Organizational Context and Quality Indicators in Nursing Homes: A Microsystem Look.
J Appl Gerontol
; 43(1): 13-25, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-37669619
ABSTRACT
The association of organizational context with quality of care in nursing homes is not well understood at the clinical microsystem (care unit) level. This cross-sectional study examined the associations of unit-level context with 10 unit-level quality indicators derived from the Minimum Data Set 2.0. Study settings comprised 262 care units within 91 Canadian nursing homes. We assessed context using unit-aggregated care-aide-reported scores on the 10 scales of the Alberta Context Tool. Mixed-effects regression analysis showed that structural resources were negatively associated with antipsychotics use (B = -.06; p = .001) and worsened late-loss activities of daily living (B = -.03, p = .04). Organizational slack in time was negatively associated with worsened pain (B = -.04, p = .01). Social capital was positively associated with delirium symptoms (B = .12, p = .02) and worsened depressive symptoms (B = .10, p = .01). The findings suggested that targeting interventions to modifiable contextual elements and unit-level quality improvement will be promising.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atividades Cotidianas
/
Indicadores de Qualidade em Assistência à Saúde
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Appl Gerontol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Canadá