Revisiting the Teaching Nursing Home Initiative Celebrates Successes During Final Grant Review

Nancy Zionts presents during the virtual grant review. 

The COVID-19 pandemic wrought unprecedented challenges for nursing homes, and the already-strained workforce has been pushed to the point of crisis. Through a two-year pilot project, the Revisiting the Teaching Nursing Home Initiative aimed to address many of the challenges made worse by the pandemic. As the pilot is concluding, Jewish Healthcare Foundation (JHF) Aging Team staff and project partners convened virtually on May 30 to reflect on two years of progress. As part of the final site evaluation for the pilot project with lead funder The John A. Hartford Foundation, the convening provided an opportunity to showcase the ongoing collaborations between nursing homes and schools of nursing established during year two of the grant.

Hosted by The John A. Hartford Foundation President Terry Fulmer, PhD, RN, FAAN, and Vice President of Programs Rani E. Snyder, MPA, the presentation was facilitated by JHF staff. Forty-one project participants and partners joined the virtual meeting. JHF President and CEO Karen Wolk Feinstein, PhD, thanked The John A. Hartford Foundation and project participants for their work to enhance the skilled nursing workforce and elevate the level of care provided to residents of these facilities.

JHF COO and Chief Program Officer and RTNH Primary Investigator Nancy Zionts, MBA, presented an overview and progress on the four aims of the initiative: (1) improve resident outcomes, (2) enrich clinical skills of nursing home staff, promote retention, (3) enhance faculty and student knowledge of nursing home care, and (4) track organizational and regulatory barriers and practices. Drawing upon existing resources from the Age-Friendly Health Systems initiative, the project exposed both nursing home staff and nursing school faculty to the 4Ms of the careforce (What Matters, Medication, Mentation, and Mobility) and achieved the goals of improving clinical care for nursing home residents, providing the nursing home careforce with tools to improve resident care and to provide valuable clinical experiences for nursing students, and strengthening nursing home placement opportunities for students. As a result of this effort, 591 residents have received Age-Friendly Health Systems care; 677 nursing home staff members have been trained on the 4Ms, and 510 nursing students have engaged with the 4Ms in the nursing home.

Another marker of success was the integration of Revisiting the Teaching Nursing Home and Age-Friendly Health Systems education to all nursing homes across Pennsylvania via the PA Long-Term Care Learning Network during the first quarter of programming for 2023. National experts in Age-Friendly Health Systems and each of the four nursing home partners presented best on practices during weekly webinars to further disseminate the learnings from the pilot project, reaching 2,245 nursing home staff at more than 200 nursing homes.

In this second year of the pilot, the focus expanded to emphasize APRN consultation and leadership development, dissemination of initial success, and effecting change beyond the participating regions via policy and advocacy. Partnerships were developed with the Pennsylvania Association of Directors of Nursing Administration and Pennsylvania Higher Education Nursing Schools Association, further strengthening the initiative's reach across the Commonwealth. Additionally, this work led to the formation of the Moving Forward Coalition, created to advance policy based on the recommendations contained in the National Academies of Science, Engineering, and Medicine report The National Imperative to Improve Nursing Home Quality. Finally, a partnership with More of a Good Thing, a program of AMDA – The Society for Post-Acute and Long-Term Care Medicine, is facilitating application of the 4Ms to the nursing home careforce.

During a panel discussion featuring representatives from participating nursing facilities (UPMC Canterbury Place, The Willows Presbyterian SeniorCare, Centre Care Rehabilitation and Wellness, and Wesley Enhanced Living Mainline, participants reflected on how their involvement in the pilot has reinvigorated their staff and empowered them to make meaningful changes in how they care for their residents. The creation, expansion, and renewal of relationships with schools of nursing has set the foundation for ongoing practice–academic partnerships. Maureen Saxon-Gioia, MS HSA, RN, JHF nurse project manager, moderated the panel.

Curriculum Taskforce Co-Chairs Ann Kolanowski, PhD, RN, FAAN, professor emerita in the Ross and Carol Nese College of Nursing at Pennsylvania State University, JoAnne Reifsnyder, PhD, MSN, MBA, FAAN, professor at University of Maryland School of Nursing, and Alice Bonner, PhD, RN, FAAN, senior advisor for aging at the Institute for Healthcare Improvement and chair of the Revisiting the Teaching Nursing Home Statewide and National Advisory Group, discussed how the project has helped to optimize academic preparation and training for the current and future nursing home careforce and shared exciting news about a new nursing home curriculum textbook, edited and authored by many of the partners in this initiative, that will be published this fall.

In a second panel discussion, representatives from the University of Pittsburgh School of Nursing, the Ross and Carol Nece College of Nursing at the Pennsylvania State University, and the University of Pennsylvania School of Nursing shared their experiences on establishing strong linkages with nursing facilities and increasing student engagement through meaningful clinical placements. As a result of the initiative, schools of nursing have expanded education on geriatrics and are collaborating with nursing home staff on curriculum enhancements. Jackie Dunbar-Jacob, PhD, RN, FAAN, JHF nursing leadership advisor, Aging Initiatives, facilitated the panel.

Steven Handler, MD, PhD, associate chief of staff for geriatrics and associate GRECC director at the U.S. Department of Veterans Affairs, is serving as the external evaluator for year two of the pilot and provided initial feedback on the initiative's outcomes. A final report on the site visit will incorporate input from Dr. Handler and The John A. Hartford Foundation.