Exploring Nursing Home Staffʼs Perceptions of Communication and Leadership to Facilitate Quality Improvement

Abstract

Leadership and clinical staff were surveyed to explore communication and leadership in nursing homes. Registered nurses and other professionals perceived communication as better than their nursing colleagues did. Overall, results suggest all factors of communication could improve. In terms of leadership, licensed practical nurses perceived less clarity of expectations, encouragement of initiative, and support than other groups. The study provides insight into what is organizationally necessary to improve quality of care in nursing homes.

Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study

“…This is consistent with US nursing home care workers where teamwork was the most influential factor in the ability to provide good care, followed by good communication and working with experienced and dedicated colleagues. 51 Good teamwork in health care teams is reached through interdependent collaboration, open communication, and shared decision-making. 52 Care workers themselves identify local interaction patterns, such as being approachable, pitching-in, seeking assistance, and giving praise or respect, as fundamental activities that improve teamwork and quality of care.…”

“…56 Other studies confirm this link between the lack of adequate time and perceived staffing and the ability to form meaningful relationship with residents 57 and to provide individualized care. 51,58 Based on interviews in hospitals, nurses included in their rating of staffing adequacy the personnel mix, the cohesiveness of the staff, the care delivery systems, and how well nurses knew the patients, 59 which covers more than just actual staffing numbers. The lack of a relationship between staffing levels and quality of care in this study might point to the importance of not only the numbers of care workers but the quality of the team: Care workers who are able to collaborate as a team, have a shared concept about care, a clear task distribution, and an open communication, might better handle a higher workload than a team that is less well functioning.…”

An Exploration of Nursing Home Organizational Processes

“…Staff members are well aware that communication is essential. In two separate studies, staff noted communication to be essential to quality resident care and communication to be the primary weakness in their facility (Forbes, 2001;Scott-Cawiezell et al, 2004). Communication, teamwork, and leadership have also been shown to affect end-of-life care.…”

“…Understanding involves the extent to which the staff believes communication in the nursing home is comprehensive and effective. Nursing homes with more open communication have better resident outcomes in some areas such as mobility; although research has been minimal and the results have been mixed (Anderson, Issel, & McDaniel, 2003;Scott-Cawiezell et al, 2004).…”

Supervisory Support, Job Stress, and Job Satisfaction Among Long-term Care Nursing Staff

“…Many staff members note that lack of strong leadership is a barrier to quality improvement in LTC. 1 Job-related stress is a major problem for NAs working in LTC settings, and this concern is linked to negative job satisfaction outcomes for staff. 2 Research on NAs' job stress has focused on the patient, on the NA, and at the unit level.…”