The Nurse as Supervisor of Direct-Care Staff Paraprofessional Healthcare Institute, Inc.

Grant Summary

The John A. Hartford Foundation, in partnership with Atlantic Philanthropies, has awarded a grant to the Paraprofessional Healthcare Institute to test and then disseminate a model program in 42 agencies where nurses who oversee paraprofessional staff are trained to be better supervisors to reduce home health aide turnover. Annual turnover rates among home health aides range from 50 to 300 percent, having a major negative impact on the quality of care for elderly patients. The Paraprofessional Healthcare Institute, a national, non-profit organization focused on increasing the quality of care provided to older and disabled patients, will use funding to expand its staff capacity and teaching tools in order to rigorously test a previously designed nurse coaching model in an expanded range of sites. The project will formalize a curriculum on nurse coaching, create tools to help agency managers implement supervision training, implement management training at home health care agencies, evaluate the results of the program and develop partnerships with three nursing schools for dissemination of effective outcomes. High turnover rates among home health aides force elderly and disabled consumers to endure a constant churn of strangers who provide care that is at best rushed and impersonal, and at worst isolating, disorienting, and at times even dangerous. The cycle of instability related to high turnover and its impact on the care of homebound elders will only worsen if left unaddressed as the population ages and more people choose to remain living at home. To keep the current workforce engaged and to attract other potential workers to the field, systemic changes need to be implemented, and one potential fulcrum to achieve better care for elderly patients is to enhance nurses' supervisory abilities. The funded project is part of the Hartford Foundation's grantmaking to support a limited number of efforts to improve and integrate the "system" of services needed by older adults. Since 1982, Hartford Foundation Trustees have authorized $71 million in model development projects such as this to integrate and improve health services for the elderly.