Successful Implementation of Consistent Staff Assignment in VA CLCs

退伍军人健康管理局(VHA)社区生活中心(CLCs；以前称为“疗养院” 看护单元“)正在进行文化转型，旨在提供以居民为中心的、像家一样的 促进老年退伍军人最佳健康和生活质量的环境。《中图法》的一个关键目标 文化转型就是全面落实一致的员工分配。一致的工作人员分配 最大限度地减少在疗养院住宿期间为居民提供护理的工作人员数量，即 被认为会导致员工和居民之间更好、更持久的关系。这些依次是 旨在促进疗养院居民更好的医疗保健和更高的生活质量。 基于这些观点，VHA老年和长期护理(GEC)和CLC领导层以及国家 在美国养老院运动中促进卓越，所有人都支持并已采取具体步骤 鼓励及时、充分地在所有社区护理中心和养老院实施一致的工作人员分配。 然而，VHA CLC单位实际上在多大程度上实现了这一目标尚不清楚。我们也不知道 哪些CLC单元级特征可能与更早、更完整、更持久地关联 执行一致的工作人员分配。 为了解决这些知识差距，该项目将使用人员配置做法调查来收集以下信息 关于300个VHA CLC单位实施一致工作人员的程度、持续时间和稳定性 作业做法，以及可能促进或干扰的单位级特征 执行一致的工作人员分配。这些信息将被汇编和分析，以实现两个目标 目标： 目标1：记录各中央图书馆单位在执行一致的工作人员分配方面的进展情况， 通过实现目标的程度、时间和稳定性来评估。 目标2：确定具体的《中图法》单位特征、调度政策和做法以及工作人员 调度器属性，以及与早期的、 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这一项目的结果，以 支持扩大和调整当前的做法，以促进更及时、更完整和更 稳定执行一致的工作人员分配。该项目的结果将确定具有 在实现一致的工作人员分配目标和遇到困难的CLC单位方面进展最慢 随着时间的推移保持一致的工作人员分配，并将建议哪些证据-和专家意见- 在我们的概念模型中，基于预测因素是潜在的富有成效的改进的干预场所 执行一致的工作人员分配。这些结果将为未来的项目提供基础 旨在改进正在进行的努力，以便在VHA CLC充分执行一致的工作人员分配。

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.