Successful Implementation of Consistent Staff Assignment in VA CLCs

在 VA CLC 中成功实施一致的人员分配

• 批准号: 8729712
• 负责人: Penny Brennan
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2015-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8729712
• 关键词: Address; Adoption; Americas; CLC Gene; Caring; Characteristics; Communities; Data Analyses; Elderly; Ensure; Environment; Evaluation; Expert Opinion; Foundations; Future; Goals; Health; Health Services; Healthcare; Home Nursing Care; Home environment; Hospitals; Individual; Intervention; Knowledge; Leadership; Long-Term Care; Modeling; Monitor; Movement; Nursing Homes; Policies; Predictive Factor; Quality of life; Research; Research Personnel; Schedule; Scheduling and Staffing; Surveys; Time; Veterans; base; community living; design; health administration; health care quality; improved; innovation; meetings; nursing home length of stay; response; tool

Veterans Health Administration (VHA) Community Living Centers (CLCs; formerly known as "nursing home care units") are in the midst of cultural transformation aimed at providing resident-centered, home-like environments that promote optimal health and quality of life for older Veterans. One key objective of CLC cultural transformation is full implementation of consistent staff assignment. Consistent staff assignment minimizes the number of staff who provide care to a resident during his or her nursing home stay, which is thought to result in better, more sustained relationships between staff and residents. These in turn are thought to promote better health care and higher quality of life for nursing home residents. Based on these views, VHA Geriatric and Extended Care (GEC) and CLC leadership, as well as the national Advancing Excellence in America's Nursing Home campaign, all endorse and have taken concrete steps to encourage timely, full implementation of consistent staff assignment in all CLCs and nursing homes. However, the extent to which VHA CLC units have in fact attained this goal is not known. Nor do we know which CLC unit-level characteristics might be associated with earlier, more complete, and more sustained implementation of consistent staff assignment. To address these knowledge gaps, this project will use a Staffing Practices Survey to collect information from 300 VHA CLC units about the extent, duration, and stability of their implementation of consistent staff assignment practices, and about unit-level characteristics that might facilitate or interfere with implementation of consistent staff assignment. This information will be compiled and analyzed to achieve two aims: Aim 1: To document the progress of individual CLC units in implementing consistent staff assignment, as assessed by the extent, timing, and stability of goal attainment. Aim 2: To identify specific CLC unit characteristics, scheduling policies and practices, and staff scheduler attributes, as well as specific tools and innovations that are associated with earlier, more complete, and more stable implementation of consistent staff assignment. We will disseminate findings from this project throughout the VHA CLC network, to staff at all levels, to support augmentation and adjustment of current practices in ways that facilitate more timely, complete, and stable implementation of consistent staff assignment. Results of this project will identify CLC units that have made the least progress toward the consistent staff assignment goal and CLC units that have had difficulty sustaining consistent staff assignment over time and will suggest which of the evidence- and expert opinion- based predictive factors in our conceptual model are potentially fruitful loci of interventions to improve implementation of consistent staff assignment. These results will provide the foundation for a future project aimed at improving ongoing efforts to fully implement consistent staff assignment in VHA CLCs.

退伍军人健康管理局（VHA）社区生活中心（CLC;以前称为“疗养院 护理单位”）正处于文化转型之中，旨在提供以居民为中心的， 促进老年退伍军人最佳健康和生活质量的环境。CLC的一个关键目标 文化转型是全面实施员工一致性分配。一致的工作人员分配 最大限度地减少工作人员谁提供照顾居民期间，他或她的疗养院住宿，这是 这被认为会导致工作人员和居民之间更好、更持久的关系。这些反过来又是 认为促进更好的医疗保健和更高的生活质量的养老院居民。 基于这些观点，VHA老年和扩展护理（GEC）和CLC领导层，以及国家 推进美国养老院卓越运动，所有人都赞同并采取了具体措施， 鼓励在所有社区联络中心和疗养院及时、全面地执行一致的工作人员分配。 然而，尚不清楚VHA CLC单位实际上在多大程度上实现了这一目标。我们也不知道 哪些CLC单元级特征可能与更早、更完整和更持续相关 执行一致工作人员分配。 为了弥补这些知识差距，本项目将利用人员配置做法调查，从以下方面收集信息： 300 VHA CLC单位关于其实施一致的工作人员的程度，持续时间和稳定性 分配做法，以及可能促进或干扰 执行一致工作人员分配。这些信息将被汇编和分析，以实现两个 目的： 目标1：记录CLC各单位在实施一致的工作人员分配方面的进展， 通过目标实现的程度、时间和稳定性进行评估。 目标2：确定CLC单位的具体特点、排期政策和做法以及工作人员 调度器属性，以及与早期， 更完整、更稳定地执行一致的工作人员分配。 我们将通过VHA CLC网络向各级工作人员传播该项目的结果， 支持扩大和调整目前的做法，以促进更及时，完整， 稳定地执行一致的工作人员分配。该项目的结果将确定CLC单位， 在实现一致的工作人员分配目标方面取得的进展最小， 随着时间的推移，保持一致的工作人员分配，并将提出哪些证据-和专家意见- 在我们的概念模型中，基于预测因素的干预措施是潜在的富有成效的场所，以改善 执行一致工作人员分配。这些结果将为未来的项目提供基础 旨在改善正在进行的努力，以充分实施一致的工作人员分配在VHA CLC。