|
Sign In to gain access to subscriptions and/or personal tools.
|
Western Journal of Nursing Research, Vol. 28, No. 8,
935-954 (2006)
DOI: 10.1177/0193945906287053
© 2006 SAGE Publications
An Exploration of Nursing Home Organizational Processes
Sarah Forbes-Thompson
Byron Gajewski
University of Kansas School of Nursing, Kansas City
Jill Scott-Cawiezell
University of Missouri Sinclair School of Nursing, Columbia
Nancy Dunton
University of Kansas School of Nursing, Kansas City
The purpose of this study is to explore the relationship between nursing home staffs' perceptions of organizational processes (communication, teamwork, and leadership) with characteristics (turnover, tenure, and educational preparation) of the nursing home administrator (NHA) and director of nursing (DON). NHAs and DONs rate communication, teamwork, and leadership significantly higher than direct care staff do (registered nurses, licensed practical nurses, certified nurse aides [CNAs]). CNAs have the lowest ratings of communication and teamwork. Turnover of the NHA and DON is significantly and negatively associated with communication and teamwork. Two thirds of DONs surveyed hold less than a baccalaureate degree; this does not influence staffs' ratings of communication, teamwork, and leadership. Findings from this study highlight the need to explore differences in perceptions between administrative and direct care staff and how these may or may not influence staff development and quality improvement activities in nursing homes.
Key Words: nursing homes leadership communication teamwork turnover
References
- Anderson, R. A., Corazzini, K. N., & McDaniel, R. R., Jr. (2004). Complexity science and the dynamics of climate and communication: Reducing nursing home turnover. The Gerontologist, 44, 378-388.[Abstract/Free Full Text]
- Anderson, R. A., Issel, L. M., & McDaniel, R. R., Jr. (2003). Nursing homes as complex adaptive systems: Relationship between management practice and resident outcomes. Nursing Research, 52, 12-21.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Angelelli, J., Gifford, D., Shah, A., & Mor, V. (2001). External threats and nursing home administrator turnover. Health Care Management Review, 26(3), 52-62.[ISI][Medline]
[Order article via Infotrieve]
- Bernabei, R., Gambassi, G., Lapane, K., Landi, F., Gatsonis, C., Dunlop, R., et al. (1998). Management of pain in elderly patients with cancer. Sage study group. Systematic assessment of geriatric drug use via epidemiology. Journal of the American Medical Association, 279, 1877-1882.[Abstract/Free Full Text]
- Bolman, G. E., & Deal, T. E. (1997). Reframing organizations (2nd ed.). San Francisco, CA: Jossey-Bass.
- Bond, G. E., & Fiedler, F. E. (1999). A comparison of leadership vs. renovation in changing staff values. Nursing Economics, 17(1), 37-43.[ISI][Medline]
[Order article via Infotrieve]
- Bowers, B. J., Esmond, S., & Jacobson, N. (2003). Turnover reinterpreted: CNAs talk about why they leave. Journal of Gerontological Nursing, 29(3), 36-43.[Medline]
[Order article via Infotrieve]
- Cameron, K. S., & Quinn, R. E. (1999). Diagnosing and changing organizational culture. Reading, MA: Addison-Wesley.
- Castle, N. G. (2001). Administrator turnover and quality of care in nursing homes. The Gerontologist, 41, 757-767.[Abstract/Free Full Text]
- Castle, N. G., & Banaszak Holl, J. (1997). Top management team characteristics and innovation in nursing homes. The Gerontologist, 37, 572-580.[Abstract]
- Cohen-Mansfield, J. (1997). Turnover among nursing home staff. A review. Nursing Management, 28(5), 59-62, 64 64.[Medline]
[Order article via Infotrieve]
- Donabedian, A. (1966). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 44(3), 166-206.
- Donabedian, A. (1992). Quality assurance. Structure, process and outcome. Nursing Standard, 7(11 Suppl. QA), 4-5.
