Cluster Randomized Controlled Trial of An Aged Care Specific Leadership and Management Program to Improve Work Environment, Staff Turnover, and Care Quality

Journal of the American Medical Directors Association

Volumn 16, Issue 7, 2015, Pages 629.e19-629.e28

  Jeon, Yun Hee ^a   Simpson, Judy M ^b   Li, Zhicheng ^a   Cunich, Michelle M ^a   Thomas, Tamsin H ^a   Chenoweth, Lynn ^c   Kendig, Hal L ^d  

^a UNIVERSITY OF SYDNEY   (Australia)

^b UNIVERSITY OF SYDNEY   (Australia)

^c UNIVERSITY OF NEW SOUTH WALES   (Australia)

^d AUSTRALIAN NATIONAL UNIVERSITY   (Australia)

Author keywords

Care quality; Clinical leadership; Leadership styles; Long term care; Work environment

Indexed keywords

ABSENTEEISM; ADULT; ARTICLE; AUSTRALIA; CONTROLLED STUDY; COST EFFECTIVENESS ANALYSIS; DEMENTIA; DOUBLE BLIND PROCEDURE; ECONOMIC EVALUATION; EDUCATIONAL STATUS; FALLING; FEMALE; GERIATRIC CARE; HEALTH CARE QUALITY; HEALTH PERSONNEL ATTITUDE; HEALTH PROGRAM; HOSPITAL PERSONNEL MANAGEMENT; HUMAN; JOB SATISFACTION; JOB STRESS; LEADERSHIP AND MANAGEMENT PROGRAM; MALE; MIDDLE AGED; OUTCOME ASSESSMENT; PATIENT CARE; RANDOMIZED CONTROLLED TRIAL; TOTAL QUALITY MANAGEMENT; TRAVEL; URINARY TRACT INFECTION; WEIGHT REDUCTION; WORK ENVIRONMENT; WORKPLACE; CLUSTER ANALYSIS; EDUCATION; GERIATRIC NURSING; HEALTH CARE FACILITY; IN SERVICE TRAINING; LEADERSHIP; PERSONNEL MANAGEMENT; QUESTIONNAIRE; SELF CARE; STANDARDS;

AUSTRALIA; CLUSTER ANALYSIS; DOUBLE-BLIND METHOD; FEMALE; GERIATRIC NURSING; HEALTH FACILITY ADMINISTRATORS; HUMANS; INSERVICE TRAINING; LEADERSHIP; MALE; MIDDLE AGED; PERSONNEL TURNOVER; QUALITY OF HEALTH CARE; SELF CARE; SURVEYS AND QUESTIONNAIRES;

EID: 84931566482     PISSN: 15258610     EISSN: 15389375     Source Type: Journal    
DOI: 10.1016/j.jamda.2015.04.005     Document Type: Article

References (55)

