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EDU 08-427 – HSR&D Study

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EDU 08-427
Training and Coaching to Promote High Performance in VA Nursing Home Care
Carol VanDeusen-Lukas EdD
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Boston, MA
Funding Period: October 2009 - March 2011

BACKGROUND/RATIONALE:
The study explored the feasibility of an educational intervention to strengthen workplace-learning systems in four VA Community Living Centers (CLCs).

OBJECTIVE(S):
Specific aims were to 1) conduct a feasibility study to assess whether the educational intervention is practical to implement as designed and 2) conduct a pilot study to validate the methodology proposed for assessing outcomes of this educational intervention.

METHODS:
A multi-level intervention targeting the translation of workplace learning into practice was implemented. The Direct Care Worker (DCW) intervention targeted both clinical knowledge and effective communication. The Coaching Supervision training addressed management and supervision practices for nurses, combined with effective communication. Four CLCs received both interventions, administered by the Paraprofessional Health Institute (PHI), using a train-the-trainer approach over the course of four 3-day sessions. Quantitative and qualitative data were collected to assess factors influencing effectiveness of implementation and to understand the impact of the trainings on participants.

FINDINGS/RESULTS:
Seven of eight trainers successfully completed the PHI training sessions. Trainers reported the PHI sessions were well run, informative, and valuable to their work. They also reported feeling confident in their abilities to deliver the training at their CLCs. Three sites implemented the Coaching Supervision training and two sites implemented the DCW training. One site was unable to implement any of the trainings in their facility due to turnover in staff. Trainers reported receiving positive feedback about the training sessions from their CLC colleagues and the two facilities that implemented both trainings planned to spread the trainings outside of the CLC. Barriers to implementation included lack of appropriate buy-in from leadership, initial confusion about the content of the trainings, and lack of staff and time to complete the trainings. The modified Care Coordination Survey, which had a response rate of 12.5% and had been previously used in hospital settings, had Cronbach's alphas scale reliabilities between 0.65 to 0.93. This survey shows promise for use in the Long Term Care setting.

IMPACT:
The project generated knowledge about the feasibility and effectiveness of a multi-level, contextualized training approach that has led to the submission of a larger grant proposal and has potential applicability to other settings in which DCWs provide care to veterans.

PUBLICATIONS:
None at this time.


DRA: Aging, Older Veterans' Health and Care, Health Systems
DRE: Treatment - Comparative Effectiveness
Keywords: Education Research, Long-term care, Nursing
MeSH Terms: none

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