Sep 6, 2022
A mixed-methods evaluation of the Transformational Healthcare Readiness through Innovative Vocational Education Program (THRIVE), a program designed to stem the loss of newly hired entry-level caregivers, found no positive effect on caregiver retention nor financial return on investment in comparison to a baseline year.
The U.S. direct care workforce employs nearly 4.6 million people and represents one of the fastest growing occupations in the United States. Direct care workers, or "caregivers," include nursing assistants, home care workers, and residential care aides, all of whom provide basic care to older adults and individuals with disabilities in various health care settings.
Despite a growing need for caregivers, supply has not kept up with demand due to high turnover and low wages. In addition, caregivers often face high levels of workplace stress, limited training and growth opportunities, and personal stressors. Ranging from 35 to 90 percent, depending on the health care setting, the turnover rates of direct care workers pose a major challenge for health systems, as well as care recipients and workers themselves.
In 2019, the Ralph C. Wilson Jr. Foundation funded three health systems to support the implementation of a new program: Transformational Healthcare Readiness through Innovative Vocational Education (THRIVE). This 12-month program was designed to help address barriers that entry-level caregivers experience and reduce turnover through a comprehensive risk assessment, training, and one-on-one coaching. Researchers from RAND conducted a process and outcome evaluation to determine whether THRIVE was meeting its goals of improving retention and achieving a positive return on investment (ROI). They also examined potential areas for program improvement.
Data Collection: Caregiver Tracking Fields
Data Collection: Implementation Tracker
Data Collection: Sample THRIVE Staff Interview Guide
Data Collection: Sample Caregiver Interview Guide
Data Collection: Caregiver Survey Frequencies
Data Security and Quality Assurance
Methods for Assessing Changes in Retention
Methods for Assessing Return on Investment