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Mather Life Ways: LEAP for a 21st Century Workforce |
Description |
LEAP (the acronym stands for Learn, Empower, Achieve, Produce) is a comprehensive long-term care workforce initiative designed to develop leadership, mentoring, teamwork, and communication skills for all staff, as well as career mobility for certified nursing assistants. It is based on the belief that training must be implemented at all nursing levels in order to effect change. |
Sponsoring Organization |
Mather Life Ways, a not-for-profit charitable trust providing residential and community services to people over age 50, and Mather Institute on Aging, its related research and education division, in Evanston, IL. |
Setting |
The program was piloted at the Mather Pavilion at Wagner, a long-term care center in Evanston, IL, and replicated in three other area long-term care facilities. The facilities range in size from 143 to 259 beds. |
Target Group |
Registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs). |
Start Date |
LEAP was implemented at Mather Pavilion in November 1999 and replicated at the other three sites between 2000 and 2002. Its first 'train the trainer' workshop to teach staff of other facilities how to implement LEAP was conducted in June 2002. |
Objectives |
- Educate and empower frontline staff and create structures for advancement
- Reduce turnover and increase staff satisfaction
- Create a research-based model, with successful outcomes documented by formal evaluation, that can be replicated in other sites
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Key Components |
Module 1. The essential roles of nurses in LTC. All nurse managers and charge nurses (RNs and LPNs) attend this six-week program to develop leadership and care role model skills, clinical gerontological expertise, and care team building skills. In each session, action steps are role-played in realistic clinical scenarios. The curriculum includes:
- The ten key roles of effective leaders, including communication skills, giving feedback, and mentoring staff.
- The importance of the nurse as a role model in providing 'person-centered care,' and how that example can empower residents and frontline staff.
- The importance of gerontological nursing as a specialty. Nurses are encouraged to develop their own knowledge base and assessment skills.
- The need for all nurses to be care team builders who develop relationships with residents, families, and staff in the interest of delivering quality care.
Module 2. Growing the heart of care: Career development for CNAs. This is a 14-hour workshop, spread over seven weeks, that focuses on career and skill development for CNAs. A formal application, screening, and interview process weighs past performance evaluations, attendance history, and letters of reference. The curriculum, which was developed based on focus groups with CNAs, includes:
- Person-centered care
- Communication skills
- Head-to-toe inspection
- Clinical updates (preventing skin breakdown, incontinence care, and nutrition)
- Building care teams and working with families
- How to mentor new CNAs (this is a two-part program)
CNAs who complete this program advance to the status of Level 2 and receive a salary increase. The amount of the raise is determined by each facility, but typically range from 50 cents to a dollar an hour. |
Results, Outcomes, Evaluation |
Nursing staff turnover data are available from two of the four pilot facilities. At the first, nurse turnover decreased from 44 percent in 1999 to 16 percent in 2002, while CNA turnover decreased from 76 percent to 4 percent. In the second facility, nurse turnover decreased from 72 percent to 50 percent and CNA turnover from 93 percent to 79 percent between 1999 and 2001. These rates were calculated using different formulae.
A formal evaluation of leadership effectiveness, work empowerment, job satisfaction, and organizational climate found that nurses' and CNAs' perceptions of their work empowerment, job satisfaction, and organizational communication were significantly better six months after they attended the workshops than they were before. Improved scores on these variables were significantly associated with fewer health deficiencies cited in inspection surveys in all four facilities.
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Lessons Learned |
The authors of the evaluation believe the program's success is due to its multidimensional approach: addressing nurse leaders as well as frontline caregivers, providing communication as well as clinical skills, and coupling mentoring and career ladders with formal training. |
Costs and Funding |
Mather Life Ways funded the LEAP pilot program and evaluation.
For those interested in implementing the LEAP model, a four-day 'train the trainer' workshop for staff development coordinators or nurse managers costs $2,595 for the first attendee, with discounts available for additional attendees from the same facility who register at the same time. The cost of annual renewals for the LEAP licensing agreement is $500 per facility, which also covers annual evaluation and benchmarking services coordinated by Mather Institute on Aging.
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Contact Information |
Linda Hollinger-Smith, Ph.D.
Director of Research
Mather Institute on Aging
1603 Orrington Avenue, Suite 1800
Evanston, IL 60201
t: (847) 492-6815
e: Lhollingersmith@matherlifeways.com
Website: www.matherlifeways.com
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Other Resources |
Hollinger-Smith, Linda, Anna Ortigara, and David Lindeman. 2001. 'Developing a comprehensive long-term care workforce initiative.' Alzheimer's Care Quarterly 2 (3): 33-40.
Hollinger-Smith, Linda. August 2002. 'Evaluation of the LEAP replication study.' Unpublished summary.
Hollinger-Smith, Linda, David Lindeman, Mary Leary, and Anna Ortigara. 2002. 'Building the foundation for quality improvement: LEAP for a quality long term care workforce.' Seniors Housing & Care Journal, The Journal of the NIC Seniors Housing and Care Program at Johns Hopkins University
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Pagan, Joyce. 2002. 'Leaping toward culture change.'Contemporary Long Term Care 25 (9): 36-40
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