Nursing Homes as Complex Adaptive Systems

Anderson, Ruth A.; Issel, L. Michele; McDaniel, Reuben R.

doi:10.1097/00006199-200301000-00003

Cited by 358 publications

(150 citation statements)

References 34 publications

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“…Additionally, Holden (2005) argued that health care systems should be studied as complex adaptive systems, as this analysis would afford healthcare leaders opportunities to enhance patient care outcomes. Anderson, Issel, and McDaniel (2003) adopted a similar view and provided empirical evidence in support of this position. Their study measured communication openness and participation in decision-making, among other variables, and correlated these with nursing home resident outcomes such as fractures and restraint use.…”

Section: Complexity Principles and The Dynamics Of Social Systemsmentioning

confidence: 87%

Occupation and Social Complexity

Eakman¹

2007

Journal of Occupational Science

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Section: Complexity Principles and The Dynamics Of Social Systemsmentioning

confidence: 87%

Occupation and Social Complexity

Eakman¹

2007

Journal of Occupational Science

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“…[10] 3.3.5 Negative aspects concerning their work culture When the informants reflected over negative aspects concerning their work culture they mentioned stress, negative thinking, difficult to work together, discussions of difficult issues, poor communication and organization, as stated:…”

Section: Characteristics In Colleaguesmentioning

confidence: 99%

“…Work culture may be investigated using qualitative and quantitative methods. [9] Despite numerous clinical and regulatory efforts, problems of poor quality of care in nursing homes continue, [10] which is of special concern since the patient population in nursing homes is vulnerable and fragile. [11,12] Earlier studies has focused on negative factors in the nursing homes work cultures.…”

Section: Introductionmentioning

confidence: 99%

Exploring experiences of fostering positive work environment in Norwegian nursing homes: A multi method study

André

Ringdal

Skjong

et al. 2016

Clinical Nursing Studies

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Objective: The aim of the study is to explore what characterizes the work culture in Norwegian nursing homes and what promotes the positive aspects in the work culture. Methods: Research design: Multimethod research. Two surveys (N = 105) and interviews with 11 informants at three Norwegian nursing homes were conducted. We included the questionnaires: The Systematizing Person-Group Relations, that seek to explore which aspects dominate the particular work environment identifying challenges, limitations and opportunities and The Sense of Coherence (SoC) that was used as an indicator for overall quality of working life with a salutogenic orientation. The data were analyzed using independent samples student's t-test and factor analyses, the material from the interviews was systemized and worked through using well known analytical methods. Results: The results showed that the informants feel more meaning, manageability and comprehensibility in their work environment, when they are engaged and focused on goal orientation. In the interviews the informants expressed engagement related to their work environment and to patients and colleagues. They mentioned that being a team and working together was positive for their perception of their work environment. A positive work culture was characterized by solution orientation and the experiences of better opportunity to "attend to the patients in a good way". Conclusions: It seems like healthcare workers as individuals has both a positive attitude and ways to express this in the work culture, such as humor and positive thinking. But the work culture itself seems to create some negative issues.

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“…As mentioned earlier, i.e., resignation (W1), self-sacrifice (W2), criticism (O1), and assertiveness (O2) are negative qualities for the work culture that can lead to lack of empowerment. Participation, good communication, conflict resolution, and empowerment were reported to be related to resident outcomes [15,16,[18][19][20][21] . Furthermore, Shortell et al isolated attributes of the work environment and showed that they influence performance in acute hospitals [13,14] and that organizations with positive cultures were more likely to have adopted and internalized continuous quality improvement programs [25] .…”

Section: How Do Health Care Personnel At a Pmu Expect The Future Workmentioning

confidence: 99%

“…Both working conditions and employee empowerment were seen as factors that may improve job satisfaction [15][16][17][18][19] . Participation, good communication, conflict resolution, and empowerment were reported to be related to resident outcomes in nursing homes [15][16][17][18][19][20][21][22] . These studies show that organizational culture is an important factor that is also related to patient risk, mortality, and quality of care.…”

Section: Introductionmentioning

confidence: 99%

Expectations and desires of palliative health care personnel concerning their future work culture

André

Sjøvold

Holmemo³

et al. 2013

JHA

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Introduction: Exploring the work culture of health care personnel is important in order to understand the challenges they face and the issues they experience. Believing in and shaping their futures indicates a working culture influenced by promoting factors. The aims of this study were to explore how health care workers at a Palliative Medicine Unit perceive their future work culture would be and whether they perceive that their expectations and desires will be fulfilled. Design: A correlational study.Methods: Health care personnel, physicians, nurses, physiotherapists, and others (N = 26) at a PMU in Norway completed a questionnaire according to the two perspectives, expectations (future) and desire (wish). The findings in these two perspectives were compared. The method seeks to explore what aspects dominate the particular work culture and identifying challenges, limitations, and opportunities. The findings were also compared with a reference group of 347 ratings of well-functioning Norwegian organizations, named the "Norwegian Norm". Results:The findings for the wish perspective showed significant (p<0.05; p<0.01) higher rates for nurturing and synergy dimensions and significant lower rates (p>0.05; p>0.05) for opposition and control dimensions than the findings for the future perspective.Conclusions: It appears that the health care personnel wish for changes that they don't believe they will achieve. The changes the respondents wish for are fewer negative work culture qualities, such as assertiveness and resignation, and more positive work culture qualities, such as engagement and empathy. Changes must be made to give the health care personnel improved working conditions and empowerment in order to change their situations to reflect what they wish for. The present findings can give an indication as to the direction that research ought to follow in subsequent studies.

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Nursing Homes as Complex Adaptive Systems

Abstract: Complexity science was used to explain the results. The findings open the door to rethinking nursing home management practice. Practices that increase communication and interaction among people are needed for better resident outcomes.

Cited by 358 publications

References 34 publications

Occupation and Social Complexity

Occupation and Social Complexity

Exploring experiences of fostering positive work environment in Norwegian nursing homes: A multi method study

Expectations and desires of palliative health care personnel concerning their future work culture

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