Implementation of the Better Jobs Better Care demonstration: lessons for long-term care workforce initiatives.
OBJECTIVE
Better Jobs Better Care (BJBC) was a long-term care workforce demonstration that sought to improve recruitment and retention of direct care workers by changing public policy and management practice. The purpose of this article is to document and assess BJBC's implementation, analyze factors affecting implementation, and draw lessons from it for other long-term care workforce initiatives.


METHODS
We analyzed qualitative data from project work plans and progress reports, and notes from telephone and in-person interviews with project staff, coalition stakeholders, and state policy experts. We abstracted the data, categorized it, and summarized it by state in matrices for analysis.


RESULTS
The five BJBC projects did implement their demonstration plans. Factors that affected project implementation included having demonstration resources; strong, stable leadership; strong coalitions that included key stakeholders; a neutral lead agency; clear goals; effective process; and a favorable state history and context.


CONCLUSIONS
BJBC demonstrated that recruitment and retention is a long-term care industry problem, not just a nursing home problem. Future initiatives should: recognize that workforce policy and management practice change is difficult and takes time, obtain funding, develop strategies specific to the state history and context, engage key stakeholders, and develop relationships among stakeholders.
Kemper
Peter
P
Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA 16802, USA. pkemper@psu.edu
Brannon
Diane
D
Barry
Teta
T
Stott
Amy
A
Heier
Brigitt
B
D006265:Health Care Coalitions; D006284:Health Plan Implementation; D008134:Long-Term Care; D019982:Organizational Case Studies; D009937:Organizational Objectives; D014481:United States; D000078329:Workforce