News Release

Nursing Home Interventions Improve Quality of Care, Reduce Staff Turnover

July 8, 2009

CHAPEL HILL—A study recently released by the UNC Institute on Aging identifies three workplace interventions that are improving quality of care and reducing turnover of direct care workers in North Carolina’s nursing homes.  Previous research has shown that high levels of turnover and worker shortages may compromise both the availability of frontline workers and the quality of care provided in long term care, putting nursing home residents at greater risk for negative outcomes. The report, titled Workplace Interventions, Turnover, and Quality of Care Report, can be downloaded from the WIN A STEP UP website at http://winastepup.org/reports/.

The study of the impact of workplace interventions on quality of care and direct care worker turnover was conducted in North Carolina nursing homes between 2004 and 2007.  The study examines the impact of three types of interventions funded by Civil Monetary Penalties—funds collected from NC nursing homes for deficiencies in care.  These include:

• The WIN A STEP UP program, a proven initiative that upgrades skills of nursing assistants, increases their job commitment, and provides rewards and recognition;
• Quality Improvement Collaboratives in which groups of nursing homes work together with the statewide Quality Improvement Organization to improve specific quality indicators like reducing pressure sores or the use of restraints;
• Culture Change Initiatives, in which nursing homes implement changes in their structures or routines designed to make their environments more “homelike.”

The report was commissioned by the NC Department of Health and Human Services and authored by Thomas R. Konrad, PhD, Jennifer Craft Morgan, PhD, and colleagues at the Institute on Aging.

By implementing these three types of workplace interventions, nursing homes realized several specific improvements:

• Facilities delivering the WIN A STEP UP program displayed a decrease in pressure sores among their residents and had lower turnover among their direct care workers;
• Facilities participating in Quality Improvement Collaboratives exhibited a reduction in incontinence and the use of restraints;
• Facilities implementing “Culture Change” initiatives experienced a reduction in the use of restraints.

Konrad commented that the study shows “North Carolina’s unique partnerships between the state, the university, and nursing homes are effectively leveraging federal funds to improve the lives of those who live in as well as those who work in nursing homes."

About the IOA

The IOA is an inter-institutional program of the University of North Carolina with a mission to enhance the well-being of older people by fostering statewide collaboration in research, education and service. Its areas of research focus include the aging workforce and retirement, healthy aging, the long term care workforce, and diversity and aging issues. To learn more about the IOA, please visit: www.aging.unc.edu

For additional information, please contact Jennifer Craft Morgan, PhD, Associate Director of Research at the UNC Institute on Aging, at 919-966-0225 or craft@email.unc.edu or Thomas R. Konrad, WIN A STEP UP Program Director at bob_konrad@unc.edu or 919-244-8659.