老人院管理人员培训计划

1、Nursing Home Administrator Training中美亦康关怀SinoCare Organization前言中国老龄办在“中国人口老龄化发展趋势预测研究报告”中指出， 21世 纪的中国将是一个不可逆转的老龄社会。从 20012100年，中国人口老龄化将 呈现“三步走”的发展特征。第一步（20012020年）是快速老龄化阶段。到 2020年，老年人口将达 2.48亿，老龄化水平将达到17.17%;第二步（2021 2050年）是加速老龄化阶段。到2050年，老年人口总量将超过4亿，老龄化水 平推进到30犯上。第三步（20512100年）是重度老龄化阶段。2051年，中 国老年

2、人口规模将达到峰值4.37亿，约为少儿人口数量的2倍。到2100年，80 岁及以上高龄老人占老年总人口的比重将保持在25%- 30%进入一个高度老龄化的平台期。家庭养老一直是中国养老的主要方式。然而，随着独生子女政策造就的 “四二一”式的家庭结构逐渐显现，独生子女们结焙后面对的是两个人要赡养 四个老人，甚至更多，这注定了这种方式难以为继。据了解，目前我国城乡空 巢家庭超过50%部分大中城市达到70%农村留守老人约4000万，占农村老年 人口的37%城乡家庭养老条件明显缺失。截至 2009年底，我国1.67亿老年人 中失能老人1036万，半失能老人2123万，共占老年人口总数的18.9%。人口老

3、 龄化对经济和社会的发展必将带来一些新的矛盾和压力、提出新的挑战。“十二五”规划提出，今后五年要更加注重以人为本，坚持把保障和改善 民生作为加快转变经济发展方式的根本出发点。具体实施措施就是要惠民利 民，保障和改善老百姓民生。大力发展社区卫生服务机构、增加社区医疗保险 定点医院、积极发展养老服务业、建立满足庞大老年人群需求的为老社会服务 体系、增加为老服务设施及为老服务网络等，是国家政策及民生的迫切需求， 是解决我国人口老龄化问题的必由之路，是应对养老问题的重要举措，是提高 空巢老人的生活质量的一个重要途径。我国养老机构建设起步较晚，各地养老院的数量和质量还不能适应人口老 龄化需要，面临着“先

4、天不足”与“后天失调”的双重缺陷，具体表现为：.养老院硬件设施不达标。仅从养老院床位设置上看，我国已有各类养老 机构38060个，拥有床位266.2万张，收养各类人员210.9万人。养老床位总数 仅占全国老年人口的1.59%,不仅低于发达国家5%-7%勺比例，也低于一些发展中国家2%-3%勺水平.缺乏专业的管理人员。大部分养老机构管理人员普遍年龄偏大，学历偏 低。因为没有相应的专业培训，大部分没有管理方面的业务知识，管理水平参 差不齐，养老服务机构的一些优惠政策也难以落实。.缺乏专业的护理人员。一是没有接受过相应的健康教育与康复指导。例 如，在360万人口的太原市，仅有6所养老院配有从事老年护

5、理的工作人员，其 他养老院均没有配备专业护理人才。由于护理不到位，使老人出现褥疮、肌肉 萎缩、关节挛缩畸形、下肢静脉曲张、血栓形成等相关并发症。二是个人文化 综合素质较低。杭州市17家养老机构中，护理人员中仅7. 5%为护理专业，且 为中专学历。养老护理服务没有统一的分级护理标准、没有养老护理操作规范 及评价体系、没有养老护理员准入和分级管理制度，致使老年人的生活质量难 以保证。三是缺乏对老人的人文关怀与心理安抚。护理人员注重生活护理而忽 略精神需求，使老年人长期感到孤独寂寞。.缺乏专业化运作。现有不少养老院是由医疗机构托管的，有些老人及家 属将养老院当成医院的一部分，老人出现病情变化当然也由

