Leadership, staffing and quality of care in nursing homes

<p>Abstract</p> <p>Background</p> <p>Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and...

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Main Authors: Havig Anders, Skogstad Anders, Kjekshus Lars, Romøren Tor
Format: Article
Language:English
Published: BMC 2011-11-01
Series:BMC Health Services Research
Subjects:
Online Access:http://www.biomedcentral.com/1472-6963/11/327
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author Havig Anders
Skogstad Anders
Kjekshus Lars
Romøren Tor
author_facet Havig Anders
Skogstad Anders
Kjekshus Lars
Romøren Tor
author_sort Havig Anders
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care.</p> <p>Methods</p> <p>A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively.</p> <p>Results</p> <p>Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (<it>r </it>= 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff.</p> <p>Conclusions</p> <p>Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is complex. Increasing staffing levels or the ratio of registered nurses alone is not likely sufficient for increasing quality of care.</p>
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spelling doaj.art-2040747244d94778bbf981c53b8ad5ad2022-12-22T00:41:44ZengBMCBMC Health Services Research1472-69632011-11-0111132710.1186/1472-6963-11-327Leadership, staffing and quality of care in nursing homesHavig AndersSkogstad AndersKjekshus LarsRomøren Tor<p>Abstract</p> <p>Background</p> <p>Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care.</p> <p>Methods</p> <p>A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively.</p> <p>Results</p> <p>Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (<it>r </it>= 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff.</p> <p>Conclusions</p> <p>Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is complex. Increasing staffing levels or the ratio of registered nurses alone is not likely sufficient for increasing quality of care.</p>http://www.biomedcentral.com/1472-6963/11/327nursing homesleadershipstaffingquality of care
spellingShingle Havig Anders
Skogstad Anders
Kjekshus Lars
Romøren Tor
Leadership, staffing and quality of care in nursing homes
BMC Health Services Research
nursing homes
leadership
staffing
quality of care
title Leadership, staffing and quality of care in nursing homes
title_full Leadership, staffing and quality of care in nursing homes
title_fullStr Leadership, staffing and quality of care in nursing homes
title_full_unstemmed Leadership, staffing and quality of care in nursing homes
title_short Leadership, staffing and quality of care in nursing homes
title_sort leadership staffing and quality of care in nursing homes
topic nursing homes
leadership
staffing
quality of care
url http://www.biomedcentral.com/1472-6963/11/327
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AT skogstadanders leadershipstaffingandqualityofcareinnursinghomes
AT kjekshuslars leadershipstaffingandqualityofcareinnursinghomes
AT romørentor leadershipstaffingandqualityofcareinnursinghomes