“It appears that the investment that North Carolina is making in quality improvement initiatives is having a positive and significant impact on nursing home performance and the stability of the nurse aide workforce,” says Workplace Interventions, Turnover, and Quality of Care Report.
The June 2009 report analyzes three workplace interventions aimed at improving turnover rates and care quality in North Carolina nursing homes:
- The WIN A STEP UP program. This gives nursing assistants an opportunity to advance in their careers and earn additional money by completing a 30-hour curriculum. They also commit to staying in their jobs. In addition, the program provides coaching supervision training for the CNAs’ supervisors.
- Culture change initiatives. 15 North Carolina nursing homes a year are granted civil monetary penalty funding to transition from medical-model care to a more homelike environment.
- Quality improvement collaborative. About one in five North Carolina nursing homes participate in this effort to improve reduce the rate of pressure sores and the use of restraints.
The biggest improvements in retention were associated with WIN A STEP UP. Homes that implemented the program had a 27 percent likelihood of having lower than average CNA turnover rates. (The annual statewide average in North Carolina is 118 percent.)
An earlier study found the program increased the probability of having below‐average turnover by only 15 percentage points. “We assume that inclusion of Coaching Supervision in 2004, in addition to improvements in the teaching of clinical, interpersonal, and communication skills to nurse aides, has improved the effectiveness of the WIN A STEP UP intervention in lowering turnover rates of nurse aides,” the authors note.
Elise Nakhnikian
Communications Director
Direct Care Alliance
Elise Thanks for profiling our program. You folks are really developing a strong web presence and linking to great videos and resources. Keep up the good work