Abstract:Background: Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF) staff and General Practitioners (GPs) relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia ed… Show more
“…We found that teamwork, communication and leadership were consistently recognised as key elements of organisational culture which potentially influence staff and resident outcomes in care facilities [2]. Other empirical evidence supports these findings, showing that management behaviour (such as the extent of open communication patterns and relationship-oriented leadership behaviour) is associated with resident outcomes [6].…”
Section: Introductionsupporting
confidence: 67%
“…Residential care is an important component of service delivery for older people with complex health problems, particularly severe dementia [1]. Costs, staff shortages, staff turnover and communication problems are cited as barriers to sustainable improvements in the care of people living in residential care facilities [2]. Although educational interventions in residential care may be evaluated positively by participants [3], we found evidence that impact on residents may be restricted by limited staff participation [4].…”
BackgroundOrganisational culture is increasingly recognised as important for provision of high-quality long-term care. We undertook this study to measure organisational culture in residential aged care facilities in two Australian states.Methodology/Principal FindingsCross-sectional observational study in 21 residential aged care facilities in Western Australia (n = 14) and Queensland (n = 7), Australia. Staff and next-of-kin of residents participated. Measurement comprised surveys of facility staff and residents' next-of-kin, and structured observation of indicators of care quality. Staff tended to rate organisational culture positively. Some qualitative feedback from staff emphasised negative perceptions of communication, leadership and teamwork. Staffing levels were perceived as a dominant challenge, threatening care quality. Direct observation revealed variability within and between facilities but suggested that most facilities (n = 12) were in the typical range, or were quality facilities (n = 8).ConclusionThere was scope to strengthen organisational culture in participating aged care facilities.
“…We found that teamwork, communication and leadership were consistently recognised as key elements of organisational culture which potentially influence staff and resident outcomes in care facilities [2]. Other empirical evidence supports these findings, showing that management behaviour (such as the extent of open communication patterns and relationship-oriented leadership behaviour) is associated with resident outcomes [6].…”
Section: Introductionsupporting
confidence: 67%
“…Residential care is an important component of service delivery for older people with complex health problems, particularly severe dementia [1]. Costs, staff shortages, staff turnover and communication problems are cited as barriers to sustainable improvements in the care of people living in residential care facilities [2]. Although educational interventions in residential care may be evaluated positively by participants [3], we found evidence that impact on residents may be restricted by limited staff participation [4].…”
BackgroundOrganisational culture is increasingly recognised as important for provision of high-quality long-term care. We undertook this study to measure organisational culture in residential aged care facilities in two Australian states.Methodology/Principal FindingsCross-sectional observational study in 21 residential aged care facilities in Western Australia (n = 14) and Queensland (n = 7), Australia. Staff and next-of-kin of residents participated. Measurement comprised surveys of facility staff and residents' next-of-kin, and structured observation of indicators of care quality. Staff tended to rate organisational culture positively. Some qualitative feedback from staff emphasised negative perceptions of communication, leadership and teamwork. Staffing levels were perceived as a dominant challenge, threatening care quality. Direct observation revealed variability within and between facilities but suggested that most facilities (n = 12) were in the typical range, or were quality facilities (n = 8).ConclusionThere was scope to strengthen organisational culture in participating aged care facilities.
“…However our data confirm that, despite staff and GPs working in residential care frequently participating in education and generally perceiving their knowledge as good, perceived educational needs persist [16]. The most effective way to translate the available evidence to practice is not clear and there is a paucity of prospective data to guide practice.…”
BackgroundThere is scope to improve the quality of life (QOL) of people with dementia living in residential care facilities (RCF). The DIRECT study will determine if delivery of education to General Practitioners (GPs) and care staff improves the quality of life of residential care recipients with cognitive impairment.Methods/DesignA prospective randomised controlled trial conduced in residential aged care facilities in the metropolitan area of Perth, Western Australia. Participants are care facility residents, aged 65 years and older and with mini-mental state examination scores less than 25. GPs and care facility staff have been independently randomised to intervention or control groups. An education programme, designed to meet the perceived needs of learners, will be delivered to GPs and care staff in the intervention groups. The primary outcome of the study will be quality of life of the people with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) and Alzheimer Disease Related QOL Scale (ADRQL), 4 weeks and 6 months after the conclusion of the education intervention.ResultsRecruitment of 351 people with dementia, cared for by staff in 39 residential facilities and 55 GPs, was undertaken between May 2007 and July 2008. Collection of baseline data is complete. Education has been delivered to GPs and Care staff between September 2008 and July 2009. Follow- up data collection is underway.DiscussionThe study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.Trial registrationThese trial methods have been prospectively registered (ACTRN12607000417482).
“…It is also recognised that, although the residential aged care sector is often discussed as a homogeneous entity, there is considerable variability in culture and needs, highlighting the importance of identifying local barriers and solutions in any change project. Our previous work also identified the preferred format for interventions in RACF. Small group approaches which are flexible, practical and case‐based were sought.I think if you do give the people the opportunity to brainstorm solutions for their own problems they're usually very good.…”
Objective
To develop and evaluate an organisational culture change intervention for residential aged care settings.
Methods
This study was undertaken in five residential aged care facilities (RACFs). All staff working within participating RACFs were invited to take part. Participatory action research was used to develop a structured approach, supporting small workgroups of staff in each facility to undertake change cycles, focusing on improved leadership, teamwork and communication. Qualitative data were gathered from reflection and evaluation sessions with facility work team focus groups, interviews with managers and other staff who were not engaged in the work team, field journals and reflective discussion with research team members.
Results
Staff and management both positively evaluated the intervention and process, and there were perceived cultural shifts in communication, teamwork and staff empowerment.
Conclusion
An organisational culture change intervention that engages work teams through brief change cycles appears to be feasible for use in RACF.
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