Task Design, Motivation and Nursing Home Care Quality

任务设计、动机和疗养院护理质量

• 批准号: 6455842
• 负责人: VICTORIA Anne PARKER
• 金额: $ 29.97万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2003-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6455842
• 关键词: allied health personnel; behavioral /social science research tag; clinical research; health care personnel performance; health care quality; human subject; job satisfaction; motivation; nursing homes

DESCRIPTION (APPLICATION ABSTRACT): Unlike many other domains of health care, the provision of high-quality nursing home care depends on relatively untrained workers executing the same basic tasks each day, without many of the high stakes, unexpected, confusing situations that are often associated with omissions and errors in health care. In nursing home care, quality is compromised when workers as a group consistently neglect elements of good basic care; for example, when failure to regularly reposition immobile residents leads to the development of pressure ulcers. The likelihood of such occurrences is heightened by the problems of worker recruitment and retention in the low-skill, low-paying jobs that are central to the provision of such care. Research across many industries has found that several characteristics of how jobs are designed can be changed in ways that influence work motivation: creating conditions that make jobs more motivating, eliciting improved performance, and reducing turnover. Task design features are important at both the level of individual jobs and at the level of jobs performed by groups or teams. We hypothesize that variation in job design, at both the individual and group levels, is associated with differences in staff satisfaction and with differences in care quality indicators. We will study 25 nursing homes, collecting data from several sources. We will administer the Job Diagnostic Survey to nursing home employees to collect data on the design of individual jobs, and on employee job satisfaction, across multiple job categories, primarily nurse aides and licensed practical nurses. Data about group task design will be collected through structured observation and interviewing of a sample of managers and employees in each nursing home. Commonly accepted quality indicators derived from the Minimum Data Set (MDS) will be used to assess care quality. Analyses will relate job design characteristics to employee job satisfaction and to care quality. This study will provide important information regarding the variation among nursing homes in the task design of nursing care jobs, and about how such variation is related to differences in worker outcomes and differences in care quality indicators. This information will fill an important gap in current knowledge, which has largely focused on higher-level structural variables, such as nursing home size and ownership, or on individual employee variation in adherence to required elements of care. Findings may suggest approaches to task design that are likely to be associated with better worker and quality outcomes. The connections between task design, worker satisfaction, and care quality are of interest in care settings beyond nursing homes, particularly in other settings where care is increasingly provided by health care workers without extensive professional training.

描述（应用摘要）：与医疗保健的许多其他领域不同， 提供高质量的疗养院护理相对依赖于 未经培训的工人每天执行相同的基本任务，没有许多 高风险、意外、令人困惑的情况通常与 医疗保健方面的遗漏和错误。 在疗养院护理中，质量是 当工人作为一个整体始终忽视良好的要素时，就会受到损害 基本护理；例如，当未能定期重新定位不动时 居民导致压疮的发展。 出现这种情况的可能性 工人招聘和保留问题加剧了这种情况的发生 低技能、低收入的工作对于提供此类工作至关重要 关心。 对许多行业的研究发现，有几个特征 工作的设计方式可以通过影响工作的方式改变 动机：创造条件，使工作更具激励性、激发性 提高绩效并减少人员流动。 任务设计特点是 无论是在个人工作层面还是在工作层面都很重要 由小组或团队进行。 我们假设工作设计的变化，在 无论是个人还是团体层面，都与工作人员的差异有关 满意度和护理质量指标的差异。 我们将研究 25 家疗养院，从多个来源收集数据。 我们将 对疗养院员工进行工作诊断调查以收集数据 个人工作的设计以及员工的工作满意度 多种工作类别，主要是护士助理和执业护士。 有关小组任务设计的数据将通过结构化观察收集 并对每个疗养院的管理人员和员工进行抽样采访。 来自最小数据集 (MDS) 的普遍接受的质量指标 将用于评估护理质量。 分析将关联工作设计 员工工作满意度和护理质量的特征。 这项研究将提供有关之间差异的重要信息 疗养院在护理工作任务设计中的作用及其如何实施 差异与工人结果的差异和护理的差异有关 质量指标。 该信息将填补当前的一个重要空白 知识主要集中于更高层次的结构变量， 例如疗养院的规模和所有权，或员工个人的差异 遵守所需的护理要素。 研究结果可能会提出一些方法 可能与更好的工人和质量相关的任务设计 结果。 任务设计、员工满意度和护理之间的联系 疗养院以外的护理环境对质量也很感兴趣，特别是在 其他越来越多地由医护人员提供护理的环境 没有经过广泛的专业培训。