LeadingAge Magazine · July/August 2011 • Volume 01 • Number 04

A New Model for Training Assisted Living Managers

July 13, 2011 | by Bonnie Blachly

A collaboration between Aging Services of Washington and a school of nursing has created an effective three-day training program and a mechanism for promoting ongoing shared learning for participants.

A collaboration between Aging Services of Washington and a school of nursing has created an effective three-day training program and a mechanism for promoting ongoing shared learning for participants.

 Chris Eager, whose background in the hospitality field served him well when he began his new job in an assisted living community, nonetheless found that he had things to learn about managing employees—keeping them happy and invested in the mission of his organization. Eager, dining room manager at The Summit at First Hill, Seattle, Wash., is one of two dozen Aging Services of Washington (ASW) members who benefited from a new workshop to train managers of assisted living communities.

The workshop, the fruit of a collaboration between graduate nursing students from the University of Washington’s Bothell campus and ASW, debuted early this year with positive results and has potential for growth and replication elsewhere.

 “Perhaps the most important aspects of the day I spent at the Assisted Living Leadership Seminar were that I am not as isolated as I had thought, and that there were other ways I wasn’t using to engage my employees,” says Eager. “Upon returning to work I began to utilize some of the ideas that I learned, in particular the concept of learning circles. I found almost immediately that some of the issues we had been having were a result of information not getting shared, and the learning circle broke down barriers, making everyone more respectful of each other’s roles in the overall work we do.”

 

Managers of assisted living communities come from a variety of backgrounds: Some are registered nurses or licensed practical nurses and some have non-nursing backgrounds. They are often promoted into their positions because they have proven themselves reliable, responsible and accountable employees. While these are excellent qualities, they do not necessarily prepare these managers to take on assisted living director/coordinator responsibilities.

In assisted living, the manager/administrator is working where the client lives. Many of these managers are not professionally trained or equipped with the skills to assist residents in making important health care decisions. Some have little or no health care background. Yet they are functioning in responsible positions in which they oversee budgets, regulatory compliance, quality assurance and other critical operations.

That gap between training and job requirements is what inspired ASW and the UW-Bothell Masters in Nursing program to collaborate to develop the three-day workshop.

 

“A Leadership and Management Program for Assisted Living Managers” is the name of the course created by the students in their program planning and development class. The Kellogg Logic Model (W. K. Kellogg, 2004) was used to outline the program. The students conducted a needs assessment by interviewing assisted living program coordinators and directors. Using this information, the students developed the outputs, which include: a three-day workshop curriculum outline, course description and learner objectives, an evaluation tool, an annotated literature review and a list of online resources to benefit participants. The students identified short- and long-term desired outcomes and suggested the potential impact on the assisted living community.

The program took into consideration two influential factors—that program participants would have limited time for in-person class attendance, and that they must perceive the content as valuable.

The student group gave ASW an annotated literature review that yielded information on varied staff educational experiences and skills; staff satisfaction predictors; importance of staff engagement; social versus medical models of care; resident-centered care; medication administration and other policy-driven delegated tasks; “aging in place” with related resident acuity changes; and the importance of ongoing assessments.

The ASW workforce development and assisted living committees reviewed the students’ deliverables: an executive summary; a scholarly paper; and appendices that included the logic model for the programs, the template for the workshop, an evaluation tool, a course description with workshop objectives, an annotated literature review and an online resource toolkit.

After a committee of ASW members refined the content and lesson plans for the workshops, a call went out for presenters, since the goal was to have a members-teaching-members program.

“Cultivating the existing talent within our assisted living communities, the leadership program relies on the expertise of ASW members to teach and mentor our up-and-coming assisted living leaders,” says Deb Murphy, ASW CEO. “As a result, we are confident these new leaders will be better prepared to meet the challenges of tomorrow and continue to provide excellent care and services to seniors.”

