VAHHA ClinicalCompetenceDevelopment Program

The purpose of this program is to:

  1. Establish standardized new employee training
  2. Participate in the Nurse Preceptor Program
  3. Recruit and hire new graduate RNs and therapists
  4. Provide evidence-based training and development of new direct care employees.

This project will establish educational resources for preceptor development using a practice internship framework. VT Nurses in Partnership faculty will work collaboratively with VAHHA Managers/Educators to develop instructional content, clinical coaching plans, competence assessment tolls, and preceptor support for utilization within a home care internship that can be standardized for statewide/regional delivery.

The VAHHA Program (run by the individual agencies) will train 200 new direct care employees and 75 current employees in the specialty practice of home health care for entry level positions

Key outcomes:

  • Consistent, statewide training for newly hired, recent college graduates.
  • Teaching/learning preparation for clinical instructors that provide clinical experience for academic students that are learning the profession of nursing, physical therapy and /or home health aide.
  • Development of proficient home care staff.
  • Improve communication with the health care team and with patient/caregiver units.
  • Improve communication and ease of relationships with patients, family and colleagues.
  • Develop a web-based training modules for new graduates and other new hires.

Training Content and Curriculum:

  • VT Nurses In Partnership (VNIP) will provide the educational resources for both preceptor development and the specialty practice internship framework.
  • VNIP will provide texts for preceptor development and will transcribe significant components of the course to the VAHHA web delivery system, with specific facilitator guides for interactive components held at each participating agency.
  • VNIP faculty will work collaboratively with VAHHA managers/educators to develop both instructional content and clinical coaching plans to support learning in patient care settings.
  • VAHHA agencies will enroll interns and provide clinical support for the internship.
  • VAHHA will work with VNIP to create a web-based training program for new employees.

Summarize training curriculum, including number of hours.

  1. Preceptor Course: Provides instruction specific to core communications, interpersonal and teaching/learning skills needed to support experiential learning that occurs within our high acuity, medically challenging healthcare settings. This will be a 20-hour course that includes both self-directed and interactive learning. Instructional modalities will include offerings of two day preceptor workshops; but participants may choose for content delivery via the preceptor workbook with specific interactive sessions for application practice and facilitated discussion. Wherever feasible, course content will be transcribed to web-based delivery system.

Soft shills include improved communication and ease of relationships with patients, family, and colleagues. Teaching/learning skills that are inherent to clinical instruction are also used with preparing community members for self-care and optimal health maintenance.

  1. Home Care Clinical Internship: Provides instruction specific to the provision of home healthcare. Along with specific content delivery, this internship must include clinical experience that is supervised and evaluated by an experienced care provider. Clinical coaching plans will be developed that provide a written guide to both the learner and preceptor. These plans will include documentation of meeting critical performance expectations that give evidence of competent clinical practice within the specialty. Tools, concepts and framework will establish a “system approach” to competence development and assessment that will be applicable for all new hires.

Training timeline: start date, length of training, and expected end date.

We expect to begin this program one-month after acceptance of a DOL grant and will continue after the end of the grant program. Each VAHHA agency will begin as new employees are hired.

Preceptor development and support will be established with on-going enrollment process. In-person workshops will require two days plus self-directed learning modules and web-based training.

Internships will start with the completion of agency orientation and ensue for a minimum of 10 weeks. Completion of internships will be competency based, thus extended internships will be provided to those with less experience in home health care. The New Graduate internship will encompass a minimum of 6 months of specific course content integrated with experiential learning.

With instructional content set up for web-based delivery, rolling admission into the course may occur – the start dates would be dependent on the hiring and orientation completion dates for each member.

Other gains/outcomes to be achieved through training:

  • Documentation of evidence of clinical competence.
  • Improved communication and teamwork among various staff.
  • Improved teaching for patient and support persons.
  • Development of safe, capable homecare staff while collecting evidence of their competence.
  • Teaching/learning preparation for direct care staff that provided experiential learning both. Students and new hires, as the application aspects of the professions of nursing, physical therapy, and /or home care aide are learned/experienced.
  • Improved communications within the healthcare team and with patient/caregiver units.
  • Standardization of competence assessment tools.
  • Recruitment of 30 new graduate students to work in home health.
  • Training of 200 new employees to work in home health.
  • Increase average wage for new employee based on successful completion of the training.
  • Development of standardized materials for new hire training.
  • Development of web-based training module for new employees.

Budget Narrative

VNIP License – The $12,000 represents the license fee ($1,000/agency) for the VAHHA member agencies to use this program and for purchase of related materials.

VNIP faculty time – The $7,200 is the cost for the staff at VNIP to assist the VAHHA members in this project. We estimate the total cost at $14,400. The grant would cover ½ of this cost.

Administrative support – For VAHHA administrator. Billed at $25/hour which includes salary and benefits. The $1,500 represents ½ of the estimated costs.

Administrative support – To cover the expenses of the VAHHA director for this project. The $2,250 represents ½ of estimated expense.

Education/manager – The $6,000 would fund paying a nurse at a VAHHA member agency to develop the content for the web program and other in-service programs for this project. The $6,000 represents 100% of the expected costs.

Web development – The $3,000 would fund 3/5 of the estimated cost to develop the web course for the VAHHA member staff. The cost includes web design and web development. The $5,000 is based on the cost for previous web course development.

Training of New Employees – VAHHA estimates that the cost to train each new employee in this system is $10,000 for each newly hired nurses with previous experience and $20,000 for each newly hire college graduate with no experience. VAHHA is not asking for grant money for this (expect what is explained below) as this is a usual business expense that is already covered. We estimate the cost statewide to training staff for this program for one year is $1.3 million for the 11 VAHHA member agencies.

New Grad Internships – We are asking the grant to fund $1,000 for each new college graduate student enrolled in this program as in incentive to hire new graduates. Home care agencies generally are reluctant to hire new graduates because these students are very expensive to train. Home care is in a unique position because, after the training period, the newly hired staff is in a home alone, with no backup, unlike the situation in nursing homes and hospitals. Due to that fact, some agencies do not use new college graduates. Our goal for this program is to create a training system that encourages the hiring of new college graduates.