6、养老院自行解决， 随之而来的问题是因为养老机构不是医疗机构，按行业规定不能进行治疗性的 医疗行为。一旦在养老院出现纠纷，家属也会直接找到上级医疗机构，影响上 级医疗机构的正常医疗工作。归根到底，养老院种种问题与弊端源于主管人员不懂管理技能、缺乏规范 科学的管理经验。调查发现，现有养老院管理人员，尤其是养老院由社区卫生 服务中心托管的管理人员，其制订的规章制度与养老院的实际运行有差距，要 么带有浓厚的医院运作色彩，要么仅具有托老所的简单单一功能。因此，建立 和健全养老机构人才管理、服务管理、资源管理体制，借鉴欧美国家先进和成 熟的管理模式，加强学术交流和技术研究，提高管理人员的管理技能，培养出

7、合格健康管理专家，才能对老年个体或群体的健康进行全面监测，有针对性的 提供科学的健康服务。关于中美亦康关怀中美亦康关怀是非盈利组织，创建于美国加州。她拥有长期从事医院、老3 人院管理的优秀人才，专业涉及现代护理、经济管理、心理、预防、医疗、康 复等多个方面。管理团队熟悉西方国家养老机构的建设和管理，在长期的工作 实践中，积累了丰富成熟的经验，对现代医疗护理机构管理模式有深入研究。 中美亦康关怀与美国的养老机构，特别是位于加州地区的养老机构有广泛的联 系和交流，建立了很多长期合作项目。中美亦康关怀期望能把老年养老服务的 知识和经验带回中国，帮助培训老年养老机构的管理人员熟悉和了解西方国家 成熟的

8、管理经验和经营方法。培训目的及课程养老机构管理是医疗公共卫生服务管理特有的一个分支，在欧美国家是发 展相对成熟的医护管理类专业。养老机构管理人员负责监督养老机构的临床和 行政事务，应掌握现代医疗护理服务知识和相关行政及后勤保障等技能，具备 良好的沟通技巧职业素养，能够掌控复杂局面、应对各种矛盾。基于上述培训目标，本培训将传达现代医学护理的核心理念，介绍欧美养 老机构先进运营模式，基于实例讨论现代养老管理经验。本培训课程适用于养老机构管理人员，也适合继续教育和寻求知识更新的 人员。课程分六个专题，理论培训时间为二到四周。根据协议，美国基地实习培训两周。 每个专题有相应的教学材料、案例材料及相关读

9、物，授课以讲座和 案例讨论相结合。六个课程主题包括：一、养老机构住民的服务和生活质量二、养老机构的组织和人力资源管理三、养老机构的领导艺术四、市场营销与质量控制五、临终关怀服务六、老人心理保健七、特别案例分析培训内容：一、养老机构的居民服务和生活.课程简介介绍培训教材、读物及课程的设计。介绍西方社会养老服务的的过去，现在和未来。讨论长期关怀的核心理念：入住者是居民还是病人？. 一般护理管理和实践讨论现代护理学的哲学理念：护理是艺术还是科学？介绍治疗性会话交流技巧，治疗性环境部置。介绍个体化的护理规划：与个体文化背景、教育水平、认知能力相匹配 的护理介入方式。介绍责任护理模式。讨论管理人员的责任

10、：护士长、责任护士、护士助理的责任。讨论老人医疗服务：处理尿路感染、视力问题、听力问题、心理问题、 抑郁症、痴呆、褥疮、饲管喂养等。.社区支持及服务介绍社会服务中社会工作者的作用。讨论长期护理的文化变革，老年居民和子女关系协调。讨论阿尔茨海默氏病的长期病程演变。讨论老年居民的权利。.护理流程介绍入院前的检查：恰当的年龄评估技术。介绍全面护理计划：临床记录和护理回顾。介绍医疗服务包括牙医服务和欢欣疗养。介绍医疗标准、常用的医学术语、用语缩写、护理检讨。.营养服务介绍饮食服务条例。讨论营养师和膳食经理的职责讨论人员卫生、厨房卫生、菜单及营养成分分析、食品和食品准备讨论药膳；老人的饮食需求、营养学的

