养老院为何以及如何实施文化变革实践？一项混合方法研究中定性访谈的见解。
Why and how do nursing homes implement culture change practices? Insights from qualitative interviews in a mixed methods study.
作者信息
Shield Renée R, Looze Jessica, Tyler Denise, Lepore Michael, Miller Susan C
机构信息
Brown University, Providence, RI, USA
Brown University, Providence, RI, USA.
出版信息
J Appl Gerontol. 2014 Sep;33(6):737-63. doi: 10.1177/0733464813491141. Epub 2013 Jul 19.
UNLABELLED
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.
未标注
为了解疗养院实施文化变革（CC）实践的过程。对美国4149家疗养院的护理主任（DONs）和管理人员（NHAs）进行了关于CC实践的调查。对64名NHAs进行了后续访谈，并由一个多学科团队进行分析，该团队协调了审计跟踪中记录的解释。
结果
主题包括：（a）实施CC实践的原因各不相同；（b）疗养院实施CC实践的方法多种多样；（c）疗养院在决定实施实践时会考虑居民构成；（d）NHAs指出实施CC实践有好处且成本很少；（e）变革的实施具有挑战性，变革策略是根据所遇到的挑战量身定制的；（f）教育和沟通努力是实施变革的重要方式；（g）NHA和其他员工的领导力是实施变革的关键。不同的策略和领导技能似乎有助于疗养院实施改革实践，包括CC创新。
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