One of the best ways to increase market share is to do a better job training frontline caregivers. That’s what David Kohnstamm, Administrator of the Rose Schnitzer Manor assisted living facility in Portland, Oregon, and his colleagues figured out.
"At the time all we had is shadowing. We would hire somebody and we would have them shadow another employee. There was very little formal training and bad habits got passed down. It was hard to hold people accountable. If you have a team that doesn't have the tools to do its job, it's scary because you're trusted with people's lives--people's grandparents and parents--if they're left on the floor or not responded to properly after an incident or documentation is not appropriate, there are all sorts of bad things that can happen."
So Rose Schnitzer, part of Cedar Sinai Park, focused on what good things can happen, embracing a unique, structured approach to training caregivers in partnership with Portland Community College. Early findings suggest that this approach shows great potential to increase the satisfaction of patients and relatives, improve employee retention, and bolster market share. Not to mention making it much easier for healthcare administrators to sleep at night.Five long-term care facilities – Rose Schnitzer Manor (Cedar Sinai Park), Orchard House (Providence Benedictine), Farmington Centers, Concepts in Community Living, and Marquis Vintage Suites – joined with Portland Community College to create a program that:
- Identifies the competencies and skills that frontline caregivers need to feel successful at their jobs and deliver quality care to residents;
- Develops credentials that reward and recognize caregivers who achieve these competencies; and
- Delivers training within the workplace, using real-life responsibilities and experiences as “coursework.”
The project, launched in 2008, was supported by the Jobs to Career Initiative. A project of the Robert Wood Johnson Foundation and The Hitachi Foundation, this initiative is testing new ways to train frontline health care workers for sustainable careers. Linda Bifano, the Director of the Health Services Department at Cedar Sinai Park, describes the program’s impact on direct service in this video clip.
“On the whole it wasn’t very difficult to achieve,” says David Fuks, CEO of Cedar Sinai Park. “It seemed daunting at first. I think most of the challenge was psychological – taking the leap and taking the risk. What we found out is quality is free. Yes, there are some upfront expenses. You pay for tuition. You pay for people’s time. It might take some time during the day when somebody is providing mentorship around a specific skill. For example, something as simple as hand washing could mean as much as 45 minutes away from providing direct service. But the result is a staff that is much more competent, able to do their jobs more effectively, people feel better about the care they are receiving, your reputation improves, your market share improves and the thing pays for itself.”
Portland Community College (PCC) worked closely with these long-term care facilities to develop a training program that can be delivered in the workplace, as part of the workday. Experienced staff members at each facility were trained to deliver the training to frontline caregivers. The training consists of 27 modules, including topics such as roles and responsibilities, resident service plans, personal care, self-care, and diabetes care. Suesan Thompson, Health Services Coordinator at Marquis Vintage Suites describes how the training is delivered within the context of the tasks that caregivers tend to every day in this video clip. Staff members who are doing the training determine when the caregivers have mastered a task – it’s competency-based, as opposed to classroom based.
“We have no state standard for caregivers in Oregon,” says Suanne Jackson, who served as Project Director for PCC. “Some places give several hours of training, some places give none. Caregivers, basically, have to be 18 years old and pass a background check – that’s the only criterion.”
Completion of the training program leads to a certificate bestowed by PCC: Resident Assistant 1 or Resident Assistant 2. In this video clip, Pina Ibabao, Health Services Coordinator at Rose Schnitzer Manor, shares how much achieving this credential means to caregivers.
“Part of what appealed to us was the potential for a relationship with a community college, to create the capacity for frontline staff who may have never received a college credit to get a college credit for the on-the-job learning,” added Fuks.
The assisted living facilities that participated in this project report significant payoff.
“What we found out is that the families could tell which caregivers had been through at least most of the program,” Thompson reports. “I can tell you right now from our satisfaction surveys that we just had the best quarter in our history.”
Jackson, who helped run the program for PCC, agrees. “The motivation is the cost effectiveness and the fact that the turnover rate went down for everybody. Facilities lose a minimum of $2,500 per employee with turnover. We estimate our training costs between $800 and $1,000 per person.”
At Cedar Sinai Park, Fuks reports that “the results have been astounding in terms of low turnover rate, a high esprit de corps, high quality of service, and the satisfaction responses we get from residents.”
In this video clip, Emily Skipper, Lead Dayshift Aide at Marquis Vintage Suites, and Manolita Survan, Resident Assistant at Rose Schnitzer Manor, put a personal face on the value of work-based learning in long-term care facilities.
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Learn more about the work-based learning model employed at Rose Schnitzer Manor of Cedar Sinai Park in Portland, OR.
For more information about a national initiative to address the needs of today's frontline healthcare workers while ensuring a skilled and prepared health care workforce for the future, visit Jobs to Careers.
* The Hitachi Foundation is a founding funder of Jobs to Careers.