11、概念、辅助设备6.辅助服务介绍理疗康复部、语言治疗师和生活自理治疗师的责任。二、养老机构的组织与人力资源管理.养老机构组织结构常用的组织设计。具体岗位描述。组织章程及治理结构。.人力资源管理养老机构的人力资源特点。员工招聘、培训、评估和晋升。讨论员工的行为准则、 矛盾处理及员工纪律。讨论员工健康与安全。三、养老机构的领导艺术.认识群体和工作团队群体行为的特点形成有效的团队。案例分析团队管理中的问题。.员工激励员工激励的基本形式。信任是激励的实质。.沟通与突发事故处理讨论“道歉规则”和“许可规则”。案例讨论：如何使用道歉。如何弥补“疏忽”行为。（四）：市场营销与质量控制1:市场营销讨论市场伦理和

12、资源。讨论媒体与新闻发言人培训。讨论紧急事故的新闻发布。讨论市场转型：医疗保健市场。讨论如何提高市场策略。讨论长期关怀市场的长期发展。2:质量控制讨论养老机构的质量控制过程。介绍质量控制的有效手段和评估机构。介绍质量控制测量。讨论质量持续改善。（五）：临终关怀服务.临终关怀的历史与发展。.西方文化对死亡的认知。.临终关怀的核心理念。.个人对死亡的认知，情感和价值观的探讨。.绝症晚期和死亡对于法律事务和家庭财务影响。.葬礼对于家庭的影响。.家庭应对死亡采取的步骤和措施。.急性，慢性疼痛的类型。.绝症晚期病人疼痛控制的原则。.绝症晚期病人的症状描述和症状控制。.临终关怀服务计划。.临终关怀在家庭，

13、养老院，或医院中的作用。.临终关怀多学科团队的概念。.加强信心和技能训练，理解病人的沮丧，伤害，需求，分担他们的问 题。.临终关怀志愿者的作用。.临终关怀病人的感染控制。.生命最后阶段的精神需求。（六）：老人心理保健1:老年人的心理护理：介绍老龄对健康的影响。了解老人的心理表现。如何帮助让老人度过一个积极有意义的晚年。家人对老人心理卫生应有的认识。2:临终患者的心理护理：临终老年人的心理活动概述和典型心理特征。老人个体对死亡的认知，情感和价值观的探讨。临终患者常见的心理问题。老年人眼中的“来世”之谜。（七）：专题讨论.优化老人照顾基础：与年龄相符的诊断方法。.老年忧郁量表。. Braden褥疮

14、风险测量表。. Hendrich二老人摔倒风险测量表。.痴呆和澹妄的鉴别。.吞咽困难老年人误吸的预防。.避免或减少老年痴呆症患者的人身限制措施。.评估老年人睡眠质量。.老年人和痴呆症患者疼痛诊断。.老年人性健康评估。.痴呆老年患者的饮食和喂养问题。.老年痴呆住院患者的家庭合作。.宠物治疗介绍。.娱乐和丰富多彩的生活设计方案讨论。.打破沉默：增进同听力，视觉和语言障碍的老人的沟通。附：团队介绍：Sunny Song毕业于山东大学，并获得加拿大卡尔加里大学公共卫生管理硕士。曾任职于弗 吉尼亚大学心脏中心。后任职于 Kort Hospital医院的管理部主任。主要负责医 院战略发展与规划，监督政策执

15、行和条例法规的贯彻实施，提高医护服务品质 量等管理工作。Sunny在实际工作中，运用扎实的专业知识和卓越的领导技 能，建立了和临床医生，护士以及其他的治疗团队良好合作关系，保障了医院 的良性运转。在培训项目里，Sunny将负责养老机构住民的医护服务，运营管理及领导艺术 等方面的培训。Cindy WangCindy毕业于北京大学。曾经任职强生公司北京代表处。由于她出色的业绩， 很快被晋升为中国北方市场的首席客户经理。后赴美获得工商管理硕士学位。 任职于瑞银（瑞士联合银行），负责预算，业务估值，收购和税务问题。后加入 Kaiser hospital 的HMO（健康医保组织）。作为管理人员负责长期护

