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Semin Speech Lang 2015; 36(03): 167-178
DOI: 10.1055/s-0035-1551838
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Creating Positive Environments in Skilled Nursing Facilities to Support Best Practice Implementation: An Overview and Practical Suggestions

Natalie F. Douglas
1   Department of Communication Disorders, Central Michigan University, Mount Pleasant, Michigan
,
Ellen Hickey
2   School of Human Communication Disorders, Dalhousie University, Halifax, Nova Scotia
› Author Affiliations
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Publication History

Publication Date:
17 July 2015 (online)

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Abstract

The purpose of this article is to discuss various types of organizational cultures and climates in relationship to best practice implementation. Although not specific to speech-language pathology, positive organizational cultures and climates are associated with better clinician and patient outcomes in health care services than dysfunctional and/or hierarchical organizational cultures and climates. A goal of this article is to help the practicing speech-language pathologist (SLP) promote positive culture change in the skilled nursing facility (SNF) setting. Recommendations to improve the organizational culture and climate of SNFs will be presented through practical examples of collaborative practice. Further suggestions will be surmised from the organizational psychology and interprofessional education literature. The connection between organizational culture and climate, interprofessional education, collaborative practice, and SLPs' best practice implementation in the SNF setting will be discussed. Avenues for future work are suggested.

Keywords

Implementation science - skilled nursing facilities - speech-language pathologists - organizational culture and climate - collaborative practice - interprofessional education - long-term care
 

