title: Implementing person-centered care in nursing homes.
abstract: BACKGROUND
  Charged with caring for frail and disabled elders, nursing homes are complex organizations that operate under high regulatory scrutiny and low public opinion. Despite efforts to improve, many nursing home residents receive poor care. By focusing on residents' relationships, life experiences, abilities, and preferences, person-centered care represents an innovation in nursing home care. Because person-centered care requires organization-wide change, implementation can be challenging.
  
  
  OBJECTIVE
  The purpose of this research is to apply innovation implementation theory to understand factors and conditions that help or hinder the implementation of person-centered care in nursing homes.
  
  
  METHODS
  Data come from the Person-Centered Care Program conducted by the Carolinas Center for Medical Excellence. Eight nursing homes participated in the Person-Centered Care Program for 1 year. A multiple-case-study design and pattern-matching logic were employed to examine organizational factors associated with implementation effectiveness. Data sources included semistructured key informant interviews, archival documents, surveys, and expert rankings of nursing homes' implementation effectiveness.
  
  
  RESULTS
  On the basis of this research, we suggest that effective implementation of organization-wide change in nursing homes is associated with high-quality management communications about the change, organizational readiness for change, and favorable perceptions from direct care providers about the priority of the innovation to the organization. Notably, neither the amount of training nor the financial resources dedicated to person-centered care were associated with implementation effectiveness.
  
  
  CONCLUSIONS
  Effective implementation of person-centered care in nursing homes is most likely when management follows through with plans as advertised, when leadership teams have confidence in their ability to meet goals for change, and when change fosters smooth operations in the daily routines of direct care providers.
authors.affiliation: Institute on Aging, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. crosemon@med.unc.edu
authors.forename: Cherie A
authors.initials: CA
authors.lastname: Rosemond
authors.forename: Laura C
authors.initials: LC
authors.lastname: Hanson
authors.forename: Susan T
authors.initials: ST
authors.lastname: Ennett
authors.forename: Anna P
authors.initials: AP
authors.lastname: Schenck
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Weiner
mesh_terms: D000288:Administrative Personnel / Q000523:psychology / Q000706:statistics & numerical data; D005376:Financial Management; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D007318:Inservice Training; D007324:Institutional Management Teams; D007400:Interprofessional Relations; D007857:Leadership; D009657:North Carolina; D009735:Nursing Homes / Q000191:economics / Q000458:organization & administration*; D019982:Organizational Case Studies; D009936:Organizational Innovation; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration*; D013022:South Carolina; D017748:Time Management; D000078329:Workforce