Senior Care - Relias Learninggo.reliaslearning.com/rs/reliaslearning/images/Relias-Learning... ·...

Senior Care

http://www.reliaslearning.com

Introduction 3

Respondent Demographics 5

Key Takeaways 7

Findings 10

Business Alignment, Value and Impact

Budgeting and Economics

Training Drivers and Emerging Influences

Perceived Strengths and Weaknesses

Training Management, Delivery and Common Practices

Survey Methodology 36

TABLE OF CONTENTS

Relias Learning • 2015 State of Training: Senior Care 3

In 2014, we were privileged to have more than 2,000 senior care

organizations use Relias Learning to deliver training to their staff. Across

the broader health care spectrum, more than 2 million people in the United

States trained on the Relias Learning platform, completing more than

20 million courses.

A key aspect of our work is a broad, ongoing engagement with executives,

training managers, licensed and non-licensed staff, and HR directors

throughout the senior care industry.

It will come as no surprise to those who work in this field that conversations

quickly turn to the challenge of responding to rapidly changing industry

dynamics. Organizations everywhere are striving to keep up with the pace

of change, and performance improvement is an ongoing necessity.

In light of this, we’re continually looking to understand the impact of

training and workforce development on organizational performance—better

outcomes, lower costs, increased compliance, reduced turnover and more.

The purpose of this report

Relias Learning’s 2015 State of Training report was designed to get a

national perspective on five broad staff development and training issues:

The perceived business alignment, value and impact of today’s staff development and training programs

Principal training drivers and emerging influences

Perceptions about the strengths and weaknesses of existing training programs

Current common practices in training management and delivery

Budgeting and the economics of staff development and training

To get as broad a set of responses as possible, we reached out not only to

our customer base, but also to organizations throughout the industry. In

this, we are indebted to many partner organizations that promoted this

survey to their members.

Introduction

1

2

3

4

5


Who is this report for?

This report is for two groups of people: The executives responsible for

driving organizational performance and the individuals responsible for

overseeing and delivering training programs.

Our hope is that this report provides an opportunity for organizations to

1) benchmark their current practices, investments, and beliefs against a

national sample, and 2) spur discussion on how to improve staff training and

workforce development—both to fulfill your organization’s mission,

and to do so in a sustainable way.


Board Member or Chief Executive

Program Sta� Member

HR Director / Administrator / Manager

Senior Management

Other Program / Department Director / Administrator / Manager

Other

Training Director / Administrator / Manager

Position within organization

More than 900 senior care professionals participated in this survey, with 18%

of respondents holding executive or senior management positions (referred to

throughout the report as Executive) and 72% of respondents holding other key

training stakeholder positions (referred to throughout the report as Non-Executive).

Strong geographic representation—survey participants from 45 states

Position Within Organization

Organization’s Headquarters

Respondent Demographics

District of Columbia

4-9%

3%

2%

1%

0-1%

No respondents


4-9%

3%

2%


1%

0-1%

No respondents


4-9%

3%

2%


1%

0-1%

No respondents


Percentage of respondents by state:


State of Training 2015 • Senior Care • Respondent Demographics

...including CARF, COA, and Joint Commission

Accreditation

Company Size by Employee Count

Assisted Living

Skilled Nursing Therapies

Residential Living

Palliative Care

Home Health

Hospice

Other

Other services provided:

Adult day careAdult day services

Day careDementia/Alzheimer's

Dental careDomiciliary care

Intermediate careMemory care

Non-medical in-home careNon-medical private-duty

home careNon-medical/

personal care & companionshipOutpatient carePersonal care/

Companion sitterPulmonary

Short term rehab

Services ProvidedServices Provided

51% 44% 5%

For profit Not-for-profit Government, public sector

Types of Organizations

2000+ employees

1001-2000 employees

501-1000 employees

251-500 employees

51-250 employees

fewer than 50 employees

10% 26%12%19%27%7%

Yes

Accreditation pending

No


prominent weaknesses

1. Training Programs Face Both Strategic and Practical Challenges. Respondents reported a wide range of weaknesses with their current staff

Interestingly, Executive respondents reported that their organization’s

biggest training weakness is limited relevance to practical job needs/limited follow up.

2. Compliance Drives Training Agenda—But There is a Need for More Strategic Alignment. Both executives and non-executives agree

that external factors, such as compliance and funding requirements,

drive the training offered to staff. However, neither group believes this

is ideal. Respondents estimate that 50% of training is currently driven by

external factors, but believe this influence should be reduced to around

30%, providing more balance with internal tactical and strategic drivers.

Regarding the #1 external factor impacting training, 42% of executive

respondents cited government regulations, rules or other contract requirements.

One way to interpret such findings is that there is a general belief that

externally-driven, “must do training” consumes some of the resources that

should be used to support other training aims.

Key Takeaways

Industry Views on Training

Based on survey responses, executives, senior management and other key training

stakeholders see eye-to-eye on many aspects regarding the importance of training

and its delivery within their organizations. At the same time, executives and non-

executives had very different perceptions about the business impact, strengths

and weaknesses of their training programs. This may indicate the need for better

reporting, communication and understanding of current training programs or further

evaluation of the content, compliance and evidence of training being put into practice.

