by Darcey Trescone
There are many reasons why the retention of healthcare workers is critical. The focus on quality patient outcomes across the healthcare continuum is vital to meet reimbursement demands. Also, the increasing volume of elderly patients with chronic conditions entering our healthcare system increases the need for more people in these roles. As an industry, home care and hospice cannot afford to ignore reasons that potentially impact retention anymore.
Health care organizations are constantly changing because of technological advancements, aging populations, changing disease patterns, discoveries for the treatment of diseases, and political reforms and policy initiatives.1.
Change can be challenging because they contradict humans' fundamental need for a stable environment.
In a study based on semi-structured interviews with 30 healthcare professionals, including registered nurses, nursing assistants, and physicians employed in the Swedish Healthcare system,1 successful organizational change was categorized in the following manner:
Organizational changes in health care are more likely to succeed when health care professionals can influence the change, feel prepared for the change, and recognize the value of the change, including perceiving the benefit of the change for patients.1
CNAs are frequently excluded from team communication and decision-making, which often leads to job dissatisfaction with high levels of staff turnover. To develop lasting solutions to these problems, it is essential to change the culture of the current healthcare environment by empowering all members of the team to meet these goals.
The purpose of this pilot study was to explore the impact of a certified nurse's aide (CNA)-led interdisciplinary teamwork and communication intervention on the perceived quality of work environment and six-month job intentions.2
This workforce is under increasing stresses – some inherent in their demographic profile, and many brought on by a rapidly shifting and more complex resident population and, significantly, minimal changes in resources.
Care aides are an essential workforce in this setting –the perception that their work is "domestic," unskilled, and thus of lesser importance and value is counterproductive to actions that will improve their working conditions, and the quality-of-care nursing patients receive.3
The care aide workforce needs sufficient knowledge, skills, and resources to care appropriately for these seniors. Structured training programs with a career path for advancement in role and pay are critical to retention. Employees need to feel that they are adding value, they need to be recognized for their value, and they need targeted goals for growth and increasing pay.
Direct care workers, nursing assistants, and our nurses are on the frontline with home care and hospice patients. They experience the good and bad within their roles daily so our home care and hospice organizations can remain stable and profitable. The stress of working with families and patients, trying to improve health, even when a decline is inevitable, is abundant with these roles.
There is much research surrounding these roles and job satisfaction in long-term care. Similar studies need to be conducted separately for in-home care and hospice because environment and stresses can be different. Understanding the perceptions and needs of your staff and incorporating solutions to improve job satisfaction as home care and hospice evolve is necessary considering the staff shortage, which is worsening. Good employees are going to get harder and harder to find.
1 Nilsen P, Seing I, Ericsson C, Birken S, Schildmeijer K. Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses.
2 Howe E. Empowering certified nurse's aides to improve quality of work life through a team communication program.
3 Chamberlain S, Hoben M, Squires J, Cummings G, Norton P, Estabrooks C. Who Is (Still) Looking After Mom and Dad? Few Improvements in Care Aides' Quality-of-Work Life.
Darcey Trescone is a Healthcare IS and Business Development Consultant in the Post-Acute Healthcare Market with a strong background working with both providers and vendors specific to Home Care and Hospice. She has worked as a home health nurse and held senior operational, product management and business development positions with various post-acute software firms, where her responsibilities included new and existing market penetration, customer retention and oversight of teams across the U.S., Canada and Australia. She can be reached at firstname.lastname@example.org.
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