title: Making meaningful improvements to direct care worker training through informed policy: Understanding how care setting structure and culture matter.
abstract: Well-intentioned policy governing the training of direct care workers (DCWs) who serve older persons, in practice, may become merely a compliance issue for organizations rather than a meaningful way to improve quality of care. This study investigates the relationships between best practices in DCW training and the structure and culture of long term support service (LTSS) organizations. Using a mixed-methods approach to analyzing data from 328 licensed LTSS organizations in Pennsylvania, the findings suggest that public policy should address methods of training, not just content, and consider organizational variations in size, training evaluation practices, DCW integration, and DCW input into care planning. Effective training also incorporates support for organizations and supervisors as key aspects of DCWs' learning and working environment.
authors.affiliation: a College of Health, Environment, and Science , Slippery Rock University , Slippery Rock , Pennsylvania , USA.
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Kemeny
authors.affiliation: b Department of Sociology , Indiana University of Pennsylvania , Indiana , Pennsylvania , USA.
authors.forename: J Beth
authors.initials: JB
authors.lastname: Mabry
mesh_terms: D003430:Cross-Sectional Studies; D004493:Education; D005853:Geriatrics / Q000193:education*; D006282:Health Personnel / Q000193:education / Q000523:psychology / Q000592:standards; D006299:Health Services for the Aged / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D008134:Long-Term Care / Q000379:methods / Q000523:psychology / Q000592:standards; D062527:Meaningful Use; D015279:Organizational Culture; D016134:Organizational Policy; D017410:Practice Guidelines as Topic / Q000592:standards; D015397:Program Evaluation; D058996:Quality Improvement; D013192:Staff Development / Q000379:methods / Q000592:standards
keywords: Best practices; direct care workers; education; older adults; policy; quality of care; retention; supervisors; training