ASW staff recruited presenter-members who demonstrated leadership qualities and whose communities have positive regulatory inspection histories. They were given a revised template and two months to submit lesson plans in formats of their choice. Most submitted PowerPoint presentations and handouts they wanted to be distributed the day of their presentations.

 

After completing this workshop participants are able to:

1. Describe unique characteristics of assisted living communities and how their social model differs from the skilled nursing model.

2. Identify leadership strategies that can be used in management of an assisted living community.

3. Identify opportunities for making positive change in their current community environment.

4. Describe key strategies that can be used in promoting staff development, recruitment and retention.

5. Identify strategies for promoting successful inspections.

6. Explain key factors in Washington state’s Death with Dignity Act and legal issues associated with end-of-life care.

7. Describe the major components of an effective and efficient quality assurance/quality improvement program and strategies for ongoing monitoring.

8. Develop coping strategies for dealing with stress in the workplace.

9. Identify strategies for enhancing professional development.

 

The course was designed as three all-day sessions, one per week over three weeks. This gave the 24 registered participants a week between sessions to digest the information they received and determine how to apply what they were learning in their own environments. Each day had a different theme:

Day One: 

  • Leadership Within an Organization
  • Enhancing AL Practice Through Development of Positive Relationships With State Regulators
  • Recruitment, Retention and Development of Staff

Staff and those in leadership roles are often unsure about how to relate to inspectors and other state regulators. This session gave tips on how to identify opportunities to have conversations with state regulators to promote positive relationships outside of inspection or other stressful times.


Day Two: 

  • Models of Care
  • Fire & Life Safety
  • Role of the Long-Term Care Ombudsman
  • Regulations
  • Building a Great Operation

Regulations are difficult to interpret and locate. In this session, participants had an opportunity to explore regulatory sites on the Internet. They were shown how to navigate the sites and find common and frequently cited regulations.

Day Three: 

  • Career Development and Exploring the Possibilities
  • Strategies for Success
  • Where Do We Go from here?

In this last session, participants and presenters shared techniques to promote success not only for themselves but for their employees. This list resulted in new strategies managers could implement.

The focus was on all things related to leadership and management in assisted living communities. Conversation varied related to the topics, but all were encouraged to ask questions and share their experiences. Participants were given a manual of handouts and a toolkit of information. They were encouraged to adapt the tools to their environment and particular needs. The willingness of participants to share their community processes and tools supported the success of this workshop.

 

All participants were asked to complete an evaluation at the end of each session, and an all-encompassing final evaluation at the end of the program. Each speaker was rated using a Likert Scale of 1-5 with 1 being not helpful and 5 being outstanding. Scores for the speakers and the program consistently averaged between 4 and 5.

Participants were asked to comment. They appreciated the sample tools they could adapt to their own practices. Some of the final comments included:

  • “Knowledge of WAC’s [Washington Administrative Code, state assisted living regulations], ideas for disaster preparedness, looking into continuing my education and/or certifications.”
  • “Refining our [inspection] survey preparation process”
  • “The leadership training was great. It was nice being such a small group—made it more personal.”
  • “… very helpful with training and putting policies together.”
  • “… networking and quality assurance/quality improvement.”

ASW believes it is important that cohorts of participants continue to be connected after the course, as many strong bonds were created during the sessions. A listserv has been created to facilitate continued communication among participants and presenters. A quarterly educational event will be offered exclusively to the course participants, for free or at a nominal fee. They will also be encouraged to participate in the monthly Assisted Living Committee meetings, and the Nursing Forum that occurs every other month. ASW is exploring development of a mentoring program that would support these managers as they continue to develop their careers.

This program offers many benefits for assisted living communities. Ongoing education and training results in improved job satisfaction and longevity. Lower turnover results in financial savings. Resident satisfaction improves due to stability and consistency of staff. As ASW continues to offer this program, the association will identify common themes and measure outcomes to be able to clearly articulate the long-term benefits.