HRM Practices, Organizational Culture and Nurse Staffing Turnover among High-Medicaid Nursing Homes
Notice bibliographique
Résumé
Nurse staffing turnover has been associated with nursing home quality, such as worse resident outcomes, higher rates of infection, and hospitalizations. Nurse staffing turnover can be worse in under-resourced nursing homes, such as those with a high proportion of Medicaid residents. These organizations may lack the resources to attract and retain nurse staff, and this could contribute to higher nurse turnover. However, even within this group of under-resourced nursing homes, we observe variations in nurse turnover rates. Using the resource-based view of the firm (RBV), we explored the role that both human resource management (HRM) practices and organizational culture may have in explaining the variations in nursing staff turnover among high Medicaid nursing homes. Data consisted of survey and secondary data sources for 2017-2018. Survey data comprised 348 responses (33% response rate) from a national mailer of US nursing home administrators in high-Medicaid (85% or higher) facilities. Survey data were merged with secondary datasets including Long-Term Care Focus (LTCFocus) and the Area Health Resource File (AHRF). The dependent variables (nurse staffing turnover rates) consisted of the percentages of registered nurses (RNs)/licensed practical nurses (LPNs)/certified nurse aides (CNAs) that had voluntarily quit the organization during the past year. The first independent variable, HRM practices, consisted of three sub-scales: traditional, employee-centered, and high involvement practices. The second independent variable consisted of nursing homes’ classification into one of four organizational cultures: clan, market, hierarchical, and non-dominant. Organizational and market variables were controlled for. Data were modeled using Poisson log-linear regression, and propensity score weights were used to adjust for potential survey non-response bias. Results show that high involvement HRM practices and having a clan culture (compared to a market, hierarchical, and non-dominant culture) are associated with lower RN, LPN, and CNA staffing turnover. The findings of this study highlight the importance of organizational culture as well as HRM practices for practitioners and policy makers to more effectively target their efforts to reduce nurse turnover in high Medicaid nursing homes. By reducing turnover, these under-resourced facilities may be able to lower costs and improve their financial performance, which may ultimately reduce the likelihood of closure with implications for access to long-term care. Similarly, lower nurse staffing turnover rates may improve quality of care for a particularly vulnerable nursing home population, i.e. those with lower SES and racial/ethnic minorities.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».