Local interaction Strategies and Capacity for Better Care in Nursing Homes: A Multiple Case Study

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dc.contributor.utaustinauthorMcDaniel, Reuben R.en_US
dc.creatorAnderson, Ruth A.en_US
dc.creatorToles, Mark P.en_US
dc.creatorCorazzini, Kirstenen_US
dc.creatorMcDaniel, Reuben R.en_US
dc.creatorColon-Emeric, Cathleenen_US
dc.date.accessioned2016-10-28T19:53:47Z
dc.date.available2016-10-28T19:53:47Z
dc.date.issued2014-06en_US
dc.description.abstractTo describe relationship patterns and management practices in nursing homes (NHs) that facilitate or pose barriers to better outcomes for residents and staff. Methods: We conducted comparative, multiple-case studies in selected NHs (N = 4). Data were collected over six months from managers and staff (N = 406), using direct observations, interviews, and document reviews. Manifest content analysis was used to identify and explore patterns within and between cases. Results: Participants described interaction strategies that they explained could either degrade or enhance their capacity to achieve better outcomes for residents; people in all job categories used these 'local interaction strategies'. We categorized these two sets of local interaction strategies as the 'common pattern' and the 'positive pattern' and summarize the results in two models of local interaction. Conclusions: The findings suggest the hypothesis that when staff members in NHs use the set of positive local interaction strategies, they promote inter-connections, information exchange, and diversity of cognitive schema in problem solving that, in turn, create the capacity for delivering better resident care. We propose that these positive local interaction strategies are a critical driver of care quality in NHs. Our hypothesis implies that, while staffing levels and skill mix are important factors for care quality, improvement would be difficult to achieve if staff members are not engaged with each other in these ways.en_US
dc.description.departmentBusiness Administrationen_US
dc.description.sponsorshipNational Institutes of Health 2 R01NR003178-04A2en_US
dc.description.sponsorshipClaude A. Pepper Older American's Independence Center AG-11268en_US
dc.description.sponsorshipPaul A. Beeson Award NIA AG024787en_US
dc.description.sponsorshipVA Health Services Research and Development EDU 08-417en_US
dc.description.sponsorshipJohn A. Hartford Building Academic Geriatric Nursing Claire M. Fagin Fellowshipen_US
dc.identifierdoi:10.15781/T2445HF9Z
dc.identifier.citationAnderson, Ruth A., Mark P. Toles, Kirsten Corazzini, Reuben R. McDaniel, and Cathleen Colón-Emeric. "Local interaction strategies and capacity for better care in nursing homes: a multiple case study." BMC health services research, Vol. 14, No. 1 (Jun., 2014): 1.en_US
dc.identifier.doi10.1186/1472-6963-14-244en_US
dc.identifier.issn1472-6963en_US
dc.identifier.urihttp://hdl.handle.net/2152/43361
dc.language.isoEnglishen_US
dc.relation.ispartofen_US
dc.relation.ispartofserialBMC Health Services Researchen_US
dc.rightsAdministrative deposit of works to Texas ScholarWorks: This works author(s) is or was a University faculty member, student or staff member; this article is already available through open access or the publisher allows a PDF version of the article to be freely posted online. The library makes the deposit as a matter of fair use (for scholarly, educational, and research purposes), and to preserve the work and further secure public access to the works of the University.en_US
dc.rights.restrictionOpenen_US
dc.subjectnursing homesen_US
dc.subjectmanagementen_US
dc.subjectstaff interactionsen_US
dc.subjectcomplexity scienceen_US
dc.subjectcaseen_US
dc.subjectstudyen_US
dc.subjectcomplexity scienceen_US
dc.subjectresident outcomesen_US
dc.subjectmanagementen_US
dc.subjectcommunicationen_US
dc.subjectcapabilitiesen_US
dc.subjectempowermenten_US
dc.subjectsystemsen_US
dc.subjectteamsen_US
dc.subjecthealth care sciences & servicesen_US
dc.titleLocal interaction Strategies and Capacity for Better Care in Nursing Homes: A Multiple Case Studyen_US
dc.typeArticleen_US

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