title: An ethnographic study of nursing home culture to define organizational realities of culture change.
abstract: The current system of delivery of nursing home care is costly both in dollars and in human terms. Culture change may provide solutions to both issues. Culture change has a different meaning for different organizations depending on where they are in the continuum of change. Detailed observation of staff members "in action" in three long-term care facilities over a period of several months was supplemented by formal and informal interviews of organization members to gain an understanding of the culture of the nursing home organization. Four three-hour observations in each of three facilities, representing privately-held and not-for-profit organizations in urban, suburban, and rural locations yielded insights into the routine, recruitment, training, teamwork, activities, leadership, role-modeling, mentoring, staff and resident satisfaction, weekend staffing and activities, bureaucratic structure, and sharing of best practices. Discussion of each of these issues may provide a starting point for all those facilities that are contemplating significant culture change. If the objective is to have facilities truly embrace a new set of values, then the change begins with the owners and administrators of nursing homes who need to focus on building new relationships with all the stakeholders. In-depth interviews of organization members and six chief executive officers in long-term care in the Western New York area culminated the study with the development of a fifty-question survey for decision makers.
authors.affiliation: Communication Department, Buffalo State College, USA.
authors.forename: Marian T
authors.initials: MT
authors.lastname: Deutschman
mesh_terms: D000884:Anthropology, Cultural; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration* / Q000592:standards; D008330:Management Audit; D009735:Nursing Homes / Q000458:organization & administration* / Q000592:standards; D009740:Nursing Staff / Q000523:psychology / Q000592:standards; D019982:Organizational Case Studies; D015279:Organizational Culture; D009936:Organizational Innovation; D010561:Personnel Staffing and Scheduling; D011787:Quality of Health Care / Q000458:organization & administration*; D012424:Rural Population; D012945:Social Values; D013383:Suburban Population; D014481:United States; D014505:Urban Population