoming licensed practical nurses or registered nurses.
What does this mean to you? Provide direct care professionals with career advancement opportunities, tuition reimbursement, and flexible hours so they can attend classes. For those who want to remain as direct care professionals, provide job advancement opportunities, such as specialized training in restorative therapy, dementia care, or medication administration. Make sure these positions provide employees with a certification, title change, and wage increase.
Retention Specialists
Retention specialists, a designated team member who allocated at least 20% of their time for retention activities over one year, significantly reduced direct care turnover in participating nursing homes.
What does this mean to you? One individual can have a large impact on retention when they are trained in a diverse range of evidence-based retention strategies, receive ongoing support, take ownership of the retention program, and have the motivation and expertise to make it successful.
Initial Training
Just over half of nursing assistants (59%) felt their initial training prepared them well.
What does this mean to you? Initial training for direct care professionals should incorporate the top four recommendations from workers:
- More hands-on experiential training.
- Longer training.
- More communication skills training.
- Training on how to deal with residents’ behaviors and mental illness.
Continuing Education
Nursing assistants with higher job satisfaction were satisfied with the quality of their continuing education.
What does this mean to you? Based on workers’ suggestions, continuing education should:
- Be provided frequently.
- Be provided during a variety of times of day and days of the week to accommodate all workers.
- Include communication training.
- Address teamwork.
Cultural Competence
Workers from under-represented groups had lower levels of job satisfaction. Job satisfaction increased as the number of racial/ethnic remarks from other team members decreased.
What does this mean to you? Establish and reinforce no-tolerance policies on racism. Provide workshops or other training for team members on cultural diversity and cultural competence.
READ THE FULL REPORT
Check out more practical workforce solutions in: Solutions You Can Use: Transforming the Long-Term Care Workforce.