Strategies

Delay school start times for middle and high schools to better align with adolescent sleep-wake cycles; often until 8:30 a.m. or later

Increase wages and benefits for personal or home care workers, nurse aides, and others who provide direct care to patients in long-term care (LTC) settings

Pair new nurses with more experienced nurses who act as a resource and provide support as the new nurse establishes her or himself professionally

Focus heavily on reading and math achievement, enforce high behavioral expectations through a formal discipline system, lengthen instructional time, and increase feedback on teacher performance

Improve work environments for nurses via establishment of strong nursing leadership, organizational support, etc.

Teach positively stated behavior expectations to all students, often reinforced with prizes or privileges and supported with coaching and data

Support quality improvement efforts in early child care and preschool via financial incentives, standards, processes to monitor standards and ensure compliance, etc.

Provide center-based programs that support cognitive and social-emotional growth among children who are not old enough to enter formal schooling

Provide center-based programs that support cognitive and social development among young children from families with low incomes, with supports such as home visiting or parental education

Create a school culture of high behavioral and academic expectations, with intense tutoring, increased teacher performance feedback, lengthened instruction time, and health care services