Several noticeable themes emerged from the survey:

2Lack of time and competition with regular duties

Limited availability, participation and compliance

development and training programs, but

two themes were prominent: 1) a lack of

time and competition with regular duties;

and 2) limited availability, participation and

compliance. The picture that emerges is

that there is often a gap between training

program design and actual execution in the

face of many competing demands.

8

3. Regulatory Requirements and Training Budgets are Both Expected to Increase. Both

executives and staff believe that

State of Training 2015 • Senior Care • Key Takeaways

government regulations, rules and contract requirements will continue to

increase, and have a substantial impact on staff training programs.

58% of senior management also predict that training budgets will increase.

Based on respondent comments, increased training funds will be used to

train new staff, meet new regulations, meet the needs of a more diverse

client population, and train a new generation of leadership in senior care

organizations.

4. Blended Learning and the Use of Technology are Becoming More Mainstream. Almost 75% of respondents are using some sort of blended

learning (a combination of online and

class-room training) on a regular basis.

This appears to be an emerging best

practice, with 27% of respondents

indicating significant usage and

published research studies1, 2 showing

75%

of respondents are using some sort of blended learning

1 Means, B., Toyama, Y., Murphy, R., Bakia, M.,& Jones, K. (2010). Evaluation of evidence-based practices in online learning: A meta-analysis and review of online learning studies. U.S. Department of Education Office of Planning, Evaluation, and Policy Development Policy and Program Studies Service. https://www2.ed.gov/rschstat/eval/tech/evidence-based-practices/finalreport.pdf

2Bernard, R., Abrami, P., Lou, Y., Borokhovski, E., Wade,A., Wozney, L., Wallet, P., Fiset, M. & Huang, B. (2004). How does distance education compare with classroom instruction? A meta-analysis of the empirical literature. Review of Educational Research 74, 379-439

It is believed government regulations, rules and contract requirements will continue to increase—substantially impacting staff training programs.

its efficacy. Respondents using blended learning indicate usage across a

wide range of training, including advanced clinical topics, where online

courses can be used as a precursor to face-to-face discussions and training

sessions.

70% of respondents are using technology to track their training programs,

with an increasingly smaller number (30% reported here) still tracking

training manually. More than one-third of the respondents also report using

a learning management system to support the assignment and tracking of

their training programs.

5. Staff Training Programs are Still Not Viewed as Impacting “Financial” Business Priorities. Roughly two-thirds of respondents

reported that their staff training programs significantly impact their top


business priority. This top priority was frequently identified as some variant

of “providing specific services,” including providing such services with a

State of Training 2015 • Senior Care • Key Takeaways

6. Costs of Training Not Well Known. We asked executive respondents

to estimate their annual cost per employee for staff development and

training and also approximately what percent of their total operating

budget is devoted to this (cost and percent band choices were offered for

these questions). It is noteworthy that more than one-third of executive

respondents could not offer even an estimate regarding costs and

“quality emphasis.” However, tellingly, less than

half of Executive respondents indicated that

their staff training programs have a significant

impact on either financial results or staff

recruitment. As competition increases—both

for revenue and workforce—this is an area

where training will need to show more impact.

$Lowest areas of reported impact: financial results and staff recruitment

percent of budget. Given the tight budgets

most organizations are under, and given the

increasing critical need to optimize staff

training and workforce development, knowing

this number is an important first step.

Costs of training not well known

?


Providing Specific Service

Providing Specific Service—Quality Emphasis

Customer Service / Satisfaction

Budget, Revenue, Sustainability, Competitiveness

Accreditation / External Compliance

Other

None mentioned

Sta�, Client or Community Safety

Sta ng or Sta� Training & Development

Business Alignment, Value and Impact Using an open-ended question, participants were asked to indicate their organization’s

#1 business priority. These free–text responses were coded into 8 different priority

categories. Adding together the top two priority mentions for respondents in both

major job role groups (that is executive and non-executive respondents) reveals

that they are closely aligned in their beliefs about the #1 priority. Both groups listed

providing a specific service or providing quality service as the business’ #1 priority.

Indeed, both groups are very closely aligned with respect to how often other priority

categories are mentioned; however, the category customer service/satisfaction is

mentioned somewhat more often by the executive group as a #1 priority.

Findings

#1 Business Priority

While only 4% of respondents cited staff development and training as the #1 business

priority, when asked to rank its importance,

57% of respondents rated it highly—either a

6 or 7 in importance on a 7-point ranking scale.

A small group of respondents (7%) didn’t rank

staff development and training as a priority.

Executive

Non-Executive

57%

believe that staff development and training is highly important.

11

Findings

Quality patient care.

Exceptional Patient/Family care while maximizing profitability.

Excellent care of our frail and elderly population.

To serve our population with the best knowledge and service available.

Improving quality of life for senior citizens.

EXAMPLES OF VERBATIM RESPONSES:

Servicing our patients with the most up-to-date knowledge in the therapy industry in a very friendly, clean environment.

