Complexity science and the dynamics of climate and communication: Reducing nursing home turnover
Complexity science and the dynamics of climate and communication: Reducing nursing home turnover
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DOI：
10.1093/geront/44.3.378
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发表时间：
2004-06-01
期刊：
影响因子：
5.7
通讯作者：
McDaniel, RR
中科院分区：
文献类型：
--
作者：
Anderson, RA;Corazzini, KN;McDaniel, RR
目的：养老院人员流动是影响护理质量的一个普遍问题。利用复杂性理论，我们测试了行政气候、沟通模式以及两者之间的相互作用对人员流动率的影响，并控制了设施背景。设计与方法：从164个随机抽样的养老院的3,449名员工中收集了对行政氛围和沟通的看法，并将其与设施特征、资源分配和营业额的二手数据联系起来。我们使用层次回归来检验假设。结果：气候和交通都影响流动率，但流动率的降低依赖于气候和交通的相互作用。在有奖励管理氛围的养老院，相对于有模糊氛围的养老院，更高水平的沟通开放性和准确性解释了持牌职业护士和持证护士助理的低流动率。充足的人员配备和较长的任期护理主任也是重要的预测人员流动。启示：虽然环境很重要，但管理者也可以通过解决气候和沟通模式以及鼓励稳定的护理领导来影响人员流动。
Purpose: Turnover in nursing homes is a widespread problem adversely affecting care quality. Using complexity theory, we tested the effect of administrative climate, communication patterns, and the interaction between the two on turnover, controlling for facility context.Design and Methods: 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. We used hierarchical regression to test the hypotheses.Results: 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.Implications: Although context is important, managers can also influence turnover by addressing climate and communication patterns and by encouraging stable nursing leadership.