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Connection, regulation, and care plan innovation: a case study of four nursing homes.

Publication ,  Journal Article
Colón-Emeric, CS; Lekan-Rutledge, D; Utley-Smith, Q; Ammarell, N; Bailey, D; Piven, ML; Corazzini, K; Anderson, RA
Published in: Health Care Manage Rev
2006

We describe how connections among nursing home staff impact the care planning process using a complexity science framework. We completed six-month case studies of four nursing homes. Field observations (n = 274), shadowing encounters (n = 69), and in-depth interviews (n = 122) of 390 staff at all levels were conducted. Qualitative analysis produced a conceptual/thematic description and complexity science concepts were used to produce conceptual insights. We observed that greater levels of staff connection were associated with higher care plan specificity and innovation. Connection of the frontline nursing staff was crucial for (1) implementation of the formal care plan and (2) spontaneous informal care planning responsive to changing resident needs. Although regulations could theoretically improve cognitive diversity and information flow in care planning, we observed instances of regulatory oversight resulting in less specific care plans and abandonment of an effective care planning process. Interventions which improve staff connectedness may improve resident outcomes.

Duke Scholars

Published In

Health Care Manage Rev

DOI

ISSN

0361-6274

Publication Date

2006

Volume

31

Issue

4

Start / End Page

337 / 346

Location

United States

Related Subject Headings

  • Patient Care Management
  • Organizational Case Studies
  • Nursing Homes
  • North Carolina
  • Male
  • Interviews as Topic
  • Humans
  • Health Policy & Services
  • Government Regulation
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Colón-Emeric, C. S., Lekan-Rutledge, D., Utley-Smith, Q., Ammarell, N., Bailey, D., Piven, M. L., … Anderson, R. A. (2006). Connection, regulation, and care plan innovation: a case study of four nursing homes. Health Care Manage Rev, 31(4), 337–346. https://doi.org/10.1097/00004010-200610000-00009
Colón-Emeric, Cathleen S., Deborah Lekan-Rutledge, Queen Utley-Smith, Natalie Ammarell, Donald Bailey, Mary L. Piven, Kirsten Corazzini, and Ruth A. Anderson. “Connection, regulation, and care plan innovation: a case study of four nursing homes.Health Care Manage Rev 31, no. 4 (2006): 337–46. https://doi.org/10.1097/00004010-200610000-00009.
Colón-Emeric CS, Lekan-Rutledge D, Utley-Smith Q, Ammarell N, Bailey D, Piven ML, et al. Connection, regulation, and care plan innovation: a case study of four nursing homes. Health Care Manage Rev. 2006;31(4):337–46.
Colón-Emeric, Cathleen S., et al. “Connection, regulation, and care plan innovation: a case study of four nursing homes.Health Care Manage Rev, vol. 31, no. 4, 2006, pp. 337–46. Pubmed, doi:10.1097/00004010-200610000-00009.
Colón-Emeric CS, Lekan-Rutledge D, Utley-Smith Q, Ammarell N, Bailey D, Piven ML, Corazzini K, Anderson RA. Connection, regulation, and care plan innovation: a case study of four nursing homes. Health Care Manage Rev. 2006;31(4):337–346.

Published In

Health Care Manage Rev

DOI

ISSN

0361-6274

Publication Date

2006

Volume

31

Issue

4

Start / End Page

337 / 346

Location

United States

Related Subject Headings

  • Patient Care Management
  • Organizational Case Studies
  • Nursing Homes
  • North Carolina
  • Male
  • Interviews as Topic
  • Humans
  • Health Policy & Services
  • Government Regulation
  • Female