To create and maintain a dignified environment for our Residents and Employees that fosters our dedication to “Caring about you while caring for you.”

Providing exceptional care to our patients, which in turn will make us a provider of choice resulting in increased census.

State of Training 2015 • Senior Care • Findings

as the business’ #1 priority.providing a specific serviceproviding quality service

Both groups listed

or


Blended Learning at Kisco Senior LivingAt our Kisco Senior Living communities,

we are fortunate to work with educated

and experienced practitioners in

the nursing, hospitality, culinary,

environmental services, and wellness

fields. This bulk expertise, blended

with online courses and resources

available through Kisco Learning Center*

(KLC), lends itself to comprehensive

and blended learning programs for all

associates, both at the entry point of their

career and ongoing learning at all levels.

At Kisco Senior Living, we follow a Teach-

Show-Do-Practice-Review approach with

nearly all training activities and initiatives.

We deliver training in topic-specific

knowledge “chunks” to ensure that we do

not overwhelm or flood the learner with

too much information at one time. We’ve

found that this leads to an increase in

knowledge retention and application of

the learning on the job.

Teach: As a first step, we provide the

learner with foundational and key

information to convey concepts, describe

standards, share facts, etc. Topic-specific

online courses are especially helpful

to convey a consistent message and

standard expectations when navigating

the complex world of licensing-specific

training requirements.

Amy Lane Park, M.A.Ed.Organization Development—Learning & Development,Kisco Senior Living

Expert View

As a supplement to, or in place of an online course,

we create and provide detailed instruction outlines

to trainers to guide their facilitated instruction

with the learner in a one-on-one or group-training

environment.

Show: After level-setting the learner in the ‘Teach’

phase, this is where the ideal performance is

demonstrated, either in a multimedia format

(internally-recorded video, online course, etc.) or

in-person as performed by the trainer. We find

that this phase is best facilitated in-person (vs.

multimedia offering) due to enabling the learner to

see the learning topic in action performed in their

live environment.

Do: As a third step, we provide the learners with

the opportunity to apply what they learned—in

a safe training environment under the guidance

of the trainer to provide immediate positive and

constructive feedback.

Practice: This is an excellent opportunity to create

muscle memory of proper skill execution and can

be performed on-the-job under the guidance of

the trainer, or in a virtual gaming environment,

depending on the topic and available resources.

Review: At this phase, we integrate the supervisor

into the training experience to observe the learner’s

behaviors and performance on-the-job. Observable

behavior skills checklists are provided to guide the

evaluation and corresponding feedback discussion.

This helps the supervisor identify additional

and ongoing training/support to achieve peak

performance.

Kisco Senior Living specializes in full-service, private pay senior living

communities that offer an enriched lifestyle drawn from thoughtful details.

*Kisco Learning Center (KLC) is our learning management system powered by Relias Learning.



As Education Coordinator, I would like staff development to have a higher priority. Currently our focus is on hiring and retention, education is a condition of employment but not strongly enforced at this time.

If staff is trained well, there is a much improved level of care, with increased knowledge and skills expected of staff.

It is talked about at the highest levels, but often underfunded at the “line” level—making it difficult to stay current with the industry.

It recently became a focus from the corporate level.

Training compliance is directly linked to funding.

2015 budget reflects adding an education person to every location.

Having five facilities out of 16 receive tags for not completing training requirements last year has forced a greater emphasis from the corporate level.

If we do not maintain qualified/trained staff, we will fail in the attempt to be a quality facility.

Staff competency provides a solid base for our line of business. It’s not just a matter of getting people through the door; it’s a matter of them truly believing our staff are the best at what they do.

Ensuring all are trained is the #1 way to help keep all safe in all aspects of the business.

Somewhat important Not that important57%Very important

36% 7%

Ranking the importance of staff development and training

RESPONDENT COMMENTS:

It is very important, but unfortunately the trend has been to decrease the staff educator’s hours or add other responsibilities

No staff hours allotted to training or education.

Staff development is an individual’s responsibility.

Administration seems to care only when there is a DOH or IG investigation.

Becomes a top priority whenever there is a matter needing to be corrected.

QUESTION: Considering all of your organization’s top business priorities, where does staff development and training rank in importance?


Training Programs Impact Various Business Priorities

When asked how training impacts their #1 business priority, a clear majority (66%)

of all respondents report that training has a substantial impact (rating of 6 or 7

on a 7-point scale). The views of Executive and Non-Executive respondents are in

complete alignment on this point.


Training period is insufficient.

Need to increase mentoring capabilities/relationships with new team members.

Organizations priority is not geared towrds education, just mandatory processes.

We are in the design phase of the training cycle and are having some challenges ramping up.

A work in progress.

Due to financial restraints I am not able to educate staff on a level I feel to be beneficial in improving care level of residents as time is spent on other combined duties.

If our staff is better trained, we should be providing better care which in turn should increase census.

Our training is, unfortunately, lacking in many areas.

Training is highly segmented/ not collaborative.

We are still in the process of developing the training.

Constantly providing staff education through Relias and other training resources.

Training is the key for providing exceptional service and maintaining employee morale.

