Home health aides typically visit patients' homes to assist with activities of daily living, such as bathing, dressing and eating. Many people enrolled in home health care have multiple health challenges, which can result in erratic and sometimes violent behavior. Home health aides also engage in manual labors like lifting patients. These aides are often injured multiple times on the job and these injuries affect more than just the employees. Home-health-care organizations and the long-term-care industry suffer from the effects of these occupational injuries, the researchers report at the 2010 Academy of Management Annual Meeting in Montreal.

"In our research, we saw a cascading effect," said Deirdre McCaughey, assistant professor of health policy and administration. "Employees who had no training or did not believe their training prepared them well had more injuries. Those employees were also much less likely than non-injured employees to recommend their organization as a place at which to work or seek services."

The researchers analyzed data from the nationally representative 2007 National Home Health Aide Survey, which was funded by the U.S. Department of Health and Human Services and conducted by the Centers for Disease Control and Prevention. Findings show a significant drop in injury rates when employees had training. Non-injured employees had much higher job satisfaction rates and lower turnover intentions than injured employees, too.

"Employees who received training have lower injury rates," said McCaughey. "What this suggests is that investing finances into soft resources can have tangible benefits to organizations. Organizations tend to cut back on spending on soft resources, especially during hard economic times, because there is usually no tangible benefit."

Cutting back on home health aides' training increases employees' injury risk and turnover intentions, which will likely incur more costs over the long run.

Another major finding is the link between injuries, training and employee turnover, which has implications on quality of care. Employee training resulted in fewer injuries and decreased turnover rates, so the workforce remained more consistent. McCaughey worked as a physical therapist prior to her research role, and saw the extent to which people depend on a familiar face in health care, especially when a person has poor memory and is confused. New faces every few months only add to the confusion.

The Penn State researchers also found that employee perceptions of their workplace and their training could affect the likelihood of injuries. Employees who felt that their training had not prepared them well were three times more likely to be injured than employees who felt their training prepared them well. Similarly, employees who felt that they had poor supervisor support were at higher risk for injuries -- one and a half times more likely to have one injury and three times more likely to have three injuries, compared to those who felt they had supportive supervisors.

Employees who felt that their training prepared them well for their daily job duties had lower injury rates and were more likely to rate their organization highly, both as a place to work and to seek services from.

"Employee perceptions are crucial; they play a role in motivating employees to work harder or they can drive them to quit," says McCaughey.

McCaughey and her colleagues are expanding their injury research, now looking at nursing aides. Other authors on the paper include Jungyoon Kim, graduate student in health policy and administration; Gwen McGhan, project administrator, School of Nursing; Rita Jablonski, assistant professor of nursing; and Diane Brannon, professor of health policy and administration.

This research will appear as a best paper in the 2010 Academy of Management Annual Meeting Proceedings.

Note: If no author is given, the source is cited instead.

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