  • References

  • 1 Hussein S, Manthorpe J. An international review of the long-term care workforce: policies and shortages. J Aging Soc Policy 2005; 17 (4) 75-94
    CrossrefPubMedGoogle Scholar
  • 2 Kinjerski V, Skrypnek BJ. The promise of spirit at work: increasing job satisfaction and organizational commitment and reducing turnover and absenteeism in long-term care. J Gerontol Nurs 2008; 34 (10) 17-25 , quiz 26–27
    PubMedGoogle Scholar
  • 3 Brazil K, Kaasalainen S, McAiney C, Brink P, Kelly ML. Identifying educational needs in end of life care for staff and families of residents in care facilities. Int J Pall Nsg 2012; 18 (2) 77-83
    PubMedGoogle Scholar
  • 4 Cook JM, Biyanova T, Elmore DL. Traumatic stress in older adults. In: Beck JG, Sloan DM, , eds. Oxford Handbook of Traumatic Stress Disorders. New York, NY: Oxford University Press; 2012: 119-127
    CrossrefGoogle Scholar
  • 5 Tomblin Murphy G, MacKenzie A, Rigby J , et al. Service-based health human resources planning for older adults. J Am Med Dir Assoc 2013; 14 (8) 611-615
    CrossrefPubMedGoogle Scholar
  • 6 Schneider B, Ehrhart MG, Macey WH. Organizational climate and culture. Annu Rev Psychol 2013; 64: 361-388
    CrossrefPubMedGoogle Scholar
  • 7 American Speech-Language Hearing Association. Skilled Nursing Facility Considerations. Available at: http://www.asha.org/careers/recruitment/healthcare/recruit_LTC_consider/ . Accessed July 12, 2012
    PubMedGoogle Scholar
  • 8 American Speech-Language Hearing Association. The roles of speech-language pathologists working with individuals with dementia-based communication disorders: technical report [technical report]. 2005. Available at: http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935289&section=Roles_and_Responsibilities . Accessed December 17, 2014
    PubMedGoogle Scholar
  • 9 Douglas NF, Hinckley JJ, Haley WE, Andel R, Chisolm TH, Eddins AC. Perceptions of speech-language pathologists linked to evidence-based practice use in skilled nursing facilities. Am J Speech Lang Pathol 2014; 23 (4) 612-624
    CrossrefPubMedGoogle Scholar
  • 10 Kitson AL, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A. Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges. Implement Sci 2008; 3 (1) 1
    CrossrefPubMedGoogle Scholar
  • 11 Stetler CB, Damschroder LJ, Helfrich CD, Hagedorn HJ. A guide for applying a revised version of the PARIHS framework for implementation. Implement Sci 2011; 6 (99) 99
    CrossrefPubMedGoogle Scholar
  • 12 Helfrich CD, Blevins D, Smith JL , et al. Predicting implementation from organizational readiness for change: a study protocol. Implement Sci 2011; 6 (76) 76
    CrossrefPubMedGoogle Scholar
  • 13 Powell BJ, McMillen JC, Proctor EK , et al. A compilation of strategies for implementing clinical innovations in health and mental health. Med Care Res Rev 2012; 69 (2) 123-157
    CrossrefPubMedGoogle Scholar
  • 14 Hartmann CW, Meterko M, Rosen AK , et al. Relationship of hospital organizational culture to patient safety climate in the Veterans Health Administration. Med Care Res Rev 2009; 66 (3) 320-338
    CrossrefPubMedGoogle Scholar
  • 15 Hemmeglgarn AL, Glisson C, James LR. Organizational culture and climate: implications for services and interventions research. Clin Psychol Sci Pract 2006; 13 (1) 73-89
    CrossrefPubMedGoogle Scholar
  • 16 Glisson C, Schoenwald SK, Kelleher K , et al; Research Network on Youth Mental Health. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Adm Policy Ment Health 2008; 35 (1-2) 124-133
    CrossrefPubMedGoogle Scholar
  • 17 Cassie KM. A multilevel analysis of aggressive behaviors among nursing home residents. J Gerontol Soc Work 2012; 55 (8) 708-720
    CrossrefPubMedGoogle Scholar
  • 18 Barsade SG, O'Neill OA. What's love got to do with it? A longitudinal study of the culture and companionate love and employee and client outcomes in a long-term care setting. Adm Sci Q 2014; 59 (4) 551-598
    CrossrefPubMedGoogle Scholar
  • 19 Davies HTO, Mannion R, Jacobs R, Powell AE, Marshall MN. Exploring the relationship between senior management team culture and hospital performance. Med Care Res Rev 2007; 64 (1) 46-65
    CrossrefPubMedGoogle Scholar
  • 20 Williams NJ, Glisson C. Reducing turnover is not enough: the need for proficient organizational cultures to support positive youth outcomes in child welfare. Child Youth Serv Rev 2013; 35 (11) 1871-1877
    CrossrefPubMedGoogle Scholar
  • 21 André B, Sjøvold E, Rannestad T, Ringdal GI. The impact of work culture on quality of care in nursing homes—a review study. Scand J Caring Sci 2014; 28 (3) 449-457
    CrossrefPubMedGoogle Scholar
  • 22 Eklof M, Torner M, Pousette A. Organizational and social-psychological conditions in healthcare and their importance for patient and staff safety. A critical incident study among doctors and nurses. Saf Sci 2014; 70: 211-221
    CrossrefPubMedGoogle Scholar
  • 23 American Speech-Language-Hearing Association. SLP health care survey summary report: number and type of responses. 2013. Available at: http://www.asha.org/uploadedFiles/2013-SLP-Health-Care-Survey-Summary-Report.pdf . Accessed February 27, 2015
    PubMedGoogle Scholar
  • 24 Resource library. Active Implementation Hub. Available at: http://implementation.fpg.unc.edu/resources/list . Accessed December 17, 2014
    PubMedGoogle Scholar
  • 25 Active Implementation Hub. Handout 9. Creating Hospitable Environments. Available at: http://implementation.fpg.unc.edu/sites/implementation.fpg.unc.edu/files/resources/AIHub-Handout9-CreatingHospitableEnvironments.pdf . Accessed December 17, 2014
    PubMedGoogle Scholar
  • 26 Reina ML, Reina DS, Rushton CH. Trust: the foundation for team collaboration and healthy work environments. AACN Adv Crit Care 2007; 18 (2) 103-108
    CrossrefPubMedGoogle Scholar
  • 27 Kilmann RH, Thomas KW. Developing a forced-choice measure of conflict-handling behavior: the mode instrument. Educ Psychol Meas 1977; 37 (2) 309-325
    CrossrefPubMedGoogle Scholar
  • 28 World Health Organization. Framework for action on interprofessional education & collaborative practice. 2010. Available at: http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf?ua=1 . Accessed October 25, 2014
    PubMedGoogle Scholar
  • 29 Kinjerski V, Skrypnek BJ. The promise of spirit at work: increasing job satisfaction and organizational commitment and reducing turnover and absenteeism in long-term care. J Gerontol Nurs 2008; 34 (10) 17-25 , quiz 26–27
    PubMedGoogle Scholar
  • 30 Suter E, Deutschlander S, Mickelson G , et al. Can interprofessional collaboration provide health human resources solutions? A knowledge synthesis. J Interprof Care 2012; 26 (4) 261-268
    CrossrefPubMedGoogle Scholar
  • 31 Tourangeau A, Cranley L, Spence Laschinger HK, Pachis J. Relationships among leadership practices, work environments, staff communication and outcomes in long-term care. J Nurs Manag 2010; 18 (8) 1060-1072
    CrossrefPubMedGoogle Scholar
  • 32 Kaldy J. Best practices: faces of teamwork in long-term care. Consult Pharm 2007; 22 (10) 808-829
    CrossrefPubMedGoogle Scholar
  • 33 Grymonpre R, van Ineveld C, Nelson M. Inter-professional clinical placements as a recruitment strategy in geriatrics: survey of students' perceptions. Healthc Q 2013; 16 (3) 53-56
    CrossrefPubMedGoogle Scholar
  • 34 Mezey MD, Mitty EL, Burger SG. Rethinking teaching nursing homes: potential for improving long-term care. Gerontologist 2008; 48 (1) 8-15
    CrossrefPubMedGoogle Scholar
  • 35 Wieland D, Rubenstein LZ, Ouslander JG, Martin SE. Organizing an academic nursing home. Impacts on institutionalized elderly. JAMA 1986; 255 (19) 2622-2627
    CrossrefPubMedGoogle Scholar