We receive continuous training to assure this is happening.

Company is extremely driven on residents first and culture change.

We integrate our mission into our content and use training as an opportunity to reinforce mission.


Somewhat Not at all66%Substantially

28% 6%

Extent that current staff development and training program supports #1 business priority.

QUESTION: To what extent does your current staff development and training program directly support your #1 business priority?

Executive

Non-Executive


Negative No impact Positive impact

Percent of Respondents Who Reported That Training Impacts the Following Areas

Additionally, executive respondents ranked whether their current staff development

and training program positively or negatively impacts 11 distinct areas of their

organization. Responses showed a positive impact in all areas, but four particular

areas carried scores in the 90th percentile: clinical competencies (94%), program outcomes (91%), practice standardization (91%) and compliance with external requirements (91%).


Staff Recruitment

Staff Retention

Onboarding New Staff

Core Staff Clinical Competencies

Service or Program Outcomes

Clinical Practice Standardization

Our Organizations Financial Results

Management & Leadership Competencies

Compliance with External Requirements

Our Risk Management Protection

Our Brand Reputation in the Community

There were only two areas where executive/senior respondents saw little impact from

their staff development and training programs: staff recruitment and financial results.

Very few respondents believed training had a negative impact on the business.

However, perhaps surprisingly, 4% of executives believed their organization’s

training program negatively impacted onboarding of new staff.


Training as a Competitive Advantage

38% of respondents indicated that

they believe their training programs

give their organization a substantial

competitive advantage. On the

other end of the spectrum, 16%

believe their training programs give

them no competitive advantage.

We train them well and then they quit.

Training ensures quality, but other agencies do not train as well.

We still have many who would rather sit through an hour of mass training once a month. Less demanding, they rarely have to take a test, and generally, they simply sign a paper to say they were there.

Training has deteriorated, as evidenced by customer service complaints and quality audits.

A certain amount of training is a requirement in order to remain licensed by the state.

Prep for federal training.

It could be better. Computer training is not always the best way to learn for some people.

Everyone is working together to ensure the safety and care of the residents.

Being a team member helps to keep our census high.

The training helps the staff with rehab and therapy.

Observing the guidance of implementing and giving medical care.


Some advantage No advantage38%Substantial advantage

46% 16%


QUESTION: To what extent do you believe that your current staff development and training program affords your organization a competitive business advantage?


Budgeting and Economics To more accurately reflect the costs of staff development and training on

organizations, financial data was reported only from executive respondents.

Cost of Training Per Employee

33% of the executive respondents indicated that they did

not know the cost per employee for staff development

and training, leading us to believe that this metric is not

being tracked by all organizations. For the executive

respondents who did estimate an annual cost, the majority

response (20%) was that $101 to $300 per year is spent

on each employee’s training. Executive respondents from

organizations with more than 1,000 employees reported a

much higher cost per employee, spending $501 to $1,000

per employee each year.

33%of executives report they do not know their annual cost of training per employee

Annual Cost of Training per Employee (Executive estimates only)



We have a full-time staff development coordinator who is an RN and we pay for an online learning tool for all staff. In addition, there are individual trainings that occur in each department.

It costs tons in paper and staff time to create and distribute, and chase staff for completion because there is no authority to hold staff responsible.

I have no idea of the cost factor.

Department heads have more trainings and seminars than regular employees. So depending on the position an employee has depends on the amount of training cost the employee may have.

If you include orientation it is very costly, hence retention is an issue.

Depends on department/licensure/equipment needed/hours/certification/education.

Cost estimates include the salaries of clinical specialists. Online training costs per employee per year are $100 or less annually.

It’s hard to say. I know we spend over $100 per employee because of online training alone—then you add the time and teaching of the leadership team. Not sure how to measure the hours they spend.

Very position-dependent—we do promote an employee tuition reimbursement program.

This doesn’t consider new-hire training (more time and money), but does include labor hours in addition to other costs.

Our overhead funds are very low as the majority of our clients are provided through medicaid. However, we do our best to make sure that their caregivers have good training.

~$25/EE for online training partner & training budget for each department to send at least staff to 1 workshop per month. We also pay for ongoing training required (Food Handlers’ Card and 1st Aid).

$63 per employee plus cost of CNA class for new hires.



QUESTION: What are your approximate annual costs per employee for staff development and training?



Annual Percentage of Overall Annual Operating Budget Allocated to Staff Training and Development

Annual Training Budget

35% of the executive respondents expressed that they did not know what

percentage of their organization’s annual budget is allocated to staff development

and training. For the respondents that do know their training budget, more than 70%

report that their organization spends less than 5% of their annual budget on training

endeavors. Organizations with 1,000 or more employees report allocating more

of their budget toward training, with a slight majority of respondents from large

organizations reporting training expenditures of 3% to 5% of their annual budget.

Almost one-third of the executive respondents indicated that they believe their

organization’s training budget should be substantially higher. At the same time,

58% of the executive respondents

believe their training budgets actually

will increase in the next few years.

of Executives believe their training budgets actually will increase in the next few years

58%


Thank you managed care.

