Using an Adaptive Leadership Framework to Facilitate Implementation of Culture Change in Nursing Homes

2.50
Hdl Handle:
http://hdl.handle.net/10755/304394
Category:
Abstract
Type:
Presentation
Title:
Using an Adaptive Leadership Framework to Facilitate Implementation of Culture Change in Nursing Homes
Author(s):
Corazzini, Kirsten
Lead Author STTI Affiliation:
Non-member
Author Details:
Kirsten Corazzini, PhD, Kirsten.Corazzini@duke.edu
Abstract:

Session presented on: Friday, July 26, 2013

Purpose: The global culture change movement in nursing homes aims to transform current, institutionalized models of nursing care to person-directed, home-like care settings;  well over 50% of nursing homes in the U.S. are engaged in some aspect of culture change (Doty, Koren, & Sturla, 2008).  The purpose of this study was to use the adaptive leadership framework to describe, from the perspective of nursing home staff, technical versus adaptive challenges in implementing culture change, and the role of adaptive leadership to facilitate culture change. 

Methods: The overall study design was a qualitative, ‘broad-involvement’ focus group study design (Krueger & Casey, 2009), comprised of administrators, medical care providers, and nursing staff in 3 nursing homes in NC (N=7 focus groups).  Analysis was conducted in accordance with template organizing analysis (Crabtree & Miller 1999) in two steps.  Step 1 identified challenges and facilitators.  Step 2 analyzed challenges and facilitators in relation to adaptive leadership, whereby challenges were coded for ‘technical challenges’ or ‘adaptive challenges’ and facilitators were coded for ‘adaptive leadership’.  Matrices were constructed to compare codes by focus group and position type.

Results: Six themes were identified, including standards and expectations, motivation and vision, workload, respect of personhood, and physical environment.  All themes included examples of both technical and adaptive challenges, as well as adaptive leadership.  A surprising finding was that direct caregivers (e.g., nurse assistants and nurses) provided substantially more examples of the need for adaptive leadership to accomplish culture change, compared to administrators.

Conclusion: The implications of the study are that administrators may ignore adaptive challenges inherent in system change.  To achieve change in care systems, we need to develop strategies for administrators and managers to facilitate adaptive leadership on the frontlines of care.

Keywords:
leadership; culture change; nursing homes
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleUsing an Adaptive Leadership Framework to Facilitate Implementation of Culture Change in Nursing Homesen_GB
dc.contributor.authorCorazzini, Kirstenen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsKirsten Corazzini, PhD, Kirsten.Corazzini@duke.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/304394-
dc.description.abstract<p>Session presented on: Friday, July 26, 2013</p><b>Purpose: </b>The global culture change movement in nursing homes aims to transform current, institutionalized models of nursing care to person-directed, home-like care settings;  well over 50% of nursing homes in the U.S. are engaged in some aspect of culture change (Doty, Koren, & Sturla, 2008).  The purpose of this study was to use the adaptive leadership framework to describe, from the perspective of nursing home staff, technical versus adaptive challenges in implementing culture change, and the role of adaptive leadership to facilitate culture change.  <p><b>Methods: </b>The overall study design was a qualitative, ‘broad-involvement’ focus group study design (Krueger & Casey, 2009), comprised of administrators, medical care providers, and nursing staff in 3 nursing homes in NC (N=7 focus groups).  Analysis was conducted in accordance with template organizing analysis (Crabtree & Miller 1999) in two steps.  Step 1 identified challenges and facilitators.  Step 2 analyzed challenges and facilitators in relation to adaptive leadership, whereby challenges were coded for ‘technical challenges’ or ‘adaptive challenges’ and facilitators were coded for ‘adaptive leadership’.  Matrices were constructed to compare codes by focus group and position type. <p><b>Results: </b>Six themes were identified, including standards and expectations, motivation and vision, workload, respect of personhood, and physical environment.  All themes included examples of both technical and adaptive challenges, as well as adaptive leadership.  A surprising finding was that direct caregivers (e.g., nurse assistants and nurses) provided substantially more examples of the need for adaptive leadership to accomplish culture change, compared to administrators. <p><b>Conclusion: </b>The implications of the study are that administrators may ignore adaptive challenges inherent in system change.  To achieve change in care systems, we need to develop strategies for administrators and managers to facilitate adaptive leadership on the frontlines of care.en_GB
dc.subjectleadershipen_GB
dc.subjectculture changeen_GB
dc.subjectnursing homesen_GB
dc.date.available2013-10-22T20:34:58Z-
dc.date.issued2013-10-22-
dc.date.accessioned2013-10-22T20:34:58Z-
dc.conference.date2013en_GB
dc.conference.name24th International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationPrague, Czech Republicen_GB
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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