Better Jobs, Better Care Study
Robert Wood Johnson Foundation / Atlantic Philanthropies
11/01/03 - 04/30/07
Peter Kemper, Department of Health Policy and Administration
Diane Brannon, Department of Health Policy and Administration
Teta Barry, Department of Health Policy and Administration
The purpose of this project is to study the Better Jobs, Better Care (BJBC) demonstration, a new initiative aimed at creating policy and practice changes that will lead to improved recruitment and retention of paraprofessional direct care workers (DCWs) in long-term care Policy initiatives range from the development of a state licensure designation to the expansion of a nurse delegation law. Practice interventions include peer mentoring, empowering DCWs, and cultural competency training, among others. The study of BJBC, funded by The Robert Wood Johnson Foundation and Atlantic Philanthropies, will address three key questions:
- First, did the coalitions implement their policy and management practice plans as intended?
- Second, did provider management practices change over the course of the demonstration?
- Third, what effects did management practice changes have on DCW job quality and turnover?
To answer these questions, the study will analyze data from several sources:
- Management information system (MIS),
- Clinical Manager Survey,
- DCW Survey,
- Site visits.
The MIS will be used to track turnover of individual DCWs throughout the three years of the Demonstration. The Clinical Manager and DCW Surveys will be conducted at baseline and again toward the end of the Demonstration to assess changes over the course of the Demonstration. One manager from each participating provider organization will be asked to complete an internet-based survey that focuses on management practices. DCWs within each organization will be asked to take part in a survey to gather their assessments about various aspects of their jobs. In addition, site visits will be conducted during the second year of implementation to gather information on the factors and contexts that facilitate or impede success. At the end of the demonstration, semi-structured phone interviews will be conducted with management and other staff in a smaller number of providers in each state. These providers will be selected with respect to achieved changes in DCW job quality and turnover; the interviews will offer additional insight into best practices and factors that affect success.
Recruitment and retention of DCWs in long-term care continue to challenge the industry and affect both the quantity and quality of services received. Results from this project will be used to identify successful policy and practice changes that may lead to improved recruitment and retention of DCWs, who serve as the foundation of the formal long-term care system.