Our one-year and five-year forecast demonstrates a large and substantial reduction in expenditures for training.

The reimbursement environment is very tenuous at this point; emphasis is on keeping the doors open.

Not sure with impending cuts.

We added more dollars for leadership training in the proposed budget for supervisor and management employees.

As the staff grows and regulations change, we will need more funds to provide the necessary training.

We are taking on an electronic health record next year ... lots of training required.


No change Decrease58%Increase

36% 6%

Likely percentage of budget change in the next few years for staff development and training programs (Executive responses)


It should not be surprising that

executives believe their training

budgets will increase, given the

number of state and federal

regulations facing the senior care

providers. As reflected in their

comments to this question, some

of the areas executives want to use

increased funds to:

• Train large number of new staff

• Train staff in new regulations

• Train staff to deliver services to a more diverse population of residents/patients

• Train leaders to manage Increase

No change Decrease

QUESTION: How much do you think that the budget for your staff development and training program is likely to change in the next few years?




Percent of respondents who believe that changes in the macro environment will impact staff development and training programs during the next few years.

Training Drivers and Emerging InfluencesWe asked respondents how much changes in the macro environment

(legislation, state or federal regulations, public financing changes in

accreditation standards, or other) were likely to impact their staff development

and training program. We followed that up by asking what the #1 external

factor was likely to be. 68% believe that changes in the macro environment are

likely to have a positive impact. Conversely, only 16% believe these factors will

have a negative impact.

A look at some of the comments associated with this question (shown below)

provides more insight into this thinking. Many of the comments suggest that

new demands will fuel the need for additional training.

Positive impact

No impact

Negative impact

Compliance program requirements as a condition of participation for Medicare and Medicaid.

Competition for staff, and staff shortages.

Bundled payment/value-based purchasing.

Potential state requirements for CEU for nursing professions.

Medicaid & Medicare reimbursements plus being under a “Managed Care” environment.

Customer satisfaction.

Regulatory push for more required education.

Regulatory changes that impact delivery of care.

Preparing facilities for a more complex client and rapid turnover.

QUESTION: To what extent do you believe that changes in the macro environment are likely to directly impact your staff development and training programs during the next few years?


We also asked survey participants how training drivers are weighted today, and how

they should ideally be proportioned. The results show a gap between what is driving

training today and what is perceived as ideal. Respondents told us that today, 50%

of training drivers are external and only 20% are driven by strategic aims. However,

respondents indicated that ideally, they would like to see strategic and tactical aims

take on a more even weighting with external requirements.

Weighting of Training Drivers: Today vs. Ideal


Median is todayMedian should be

Training drivers can be thought of as falling on a continuum:

Support External Requirements

Example: Regulatory RequirementsState licensing authority

requires that “All staff will have

annual fire safety training.”

Support Internal Tactical Aims

Example: Onboarding New Staff“All new staff will be

oriented to the agency

benefits package.”

Support Internal Strategic Aims

Example: Better Program Outcomes“The EBP Prolonged Exposure

Therapy (PE) is applied

expertly for the treatment of

traumatic exposure.”


When asked to indicate the #1 external factor impacting staff development

programs, 41% of respondents said that government/contract regulations would

have the most impact.


Government regulations, rules or other contract requirements

Money & other resource reductions, limits, gaps

Other

Changes in client or program mix, or program size

Workforce factors

Technology factors

Managed care, the Affordable Care Act, insurance factors

Accreditation or other survey, audit, or licensing factors

Emerging EBP, expanded knowledge base, focus on outcomes

Public perception, political factors, media, investigations

Regulatory requirements drive many of our actions even if they do not directly benefit the residents.

Our training is typically driven by survey results.

It is our desire that more focus is geared toward internal tactical and internal strategic aims - we shouldn’t be doing training just for the sake of meeting regulatory requirements (although this is the case).

Half my time is spent doing what is required. Of the remaining time, half of that is spent doing things to standardize the hiring process. The rest is actually doing what benefits the residents.

Training should be driven and utilized as a strategic tool, attracting and retaining talent, as well as an onboarding method.

Patient outcomes and satisfaction should be the driving force of any strategic aims.

Ideally, turnover would be low, so new employees would not demand the attention of all the education resources.

Care is most important, and regulatory requirements go hand in hand.


QUESTION: What comments do you have about how training drivers are weighted today?

External Factors Impacting Staff Development Programs


75%Extremely important

22Somewhat Important

% 3Not at all

%


Licensing and Certification

There is very strong consensus about the importance of training programs

supporting the licensing and certification needs of the staff. 75% of respondents

believe it is “extremely important” that their organizations’ staff development and

training programs support licensing and certification, with another 22% noting it is

“somewhat important.”

The requirement of electronic medical records.

The increased need for documentation to protect us of legal dilemmas.

The economy impacting people’s ability to afford care which will impact our income and in turn amount we have to spend on training.

The changing environment for SNFs under ACO models, increased acuity, measurable outcomes, etc.

Regulatory changes.

State/Federal regulation changes.

State Survey Process & Plan of Correction.

QAPI programs.

Quality care.

