Did Better Jobs Better Care Change Management Practices and Processes?

1. Did Better Jobs Better Care Change Management Practices and Processes? Amy Stott June 8, 2008 Presented at the 25th AcademyHealth annual meeting. The authors are grateful for supported from The Atlantic Philanthropies, The Robert Wood Johnson Foundation, and the National Institute on Aging Training Grant, Interdisciplinary Training in Gerontology, #T32 AG00048

2. Data Source:Clinical Manager Survey Designed by the BJBC Evaluation Team at Penn State Questions measuring the level of use of management practices and processes Respondents: Clinical Managers 2

3. Participating States by Provider Type Note. Excluded adult day

4. Design Demonstration Timeline Before During After BJBC Interventions Clinical Manager’s Survey Clinical Manager’s Survey Top Management Training Supervisor Training Team Building DCW Career Development Caregiving Skill Development

5. Matched Practices to Interventions Clinical Manager’s Survey BJBC Interventions • Surveyed Management Practices • Scales • Items Top Management Training Supervisor Training Not Related to Interventions Team Building DCW Career Development Caregiving Skill Development

6. Did providers increase management practices and processes?

7. Methods Calculated change Time 2 – Time 1 = Difference Score Compared practices related to interventions with practices not related to interventions 7

8. Results:Supervisor Training Intervention ***p<0.01

9. Other Interventions Note. Positive change in: self-managed work groups related to team building; cross training, peer mentor, and opportunities to become a higher-level DCW or a Licensed Practical Nurse (LPN) related to DCW career development; DCW training related to caregiving skill development.

10. Not Related to Interventions

11. Was there a difference between states by BJBC intervention?

12. Methods Calculated change Time 2 – Time 1 = Difference Score Difference-in-difference for state that did intervention compared to states that did not 12

13. Results: Comparison of States with and without Supervisor Training Intervention **p<0.05 ***p<0.01

14. Comparison of States with and without Supervisor Training Intervention

15. State Comparison of Other Interventions Note. Positive difference in management communication between states that did team building and states that did not. Negative difference in permanent assignment between states that did caregiving skill development and states that did not.

16. Summary • Modest increase in management practices and processes • Greater increase related to BJBC interventions • Positive differences between state that had top management and supervisor training interventions compared to states without these interventions

17. Appendix:

18. Mean Difference of Management Practices and Processes *p<0.10 **p<0.05 ***p<0.01

19. Comparison of States with and without Top Management Training

20. Comparison of States with and without Team Building Intervention *p<0.10

21. Comparison of States with and without Team Building Intervention **p<0.05

22. Comparison of States with and without DCW Career Development

23. Comparison of States with and without DCW Career Development

24. Comparison of States with and without Caregiving Skill Development *p<0.10