Core idea

One thing we know makes for good nursing home care is stable staffing. The higher the rate of staff turnover, the more likely it is that staff are stressed, and resident care can suffer. Everyone agrees on this point, but there have not been many programs that work specifically to retain good staff. This article discusses a real-world experiment that tested the Retention Specialist Program (RSP), which was designed to improve the retention of certified nursing assistants (CNAs) in nursing homes.   

What they say

Thirty nursing homes were randomly sampled in New York state and Connecticut, and half received the program and the other half did not.  In the treatment group, a staff person was assigned the role of retention specialist (RS).  The RS provided support to address facility problems that lead to turnover and worked to improve staff attitudes towards their jobs.  The RS received training in how to retain staff, as well as programs to implement in the facility, like career ladders, peer mentoring, and employee recognition programs.

In general, the program appears to have worked. The study found that those nursing homes with a RS experienced declines in turnover rates compared to nursing homes without a RS. These differences were statistically significant. The staff were also asked a number of questions about their experience in the nursing homes. Some positive changes were found in these measures. For example, staff in the RSP facilities were more likely to say that efforts to keep good employees increased over the course of the project. They also felt that overall quality of care in the facility improved.

What it means

The authors recommend that nursing homes consider trying a dedicated Retention Specialist Program in the facility. They noted, however, that some problems came up. In particular, the retention activities were sometimes hard to keep up over a whole year, especially if the RS left and had to be replaced. Some facilities also did not have enough resources to run a lot of retention programs.  They also recommend that facilities consider having a retention team, rather than have just one specialist. A team approach could spread the workload and lesson the impact of turnover in a single position.  

References

Pillemer, K., Meador, R, Henderson, C., Robison, J., Hegeman, C., Graham, E., & Schultz, L. (2008). “A Facility Specialist Model for Improving Retention of Nursing Home Staff: Results from a Randomized Controlled Study.” The Gerontologist, 48(1), 80-89.