Workplace variables and their relationship to quality client outcomes in home health.

The purpose of the study was to investigate the relationship of workplace variables and client outcomes, and to propose a model of the fit between the workplace variable dimensions of nursing technology (NT) and organizational structure (OS) to predict client outcomes in home health. The researchers used a correlational, predictive, descriptive design to measure NT, OS, nurses' role clarity, client outcomes, and client satisfaction. A convenience sample consisted of 43 home health sites with 205 nurses and 325 clients completing surveys. Nurses perceived that clients had better outcomes when the three dimensions of NT fit the three dimensions of OS: (1) when clients' conditions were unstable, nurses interacted with peers; (2) when care was complex, nurses consulted with supervisors; and (3) when clients' needs varied, nurses used rules to guide clinical decisions. Findings suggested that nurses' understanding of their roles correlated to OS. Nurse managers in home health care settings can use the model constructed as a result of the research to adjust the dimensions of OS to improve client outcomes.