Culture change in the long term care setting in direct relation to CMS/Medicaid reimbursement.

Compliance program requirements as a condition of participation for Medicare and Medicaid.

CMS Regulatory Changes.

Workforce availability ... not enough workers for all the available jobs in the area ... all businesses competing for the same few workers (good ones).

We have the baby boomer generation that will be impacting health care due to their age and their needs and expectations are very high.

The type of residents that will be coming into the facility. They will be coming sooner from the acute care setting sicker and more complex and we will be operating more like a hospital (acute care).


QUESTION: What is the #1 external factor that will likely impact your staff development and training program during the next few years?



Perceived Strengths and Weaknesses

Strengths: Today’s training programs give staff easy access to topics that meet their unique needs.

Main Strengths of Current Staff Development/Training Program

Respondents were asked to list the top two

strengths of their staff development and training

program. These free-form text responses were

coded into 16 strengths categories. The results

show that the executive view of current staff

development and training program strengths

Most Commonly Cited Strengths of Training Programs

is in fairly close alignment with the views of all non-executive respondents. Both

groups cited availability and accessibility as the top strength of their program,

followed by job relevance. These two categories accounted for nearly 30% of all

strengths mentioned by the executive group, and 28% of all strengths mentioned

by the non-executive group. Other common strengths mentioned included the staff training and development personnel and online technology resources.

Availability, accessibility, convenience, flexibility, easy to use / understand

Relevant to job, needs of the organization; individualized

Sta� training and development personnel

Online technology resources

Consistency; quality of training material

Administrative support; Resources; Organized

Variety of instructional / development methods; is engaging

Addresses requirements

Breadth / mix of training made available; up-to-date

Onboarding, orientation

Other

Support for sta� licensure, certification, development

Impact on key indicators, performance metrics, quality

Data driven; responsive to input; continuous improvement

Positive sta� response

Training Strengths



It is worth noting that neither respondent group spontaneously mentioned their

onboarding/orientation program as a top strength very often (only 4% of total

mentions). Given the foundational importance of onboarding and orientation, this

may suggest an area that warrants additional attention. In a similar vein, only 2-3%

of the strengths mentioned cited support for staff licensure/certification as a top

strength. This may be noteworthy insofar as in another section of the survey, 75%

of all respondents indicated that it is very important that the staff development and

training program supports the licensing/certification needs of the staff.


All staff are competent to provide basic care to 90% of our clients within 30 days of being hired.

Convenient.

E-learning is highly organized and easier to track.

Everyone gets involved on all shifts.

It is supported by management including Board of Directors

Lots of training experience by the person doing most of it.

Meets regulatory requirements in all states we operate in.

Online access 24/7.

Our culture supports staff training and development.

We are able to design custom training programs based on individual client needs.

Ability to assign courses globally to multiple facilities.

Can be completed at employee’s leisure.

Can be done at work online.

Consistency.

Ease of access.

Everyone receives the same training to the same standard.

Provide CEU credits for license renewal.

QUESTION: What are the main strengths of your current staff development and training program?


Main Weaknesses of Current Staff Development/Training Program

Time; competes with regular duties, loss of billable hours

Limited availability, limited staff participation, buy in, compliance; high staff turnover

Poor structure, organization, consistency, communication, accountability, documentation

Technology limitations

Limited relevance to practical job needs; limited follow up, supports for application on the job

Limited in breadth/depth, quality; repetitive, not engaging

Limited resources, cost, limited budget

No or minimal staff development and training function; stretched thin

Other

Lack of leadership, management, supervisory support; don’t seek input

Focused mainly on external requirements; not enough development, CEU, license support

Specific topic or CEU omission

Limited or no onboarding/orientation program

Knowledge, skills of training dept and/or supervisory staff are limited

Too much information; too many requirements

Not kept up to date, hard to keep current

Inconvenient training location; poor space

Weaknesses: There is never enough time or money to create the ideal training program.

Most Commonly Cited Weaknesses of Training Programs

Respondents were asked to list the top two weaknesses of their staff development

and training program. These free-form text responses were coded into 17 weakness

categories. Executive responses were not


quite as closely aligned with non-executive

responses as on the strengths question.

The weakness mentioned most often by the

executive group (15% of total mentions)

was limited relevance to practical job

needs/limited follow up, whereas the most frequent mention by non-executive respondents (18% of total mentions) was time/competes with regular duties/loss of billable hours—this weakness was the second most frequently mentioned item

(14%) by the executive respondents.



Approaching required training as a “check off” or “get it done” task.

Chasing paper—needs to be electronic if other jobs keep being added to my list.

Courses are the same every year—staff get tired of them.

Getting all staff on task/ in compliance with due dates.

Having time available for staff to complete the number of trainings we would like to see them have available.

Having to split hours between staff development and other jobs/responsibilities in the facility.

Language barriers.

Limited amount of time.

Limited budget.

Limited clinical “hands-on” competencies.

Many employees have no computer.

New staff need more one-on-one training with a nurse in the field.

New staff orientation should be longer than 2-3 weeks.

No consistency in training.

Not 24/7.

Not enough computers available for staff during high-staffing times.

