PHI’s New Hybrid Home Care Training Responds to the Moment

When the COVID-19 pandemic arrived in the U.S. in March 2020, PHI and our partners at Cooperative Home Care Associates (CHCA) immediately recognized the challenges it would pose to the direct care workforce. In addition to the pressing need to ensure that both home care workers and their clients remained safe during a global health crisis, our long-term care sector quickly encountered another major hurdle—even as the demand for direct care workers was increasing as the pandemic went on, in-person trainings for prospective home care workers had either ground to a halt or were severely curtailed.

As Gloria Garan, CHCA’s Vice President of Clinical Services, recalled of the early days of the pandemic, “We had to completely shut down our training program for a while.” Once CHCA resumed in-person trainings, they limited the number of participants, in order to ensure people’s health and safety and to comply with social distancing regulations. “The number of participants being trained really dropped, and the need for caregivers was increasing every day,” Garan said.

In New York, the state’s Department of Health responded by allowing already-certified home health aide training programs, such as the one PHI developed and conducts in partnership with CHCA, to shift to a hybrid model—one where the knowledge-based lessons would be virtual, while the practical, hands-on trainings would continue to be taught in-person. PHI was well-prepared to make the pivot: Even before the COVID-19 pandemic, PHI had already begun exploring the potential of online training models. “The pandemic just accelerated the development of online training models,” Kathleen Graham, PHI’s lead nurse educator, said.

DEVELOPING A HYBRID MODEL

At the end of 2020 and into 2021, PHI worked with CHCA to translate the existing training—an 18-day, 120-hour certification program—into a hybrid format. Graham, who led the process of reimagining the curriculum to suit the hybrid model, also had to ensure that enrollees were equipped to participate in online classes. “You have to design broadly, and accommodate people where they are,” she noted. To that end, she and CHCA’s staff ensured that all participants were provided laptops and, in some cases, with portable Wi-Fi devices. PHI and CHCA’s joint pilot program began in August 2022, with a class of 10.

Ensuring that the hybrid training maintained the key elements of PHI and CHCA’s training program—the use of adult learner-centered teaching principles and a focus on building person-centered relationships with clients—was an important element of the program’s success. “Our program goes above and beyond New York’s training requirements for home health aides,” said Emily Dieppa, PHI’s Vice President of Workforce Innovations.

“One of the most important aspects of our hybrid program is its ability to replicate best practices for adult learning in an online setting, just like we do in-person. We provide opportunities for interactive engagement, discussion, and applied practice.” ~ Emily Dieppa, Vice President of Workforce Innovations, PHI

While the shift to a hybrid training model stemmed largely from necessity, PHI’s staff recognized that the broader benefits would extend beyond the COVID-19 pandemic. “We see online training as a way to address some of the common barriers that people have to in-person training,” said Dieppa, noting that these barriers are not unique to the direct care workforce. Those barriers to participation often include the lack of childcare and difficulties in accessing transportation to an in-person training site; offering an option like hybrid training, she said, makes the program more accessible. Dieppa continued: “We’ve seen a growing demand from employers and from learners to have more flexibility built in, and that flexibility innately comes along with online and different hybrid training models.”

That flexibility benefitted participants like Esmerelda Pascuzzi, part of CHCA’s first cohort to go through the hybrid training program, which concluded in mid-August. A mother to a nine-year-old, she was only able to participate due to the fact that many of the sessions were online. “I didn’t have childcare for the summer,” she said. “Without the hybrid option, I don’t know when I would have been able to do the training.” Pascuzzi began working as a home health aide a few days after the program finished. “It definitely prepared me, in a great way,” she said.

Pascuzzi wasn’t the only participant who felt that the flexibility offered by the hybrid training was a plus. According to a post-class survey Graham conducted of those who went through CHCA’s pilot program, several of the participants with children shared that the hybrid nature made it more accessible. “If you’re not working at the moment, you don’t necessarily have the money to pay for daycare for your kids,” Graham pointed out. “Some of the women said that doing it as a hybrid has really put this training within their reach.”

A Long Term Strategy

Two cohorts have already gone through CHCA’s hybrid training program, and the home care agency plans on continuing to offer it as an option. “I would like to see it continue to succeed,” said CHCA’s Bridget Winslow, a nurse educator and trainer. “The pandemic really brought on these ideas, and I think they’re good ones.”

PHI’s Dieppa agreed, noting that offering hybrid training and certification programs are part of the solution in addressing the direct care workforce shortage. “This is one promising strategy to help us do that, because we are able to expand who’s in the pipeline for recruitment,” Dieppa said.

Dieppa added, “This is what innovation is about—figuring out how to do something differently to better respond to the emerging needs of our community.”