期刊论文详细信息
BMC Health Services Research
Real teams and their effect on the quality of care in nursing homes
Tor Inge Romøren1  Marijke Veenstra2  Anders Skogstad3  Anders Kvale Havig1 
[1] Centre for Care Research, Gjøvik University College, Gjøvik, Norway;Norwegian Social Research (NOVA), Oslo, Norway;Faculty of Psychology, University of Bergen, Bergen, Norway
关键词: Long-term care;    Quality of care;    Teamwork;    Teams;    Team;    Nursing homes;   
Others  :  1134510
DOI  :  10.1186/1472-6963-13-499
 received in 2013-04-25, accepted in 2013-11-21,  发布年份 2013
PDF
【 摘 要 】

Background

Use of teams has shown to be an important factor for organizational performance. However, research has shown that a team has to meet certain criteria and operate in a certain way to realize the potential benefits of team organizing. There are few studies that have examined how teams operate in the nursing home sector and their effect on quality of care. This study investigates the relationship between teams that meet an academic definition of the team concept and quality of care in nursing homes.

Methods

A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilized to test our research question: (1) self-report questionnaires to 444 employees, (2) interviews with 40 ward managers, (3) self-report questionnaires to 40 ward managers, (4) telephone interviews with 378 relatives, and (5) 900 hours of field observations. Use of teams in nursing home wards was assessed by field observations and by interviews with ward mangers. Quality of care was assessed by data from surveys and interviews with relatives and staff and through field observations. All data were aggregated to the ward level and two-level analyses were used to assess the relationships.

Results

The multi-level analyses showed that teams – as operationalized in the present study – were significantly positively related to two out of the three quality of care indices when controlled for ward size, days of sick leave and care level. One significant interaction effect was found between teams and days of sick leave, implying that the effect of teams decreased with higher numbers of days of sick leave.

Conclusions

The results suggest that teams are related to higher levels of quality of care in nursing homes. However, the study shows that there is a substantial difference between real, functional teams that meet an academic definition of the concept and quasi teams, the latter having a significantly lower effect on quality of care. Hence, nursing home leaders, directors and ward leaders should be aware of the substantial differences betweens dysfunctional – or quasi – teams and real teams, and encourage the development of real functional teams to take advantage of the potential benefits of team organizing.

