A Person-Centered Workplace: The Foundation for Person-Centered Caregiving in Long-Term Care
Objective
This study seeks to understand what role managers and the work setting they create play in a nursing facility that seeks to make a transition to person-centered care.
Design
The study uses a human-relations framework to test 3 propositions: Managers play a critical role in the satisfaction, loyalty and commitment (ie, the engagement) of their staff; managers construct a person-centered workplace that deepens staff engagement; and engaged staff promote the well-being of the residents.
Setting and participants
The study draws on responses of Certified Nurse Assistants (CNAs) and families of residents collected in 2 satisfaction surveys conducted in 156 nursing facilities. It also uses state inspection survey data from the same facilities.
Measurements
The analysis uses measures of satisfaction, loyalty, and commitment as well as 6 scales of quality; 3 as they pertain to staff and 3 as they pertain to families. Data reduction, correlational, and risk analyses assess how managers and the work environment affect CNA engagement and the quality of caregiving.
Results
Management approach and the work environment are powerful predictors of CNA satisfaction, loyalty, and commitment. The work environment also correlates with how families and state surveyors evaluate quality in a nursing facility.
Conclusion
The managers and the work setting they create hold primacy in the work life of the CNAs. Caring managers fashion a person-centered workplace conducive to turn workers into devoted caregivers. When the workplace adds quality to the life of caregivers, the caregivers add quality to the life of the resident.
Keywords: Culture change, work environment, management, person-centered care, satisfaction surveys
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This research was funded by My InnerView, Inc, which is a Wisconsin-based company that promotes an evidence-based approach to quality in long-term care. Most of the data for this study were drawn from the archives of My InnerView, Inc, 2620 Stewart Avenue, Suite 16, Wausau, WI 54401. E-mail: info@myinnerview.com.
PII: S1525-8610(06)00484-1
doi:10.1016/j.jamda.2006.09.009
© 2007 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