1. Australia's health 2014, Australian Institute of Health and Welfare, Australian Institute of Health and Welfare, Canberra, Australia.
2. Hirschfeld M.J. Accepting responsibility for long-term care-A paradox in times of a global nursing shortage?. J Nurs Scholarsh 2009, 41:104-111.
3. Rechel B., Doyle Y., Grundy E., McKee M. How can health systems respond to population ageing? 2009, WHO Reginal Office for Europe, Copenhagen, Denmark.
4. World Health Organization and U.S. Department of Health and Human Services. Global Health and Aging. US National Institute on Aging, National Institutes of Health (NIH Publication no. 11-7737), October 2011.
5. Caring for Older Australians: Overview, Report No. 53, Final Inquiry Report 2011, Productivity Commission, Productivity Comission, Canberra, Australia.
6. Jeon Y.H., Merlyn T., Chenoweth L. Leadership and management in the aged care sector: A narrative synthesis. Aust J Ageing 2010, 29:54-60.
7. Comondore V.R., Devereaux P.J., Zhou Q., et al. Quality of care in for-profit and not-for-profit nursing homes: Systematic review and meta-analysis. Br Med J 2009, 339:b2732.
8. Castle N.G., Engberg J. The influence of staffing characteristics on quality of care in nursing homes. Health Serv Res 2007, 42:1822-1847.
9. Harrington C., Swan J.H. Nursing home staffing, turnover, and case mix. Med Care Res Rev 2003, 60:366-392.
10. Akinci F., Krolikowski D. Nurse staffing levels and quality of care in Northeastern Pennsylvania nursing homes. Appl Nurs Res 2005, 18:130-137.
11. Konetzka R.T., Stearns S.C., Park J. The staffing-outcomes relationship in nursing homes. Health Serv Res 2008, 43:1025-1042.
12. Page A. Keeping patients safe: Transforming the work environment of nurses 2004, National Academies Press, Washington D.C.
13. Castle N.G., Engberg J. Staff turnover and quality of care in nursing homes. Med Care 2005, 43:616-626.
14. Castle N.G., Lin M. Top management turnover and quality in nursing homes. Health Care Manage Rev 2010, 35:161-174.
15. Aiken L.H., Sermeus W., Van den Heede K., et al. Patient safety, satisfaction, and quality of hospital care: Cross-sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012, 344:e1717.
16. Cummings G.G., MacGregor T., Davey M., et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. Int J Nurs Stud 2010, 47:363-385.
17. Brodaty H., Low L.F., Liu Z., et al. Successful Ingredients in the SMILE Study: Resident, staff, and management factors influence the effects of humor therapy in residential aged care. Am J Geriatr Psychiatry 2014, 22:1427-1437.
18. Jeon Y.H., Luscombe G., Chenoweth L., et al. Staff outcomes from the Caring for Aged Dementia Care REsident Study (CADRES): A cluster randomised trial. Int J Nurs Stud 2012, 49:508-518.
19. Moos R.H. Work Environment Scale Sampler Set: Manual, Test Booklet, Answer Sheet, Profile, and Scoring Key 2008, Mind Garden, Inc, Palo Alto, CA. 4th ed.
20. Pearson A., Nay R., Koch S., et al. Recuitment and retention of nurses in residential aged care: Final report 2002, Availble at:. http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-workforce-recruit.htm.
21. Adams A., Bond S. Hospital nurses' job satisfaction, individual and organizational characteristics. J Adv Nurs 2000, 32:536-543.
22. Wallin A.O., Jakobsson U., Edberg A.K. Job satisfaction and associated variables among nurse assistants working in residential care. Int Psychogeriatr 2012, 24:1904-1918.
23. Brannon D., Zinn J.S., Mor V., Davis J. An exploration of job, organizational, and environmental factors associated with high and low nursing assistant turnover. Gerontologist 2002, 42:159-168.
24. Karsh B., Booske B.C., Sainfort F. Job and organizational determinants of nursing home employee commitment, job satisfaction and intent to turnover. Ergonomics 2005, 48:1260-1281.
25. Hayhurst A., Saylor C., Stuenkel D. Work environmental factors and retention of nurses. J Nurs Care Qual 2005, 20:283-288.
26. Chenoweth L., Jeon Y.H., Merlyn T., Brodaty H. A systematic review of what factors attract and retain nurses in aged and dementia care. J Clin Nurs 2010, 19:156-167.
27. Choi S.P., Cheung K., Pang S.M. Attributes of nursing work environment as predictors of registered nurses' job satisfaction and intention to leave. J Nurs Manag 2013, 21:429-439.
