School of Psychology, Deakin University, Burwood, Victoria, Australia.
Health and Ageing Research Group, School of Health Sciences, Swinburne University, Hawthorn, Victoria, Australia.
Clin Gerontol. 2022 Oct-Dec;45(5):1226-1235. doi: 10.1080/07317115.2022.2048286. Epub 2022 Mar 13.
The aim of this study was to use the ADKAR model of organizational change to gain an understanding of why a training program designed to equip staff with the skills to provide a Consumer Directed Care (CDC) model in nursing homes produced little change in the outcome variables, including resident quality of life.
We collected and analyzed various forms of site-specific data including CDC implementation plans developed by staff trained in 21 facilities, and their training facilitators' records.
Staff trained in the principles of CDC produced well-developed, facility-specific plans to introduce a CDC model of care, yet they faced many barriers to the implementation of these plans. These barriers were spread across multiple stages of the ADKAR model and included staff turnover (including managers), lack of engagement by management, lack of or inconsistent availability of a CDC champion, and disruptions to the training program.
We identified several organizational factors contributing to the failure of the training program to produce anticipated changes.
Without organizational commitment and full management support, attempts to implement CDC training programs are likely to fail, leading to negative consequences for residents' autonomy and control over how they are cared for.
本研究旨在运用组织变革的 ADKAR 模型，了解为什么旨在培养员工提供养老院消费者指导型护理（CDC）模式技能的培训计划，对包括居民生活质量在内的结果变量几乎没有产生任何变化。
我们收集并分析了各种特定于地点的数据，包括在 21 个设施中接受培训的员工制定的 CDC 实施计划，以及他们的培训辅导员的记录。
接受过 CDC 原则培训的员工制定了完善的、针对特定设施的计划，以引入 CDC 护理模式，但他们在实施这些计划时面临许多障碍。这些障碍分布在 ADKAR 模型的多个阶段，包括员工（包括管理人员）流动率高、管理层缺乏参与、缺乏或不一致的 CDC 拥护者，以及培训计划中断。
我们确定了导致培训计划未能产生预期变革的几个组织因素。
如果没有组织承诺和全面的管理层支持，尝试实施 CDC 培训计划很可能会失败，从而对居民的自主权和对护理方式的控制产生负面影响。