Staff time/ability to participate in training.

Time available to complete course in a busy day, with the training also being considered work time and not want to go OT.

Facility needs more monitoring of staff after education.

Reaching all shifts of employees.

External regulations overpower internal.


44%

vs.

Tracking Training44% of respondents using an LMS to

track training indicate being highly satisfied with how they track training.

This is in contrast to only 25% of

those who report that they track

another way indicating being highly satisfied with their methods for

tracking training. 25%

highly satisfied using LMS

highly satisfied using other methods

QUESTION: What are the main weaknesses or limitations of your current staff development and training program?

Peak Resources offers residential

rehabilitative care for seniors, as well

as long-term care and medical care, in

seven North Carolina locations.

Expert View

Kevin D. Darden, LNHA, MBA Regional Care Management Consultant, Peak Resources Inc.

Onboarding Earlier in the Month Helps with Training CompletionThe timing of the enrollment of a new hire is also

a key component of compliance. We enroll all

new hires in the first 2 weeks of the month to give

adequate time for completion of required training.

This prevents new hires from being added a few

days before the end of the month with all of the

monthly assignments coming due in just a few days.

For the new hire required trainings, the employees

are required to complete company mandated items

not mentioned in our orientation process, with 60

days to complete.

Weekly Compliance Monitoring and Auto-Reminders Builds AccountabilityWe’ve found that monitoring compliance weekly

for monthly assignments helps hold managers

accountable for ensuring that their employees

complete the required trainings. We have created

reports to be auto-generated weekly and emailed

to each HR Manager showing all incomplete courses

and this is posted for all employees to see.

Finding the Right Mix for Onboarding—Lessons Learned

Smaller Chunks Leads to Increased Compliance As a company, we initially thought that

it was a good idea to assign as many

online classes as we could, due to the

large amount of courses available on

our online system. However, when

we did this, we found that there was

low compliance, due to the time

commitments of these extensive

assignments. So in revamping our

company requirements, we switched

from quarterly to monthly assignments.

We discovered that it was much easier as

a company to monitor compliance on a

monthly level.

Reducing Corporate Mandatory Courses to Allow for Facility-Specific Training NeedsAdditionally, we decided that we would

scale back to offer only 2-3 mandatory

courses at the corporate level and then

allow each facility to add additional

courses, as needed, based on the

training needs of each facility. We

also changed the curriculum to show

monthly assignments 45 days before

the due date, giving each employee an

additional 2 weeks to get the courses

completed.


Training Management, Delivery and Common Practices

Training Evaluations

Not everyone embraces training, and they forget what they were trained to do.

This is a significant area of opportunity.

This is very challenging and time consuming.

We have a post-training program behavioral observations for new-hires.

Not near enough follow-up from supervisors to observe staff to ensure training transfer occurred.

No real measurements other than work performance.

Audits, spot checks and unfortunately continuing to catch problems after a skill or protocol has been reviewed or taught.

Regular supervisor visits and retraining as necessary.

Testing, random checks of managers and outcomes from patient care are some of the steps used to evaluate if training is put in to practice.

After online DSP training, there is another 80 hours of clinical OJT (supervised) training to reinforce.

Some methods None at all8%Well-developed methods

74% 18%

Extent to which current methods evaluate whether training is put into practice on the job.



QUESTION: To what extent does your organization have any methods in place to evaluate whether what is taught in training is put into practice on the job?

The data suggests that

organizations do a good job

disseminating training to staff,

but fall short in measuring

training effectiveness. Only a

small number of respondents

(8%) report well-developed

methods to evaluate training

effectiveness, while the majority

of respondents (74%) report

using some methods.


Skills and Competency Checklists

Skills and competency checklists are used to some extent to support staff

development by 90% of respondents, but only 26% of respondents use it across all

staff roles/positions.


Yes - almost all job roles

Yes - many job roles

Yes - but limited job roles

No

Learning management system software

Paper/Word Files

Spreadsheet (e.g. Excel)

Data bases (e.g. Access or internal data base)

Other

Current methods used for tracking training

Percent that skills and competency checklists are being used

34%utilize a learning management system to track training

90%utilize skills and competency checklists to some extent

Tracking Completions

Only 34% of respondents report using a dedicated Learning Management System to

track training completions. 30% still rely on paper methods.


Over half (51%) of respondents are satisfied with methods used to track completed

training, 30% of respondents had no opinion on the subject and 19% are

dissatisfied.

24% of executives showed a slightly higher level of dissatisfaction compared to

18% of non-executives. More telling was the satisfaction level based on LMS usage.

Only 10% of respondents using an LMS were dissatisfied with their training tracking,

compared to 30% of respondents without an LMS.


Very dissatisfied

Neutral

Very satisfied

Reported Levels of Satisfaction in Tracking Training, by Primary Tracking Technology


The healthcare professionals of Pointe Coupee

Healthcare provide general and restorative care

to those who can no longer live alone due to the

caregiving demands placed upon their loved ones.

