QIO NHQI Weekly Update :: January 18, 2008  

 

TIP OF THE WEEK

Eight Easy Steps to Lower Your Staff Turnover Rate

 

  1. Identify your current staff turnover rate.

    2. Identifying the staff turnover rate helps a facility determine areas for improving staff stability and provides a benchmark for developing a quality improvement action plan.

     

    • American Health Care Association (AHCA)’s 2002 study of staff turnover showed annual turnover for RNs, LPNs, and DONs of approximately 50 percent across all three positions.
    • The high turnover rate and numerous vacancies among nursing assistants has been a particular concern because nursing assistants provide most direct resident care.

     

  2. Seek and identify causes that underlie staff turnover.

    3. Identifying trends, patterns, and causes can help alert the facility to readily addressable issues that may be resolved with simple approaches, as well as helping to identify other cause-specific interventions.

     

    • Numerous studies have identified factors related to job satisfaction and other issues that affect an individual’s willingness to remain in a workplace.
    • Examples of areas that have been identified as contributing to turnover include deficits in management styles and practices, orientation, work design and practices, support of staff efforts, human resource management and sufficient staff and resources.

  3. Identify goals for improving turnover rates.

    4. Goal setting allows the facility to envision potential achievements through their quality improvement efforts.

     

  4. Develop an action plan to address causes and attain identified goals.

    5. An action plan provides a “roadmap” to meeting goals.

     

    • Without an action plan to guide the quality improvement efforts, it is less likely that the goal will be achieved and sustained.
    • Interventions that address specific causes may provide more definitive and enduring improvements. Some general interventions such as ways to recognize desired staff performance are also beneficial.
    • In determining appropriate interventions, the facility should consider utilizing available resource material and best practices from expert sources.

  5. Implement the action plan.

    6. The success of the plan depends on various factors, including understanding by involved parties and the support given to making definitive changes in work environment, work flow, care processes, etc. All parties involved should be aware of their responsibilities and the expectations to which they will be held accountable.

     

  6. Evaluate the implementation of the action plan.

    7. Evaluation of the progress of implementation allows the facility to determine if they are “on the right track” or need to take a different path to try to meet their goal. Barriers commonly arise as action plans are being implemented, which necessitate revisions in order to achieve the goal.

     

  7. Update and revise the action plan as indicated by the evaluation process.

    8. Positive changes need continuing support in order to be sustained.

     

  8. Determine ongoing methods of monitoring the satisfaction and needs of staff.

    9. Sustained improvement requires monitoring both results and the status of processes and issues that influence those results.

     

Sources:


Process Frameworks, Advancing Excellence in America’s Nursing Homes Campaign, 2007.
http://nhqualitycampaign.org/star_index.aspx?controls=nhTechAssist, Accessed January 2008.


2002 AHCA Survey of Nursing Staff Vacancy and Turnover in Nursing, Health Services Research and Evaluation American Health Care Association.
http://www.ahcancal.org/research_data/staffing/Documents/Vacancy_Turnover_Survey2002.pdf. Accessed January 2008.

 

 

RESOURCE SPOTLIGHT

 

Calculation of Turnover Workbook (XLS)
This easy-to-use template is a mechanism for tracking and monitoring monthly turnover. This workbook will also help nursing home staff prepare entries for submission of turnover data for Goal #7 of the Advancing Excellence in America’s Nursing Homes Campaign.

 

 

 

IN THE NEWS

 

CMS RELEASES FINAL VERSION OF MDS 3.0

January 17, 2008 - - CMS - - Federal regulators released the draft version of the MDS 3.0, a week before they will hold a special, informational Open Door Forum on it. According to an introduction to the MDS 3.0 found on CMS's Web site, "revisions have been based on feedback from MDS users, resident advocates and families, input from subject-area experts, and new knowledge and evidence about resident assessment. MDS 3.0 aims to increase the clinical relevance, accuracy and efficiency of assessments, obtain information directly from residents, include assessment items used in other care-settings, and move items toward future electronic health record formats.”


Next on the MDS 3.0 timeline is the MDS 2.0/MDS 3.0 crosswalk to states, providers and vendors, scheduled for this spring. The latest MDS 3.0 documents can be viewed at http://www.cms.hhs.gov/NursingHomeQualityInits/Downloads/MDS30DraftVersion.pdf.

 

 

MAKING IT MORE LIKE HOME

January 6, 2008 - - The Oklahoman - - Grace Living Center, a nursing home in Clinton, Okla., has made changes to create a comfortable home for residents to live their lives with meaning and purpose. Read more >>

 

 

LIKE THE FOOD GUIDE, RATINGS FOR DOCTORS

January 9, 2008 - - NY Daily News - - An insurance provider, WellPoint, says it will launch doctor ratings in Connecticut, Los Angeles, and Ohio. The insurer will team with Zagat Survey on a program that will allow patients to rate doctors on trust, ability to communicate, availability, and office environment. Read more >>

 

 

FINDING DAY CARE -- FOR YOUR PARENTS

January 10, 2008 - - Wall Street Journal - - The Wall Street Journal examines how adult day care is becoming an increasingly important player in the business of elder care. Demand for adult day care is growing between an estimated five percent and 15 percent annually, depending on location. Adult day care facilities serve about 400,000 elderly U.S. residents nationwide.
Read more >>

 

 

HEALTH LITERACY PRACTICES IN PRIMARY CARE SETTINGS: EXAMPLES FROM THE FIELD

January 11, 2008 - - Commonwealth Fund - - According to a study released by The Commonwealth Fund, low health literacy is a growing concern in the United States, particularly among older adults and people with limited education or English proficiency. Patients with low health literacy are at greater risk of misunderstanding treatment recommendations, taking prescription medications improperly, and experiencing lower health status and poorer health outcomes. Read more >>

 

 

 

INDUSTRY EVENTS

 

Special Open Door Forum: Minimum Data Set, Version 3.0 (MDS 3.0)

Thursday, January 24, 2008, 1:00 p.m. to 3:00 p.m. EST

A report on the findings of a 5-year CMS Nursing Home MDS 3.0 Validation Study.

Recording will be available 1/30/08 to 2/29/08 on this Web page

 

 

 

 

 

NAVIGATING THE MDS THROUGH THE OHIO MEDICAID REIMBURSEMENT SYSTEM

February 7 and May 1, 2008, 8:30 a.m. to 4:45 p.m. EST

Speakers: Claire Spellmire, RN, BSN and Karen Jennings, LNHA, MHA from the Case Mix Section, Bureau of Long Term Care Facilities, Office of Ohio Health Plans.

Cost: Free

For more information or to register, call Cheryl Robertson at 614-466-9088.

Space is limited to two per facility.

 

Medicare Learning Network: Learning resources and products for the healthcare professional.

 

Alzheimer’s Association Training Events

 

AOPHA Events

 

Case Western Reserve University School of Medicine Courses

 

Ohio Department of Health, Technical Assistance Program – New Programs

 

Ohio Health Care Association Events

 

 

 

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