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. 2014 Sep;33(6):737-63.
doi: 10.1177/0733464813491141. Epub 2013 Jul 19.

Why and how do nursing homes implement culture change practices? Insights from qualitative interviews in a mixed methods study

Renée R Shield  1 , Jessica Looze  2 , Denise Tyler  2 , Michael Lepore  3 , Susan C Miller  2
Affiliations

Why and how do nursing homes implement culture change practices? Insights from qualitative interviews in a mixed methods study

Renée R Shield et al. J Appl Gerontol. 2014 Sep.

Abstract

To understand the process of instituting culture change (CC) practices in nursing homes (NHs). NH Directors of Nursing (DONs) and Administrators (NHAs) at 4,149 United States NHs were surveyed about CC practices. Follow-up interviews with 64 NHAs were conducted and analyzed by a multidisciplinary team which reconciled interpretations recorded in an audit trail.

Results: The themes include: (a) Reasons for implementing CC practices vary; (b) NH approaches to implementing CC practices are diverse; (c) NHs consider resident mix in deciding to implement practices; (d) NHAs note benefits and few costs to implementing CC practices; (e) Implementation of changes is challenging and strategies for change are tailored to the challenges encountered; (f) Education and communication efforts are vital ways to institute change; and (g) NHA and other staff leadership is key to implementing changes. Diverse strategies and leadership skills appear to help NHs implement reform practices, including CC innovations.

Keywords: culture change; leadership; nursing home; resident-centered care.

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