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The relationship between organizational factors and resident satisfaction with nursing home care and life
- Authors:
- LUCAS Judith A., et al
- Journal article citation:
- Journal of Aging and Social Policy, 19(2), 2007, pp.125-151.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
In this study the authors examined the relationships between nursing home (NH) resident satisfaction and NH organizational characteristics, while controlling for the effect of resident characteristics within facilities. The study used a stratified, random sample of NHs (N = 72) from two American states and a pre-screened and randomized sample of 1496 residents. Data sources included resident interviews, an administrator survey, the Minimum Data Set (MDS), and the Online Survey, Certification and Reporting System (OSCAR). Using Hierarchical Linear Modeling (HLM) techniques, results found that non-chain affiliation, certified nursing assistant staffing, and provision of a family council had significant positive effects on total resident satisfaction. The presence of a special care unit was associated with lower levels of satisfaction. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Changing institutional culture: can we re-value the nursing home?
- Author:
- RONCH Judah L.
- Journal article citation:
- Journal of Gerontological Social Work, 43(1), 2004, pp.61-83.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The struggle to improve the quality of life for older people in nursing homes has a long history, and yet little has been achieved. Humanization of nursing homes and changing the culture of care remain elusive goals in many, if not most, homes. A re-valued culture is proposed, and steps necessary to the process are delineated. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
HRM effectiveness in older people's and nursing homes: the search for best (quality) practices
- Authors:
- DE PRINS Peggy, HENDERICKX Erik
- Journal article citation:
- Nonprofit and Voluntary Sector Quarterly, 36(4), December 2007, pp.549-571.
- Publisher:
- Sage
This article presents an empirical evaluation of the human resources management (HRM) effectiveness in relation to quality of labour and quality of care in older people's and nursing homes. The authors suggest that innovative policies, in terms of HRM and work design, increase the likelihood of lower stress rates and higher scores on quality of care. The data supply little empirical evidence for this hypothesis, which means that innovative policy practices have very little effect on the realities of stress, burnout, and individually tailored care. A question that arises from this is whether the search for best practices is then equal to a measure for nothing. This is not the authors' opinion. The reference framework for research must be turned round. This can be achieved by no longer starting from the normative (practice) theory but starting instead with excellent practice, which can teach researchers important content and policy lessons.
Continuous quality improvement as an innovation: which nursing facilities adopt it?
- Authors:
- LUCAS Judith A., et al
- Journal article citation:
- Gerontologist, 45(1), February 2005, pp.68-77.
- Publisher:
- Oxford University Press
The authors identify environmental and organizational predictors that best discriminate between formal continuous quality improvement (CQI) adopters and nonadopters in nursing homes (NHs) and create a diagnostic profile for facility administrators and policy makers to promote CQI. The authors performed a cross-sectional survey of licensed NH administrators in New Jersey in 1999, using The Nursing Care Quality Improvement Survey and The New Jersey NH Profiles Chart. Of 350 NHs, 46% returned completed questionnaires. Using variance innovation, resource dependence, and institutional perspectives, the authors found that new requirements, environmental competition, organizational time and structural facilitators, and manager training made statistically significant contributions to discriminating between formal CQI adopters and nonadopters. Regardless of size, NHs adopt formal CQI to meet external expectations of new regulations and accreditation criteria. CQI adoption is facilitated by information systems, flexible use of personnel, and team supports, as well as CQI training for managers. This profile of adopters can guide administrators and policy makers in promoting CQI for NHs, and it can help NHs already interested in CQI focus internal resources on key facilitators.
Complexity science and the dynamics of climate and communication: reducing nursing home turnover
- Authors:
- ANDERSON Ruth A., et al
- Journal article citation:
- Gerontologist, 44(3), June 2004, pp.378-388.
- Publisher:
- Oxford University Press
Turnover in nursing homes is a widespread problem adversely affecting care quality. Using complexity theory, the authors tested the effect of administrative climate, communication patterns, and the interaction between the two on turnover, controlling for facility context. Perceptions of administrative climate and communication were collected from 3,449 employees in 164 randomly sampled nursing homes, and they were linked to secondary data on facility characteristics, resource allocation, and turnover. Climate and communication both affected turnover, but lower turnover was dependent on the interaction between climate and communication. In nursing homes with reward-based administrative climates, higher levels of communication openness and accuracy explained lower turnover of licensed vocational nurses and certified nurse assistants, relative to nursing homes with an ambiguous climate. Adequate staffing and longer tenure of the nursing director were also important predictors of turnover. Although context is important, managers can also influence turnover by addressing climate and communication patterns and by encouraging stable nursing leadership.