【 授权许可】

   
2013 Havig et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150306003133280.pdf 422KB PDF download
Figure 1. 112KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Bostick JE, Rantz MJ, Flesner MK, Riggs CJ: Systematic review of studies of staffing and quality in nursing homes. J Am Med Dir Assoc 2006, 7(6):366-376.
  • [2]Castle NG: Nursing home caregiver staffing levels and quality of care. J Appl Gerontol 2008, 27(4):375-405.
  • [3]Spilsbury K, Hewitt C, Stirk L, Bowman C: The relationship between nurse staffing and quality of care in nursing homes: a systematic review. Int J Nurs Stud 2011, 48(6):732-750.
  • [4]Rahman A, Straker JK, Manning L: Staff assignment practices in nursing homes: review of the literature. J Am Med Dir Assoc 2009, 10(1):4-10.
  • [5]Zimmerman S, Cohen LW: Evidence behind the green house and similar models of nursing home care. Aging Health 2010, 6(6):717-737.
  • [6]NOU: Innovasjon i omsorg, Volume 11. Edited by omsorgsdepartementet H-o. Oslo: Oslo; 2011.
  • [7]Temkin-Greener H, Cai S, Katz P, Zhao H, Mukamel DB: Daily practice teams in nursing homes: evidence from New York State. Gerontologist 2009, 49(1):68-80.
  • [8]Yeatts DE, Cready CM, Noelker LS: Empowered work teams in long-term care : strategies for improving outc omes for residents & staff. Baltimore: Health Professions Press; 2008.
  • [9]Buss IC, Halfens RJG, Abu-Saad HH, Kok G: Pressure ulcer prevention in nursing homes: views and beliefs of enrolled nurses and other health care workers. J Clin Nurs 2004, 13(6):668-676.
  • [10]Rantz MJ, Hicks L, Grando V, Petroski GF, Madsen RW, Mehr DR, Conn V, Zwygart-Staffacher M, Scott J, Flesner M, et al.: Nursing home quality, cost, staffing, and staff mix. Gerontologist 2004, 44(1):24-38.
  • [11]Tyler DA, Parker VA: Staff teamwork in long-term care facilities: the influence of management style, training, and feedback. Res Gerontological Nursing 2011, 4(2):135-146.
  • [12]Bass BM, Bass RR: The Bass handbook of leadership: Theory, research, and managerial applications. New York: Free Press; 2008.
  • [13]Kozlowski SWJ, Bell BS: Work groups and teams in organizations. In Handbook of Psychology. 2nd edition. John Wiley & Sons, Inc; 2003.
  • [14]Yukl GA: Leadership in organizations. 7th edition. Upper Saddle River, N.J: Pearson Education; 2010.
  • [15]Kirkman BL, Benson R: Beyond self-management: antecedents and consequences of team empowerment. Acad Manage J 1999, 42(1):58-74.
  • [16]Pierce JL, Kostova T, Dirks KT: Toward a theory of psychological ownership in organizations. Acad Manage J 2001, 26(2):298-310.
  • [17]Avey JB, Avolio BJ, Crossley CD, Luthans F: Psychological ownership: theoretical extensions, measurement and relation to work outcomes. J Organ Behav 2009, 30(2):173-191.
  • [18]Tannenbaum SI, Salas E, Cannon-Bowers JA: Promoting team effectiveness. In Handbook of Work Group Psychology. Edited by West MA. Chichester, England; 1996:503-529.
  • [19]Guzzo RA, Dickson MW: Teams in organizations: recent research on performance and effectiveness. Annu Rev Psychol 1996, 47(1):307-338.
  • [20]Anderson N, West MA: The team climate inventory: development of the TCI and its applications in teambuilding for innovativeness. European J Work Organ Psychol 1996, 5(1):53-66.
  • [21]Katzembach JR, Smith DK: The Wisdom of Teams: Creating the High-Performance Organization. Boston: Harvard Business Press; 1993.
  • [22]Suter E, Arndt J, Arthur N, Parboosingh J, Taylor E, Deutschlander S: Role understanding and effective communication as core competencies for collaborative practice. J Interprof Care 2009, 23(1):41-51.
  • [23]Hackman JR: Leading teams: setting the stage for great performances. Boston, Mass: Harvard Business School Press; 2002.
  • [24]Paulsen B, Harsvik TH, Halvorsen T, Nygård L: Bemanning og tjenestetilbud i sykehjem. SINTEF: Trondheim; 2004.
  • [25]Ouwens M, Hulscher M, Akkermans R, Hermens R, Grol R, Wollersheim H: The team climate inventory: application in hospital teams and methodological considerations. Quality Safety Health Care 2008, 17(4):275-280.
  • [26]Yeatts DE, Cready CM: Consequences of empowered CNA teams in nursing home settings: a longitudinal assessment. Gerontologist 2007, 47(3):323-339.
  • [27]Alderfer CP: Group and intergroup relations. Improving Quality Work Life 1977, 227:296.
  • [28]Hackman JR: The design of work teams. Ariel 1987, 129:32.197.
  • [29]Temkin-Greener H, Zheng NT, Cai S, Zhao H, Mukamel DB: Nursing home environment and organizational performance: association with deficiency citations. Med Care 2010, 48(4):357-364.
  • [30]Goldman BD: Nontraditional staffing models in long-term care. J Gerontol Nurs 1998, 24(9):29-34.
  • [31]Teresi J, Holmes D, Benenson E, Monaco C, Barrett V, Ramirez M, Koren MJ: A primary care nursing model in long-term care facilities: evaluation of impact on affect, behavior, and socialization. Gerontologist 1993, 33(5):667-674.
  • [32]Castle NG: The Influence of consistent assignment on nursing home deficiency citations. Gerontologist 2011, 51(6):750-760.
  • [33]Burgio LD, Fisher SE, Fairchild JK, Scilley K, Hardin JM: Quality of care in the nursing home: effects of staff assignment and work shift. Gerontologist 2004, 44(3):368-377.
  • [34]Cox CL, Kaeser L, Montgomery AC, Marion LH: Quality of life nursing care: an experimental trial in long-term care. J Gerontol Nurs 1991, 17(4):6-11.
  • [35]Patchner MA (Ed): Permanent assignment: A better recipe for the staffing of aides. Phoenix: Oryx Press; 1989.
  • [36]Zimmerman S, Sloane PD, Williams CS, Reed PS, Preisser JS, Eckert JK, Boustani M, Dobbs D: Dementia care and quality of life in assisted living and nursing homes. Gerontologist 2005, 45(suppl 1):133-146.
