The Margaret Blenkner Research Institute (MBRI) of the Benjamin Rose Institute on Aging is evaluating the impact of the REACH project over a three-year period. The REACH project is targeted to address concerns about the future of quality care for an increasingly elderly population by giving employers a systemic, sustainable and replicable workforce development solution that is grounded in evidence-based practices. REACH was planned and implemented with the assistance of the following partners: educational partners – Cuyahoga Community College, Kent State University, and Youngstown State University; long term care employers – Assumption Village (Humility of Mary Health Partners), Eliza Bryant Village and Jennings Center for Older Adults; social services partners – Burdman Group and Towards Employment; and Workforce Investment Board Partners - Cleveland/Cuyahoga County Employment Connection and The One Stop of Trumbull, Mahoning and Columbiana Counties.
As part of REACH, these partners have adopted a series of interventions aimed at reducing the high turnover of staff and increasing employee job satisfaction. Some of these interventions include hiring the right employees by using behavioral interviewing, assessment and job shadowing, customizing job orientation and in-services to meet the needs of new hires, providing on-the-floor professionalism and leadership training, and providing on-site career coaching and planning to enhance staff members ability to advance internally within the organization.
To address the study objectives, data are gathered from two sources:
- Employee Surveys: Information on issues such as job satisfaction, satisfaction with supervision, career aspirations and barriers to education and training. These data were collected on-site using paper and pencil surveys. Some sites chose to mail in copies of the survey using postage-paid Business Reply Envelopes provided by MBRI. In 2008, an on-line survey was also developed to provide employees with the option of completing surveys. However, it was discontinued in the following years because of the small number of employees who used this option.
- Human Resource Directors: issues such as employee turnover, and promotions and pay increases for minority and non-minority staff. These data were provided by sites using an electronic Excel form developed by MBRI.
All protocols were approved by Benjamin Rose Institute’s Institutional Review Board. Employees were also required to complete an informed consent form. However, some employees refused to complete these forms and tore off the consent sheet attached to the survey.
This report contains information gathered in the final year of REACH, i.e., in 2010 from all three participating sites; and compares findings from the first and second reports, i.e., from 2008 and 2009.
This report provides information organized under the following three sections:
- Findings from the employee survey conducted in 2010; and comparisons with the employee survey conducted in 2008 and 2009;
- Findings on organizational employee turnover between 2008, 2009 and 2010 (for two sites that provided turnover data for all three years); and between 2009 and 2010 (for all three sites).
- Findings on staff promotions and changes at all three sites are from 8/1/2008 to 1/31/2011.
In addition to this report that summarizes the information from all three sites, each site will also receive a separate report containing information for their particular site. In the graphs and pie-charts presented in the report, percentages may not total 100% due to rounding. This holds true for this report as well as the individual site reports.
Objectives to be accomplished by January 31, 2011
It is important to remember that a few percentage point differences from one year to the next may not reflect significant or actual changes but could be due to random fluctuations.
With respect to analyzing survey responses, it is also likely that different staff, as well as some of the same staff, responded to the survey each year.
Incumbent staff will be placed in at least 20% of open, higher paying positions
- During the study period from 8/1/2008 to 1/31/2011, 11% of the open, non-entry level positions were filled by incumbents. One caveat to this finding is that organizations described ‘entry’ and ‘non-entry’ level positions differently based on whether they were bound by union-based pay scales or not. Thus, this finding has to be viewed with caution. Further, the number of open positions went down between 2009 and 2011 since some sites had hiring freezes and did not replace staff who turned over.
From 8/1/08 to 12/31/08
- 8% of the open, non-entry level positions were filled by incumbents.
From 1/1/09 to 12/31/09
- 10% of the open, non-entry level positions were filled by incumbents.
From 1/1/10 to 1/31/2011
13% of the open, non-entry level positions were filled by incumbents.
- Overall, the percent of open non-entry level positions increased from year to year despite the fact that the number of openings decreased.
Minority staff members or applicants will fill at least 25% of available program and staff management positions where recruiting geography allows.
During the study period from 8/1/08 to 1/31/2011
- 22% of all open program and management positions were filled by minorities (Excluding one employer with primarily minority staff members).
57% of all open program and management positions were filled by minorities (Including one employer partner with primarily minority staff members).
From 8/1/08 to 12/31/08
- 20% of all open program and management positions were filled by minorities (Excluding one employer with primarily minority staff members)
67% of all open program and management positions were filled by minorities (Including one employer partner with mostly minority staff members).
