Nursing homes that adopt a model of culture changein which residents enjoy more privacy and have greater control over their livessee greater benefits in terms of staff retention, higher occupancy rates, better competitive position and improved operational costs, according to a new study from the Commonwealth Fund.
Using a representative sample of 1,435 nursing homes between February and June 2007, the Commonwealth Fund administered a questionnaire to directors of nursing about three areas of culture change: resident care, staff culture and working environment, and physical environment. Specifically, the survey examines whether nursing homes have adopted practices that make care more resident-directed, that engender a work environment that fosters staff autonomy and decentralized decisionmaking, and that alter the physical environment to make their facilities look and function like a home, rather than a hospital, the study said.
Based on the self-reported data, the survey showed that about 31% of the nursing homes were culture-change adopters, 25% were culture-change strivers, and the remaining 43% were traditional nursing homes. (Numbers do not add to 100 because of rounding, the study said). Of the culture-change adopters, 58% of the homes allowed residents to determine their own schedules, compared with just 22% of traditional nursing homes. Also, 59% of homes that adopted culture change included direct-care workers and residents on the senior management team, compared with 24% of traditional nursing homes.
With regard to the marketplace, 78% of homes that have implemented seven or more culture-change initiatives reported that the changes have improved their competitive advantage in their market, compared with 54% of nursing homes that have implemented three or fewer initiatives.
Representatives from the Commonwealth Fund and the Pioneer Network, a Rochester, N.Y.-based group devoted to the culture-change model, will host an online meeting based on the surveys findings on May 19. -- by Jessica Zigmond
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