期刊
HEALTH SERVICES RESEARCH
卷 51, 期 -, 页码 398-417出版社
WILEY
DOI: 10.1111/1475-6773.12428
关键词
Qualitative research; long-term care; nursing home; geriatrics; health workforce; culture change
资金
- Robert Wood Johnson Foundation
- Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS) [UL1TR000427]
ObjectiveTo describe conditions that influence how Green House (GH) organizations are sustaining culture change principles and practices in a sample of GH skilled nursing homes. Data Sources/Study SettingPrimary data were collected at 11 skilled nursing GH organizations from 2012 to 2014. These organizations have adopted the comprehensive and prescriptive GH model of culture change. Study DesignTo develop an understanding of sustainability from the perspective of staff who are immersed in GH daily work, grounded theory qualitative methods were used. Data Collection MethodsData were collected using semi-structured interviews with 166 staff and observation of house meetings and daily operations. Data were analyzed using grounded dimensional analysis. Principal FindingsOrganizations varied in their ability to sustain GH principles and practices. An organization's approach to problem solving was central to sustaining the model. Key conditions influenced reinforcement or erosion of GH principles and practices. ConclusionsReinforcing the GH model requires a highly skilled team of staff with the ability to frequently and collaboratively solve both mundane and complex problems in ways that are consistent with the GH model. This raises questions about the type of human resources practices and policy supports that could assist organizations in sustaining culture change.
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