Bridging Education, Research and Clinical Care

^{Implementing the Teaching Nursing Homes} Initiative: Scoping Study

Bridging Education, Research and Clinical Care – The Teaching Nursing Home: Discussion Paper

DR KATE BARNETT

With assistance from Prof Jennifer Abbey & Ms Jonquil Eyre

REPORT PREPARED FOR: Better Practice Section

^{Aged Care Workforce & Better Practice Programs Branch}

Office of Aged Care Quality and Compliance

Dept of Health and Ageing, Canberra

CONTENTS

Contents

CONTEXT FOR THE DISCUSSION PAPER 6

THE PROJECT TEAM 6

THE PROJECT MANAGEMENT TEAM 6

The Model 8

Benefits of the TNH Model 8

Impact on clinical education 10

Critical Success Factors in achieving quality clinical placement in aged care 10

Critical inputs at the preparation and planning phase 10

Critical inputs at the implementation and evaluative phases 10

Benefits associated with a TNH 11

Challenges associated with the TNH model 13

Enablers of the TNH model 14

Resourcing to support a TNH 15

1.1 ORIGINS OF THE TNH MODEL 16

1.1.1 TNHP GOALS 17

1.1.2 FEATURES OF AGED CARE FACILITIES PARTICIPATING IN THE TNHP INITIATIVE 17

1.1.3 FEATURES OF TNHS IN THE VETERANS CARE SECTOR 18

1.2 KEY FEATURES OF THE TNH MODEL 18

1.2.1 INTENDED BENEFITS OF THE TNH MODEL 20

1.2.2 IDENTIFIED BENEFITS OF THE TNH MODEL 21

1.2.2.1 INTERNATIONAL FINDIN GS ABOUT TNH BENEFIT S 23

1.2.3 GUIDING PRINCIPLES FOR A TNH 23

1.2.4 CASE STUDY 1 24

1.3 VARIATIONS OF THE MODEL 26

1.3.1 CASE STUDY 2 28

1.4 OTHER INTERNATIONAL EXAMPLES OF THE TNH MODEL 30

1.4.1 THE TNH IN THE NETHERLANDS 30

1.4.2 THE TNH IN NORWAY 30

2.1 AGED CARE WORKFORCE ISSUES: POTENTIAL RELEVANCE OF THE TNH MODEL 32

2.2 GOVERNMENT INITIATIVES TO SUPPORT IMPROVED CLINICAL EDUCATION 34

2.3 ISSUES ASSOCIATED WITH CLINICAL EDUCATION IN AGED CARE 35

2.3.1 SYSTEM-LEVEL ISSUES 36

2.3.2 ADDRESSING NEGATIVE STUDENT ATTITUDES/AGEIST ATTITUDES/NEGATIVE VIEW OF AGED CARE 36

2.3.3 CASE STUDY 3 - QUALITY CLINICAL EDUCATION IN TASMANIA 37

Project 2: Building Connections in Aged Care 38

Project 3: Modelling Connections in Aged Care 39

3.1 ACHIEVING GOOD PRACTICE IN CLINICAL PLACEMENT 42

Critical inputs at the preparation and planning phase 43

Critical inputs at the implementation and evaluative phases 43

3.1.1 CASE STUDY 4: PACE – GOOD PRACTICE IN CLINICAL EDUCATION 45

3.2 ATTENTION TO PLANNING 46

3.3 INFORMED PARTICIPATION AND MUTUAL UNDERSTANDING 46

3.3.1 UNDERSTANDING THE IMPACT ON PARTNERS OF THE TNH AFFILIATION 48

3.4 SHARED COMMITMENT BY TNH PARTNERS AND STRONG LEADERSHIP 49

3.4.1 CASE STUDY 5: HAMMONDCARE AND UNSW – LINKING RESEARCH AND MULTIPLE CARE SECTORS 49

3.5 FORMALISATION OF AFFILIATIONS BETWEEN EDUCATION AND AGED CARE PROVIDERS 50

3.6 CLINCIAL PRACTITIONERS AND SUPERVISORS 51

3.7 INTERDISCIPLINARY FOCUS 52

3.7.1 CASE STUDY 6: INTERDISCIPLINARY FOCUS: A TNH AFFILIATION IN SA 52

3.8 PHYSICAL INFRASTRUCTURE 53

3.8.1 CASE STUDY 7: ACH GROUP AND FLINDER UNIVERSITY OF SA 54

3.9 ADEQUATE AND SUSTAINED RESOURCING 55

3.10 CRITICAL MASS 57

4.1 ETHICAL AND LEGAL ISSUES 58

4.2 DISINCENTIVES FOR AGED CARE PROVIDERS 60

4.3 DISINCENTIVES FOR EDUCATION AND TRAINING PROVIDERS 62

4.4 MANAGING DIFFERENT CULTURES, CAPACITY AND EXPECTATIONS 62

4.5 THE IMPORTANCE OF CONTINUITY OF PERSONNEL 64

4.6 OVERCOMING AGEIST ATTITUDES 66

5.1 PROVISION FOR EVALUATION 67

5.2 CRITERIA FOR SELECTING A NURSING HOME SITE FOR A TNH 67

5.2.1 THE TNH AS A HUB 70

5.2.2 CASE STUDY 8: AN INTERDISCIPLINARY NETWORK OF TNHS IN TEXAS 70

5.2.3 LESSONS FROM NORWAY: THE TNH ‘LIGHTHOUSE NETWORK’ 71

7 Bibliography cont. 80

7 Bibliography cont. 81

7 Bibliography cont. 83

TABLES

TABLE 1: TNH STAKEHOLDERS AND THE BENEFITS OFFERED TO EACH ..................................................................................... 10

TABLE 2: BARRIERS TO TNH AFFILIATION (MEZEY ET AL 1997) ............................................................................................ 40

Australian Institute for Social Research

The University of Adelaide

230 North Terrace, Adelaide

South Australia 5005

Website Australian Institute for Social Research (www.aisr.adelaide.edu.au)

Published August 2011

ISBN: 978-0-9871430-3-7

Suggested citation:

Barnett K, Abbey J & Eyre J (2011) Bridging Education, Research and Clinical Care – the Teaching Nursing Home: Discussion Paper, Australian Institute for Social Research, The University of Adelaide

DISCLAIMER: This report describes current state of play and does not attempt to evaluate current practice.

FOREWORD

CONTEXT FOR THE DISCUSSION PAPER

In late December 2010, the Department of Health and Ageing (DoHA) commissioned the Australian Institute for

Social Research (AISR) at The University of Adelaide to provide research and analysis to inform the implementation of the Teaching Nursing Homes Initiative.