Schedule Control and Nursing Home Quality: Exploratory Evidence of a Psychosocial Predictor of Resident Care

日程安排控制与养老院质量:居民护理心理社会预测因素的探索性证据

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Abstract

AIM: To examine whether nursing homes' quality of care was predicted by schedule control (workers' ability to decide work hours), independently of other staffing characteristics. METHOD: Prospective ecological study of 30 nursing homes in New England. Schedule control was self-reported via survey in 2011-2012 (N = 1,045). Quality measures included the prevalence of decline in activities of daily living, residents' weight loss, and pressure ulcers, indicators systematically linked with staffing characteristics. Outcomes data for 2012 were retrieved from Medicare.gov. RESULTS: Robust Linear Regressions showed that higher schedule control predicted lower prevalence of pressure ulcers (β = -0.51, p < .05). This association was independent of staff mix, staffing ratios, job satisfaction, and turnover intentions. CONCLUSION: Higher schedule control might enhance the planning and delivery of strategies to prevent or cure pressure ulcers. Further research is needed to identify potential causal mechanisms by which schedule control could improve quality of care.

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