16、理部门和 养老院的发展和运营。在培训项目里，Cindy将负责人力资源，市场营销及推广方面的培训。David WangDavid毕业于泰山医学院，挪威卑尔根大学医学博士，美国斯坦福大学博士 后。作为神经外科医生，有10年的临床工作经验，后被加拿大麦吉尔大学邀请 做访问学者2年。随后转赴挪威卑尔根大学完成博士学位。David目前任职于美国斯坦福大学，作为资深研究员，从事月中瘤学和干细胞学的研究。他曾经被 中国政府授予“中国2006年优秀出国自费留学人员”。David不仅表现杰出的 医学科研能力，更具有卓越的领导才能。他获得多项挪威科研基金，并带领他 的研究小组在全球著名医学期刊发表 20多篇价值很

17、高的论文。在培训项目里，David将负责护理计划及临终关怀方面的培训。Cherry Wang毕业于东南大学，管理科学和工程专业博士。目前是山东大学管理学院副教授。2005年2006年美国马里兰州立大学高级访问学者，2008- 2009年加州大学旧金山分校高级访问学者。长期从事管理学及运营管理的本科和研究生教学。承担了多项科研和科技公关项目，并有多部论著出版。在培训项目里，Cherry负责运营管理和领导艺术的培训。Sarah EdwardSarah获得了波士顿大学的护理学学士学位。服务与数个养老机构。目前任职与加洲山景城养老中心主任。Sarah拥有20年专业护理知识，也是加洲养老管 理协会的成员

18、之一。在培训项目里，Sarah将负责培训人员的美国培训项目。Charlie Low毕业于新加坡国立大学，曾任职于微软。后在加拿大创建网络安全公司。是资深IT专业人士。作为中美亦康关怀的IT技术顾问，Charlie将负责老年养老机构的管理软件的 开发和运营。PrefaceChina will face a dramatic transition from a young to an aged society in the coming 30 to 40 years. According to Research report of Chinas aging population: Future a

19、nd Trend, China will inevitably become an aged country. In 2000, there were 88,110,000 persons aged 65 years and older, which represented 7% of the population. By the end 2008, it reached 159,890,000 persons, which represented 12% of the population. It is projected that this number will increase to

20、248,000,000 by 2020; and the percentage of people aged 65 years and older will increase to 23% in 2050. Currently, 50% of the families in urban China become typical empty-net where heads of household are seniors; the percentage reached 70% in certain metropolitan areas. It is estimated that 40, 000,

21、000 seniors are left alone in rural areas while their children migrated to the big cities. There is a substantial lack of caring system for these seniors. In China, about 10,360,000 seniors became disabled, 21,230,000 seniors are semi-disabled; they made up of 18.9% of the total senior population. T

22、hey need different levels of elder care and assistances in daily lives, how to provide elder care to these fast growing populations has become an urgent issue that will significantly impact every aspect of Chinas development, economically, politically, and socially.Regarding health and long-term car

23、e for older adults, the current challenge is to build a comprehensive system of care for older adults. Nursing home care is an inevitable care model for frail older adults in China, which is largely sponsored by the government of China with contributions from some nongovernment organizations and pri

24、vate investors. China is a large country. Within the country, long-term care varies greatly between rural and urban areas, and among the different economic developing areas. In a recent national meeting, Government of China proposes to build more nursing home facilities in both rural and urban areas

25、 to reach the goal of having 30 beds for every thousand senior citizens. However in reality, there are about 38,060 nursing facilities of various sizes nationwide, and can provide 2,662,000 beds. It accommodates only 1.5% of total senior population. This is far less than 5-7% average in the develope

26、d countries, and even less than 2-3% average in some developing countries.The Star Light Program and Beloved Care Engineering were recent government initiatives to improve aged care. They were launched in 2001 and have dramatically increased the number of both senior centers and nursing homes for ol

27、der adults. While the quantity of nursing homes is still inadequate with an additional mismatch problem between the supply and demand, the quality of care in most nursing homes is suboptimal. At present, most administrative and frontline workers in nursing homes have received little training in elde