- Eaton, S. C. (2000). Beyond unloving care: Linking human resource management and patient care quality in nursing homes. International Journal of Human Resource Management, 11, 591-616.[CrossRef]
- Forbes, S. (2001). This is heaven's waiting room: End of life in one nursing home. Journal of Gerontological Nursing, 27(11), 37-45.[Medline]
[Order article via Infotrieve]
- Forbes-Thompson, S., Dunton, N., Gajewski, B., & Lee, R. (2005). Kansas nursing facility project: Year 2. Kansas City: University of Kansas School of Nursing.
- Forbes-Thompson, S., & Gessert, C. E. (2005). End of life in nursing homes: Links between structure, process, and outcomes. Journal of Palliative Medicine, 8, 545-555.[CrossRef][Medline]
[Order article via Infotrieve]
- Gajewski, B. J., Thompson, S., Dunton, N., Becker, A., & Wrona, M. (2006). Inter-rater reliability of nursing home surveys: A Bayesian latent class approach. Statistics in Medicine, 25, 325-344.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Hocking, R. R. (1996). Methods and applications of linear models. New York: John Wiley.
- Pennington, K., Scott, J., & Magilvy, K. (2003). The role of certified nursing assistants in nursing homes. Journal of Nursing Administration, 33, 578-584.[ISI][Medline]
[Order article via Infotrieve]
- Reinhard, S., & Stone, R. (2001). Promoting quality in nursing homes: The wellspring model. New York: The Commonwealth Fund.
- Schein, E. H. (1992). Organizational culture and leadership (2nd ed.). San Francisco: Jossey-Bass.
- Scott, J., Vojir, C., Jones, K. R., & Moore, L. (2005). Assessing nursing home's capacity to create and sustain improvement. Journal of Nursing Care Quality, 20, 36-42.[ISI][Medline]
[Order article via Infotrieve]
- Scott-Cawiezell, J., Schenkman, M., Moore, L., Vojir, C., Connoly, R. P., Pratt, M., et al. (2004). Exploring nursing home staff's perceptions of communication and leadership to facilitate quality improvement. Journal of Nursing Care Quality, 19, 242-252.[ISI][Medline]
[Order article via Infotrieve]
- Sheridan, J. E., White, J., & Fairchild, T. J. (1992). Ineffective staff, ineffective supervision, or ineffective administration? Why some nursing homes fail to provide adequate care. The Gerontologist, 32, 334-341.[Abstract]
- Shortell, S. M., Rousseau, D. M., Gillies, R. R., Devers, K. J., & Simons, T. L. (1991). Organizational assessment in intensive care units (ICUs): Construct development, reliability, and validity of the ICU nurse-physician questionnaire. Medical Care, 29, 709-726.[ISI][Medline]
[Order article via Infotrieve]
- Shortell, S. M., Zimmerman, J. E., Rousseau, D. M., Gillies, R. R., Wagner, D. P., Draper, E. A., et al. (1994). The performance of intensive care units: Does good management make a difference? Medical Care, 32, 508-525.[ISI][Medline]
[Order article via Infotrieve]
- Singh, D. A., & Schwab, R. C. (2000). Predicting turnover and retention in nursing home administrators: Management and policy implications. The Gerontologist, 40, 310-319.[Abstract/Free Full Text]
- Teno, J. M., Kabumoto, G., Wetle, T., Roy, J., & Mor, V. (2004). Daily pain that was excruciating at some time in the previous week: Prevalence, characteristics, and outcomes in nursing home residents. Journal of the American Geriatrics Society, 52, 762-767.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Unruh, L., & Wan, T. T. (2004). A systems framework for evaluating nursing care quality in nursing homes. Journal of Medical Systems, 28, 197-214.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Wunderlich, G. S., Kohler, P. O., & Gooloo, S. (2001). Improving the quality of long term care. Washington, DC: National Academy Press.

CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this?
|