Advisory Council October 2019 Meeting Presentation: Hand in Hand Dementia Training Program

10/21/2019

ADVISORY COUNCIL ON ALZHEIMER'S RESEARCH, CARE, AND SERVICES

Monday, October 21, 2019

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Hand in Hand Dementia Training Program: Process Evaluation of Dissemination within VHA Community Living Centers

Eleanor S. McConnell, PhD, RN
Principal Co-Chair, VHA Dementia Education and Training Committee
Durham Geriatric Research, Education and Clinical Center

Purpose

Present key findings from VHA’s dissemination and process evaluation of Centers for Medicare and Medicaid Services (CMS) “Hand in Hand” Dementia Training Program within VHA’s Community Living Centers (CLCs).

Background

  • CMS developed Hand in Hand training program for use in skilled nursing homes nationally
  • VHA Geriatrics and Extended Care asked VHA Dementia Education and Training (DET) Committee to evaluate use of Hand in Hand within VHA CLCs
  • Hand in Hand dissemination to CLCs and process evaluation occurred from 2015 through 2017

Hand in Hand Key Features

  • DVDs and print manual guides consistent in-person training experience
    • 6 modules: 4 focused on dementia
    • Slides to guide 1-hour long interactive learning sessions
    • Video resources demonstrate key behavioral symptoms and desired staff responses
    • Facilitators guide

Implementation Process

  • Workgroup convened to guide process
    1. Obtain administrative support locally and nationally
    2. Purchase and distribute toolkits with EES support
    3. Support Clinical Educators in implementation
    4. Develop and implement evaluation tools
    5. Analyze evaluation data and make recommendations for continued use

Findings

  • Reach
    • 1400+ staff trained between 2015-2016 in all VISNs
  • Staff experience
    • > 90% rated module objectives achieved
    • 88-91% indicated they:
      • learned new techniques for care
      • can use skills in their everyday work
      • found new ways to become less distressed by behavioral symptoms
  • Staff Educator Responses
    • “I hold classroom sessions using the training manual. I modified the materials to make them relevant to multiple disciplines.”“I hold classroom sessions using the training manual. I modified the materials to make them relevant to multiple disciplines.”
    • “Our CLC is 97% complete in attending.... They leave the program inspired to change the way they practice...
    • “Staff need permission and support to take the time to practice the Hand in Hand principles. “
    • “Our discussions within the classroom are very rich and beneficial since nearly half of all the participants have usually had a personal experience with a family member with dementia.”

Keys to Success and Lessons Learned

  • Leadership support at multiple levels of the organization
  • Diverse stakeholder perspectives from implementation workgroup
  • Technical assistance from peer-educator
  • Existing systems to track attendance and staff response facilitate evaluation

New Products Developed

  • Employee satisfaction with learning survey questions
  • Knowledge questions for dementia modules in Hand in Hand

Next Steps

  • DET has also made available the 2018 web-based, self-instructional version of the Hand in Hand dementia training to the field through TMS.
  • DET will promote continued use of Hand in Hand training materials by integrating the modules in ongoing dementia training, and by maintaining a Hand in Hand Training resource site.

Summary Report

Hand in Hand Dementia Training Program:  Process Evaluation of Dissemination Within Veterans Health Administration Community Living Centers.”

The report is available on the U.S Department of Veterans Affairs (VA) Office of Geriatrics and Extended Care Internet website at https://www.va.gov/GERIATRICS/GEC_Data_Reports.asp.

Acknowledgements

  • Scotte Hartronft, MD, MBA, FACP, FACHE Executive Director, Geriatrics and Extended Care, U.S. Department of Veterans Affairs
  • Lisa Minor, RN, MSSL Director, Community Living Centers. Geriatrics and Extended Care, U.S. Department of Veterans Affairs
  • Susan G. Cooley, PhD Chief, Dementia Initiatives, Geriatrics and Extended Care, U.S. Department of Veterans Affairs
  • Marianne Shaughnessy, PhD, CRNP Director, Geriatric Research, Education and Clinical Center Programs, Geriatrics and Extended Care, U.S. Department of Veterans Affairs
  • Kathryn (Kitty) Hancock, RN, MSN, Nurse Educator (retired), Charles George VAMC, Asheville, NC, US Department of Veterans Affairs
  • Hand in Hand Implementation Workgroup Members from across VHA

Questions

Thank you


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