28、r care. There is a need for good-quality structured training in long-term care for all types of staff. Moreover, quality standard for care, including standard setting, assessment, and monitoring, is an important issue and needs substantial improvement for nursing homes in China.Given the fact that o

29、nly 1.5% of the older adults live in the nursing or assist living facilities and a peculiar 4-2-1 family structure in China, we expect the prevalence of nursing home placement of older adults will increase in the coming years. The government of China has realized that it is financially not sustainab

30、le to expand in this area using only the governments resources. The current policy is to encourage private and foreign investors to participate in the nursing home business in China.As a non-profit organization, SinoCare has extensive knowledge and knowhow of running nursing home in the US. We have

31、a team of experts made up of geriatric doctors, nurses, dieticians, physical therapist, and social workers; we master efficient western system management and operation control; we own resources and manpower relating to hospital and nursing homes especially in CA bay area. What distinguishes us from

32、others is our inborn understanding of Chinese market. We do not just simply introduce the western management of nursing home care; more importantly, we know how tobridge the gap so that a new integrated nursing home care model, a crystal of western advance management and Chinese characteristic infra

33、structure, will be established in China. This is our mission and our destiny.About the courseNursing Home Administration is a specialized area of medical and health services management. Nursing Home Administrators work to supervise clinical and administrative affairs of nursing homes and related fac

34、ilities. Typical duties of Nursing Home Administrators include overseeing staff and personnel, financial matters, medical care, medical supplies, facilities and other duties as specific positions demand.Nursing Home Administrators work at the cross-section of the health care and business fields. To

35、be successful, it requires skills and knowledge from both. Being able to absorb and interpret large amounts of possibly conflicting information, being a decisive leader and possessing good communication skills will help you to be effective as a Nursing Home Administrator.This course will provide all

36、 requirements necessary to sit for those who are seeking positions in nursing home administration. This course would also benefit administrators seeking a refresher course or any individuals wanting to learn more about the nursing home administration profession. The course consists of 6 classes; eac

37、h accompanied by corresponding outlines, assignments and related reading materials. Upon successful competition of all classes, qualified students will receive a certificate of completion from the SinoCare Foundation.Course Aims and ContentThe course was aimed at aiding administrators to operate the

38、ir homes more efficiently and in the manner most satisfactory to themselves, their employees, and the patients. It was designed to acquaint them with current philosophies of care and rehabilitation of the aged and chronically ill. The course sought to make the staffs aware that patients have many of

39、 the desires, motivations, needs, and likes of all people, and that the aged especially treasure an extra bit of special attention. Research shows that staff members who adopted these ideas significantly improve the quality of their services.The content was also arranged to give the nursing home pro

40、viders a refresher course in their everyday tasks, such as housekeeping, bed-care techniques, and keeping records and reports; to assist the employees in using their equipments and facilities to do better, more efficient work; and to help the administrators designate their employees most effectively

41、.Instructors will offer quality materials in a“down to earth ” , easily understoodmanner in the following domains of practice:? DOMAIN 1: Resident Care and Quality of Life? DOMAIN 2: Human Resources? DOMAIN 3: Leadership and Management? DOMAIN 4: Marketing and Quality Control? DOMAIN 5: Hospice Serv

42、ice? DOMAIN 6: Senior residents mental health? DOMAIN 7: Special TopicsCourse arrangement:Class 1: Resident Care and Quahty of LifeCourse introductionReview of course, textbooks and reading assignments.Describe nursing home in west, her past, present and future.Discuss the philosophy of long term ca

43、ring: Resident vs. Patient?General Nursing Management and Resident Care PracticeDiscuss modern nursing philosophy: Art vs. Science?Introduce therapeutic conversation, therapeutic physical environment, etc.Introduce culturally sensitive approach and individual care plan.Introduce primary nursing home

44、 model.Describe adminis trator s roles: the job description of DON (director of nursing), Charge nurse, CNA (certified nurse assistance).Discuss resident care practice including UTIs, problems with sight, hearing, swallowing; mentally challenged: depression; dementia; pressure sores; tube feedings;