Models for individuals with Alzheimer disease: beyond the special care framework
- Authors:
- HOLMES Douglas, RAMIREZ Mildred
- Journal article citation:
- Journal of Social Work in Long-Term Care, 2(1/2), 2003, pp.175-181.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
For the past two decades much attention has been given to the definition and evaluation of special care units for nursing home residents with dementia. Beyond their potential as a marketing device, the controversy rages regarding the qualities, qualifications and benefits of special care. Inasmuch as 80-90% of nursing home residents suffer from some form of cognitive impairment, the debate would be better focussed on the quality of care and living for all residents. In that regard a fundamental restructuring of all nursing home care and life is a more appropriate direction than the continued debate on this more narrow theme.
The impact of organisational qualities of old age homes in Israel on the subjective well-being of female residents
- Author:
- IOECOVICH Esther
- Journal article citation:
- Journal of Social Work in Long-Term Care, 1(3), 2002, pp.37-53.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Previous studies, especially those conducted during the 1960s, have maintained that institutions have a negative impact on the quality of life and well-being of their elderly residents. Various studies have focused on organisationaltraits, such as size and type of ownership, as being explanatory variables affecting SWB (subjective well-being). The present study investigated: theSWB levels among functionally independent female residents of old age homes in Israel; whether old age homes differ in terms of SWB levels; and, theimpact of organisation characteristics, such as levels of centralisation and formalisation, on residents' SWB. The sample included 464 residents and 164 staff members in 48 old age homes. The findings show that the majority of theresidents expressed moderate to high levels of SWB and that the facilities differed significantly in terms of the level of SWB reported by their residents. The facilities were homogeneous in terms of formalisation, but differed significantly in terms of centralization and in their organisational structure.No correlation was found, however, linking the organizational qualities to theSWB reported by the elderly residents. The implications of the study results arediscussed for policy and program development purposes.
Empowering organizational contexts: patterns and predictors of perceived decision-making influence among staff in nursing homes
- Author:
- KRUZICH Jean M.
- Journal article citation:
- Gerontologist, 35(2), April 1995, pp.207-216.
- Publisher:
- Oxford University Press
Examines staff members' self-perceived influence on decision making in nursing homes. Distinct patterns of perceived staff influence emerged for decisions related to direct resident care and those involving the personnel providing the care. Structural characteristics, including ownership type, number of beds in the facility, and number of facilities owned by the parent corporation were also related to staff's assessment of their decision-making influence.
Apple Health Care: culture change in a privately owned nursing home chain
- Author:
- HAGY Allison
- Journal article citation:
- Journal of Social Work in Long-Term Care, 2(3/4), 2003, pp.295-299.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The future of long-term care in America is uncertain. As the population ages, it is becoming more apparent that needs and desires of our elders are changing. Culture Change is an initiative that will provide the individualized care and meaningful interactions that residents, families, and staff desire. Apple Health Care, a for-profit provider of skilled nursing services based in Avon, Connecticut, embraced culture change in 1997 and has felt the positive impact of the gradual transition from a medical to a more social model of care in each of its 21 homes. This brief provides a perspective of how to begin the journey from the vantage points of service, care, quality, and the for-profit sector. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
The historical context of “humanistic” culture change in long-term care
- Author:
- TOBIN Sheldon S.
- Journal article citation:
- Journal of Social Work in Long-Term Care, 2(1/2), 2003, pp.53-61.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
In the 1700s, there were public poor houses; in the later 1800s, more humanistic not-for-profit homes for the aged; and by the mid-1900s, less humanistic, particularly proprietary, nursing homes. The 1970s witnessed the beginning of a burgeoning literature on piecemeal programmes. which are beneficial for residents but often have neither produced humanistic culture change nor have persisted. Also, these cultures did not emerge from even ambitious legislated reforms. Yet, the ingredients for humanistic cultures have appeared in many publications even though they have not been incorporated into practice. This article traces the history of humanistic approaches to care and the role of government in catalyzing change.