Overcoming Resistance to Culture Change: Nursing Home Administrators’ Use of Education, Training, and Communication

Abstract

Nursing home culture change is becoming more prevalent and research has demonstrated its benefits for nursing home residents and staff, but little is known about the role of nursing home administrators in culture change implementation. The purpose of this study was to determine what barriers nursing home administrators faced in implementing culture change practices and to identify the strategies used to overcome these. We conducted in-depth individual interviews with 64 administrators identified through a nationally representative survey. Results showed that a key barrier to culture change implementation reported by administrators was staff, resident and family member resistance to change. Most nursing home administrators stressed the importance of using communication, education and training to overcome this resistance. Themes emerging around the concepts of communication and education indicate that these efforts should be ongoing, communication should be reciprocal, and that all stakeholders should be included.

Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change

“…We revised the coding tree over the course of coding interviews based on interview data. For example, we removed any preliminary codes that did not apply to the interview data and added new codes as needed to address interview data (coding tree presented in Tyler, Lepore, Shield, Looze, & Miller, 2014). Five team members (ML, RS, JL, DT, SM) independently coded each interview, applying relevant codes to a line-by-line reading of each transcript.…”

“Would You Do That in Your Home?” Making Nursing Homes Home-like in Culture Change Implementation

“…Administrators said some staff members “feel that, no, I’ve been at this for this many years, and I’m not going to change.” In response, some administrators hired new staff members “who don’t know it any other way … this is how we do things here.” Constant communication was cited along with leadership (Tyler, Lepore, Shield, Looze, & Miller, 2013). An administrator said, “We gently try to educate them and get them involved.” One credited “a big piece of [success] is that strong nursing team.” Others noted the help of team managers and including “all the necessary players at the table” to institute physical and other culture change practices successfully.…”

Somewhat united: primary stakeholder perspectives of the governance of schoolboy football in Ireland

“…Unmanaged task and process conflict which can escalate and trigger relationship conflict can develop from a lack of communication (Hamm-Kerwin, 2010). Communicating to stakeholders is key in initiating any operational change within organisations (Tyler et al, 2013). Due to the voluntary nature of non-profit sporting organisations and the multiple levels involved, informal communication is often used which can lead to message confusion (Danylchuk et al, 2015), trust issues and the message being negatively influenced (Legg et al, 2016).…”