45、etc.Case study: Kaiser long-term care nursing model (practice).Medical Social ServicesIntroduce Medical Social services; social workers roles.Discuss cultural changes in long-term care; handling resident and family concerns.Discuss the journey through Alzheimer s disease.Discuss resident rights from

46、 the nursing home facilitys perspective.The Nursing OperationIntroduce resident preadmission screening; age appropriate assessment skills.Introduce comprehensive care planning; clinical records and nursing review.Describe physician services; dental services and therapeutic recreation. Introduce medi

47、cal criteria; common medical terms, abbreviations; prefixes, suffixes.Dining ServicesIntroduce dietary services - regulatory guidelines.Discuss the roles of dietitian and dietary manager.Describe the request of staff hygiene; kitchen sanitation; food and food preparation.Discuss therapeutic diets, e

48、lderly food needs; nutrition; menus and nutritional adequacy; assistive devices.Anc川ary servicesIntroduce interdisciplinary team caring model.Discuss physical therapy in long-term care-roles of physical therapist.Introduce rehab treatment team: roles of speech therapists and occupational therapists.

49、Class 2: Human ResourcesManagement SkillsDiscuss employee communication; recruitment, evaluation, retention and promotion.Describe long term care employee code of conduct, conflict management, and employee discipline process.Discuss employee health and safety.Legal aspects of Human Resources.Introdu

50、ce labor law and employment regulation.Communication Guidelines for Disclosing Adverse Events:Discuss The apology rule and the permission rule.Discuss breaking news to residents, their family members and caregivers;Describe examples of forms of apology; concerns of using“sorry in apology.Discuss use

51、 of language:negligence ” ,“fault ” , and “failing to meet thestandard of care ” .16Class 3: Leadership and ManagementLeadershipDiscuss human relations and organizational communications.Describe what is controlling, governing boards, types of organizations and articles of incorporation.ManagementInt

52、roduce management hierarchy.Discuss management goals.Describe types of managers.Discuss functions of managers; planning, organizing, staffing and directing/leading.Class 4: Marketing of Nursing home, Quality Control and ComplianceMarketingIntroduce what is marketing ethics and resources.Introduce me

53、dia and spokesperson training program.Discuss handling news media.Discuss how to face the media interview during a health emergency.Introduce “The Turn to Marketing ” : marketing of Health Care.Discuss how to develop a Marketing Strategy.Discuss Long Term Care in the health care continuum.Quality co

54、ntrolDiscusses Nursing Home Quality InitiativeDescribe some requirements for effective control of quality and evolution of the organization.Introduce quality measures.PolicyDiscuss internal policy and procedures to keep nursing home facility stay compliant with current regulatory rules and laws.Disc

55、uss resident rights reports.Class 5: HospiceDiscuss the history of Hospice and its recent development.Describe aspects of death in the American culture.Describe the Hospice concept of care.Investigate personal values and emotions concerning death and dying.Discuss the legal considerations and financ

56、ial impact of terminal illness and death on families.Explore the implications for the family when funeral planning occurs.List steps to be taken when death occurs at home.Compare acute and chronic types of pain.List the principles of pain control in the terminally ill patient.Describe physical sympt

57、oms and symptom management in the dying patient.Discuss the components of the Hospice Program.Describe the function of the Hospice Program at home, in a nursing home, or in the hospital.Explore the interdisciplinary team concept.Gain confidence and skill, through practice, in giving understanding to

58、 persons who are upset, hurting, needy, or sharing a problem.Describe the role of the Hospice volunteer.Identify infection control issues in the care of the Hospice patient.Explore spiritual care needs at the end of life.Class 6: Senior residents mental healthCaring of senior adults mental healthDis

59、cuss how aging process affects the seniors mental health.Describe the senior s psychological and mental status.Discuss how to help the senior live a positive and meaningful life.Involve family members in caring of the senior: what essential psychology knowledge family members should understand in or

60、der to provide best possible care.Psychological care of the senior with terminal illnessIntroduce typical mental/psychological activities in people s dying process.Investigate personal values, beliefs and emotions concerning death and dying.Describe common psychological issues during the dying proce