  • [37]Dellefield M: Best practices in nursing homes: clinical supervision, management, and human resource practices. Res Gerontol Nurs 2008, 1(3):197-207.
  • [38]Castle N, Degenholtz H, Rosen J: Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania. BMC Health Serv Res 2006, 6(1):60. BioMed Central Full Text
  • [39]Parson SK, Simmons WP, Penn K, Furlough M: Determinants of satisfaction and turnover among nursing assistants. The results of a statewide survey. J Gerontol Nurs 2003, 29(3):51-58.
  • [40]Eaton SC: Beyond ‘unloving care’: linking human resource management and patient care quality in nursing homes. Int J Human Resource Manage 2000, 11(3):591-616.
  • [41]Bowers BJ, Esmond S, Jacobson N: The relationship between staffing and quality in long-term care facilities: exploring the views of nurse aides. J Nurs Care Qual 2000, 14(4):55-64.
  • [42]Glouberman S, Mintzberg H: Managing the care of health and the cure of disease-Part I: differentiation. Health Care Manage Rev 2001, 26(1):56-69.
  • [43]Ouwens MM, Marres HA, Hermens RR, Hulscher MM, van den Hoogen FJ, Grol RP, Wollersheim HC: Quality of integrated care for patients with head and neck cancer: development and measurement of clinical indicators. Head & neck 2007, 29(4):378-386.
  • [44]Wagner EH: The role of patient care teams in chronic disease management. BMJ: British Medical Journal 2000, 320(7234):569.
  • [45]Schnelle JF, Ouslander JG, Simmons SF: Direct observations of nursing home care quality: does care change when observed? J Am Med Dir Assoc 2006, 7(9):541-544.
  • [46]HOD: Forskrift om kvalitet i pleie- og omsorgstjenestene for tjenesteyting etter lov av 19. november 1982 nr. 66 om helsetjenesten i kommunene og etter lov av 13. desember 1991 nr. 81 om sosiale tjenester m.v. 2003. Oslo, Norway: Helse- og omsorgsdepartementet; 2003.
  • [47]Kirkevold Ø, Engedal K: The quality of care in Norwegian nursing homes. Scand J Caring Sci 2006, 20(2):177-183.
  • [48]Romøren TI: Kvalitet i sykehjem sett fra tre kanter. Tid skrift for Velferdsforskning 2005, 8(4):226-233.
  • [49]Donabedian A: The definition of quality and approaches to its assessment. Ann Arbor, Mich: Health Administration Press; 1980.
  • [50]Kane RL, Kane RA, Bershadsky B, Degenholtz H, Kling K, Totten A, Jung K: Proxy sources for information on nursing home residents' quality of life. J Gerontol B Psychol Sci Soc Sci 2005, 60(6):S318-S325.
  • [51]Novella JL, Jochum C, Jolly D, Morrone I, Ankri J, Bureau F, Blanchard F: Agreement between patients' and proxies' reports of quality of lifein Alzheimer's disease. Qual Life Res 2001, 10(5):443-452.
  • [52]Anderson RA, Issel LM, McDaniel RR: Nursing homes as complex adaptive systems: relationship between management practice and resident outcomes. Nurs Res 2003, 52(1):12-21.
  • [53]Castle NG, Engberg J: The influence of staffing characteristics on quality of care in nursing homes. Health Serv Res 2007, 42(5):1822-1847.
  • [54]Scott-Cawiezell J, Main DS, Vojir CP, Jones K, Moore L, Nutting PA, Kutner JS, Pennington K: Linking nursing home working conditions to organizational performance. Health Care Manage Rev 2005, 30(4):372-380.
  • [55]Snijders TAB, Bosker RJ: Multilevel analysis: an introduction to basic and advanced multilevel modeling. London: Sage; 1999.
  • [56]Aiken LS, West SG: Multiple regression: Testing and interpreting interactions: Sage Publications. London: Sage; 1991.
  • [57]Edmondson AC: Speaking up in the operating room: how team leaders promote learning in interdisciplinary action teams. J Manage Stud 2003, 40(6):1419-1452.
  • [58]Katz R: The effects of group longevity on project communication and performance. Adm Sci Q 1982, 27(1):81-104.
  • [59]Fried JF, Toppin S, Edmondson AC: Groups and teams. In Health care management. Edited by Shortell SM, Kaluzny AD. NY: Delmar; 2006.
  • [60]Rand G: MD-99 crew pairing test restults. 1998.
  • [61]Lynn GS, Reilly RR, Akgun AE: Knowledge management in new product teams: practices and outcomes. Eng Manage 2000, 47(2):221-231.
  • [62]Alderfer CP (Ed): Group and intergroup relatinos. New York: Wiley; 1980.
  • [63]Northouse PG: Leadership: Theory and practice, 5nd edn. edn. Los Angeles: Sage; 2009.
  • [64]Druskat VU, Pescosolido AT: The content of effective teamwork mental models in self-managing teams: ownership, learning and heedful interrelating. Human Relations 2002, 55(3):283-314.
  • [65]Hofstede G: Culture's consequences: comparing values, behaviors, institutions, and organizations across nations. Thousand Oaks, Calif: Sage; 2001.
  • [66]Schramm Nielsen J, Sivesind KH, Lawrence P: Management in Scandinavia: culture, context and change. Cheltenham: Edward Elgar; 2004.
  • [67]Strand T: Ledelse, organisasjon og kultur. Bergen: Fagbokforl; 2007.
  • [68]Anderson RA, Ammarell N, Bailey D, Colón-Emeric C, Corazzini KN, Lillie M, Piven MLS, Utley-Smith Q, McDaniel RR: Nurse assistant mental models, sensemaking, care actions, and consequences for nursing home residents. Qual Health Res 2005, 15(8):1006-1021.
  • [69]Clarke E: Role conflicts & coping strategies in caregiving: a symbolic interactionist view. J Psychosocial Nursing Mental Health Services 2001, 39(1):28-37.
  • [70]Harsvik TH, Hofseth C, Norvoll R, Hem K-G: Sykepleiere i sykehjem. Oslo: SINTEF; 2002.
  • [71]Lichtenstein R, Alexander JA, Mccarthy JF, Wells R: Status differences in cross-functional teams: effects on individual member participation, job satisfaction, and intent to quit. J Health Soc Behav 2004, 45(3):322-335.
  文献评价指标  
  下载次数:20次 浏览次数:21次