Citizen Participation and Its Impact on Performance in U.S. Nursing Homes

Abstract

Fundamental to democratic societies, citizen participation is an important tool for promoting active, informed, and empowered citizenry as well as responsive and accountable administration. Past literature on citizen participation has focused on its determinants, forms, and prevalence. This study examines the relationship between a specific form of citizen participation—client participation—and organizational performance. We use hybrid data on U.S. nursing homes that combine a survey of nursing home administrators’ managerial practices with federal performance appraisal data. Our empirical findings suggest that more intense levels of client participation, such as the use of clients’ feedback in decision-making, are positively associated with performance: They increase the overall five-star ratings and lower health deficiencies. In contrast, less intense client participation efforts, such as merely communicating with client/family groups, are not significantly related to performance. This study highlights the role of participation intensity, suggesting that public administrators should not only go beyond informing and listening to their stakeholders, but also take steps to use the obtained feedback in organizational decision-making.

Patiëntbetrokkenheid tijdens crisisbesluitvorming

“…Verschillende belangrijke denkstromen in de zorg, zoals shared decision-making, evidence-based medicine en value-based healthcare benadrukken al jaren het belang van patiëntbetrokkenheid voor de kwaliteit van de besluitvorming en de prestaties van zorgorganisaties [ 2 ]. Ook in de bestuurskunde wordt dit belang onderstreept, bijvoorbeeld voor de legitimiteit van besluitvorming [ 3 – 5 ].…”

“…Het gaat hierbij om een bijdrage die verder gaat dan individuele belangen. Onderzoek onder verzorgingstehuizen in de Verenigde Staten laat zien dat een sterkere betrokkenheid van patiënten bijdraagt aan de prestaties van de organisatie [ 3 ]. Uit ander bestuurskundig onderzoek blijkt dat coproductie niet alleen het gevoel van zeggenschap over de eigen gezondheid bevordert, maar ook het vertrouwen in zorgprofessionals versterkt [ 4 ].…”

Social Equity and Clientele Participation: A Cross-National Study of Immigrant Education

“…The Overall Impact of Participation on Performance Engaging the public in governance can generate various policy benefits including improved service performance (Amirkhanyan et al, 2019). First, public participation allows for incorporating public preferences and expectations into decision making for public services, which can, in turn, promote service quality and accountability (Amirkhanyan & Lambright, 2017;Heikkila & Isett, 2007;Mingus & Zhu, 2018).…”

“…Parent Participation. This study focuses on client participation, considered one of the most prevalent forms of public participation (Amirkhanyan & Lambright, 2017) because service users have greater motivation to participate than the general public and their active participation makes a difference in performance (Amirkhanyan et al, 2019). The measure focuses on direct participation rather than indirect participation, which should be more closely related to service processes and outcomes.…”

The implications of COVID-19 for concepts and practices of citizenship

“…Seventy-one articles were categorised by the year of publication and the type of participation mechanisms based on citizen participation models (Thomas, 2013;Roberts, 2004;Callahan, 2007;Nabatchi et al, 2017). One group of articles (52 articles of 71) deals with 'basic citizen participation mechanisms' involving simple one-or twoway citizen participation methods, such as public meetings, focus groups, simulations and advisory committees (Dudley et al, 2018;Ammons and Madej, 2018;Amirkhanyan et al, 2019;Kroll et al, 2019;van Holm, 2019;Jo, 2021), and political participation, such as mobilisations and protests (Marx and Nguyen, 2018;Schmidthuber et al, 2019;Nesti and Graziano, 2020). Citizens in this category might be considered informed observers or limitedly engaged participants in policymaking processes (Hensengerth and Lu, 2019).…”