Local interaction strategies and capacity for better care in nursing homes: a multiple case study

Public Deposited
Analytics

Downloadable Content

Download PDF
Request Version for Screen Reader
Creator
  • Anderson, Ruth A
    • Other Affiliation: Duke University School of Nursing
  • Toles, Mark
    • Affiliation: School of Nursing
  • Corazzini, Kirsten
    • Other Affiliation: Duke University School of Nursing
  • McDaniel, Reuben R
    • Other Affiliation: The University of Texas at Austin
  • Colón-Emeric, Cathleen
    • Other Affiliation: Veterans Administration Medical Center
Abstract
  • Background To describe relationship patterns and management practices in nursing homes (NHs) that facilitate or pose barriers to better outcomes for residents and staff. Methods We conducted comparative, multiple-case studies in selected NHs (N = 4). Data were collected over six months from managers and staff (N = 406), using direct observations, interviews, and document reviews. Manifest content analysis was used to identify and explore patterns within and between cases. Results Participants described interaction strategies that they explained could either degrade or enhance their capacity to achieve better outcomes for residents; people in all job categories used these ‘local interaction strategies’. We categorized these two sets of local interaction strategies as the ‘common pattern’ and the ‘positive pattern’ and summarize the results in two models of local interaction. Conclusions The findings suggest the hypothesis that when staff members in NHs use the set of positive local interaction strategies, they promote inter-connections, information exchange, and diversity of cognitive schema in problem solving that, in turn, create the capacity for delivering better resident care. We propose that these positive local interaction strategies are a critical driver of care quality in NHs. Our hypothesis implies that, while staffing levels and skill mix are important factors for care quality, improvement would be difficult to achieve if staff members are not engaged with each other in these ways.
Date of publication
DOI
Identifier
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Ruth A Anderson et al.; licensee BioMed Central Ltd.
License
Journal title
  • BMC Health Services Research
Journal volume
  • 14
Journal issue
  • 1
Page start
  • 244
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1472-6963
Bibliographic citation
  • BMC Health Services Research. 2014 Jun 05;14(1):244
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • August 26, 2015

Relations

Parents:

This work has no parents.

Items

Thumbnail Title Date Uploaded Visibility Actions
file details 1472-6963-14-244.pdf 2019-05-07 Public Download