28. Castle N.G., Decker F.H. Top management leadership style and quality of care in nursing homes. Gerontologist 2011, 51:630-642.
29. Wong C.A., Cummings G.G. The relationship between nursing leadership and patient outcomes: A systematic review update. J Nurs Manag 2013, 15:508-521.
30. Meissner E., Radford K. Importance and performance of managerial skills in the Australian aged care sector-A middle managers' perspective. J Nurs Manag 2014 Jan 21, [Epub ahead of print].
31. Conway J, Jeon YH, Edwards C. Implementing a clinical leadership program in Aged care: The CLIAC experience. Proceedings of the 25th International Council of Nurses (ICN) Quadrennial Congress; 18-23 May, 2013; Melbourne, Victoria, Australia.
32. Jeon Y.H., Glasgow N.J., Merlyn T., Sansoni E. Policy options to improve leadership of middle managers in the Australian residential aged care setting: A narrative synthesis. BMC Health Serv Res 2010, 10:190.
33. Campbell M., Piaggio G., Elbourne D., Altman D. CONSORT 2010. Statement: Extension to cluster randomised trials. BMJ 2012, 4:e5661.
34. Jeon Y.H., Simpson J., Chenoweth L., et al. The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: Design of a cluster randomised controlled trial. Implement Sci 2013, 8:126.
35. Jeon Y.H., Conway J., Chenoweth L., et al. Validation of a clinical leadership qualities framework for managers in aged care: A Delphi study. J Clin Nurs 2015, 24:999-1010.
36. Bass B.M., Avolio B.J. Transformational leadership development: Manual for the MultifactorLeadership Questionnaire 1993, Consulting Psychologist Press, Palo Alto, CA.
37. Lintern T., Woods B. Approaches to dementia questionnaire 1996, University of Wales, Bangor, UK.
38. Edvardsson D., Fetherstonhaugh D., Nay R., Gibson S. Development and initial testing of the Person-centered Care Assessment Tool (P-CAT). Int Psychogeriatrics 2010, 22:101-108.
39. Barry T.T., Kemper P., Brannon S.D. Measuring worker turnover in long-term care: Lessons from the better jobs better care demonstration. Gerontologist 2008, 48:394-400.
40. Spence Laschinger H.K., Finegan J., Shamian J. The impact of workplace empowerment, organizational trust on staff nurses' work satisfaction and organizational commitment. Health Care Manage Rev (Summer) 2001, 26:7-23.
41. Nanncarrow S. Workforce Dynamics Questionnaire 2006, Available at:, Accessed September 5, 2013. http://works.bepress.com/susan_nancarrow/73.
42. Easton F.F. Staffing, cross-training, and scheduling with cross-trained workers in extended-hour service operations 2011, Robert H. Brethen Operations Management Institute, Syracuse, NY.
43. Cox H., Puffer S., Morton V., et al. Educating nursing home staff on fracture prevention: A cluster randomised trial. Age Ageing 2008, 37:167-172.
44. Gilmartin M.J., D'Aunno T.A. Leadership research in healthcare: A review and roadmap. Acad Manage Ann 2007, 1:387-438.
45. Quality of residential aged care: The Consumer Perspective 2013, Alzheimer's Australia, Alzheimer's Australia, Canberra, Australia.
46. Bass B.M. Two decades of research and development in transformational leadership. Eur J Work Organ Psychol 1999, 8:9-32.
47. Havig A., Skogstad A., Kjekshus L., Romøren T. Leadership, staffing and quality of care in nursing homes. BMC Health Serv Res 2011, 11:327.
48. Havig A.K., Skogstad A., Veenstra M., Romoren T.I. The effects of leadership and ward factors on job satisfaction in nursing homes: A multilevel approach. J Clin Nurs 2011, 20:3532-3542.
49. Mor V. Defining and measuring quality outcomes in long-term care. J Am Med Dir Assoc 2007, 8:e129-e137.
50. Kane R.L. Improving the quality of long-term care. JAMA 1995, 273:1376-1380.
51. King D., Mavromaras K., Wei Z., et al. The Aged Care Workforce 2012, Australian Government Department of Health and Ageing, 2012, Canberra.
52. Donoghue C. Nursing home staff turnover and retention: An analysis of national level data. J Appl Gerontol 2010, 29:89-106.
53. Trinkoff A.M., Han K., Storr C.L., et al. Turnover, staffing, skill mix, and resident outcomes in a national sample of US nursing homes. J Nurs Adm 2013, 43:630-636.
54. Capko J. Identifying the causes of staff turnover. Fam Pract Manag 2001, 8:29-33.
55. Decker F.H., Harris-Kojetin L.D., Bercovitz A. Intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants in nursing homes. Gerontologist 2009, 49:596-610.