At Pointe Coupee Healthcare, we provide classroom

lectures, video learning and open discussions. This

type of education allows our employees to learn

the content through a variety of learning methods

all while sharing personal experiences throughout

the course. We find that employees have a positive

attitude towards the education material when there

is integration between the software and group

involvement. Combining the group setting and

computer based training ensures that all learners

are receiving the same educational material while

building relationships among the team and learning

what is needed to perform day to day job duties.

Technology is often times scary for some employees.

We also recognize, as studies have suggested, not

all employees learn and comprehend the same

way and while some may know the material, they

freeze up when it’s time to apply what they have

learned on the test material. We understand that

this can be very frustrating for the employee. We

acknowledge that if an employee can’t learn the

way we teach, maybe we should teach the way the

employee learns. This empowers the employee,

which ultimately has a positive result for the resident

and facility. It’s a “win win situation” for everyone.

Proper education and training is one of the most

important assets we can offer due to the ongoing

changes in the healthcare industry. We must provide

education on the most current techniques, implement

new strategies, and empower the employee through

education in order to provide the highest level of

care to our residents, at the lowest cost, in order to

remain competitive in the healthcare industry.

Expert View

Lisa Gunnells,Staff Developer, Pointe Coupee Healthcare

Blended Training: Still in the Early Stages of Adoption

Organizations are increasingly

adopting a blended learning

approach as part of their staff

development and training

program, but are not using

it to varying degrees. 76% of

respondents cited ‘some use’ of

blended learning, but only 12%

reported ‘extensive use.’ Only

12% of respondents reported

that blended learning is not

part of their staff development

and training program at all.

Respondents’ comments were

filtered to explore which parts

of blended learning are most

difficult to implement. For

senior care providers, it appears

online training is the easier

component of blended learning

to adopt, because of low costs

and ease of scheduling. A

number of comments indicated

that face-to-face training still

poses scheduling conflicts for

many organizations.



Some use

Extensive use

Not at all

The Extent to Which Blended Learning is a Part of Staff Development and Training Programs:

We use online training, along with some training in our meetings.

Not enough time to do live inservices on all shifts when working at two facilities with two different jobs.

This is very dependent upon the personal comfort level of the community directors.

We do some group training sessions which includes this (blended training), but very limited “blending.”

We most heavily rely on the online learning management system.

We use Relias training along with some training in our meetings.

It is important because online courses are informative—but actually doing it helps you to learn it more.

Providing online initial exposure makes the face-to-face training much easier to present and provides time for the employees to formulate their questions.


Some use None at all12%Extensive use

76% 12%

QUESTION: To what extent is “blended training” a part of your of your staff development and training program?


Annual Training Plans

Training plans prove to be popular tools among organizations. 73% of respondents

reported that written annual training plans are developed in some part of their

organization. 20% do not currently develop formal, written training plans.

We will begin this at the beginning of the new year.

This one thing I want to accomplish for the upcoming year. Right now our plan is based on Mandatory education and DOH requirements.

We are just beginning this for 2015.

This is done by the ETD, it only includes the mandated inservices that need to be given. No plan is developed for training or educational enhancement of the staff.

We use the mandated trainings as our annual program.

We have formal lists of required training tracked in a spreadsheet, sorted by ‘Job Classification’.

We have a training schedule for the year but not in an official training plan.


No, we do not have a formal, written annual training plan

This is done for some but not for the whole organization

Yes, we do develop a formal, written annual training plan

Other

Done for each location, month-by-month at start of the year.

It centers around the regulatory requirements primarily.

Does Your Organization Create Written Annual Training Plans?

7% 20%

27%

46%


Survey Methodology

About Relias Learning

Relias Learning provides online training solutions to 4000 organizations, across a

variety of health care sectors, and is the leading provider in the Senior Care field.

The Relias platform includes content needed for accreditations, CE’s, and staff

development—as well as the ability for customers to create unique content and

incorporate live training—all in a singular, feature-rich learning management

system. For more information, please visit us at www.reliaslearning.com.

The invitation to participate in the online survey was extended to more than

30,000 executives, managers, and training personnel in the field of senior care.

Links to the survey were also made available through several national associations

to their memberships, and through social media channels. As an incentive,

respondents were entered into a drawing for a gift certificate for one of seven

iPad minis.

The survey was open during the period from October 22, 2014 through November

8, 2014. Respondents who only answered the first question in this thirty-one

question survey were eliminated. This report provides a synopsis of findings for

900 respondents in the Senior Care sector.

Data was received and processed by the Center for Outcome Analysis (COA),

a non-profit research organization.

Some of the questions involved free text responses, and in these instances,

responses were hand-coded into broad categories.

About the Team Executive Sponsors: Gerald McCleery, Ph.D, Robert Wilburn, and Eric Masters Author: Janet Martin Data Analysis: Gerald McCleery, Ph.D, Center for Outcome Analysis, Dino NuguidReport Design: Cheryl Mills


Survey Methodology

www.reliaslearning.com


Senior Care - Relias Learninggo.reliaslearning.com/rs/reliaslearning/images/Relias-Learning... ·...

Documents

Transcript of Senior Care - Relias Learninggo.reliaslearning.com/rs/reliaslearning/images/Relias-Learning... ·...