MHA-FPX5022_GarciaMartina_Assessment4-1

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Jan 9, 2024

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1 Training Plan Martina Garcia Capella University MHA-FPX5022: Human Capital Management Dr. Wanda Allen December 2023

2 Training Plan In the August 2023 employee engagement survey at Margolis Medical Center (MMC), among the inpatient and emergency department nursing workforce, nearly 38% of respondents said they would consider leaving the hospital if offered a job elsewhere, 36% of nursing reported experiencing symptoms of burnout, and 31% of respondents indicated they felt a lack of support from management for them as a person. In addition, patient satisfaction scores associated with nursing communication have fallen steadily in the previous 12 months, with two of the medical/surgical floors routinely failing to achieve scores above 70%, putting them in the 30 th percentile nationally for nursing communication and likelihood to recommend. In a qualitative analysis of patient and family member perceptions of nurse communication, the ability of nurses to communicate clearly, authentically, and most importantly, empathetically had the largest influence in the participants of nursing quality (Ng, 2019). In response, the Human Resources (HR) department at MMC conducted a series of focus groups with staff from two departments with the lowest scores in employee engagement and patient satisfaction, and from two departments with the highest scores. The responses from the lower performers were compared to the higher performing units to identify common themes and contributing factors. A few themes emerged from the focus groups. First, the two low-performing departments never fully recovered from the stress, burnout, and turnover from the COVID-19 pandemic. Second, staffing shortages had resulted in a high degree of employees working extra shifts and not being able to carve out time for ongoing professional development. Third, the leaders from the low-performing departments demonstrated a high degree of disengagement and burnout, which was identified by staff as a contributing factor to decreased morale in their units. Subsequently, the HR team determined that implementing an evidence-based empathy and compassion training program for nursing staff could improve morale, personal resilience, joy at work, and service delivery to patients. The following training plan proposes a multi-phased implementation of Stanford University’s

3 Compassion Cultivation Training (CCT) Program (Goldin & Jazaieri, 2017), with a budget, implementation timeline, overview of the curriculum and delivery mechanism, and an evaluation plan to ensure the needs of the relevant stakeholders are met. Training Objectives Designers of the CCT Program (Goldin & Jazaieri, 2017) define compassion as involving cognitive, affective, and behavioral components where individuals are concerned about and able to discern suffering in others and demonstrate a readiness to take action to end suffering in others and themselves. This definition aligns with Pehrson et al. (2016) whose studies indicated that empathy and compassion capacity-building require the identification of empathic opportunities, normalizing the sharing of emotions and vulnerability, and fostering opportunity- responses to alleviate suffering. Sinclair et al. (2021) found health care settings offering compassion training often were organizations that had typically emphasized throughput over relationship-based care, and had a breakdown in staff-leader relationships, teamwork, and communication resulting in burnout. Therefore, the training objectives of the CCT Program at MMC are to:  Increase in self-reported employee confidence in their communication and self-care skills among those who complete the CCT Program (Kerr et al., 2020).  Increase in patient satisfaction with nursing communication in departments implementing the CCT Program (Ng, 2020).  Increase by 10% the number of employees who report their leaders see them as people and that their leaders are good communicators (Suprapto et al., 2023).  Increase in reports of joy of practice and sense of belonging among those participating in the CCT Program (Sinclair et al., 2021). Target Audience In the first phase of the training plan (see timeline on page 5), MMC will focus on the nursing staff (registered nurses and patient care assistants) on the third and fourth floors, which number just under 200 staff members. The focus on the nursing teams in this first phase is critical and based on published evidence. A systematic review of compassion training in the

4 health care setting by Sinclair et al. (2021) indicated that in the 45 studies included in their final review, 53% of staff trained were nurses, with providers (including midwives) comprising 22%, and 29% representing a variety of other clinical and non-clinical staff. Moreover, as Kerr et al. (2020) identified in their systematic review of nurse training interventions, nursing staff are the health care workers who spend much of their time in direct contact with patients and the patients’ support teams, and are often challenged with complex and fraught conversations, including end-of-life discussions, sexuality, disease-specific issues, home environment, and family dynamics. In subsequent phases of the rollout, the training will extend to additional floors, nursing areas, and clinical and non-clinical areas, with ongoing cohorts of learners going through the program to accommodate new hires (Sinclair et al., 2021). The first phase of the training rollout will also include a concurrent train-the-trainer component for nursing leadership for all inpatient, emergency and ambulatory surgery areas, including unit directors, charge nurses, relief charge nurses, and clinical educators. This group also includes the nursing house supervisors who provide a critical role in de-escalation and service recovery during evening and weekend shifts. This will not only address the ability of leaders to increase their compassion and emotional resilience but enable them to cultivate a culture of compassion in their respective departments. As the number of leaders with training capacity in the organization increases, the training can be cascaded to other departments and disciplines without depending on the organizational development team or outside training. This strategy is in keeping with the cost-benefit analysis of social and emotional training conducted by Belfield et al. (2015), which highlighted a Swedish program that leveraged a train-the-trainer approach for 1,028 learners. This strategy was able to decrease the costs associated with the intervention from $540 per student to $170 per student. It also resulted in stronger employee engagement, as managers with strong mentorship skills serve as a trusted sounding board, advisor, and advocate during period of high stress (Fallon & McConnell, 2014). Topics and Delivery Description In the Sinclair et al. (2021) study, they identified the core components that enable a successful compassion training program: a strong evaluation strategy, significant short- and

5 long-term outcomes, and a high degree of concordance in training topics and delivery mechanism. Fundamental training topics include articulating an operating definition of compassion and how it is expressed (although the definitions used vary greatly across interventions); defining competencies that can be demonstrated and assessed; incorporating best practices in adult education that integrate multiple teaching methods to engage adult learners (such as video, group discussions, individual reflection, and didactic) and convey the competencies required; addressing barriers or resistance to the interventions; evaluating and sustaining practices over time; and including perspectives of peers, supervisors, participants, and patients into the evaluation methodology (Sinclair et al., 2021). The Stanford CCT curriculum meets all the above criteria and is recommended for MMC (Goldin & Jazaieri, 2017). Overwhelmingly, the study by Sinclair et al. (2021) indicated that the most effective programs were those that were conducted from six to 10 weeks, usually for at least an hour each session. Between sessions, participants would conduct self-reflections and at-home exercises to build their competencies in each session’s topic. Additionally, each cohort is evaluated over time (anywhere from three to 12 months later) to assess whether participants were using the training they had received in their daily work (Shuster et al., 2023). This can be a hard sell for health care organizations struggling with staffing shortages, as they tend to resist having staff out of the schedule. It is critical to reinforce that investing in compassion training is a strategy to support staff retention, reduce absenteeism, and increase morale (Pehrson et al., 2016). Training Format The CCT program is typically instructed in-person with 20-30 participants and led by at least one facilitator to manage group dynamics (Goldin & Jazaieri, 2017). Each class is approximately two hours in length and taught on a weekly basis for eight weeks. Sessions follow a similar structure: an introductory guided meditation, small group reflections on the previous week’s homework, didactic on the new topic with interactive exercises by participants to build skills, a longer guided meditation that reinforces the topic that is recorded for home use, a debrief, then assignment of the new homework, and closed with a final activity related to the

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