From 1/1/09 to 12/31/09
- 18% of all open program and management positions were filled by minorities (Excluding one employer with primarily minority staff members)
57% of all open program and management positions were filled by minorities (Including one employer partner with mostly minority staff members).
From 1/1/10 to 1/31/11
- 27% of all open program and management positions were filled by minorities (Excluding one employer with primarily minority staff members)
45% of all open program and management positions were filled by minorities (Including one employer partner with primarily minority staff members).
See Table 3 for greater details.
Entry level staff members’ job satisfaction will improve by 50%, related to supervisory effectiveness in supporting their ability to sustain employment and advance.
- Researchers developed an index of satisfaction with supervision based on seven questions (marked with asterisks in Figure 4) with the greatest variance (responses being spread across all response choices/categories) and relevance to the literature. Reliability for the index was high (Cronbach’s alpha = .86). Mean scores for the index in each of the three years were compared: 16.78 in 2010; 16.69 in 2009 and 15.72 in 2008 out of a total score of 21. Mean scores were examined for statistical change over time. Data demonstrated a statistically significant improvement in employee satisfaction with supervision. The significant change occurred between 2008 and 2010 but not between 2009 and 2010.
Reduce turnover from an average of 47% to 30% (a 36% reduction).
Since the starting average turnover rate is unknown (one site had not tracked turnover prior to the project start and therefore, baseline data was not available), this objective was difficult to address directly. Further, turnover data were obtained from only two sites in 2008 but from all three sites in 2009 and 2010. Using the available data, it was apparent that overall, turnover progressively declined in all three years of the project.
- A total of 581 staff turned over in all three sites over the three year period.
- In 2008, 163 staff out of a total of 548 staff (29.74%) in two sites that reported turnover data;
- In 2009, 208 out of 804 staff (25.87%) turned over in three sites.
- In 2010, 210 out of 840 staff (25.00%) turned over in all three sites.
Table 2 has greater details on turnover.
- Between 2008 and 2010:
- Sites A & C experienced a relative reduction of 23.24% in turnover. This was a statistically significant reduction;
- Site A experienced the greatest relative reduction in turnover (39.91%). This was a statistically significant decline;
- Site B was not included in the analyses for percent change between 2008 and 2010, since it did not have turnover data for 2008;
- Site C had begun implementing REACH in 2005, prior to the start of this project at which time they had a turnover rate of over 50%.
Overall, the two sites with three years of data had greater reductions in turnover between 2008 to 2009 compared to 2010. Thus, the greatest turnover reductions took place in the first year of implementing REACH while this plateaued in the second year. See Figures 6 for greater details.
Summary
The issues related to the project objectives (i.e. incumbent staff placed in non-entry level positions, minority staff members filling program and staff management positions, employee satisfaction with supervisor, and turnover) all showed positive changes between 2008 and 2010 suggesting that REACH components were likely to have positive effects across a variety of outcomes. However, most of the changes appear to have taken place between 2008 and 2009 and not between 2009 and 2010.
During the project period, 11% of non-entry positions (as defined by the participating sites) were filled by incumbents. Although this percent is not as high as originally expected, a number of staff are currently enrolled but have not yet completed educational programs in order to fill higher level positions at the participating sites. The need for remediation and completion of prerequisite courses prior to enrollment in degree or certificate programs, coupled with the need to remove barriers (financial and family/life issues) is likely to have delayed the movement to a new position for some employees.
Another finding from the project demonstrated that about a fifth (22%) of all management and open program positions were filled by minorities in two of the participating sites (excluding the site with primarily minority staff).
Mean scores on employee satisfaction with supervision significantly improved over time with the change occurring between 2008 and 2009. REACH practices such as providing enhanced educational programs and sessions to staff and supervisors as well as supervisors receiving leadership training is likely to have improved employee satisfaction with supervision.
In terms of examining turnover, data suggests that for the two sites with complete data for 2008, significant declines in turnover were experienced between 2008 and 2010. Site A had the greatest significant decline from 2008 to 2010. Turnover did not change significantly between 2009 and 2010.
Limitations of the study are that it was limited to only three sites in North-East Ohio. The findings demonstrate the need to conduct a more rigorous evaluation using a randomized, control trial by matching similar intervention and control sites to examine significant changes in outcomes over time. In the long-term, researchers would also like to test the intervention in other long-term care settings using a two year evaluation period rather than three years; and/or using strategies to keep up the momentum of the intervention in year three. Finally, in order to establish the evidence-base for the intervention, it also needs to be implemented using a larger, nationally representative and generalizable sample.
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