Elizabeth M. White (
Jasmine L. Travers, New York University, New York, New York.
Health Aff (Millwood). 2023 Feb;42(2):217-226. doi: 10.1377/hlthaff.2022.01011.
COVID-19 vaccination and regular testing of nursing home staff have been critical interventions for mitigating COVID-19 outbreaks in US nursing homes. Although implementation of testing has largely been left to nursing home organizations to coordinate, vaccination occurred through a combination of state, federal, and organization efforts. Little research has focused on structural variation in these processes. We examined whether one structural factor, the primary shift worked by staff, was associated with differences in COVID-19 testing rates and odds of vaccination, using staff-level data from a multistate sample of 294 nursing homes. In facility fixed effects analyses, we found that night-shift staff had the lowest testing rates and lowest odds of vaccination, whereas day-shift staff had the highest testing rates and odds of vaccination. These findings highlight the need to coordinate resources and communication evenly across shifts when implementing large-scale processes in nursing homes and other organizations with shift-based workforces.
译文：
COVID-19 疫苗接种和定期对养老院工作人员进行检测是减轻美国养老院 COVID-19 疫情的关键干预措施。尽管检测的实施主要由养老院组织协调，但疫苗接种是通过州、联邦和组织的共同努力来完成的。很少有研究关注这些过程中的结构变化。我们使用来自多州 294 家养老院的员工级样本数据，研究了一个结构因素（员工的主要班次）是否与 COVID-19 检测率和疫苗接种几率的差异有关。在固定效应分析中，我们发现夜班员工的检测率最低，接种疫苗的几率也最低，而白班员工的检测率和接种疫苗的几率最高。这些发现强调了在养老院和其他以轮班为基础的劳动力的组织中实施大规模流程时，需要在各轮班之间平均协调资源和沟通。
