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A Quality Direct Care Job Provides Real Opportunity

By Robert Espinoza (he/him) | November 23, 2020

On October 26, PHI introduced its new framework—The 5 Pillars of Direct Care Job Quality—which is meant to guide employers, policymakers, and industry leaders in designing high-quality jobs for direct care workers. The framework covers 29 elements across five pillars: quality training, fair compensation, quality supervision and support, respect and recognition, and real opportunity. The excerpt below on real opportunity, the fifth pillar, is taken from Would You Stay? Rethinking Direct Care Job Quality.

Real Opportunity

A quality direct care job should invest in workers’ learning, development, and career advancement.

Employer-sponsored continuous learning available to build core and specialized direct care skills

Entry-level training is essential, but a quality direct care job should also provide continuous learning opportunities to workers. Ongoing training reinforces and enhances workers’ core competencies in direct care, while also boosting their capacity to care for an increasingly complex and diverse range of long-term care consumers. Employers should also be responsive to what workers identify as their learning needs.

Opportunities for promotion into advanced direct care roles with wage and title increases

The opportunity to move into advanced roles—with increased training, responsibilities, and compensation—is a critical element of job quality in direct care. Career advancement opportunities can improve job satisfaction, recruitment and retention, and care for consumers. Examples of advanced roles include (among others): peer mentors, where workers support both new and incumbent direct care workers; care coordination roles, where workers are integrated into care teams and help with upskilling workers, care transitions, and interdisciplinary team communication; and specialty roles, where workers provide condition-specific care, for example, care for individuals living with Alzheimer’s disease or other forms of dementia. These roles can be created at the employer or health system-level and customized per setting.

Organizational commitment to cross-training workers and promoting from within

Quality jobs for direct care workers also depend on their employers’ commitment to cross-training and hiring from within. For example, current employees should be considered first when recruiting for administrative positions, assistant trainers, or any of the positions noted above. When workers trust that their employers are looking out for their career growth—by providing clear pathways for advancement and looking internally first for strong job candidates—their job satisfaction will improve, and they will be less likely to leave their jobs in search of better opportunities.

Connections to external training and job development programs for other health care and social service careers

Direct care workers may also be interested in pursuing other health care and social services careers. To facilitate these goals, employers should develop formal relationships with external training and workforce development providers that open the door for career advancement beyond direct care (into licensed nursing roles, for example). Workers should also have easy access to information about these programs; one option is to designate an employee in-house who can be trained and charged with managing these inquiries and making referrals when requested.

Download The 5 Pillars of Direct Care Job Quality here.

Private: Robert Espinoza (he/him)
About The Author

Robert Espinoza (he/him)

Former Executive Vice President of Policy
Robert Espinoza oversees PHI's national advocacy and public education division on the direct care workforce, and contributes vision and leadership to the organization's strategies.

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