title: Schedule Control and Nursing Home Quality: Exploratory Evidence of a Psychosocial Predictor of Resident Care.
abstract: OBJECTIVE
  To examine whether nursing homes' quality of care was predicted by schedule control (workers' ability to decide work hours), independently of other staffing characteristics.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Harvard School of Public Health, Boston, MA, USA dhurtado@mail.harvard.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Hurtado
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Berkman
authors.affiliation: Harvard School of Public Health, Boston, MA, USA Pennsylvania State University Harvard Medical School, Boston, MA, USA.
authors.forename: Orfeu M
authors.initials: OM
authors.lastname: Buxton
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Cassandra A
authors.initials: CA
authors.lastname: Okechukwu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D009511:New England / Q000453:epidemiology; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010563:Personnel Turnover; D003668:Pressure Ulcer / Q000517:prevention & control / Q000628:therapy; D011446:Prospective Studies; D011787:Quality of Health Care; D015431:Weight Loss; D014940:Work Schedule Tolerance / Q000523:psychology*
keywords: job flexibility; nursing home quality; pressure ulcers; schedule control; staffing mix