Nursing home environment and organizational performance: association with deficiency citations.
Nursing home environment and organizational performance: association with deficiency citations.
复制标题
疗养院环境和组织绩效：与缺陷引用的关联。
DOI：
10.1097/mlr.0b013e3181ca3d70
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发表时间：
2010
期刊：
影响因子：
3
通讯作者：
Mukamel,DanaB
中科院分区：
文献类型：
--
作者：
Temkin-Greener,Helena;Zheng,NanTracy;Cai,Shubing;Zhao,Hongwei;Mukamel,DanaB
背景：工作环境的属性，工作设计，团队合作和工作效率，被认为是影响护理之家（NH）的护理质量。然而，很少有研究测试这些relationships empirically. Objective：我们调查了这些工作环境的属性和质量之间的关系的护理设施水平的监管deficiency.Methods：工作环境的数据来自调查问卷（在2006 - 2007年）从7418直接护理工作者在162 NHs在纽约州。关于设施缺陷和特点的数据来自在线调查、认证和报告数据库。我们将具有随机效应和概率权重的多变量线性回归和逻辑回归拟合到具有以下因变量的模型：存在/不存在生活质量缺陷、护理质量（QC）缺陷的数量以及存在/不存在高严重度GL缺陷（造成实际伤害/立即危险）。关键的独立变量包括工作效率（5分李克特量表得分）;日常护理团队和主要任务的工作人员百分比。工作效率测量已被证明是心理测量的可靠性和有效性。其他变量包括人员配备，规模，设施的情况下，组合，和ownership.Results：在支持提出的假设，我们发现工作效率是一个统计上显着的预测所有3个措施的缺陷。工作人员的主要分配居民与较少的QC和高严重性缺陷显着相关。自我管理团队的更大渗透率与较少的QC deficiency.Discussion：工作环境属性影响护理质量在NHs。这些发现为NH管理人员和监管机构努力提高居民护理质量提供了重要见解。
Background:Work environment attributes—job design, teamwork, and work effectiveness—are thought to influence nursing home (NH) quality of care. However, few studies tested these relationships empirically.Objective:We investigated the relationship between these work environment attributes and quality of care measured by facility-level regulatory deficiencies.Methods:Data on work environment were derived from survey responses obtained (in 2006–2007) from 7418 direct care workers in 162 NHs in New York State. Data on facility deficiencies and characteristics came from the Online Survey, Certification and Reporting database. We fit multivariate linear and logistic regressions, with random effects and probability weights, to models with the following dependent variables: presence/absence of quality of life deficiencies, number of quality of care (QC) deficiencies, and presence/absence of high severity GL deficiencies (causing actual harm/immediate jeopardy). Key independent variables included work effectiveness (a 5-point Likert scale score); percent staff in daily care teams and primary assignment. The work effectiveness measure has been demonstrated to be psychometrically reliable and valid. Other variables included staffing, size, facility case-mix, and ownership.Results:In support of the proposed hypotheses, we found work effectiveness to be a statistically significant predictor of all 3 measures of deficiencies. Primary assignment of staff to residents was significantly associated with fewer QC and high severity deficiencies. Greater penetration of self-managed teams was associated with fewer QC deficiencies.Discussion:Work environment attributes impact quality of care in NHs. These findings provide important insights for NH administrators and regulators in their efforts to improve quality of care for residents.