The Influence of Staff Turnover on Quality

员工流动对质量的影响

基本信息

批准号：
7234351
负责人：
NICHOLAS G CASTLE
金额：
$ 6.49万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-06-01 至 2009-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7234351
关键词：
Accounting Activities of Daily Living Acute Address Administrator Affect American Annual Reports Area Attention Beds Belief Binding Biological Models Budgets Businesses California Caregivers Caring Case Mixes Categories Certification Cessation of life Characteristics Cherry - dietary Cities Client Closure Code Condition Continuity of Patient Care Critiques Daily Data Data Collection Data Set Data Sources Databases Death Rate Decision Making Decubitus ulcer Dependency Discipline Discipline of Nursing Doctor of Philosophy Effectiveness Employee Employment Ensure Environment Environmental Risk Factor Financial compensation Florida Fraud Fright Genetic Government Grant Head Health Health Services Research Health Status Healthcare Healthcare Systems Home Nursing Care Hospital Nursing Hospitalization Hospitals Human Resources Incidence Individual Industry Infection Institute of Medicine (U.S.)Institution Job Satisfaction Journals Kansas Knowledge Labor Forces Lead Licensed Practical Nurse Licensing Literature Long-Term Care MEDLINE Marketing Masks Measurement Measures Medicaid Methods Modeling Negative Finding North Carolina Numbers Nurses Nurses&apos Aides Nursing Homes Nursing Staff Nutritional status Outcome Outcome Measure Ownership Pain management Patients Performance Persistent pain Pharmaceutical Preparations Physical Restraint Play Policy Maker Positioning Attribute Price Principal Investigator Problem Solving Process Productivity Provider Proxy Publications Quality Indicator Quality of Care Questionnaires Range Rate Records Registered nurse Regulation Reporting Research Research Personnel Resolution Respondent Review Literature Risk Risk Adjustment Role Sample Size Secondary to Services Significance Level Small-Area Study Standards of Weights and Measures Statistical Models Statistically Significant Structure Sum Surveys System Systems Theory Testing Texas Thinking Time Unemployment United States Centers for Medicare and Medicaid Services Urethral Catheterization Variant Voice Wisconsin Work Workload administrative database analytical method base caregiver education caregiving cost dalton day design expectation experience functional decline functional improvement improved innovation interest payment programs psychological distress response shift work size time use

项目摘要

DESCRIPTION (provided by applicant): The belief that staff turnover influences quality is pervasive. Indeed, staff turnover in nursing homes is often used as a quality indicator. However, based on empirical studies in the literature this may be premature, as the association between turnover and quality is generally inconclusive. Some further research in this area is clearly warranted. Results from turnover studies set in other industries have also shown that some staff turnover is beneficial, and it is higher levels of turnover that negatively influence performance. Clearly, if turnover does influence quality in different directions depending on the level observed, then by using one linear measure of turnover the effects may be masked. Some further research in this area in nursing homes is also clearly warranted. In this initiative, we propose to use data previously collected from 2,127 nursing facilities and examine the association between staff turnover and quality. The caregiving labor force consists primarily of nurse aides (NAs) who provide 80 to 90% of resident care, but also includes licensed practical nurses (LPNs), and registered nurses (RNs). These are the staff we examine. The information on staff turnover was collected as part of an ongoing study investigating the accuracy of turnover reporting by nursing homes. We propose to use five well-accepted indicators of care quality in nursing homes. These are the rates of physical restraint use, urethral catheterization, pressure ulcers, psychoactive medication use, and persistent pain. We believe that by: (1) examining different levels of turnover; (2) using our precise measure of turnover; and (3) using the Minimum Data Set (MDS) resident-level data on quality and case mix - this proposed study represents a considerable improvement over prior works. Thus, using previously collected primary data matched to secondary data sources, such as the MDS, we propose to examine: (1) Association between caregiver turnover (RNs, LPNs, and NAs) and quality indicators in nursing homes; (2) Contribution of different caregivers (RNs, LPNs, and NAs) to the association between turnover and quality indicators; (3) Whether some level of turnover is positively associated with quality indicators and at what point turnover is negatively associated with quality indicators.

描述（由申请人提供）：人们普遍认为员工流动会影响质量。事实上，疗养院的员工流动率经常被用作质量指标。然而，根据文献中的实证研究，这可能还为时过早，因为营业额和质量之间的关联通常是不确定的。显然有必要在这一领域进行一些进一步的研究。其他行业的人员流动研究结果也表明，一定程度的员工流动是有益的，而较高水平的流动会对绩效产生负面影响。显然，如果营业额确实根据观察到的水平在不同方向上影响质量，那么通过使用一种线性的营业额衡量标准，这种影响可能会被掩盖。疗养院在这一领域的一些进一步研究也显然是有必要的。在此计划中，我们建议使用之前从 2,127 个护理机构收集的数据，并检查员工流动率与质量之间的关联。护理劳动力主要由护士助理 (NA) 组成，他们提供 80% 至 90% 的住院护理，但也包括执业护士 (LPN) 和注册护士 (RN)。这些是我们检查的工作人员。有关员工流动率的信息是作为一项正在进行的研究的一部分收集的，该研究调查了疗养院流动率报告的准确性。我们建议在疗养院使用五个广为接受的护理质量指标。这些是使用身体约束、导尿、压疮、精神药物使用和持续性疼痛的比率。我们认为，通过：（1）考察不同的营业额水平； (2) 使用我们精确的营业额衡量标准； (3) 使用关于质量和案例组合的最小数据集 (MDS) 居民级数据 - 这项拟议的研究比以前的工作有了相当大的改进。因此，使用先前收集的与二级数据源（例如 MDS）相匹配的一级数据，我们建议检查：（1）护理人员流动率（RN、LPN 和 NA）与疗养院质量指标之间的关联； (2) 不同护理人员（RN、LPN 和 NA）对营业额和质量指标之间关联的贡献； (3)一定程度的人员流动是否与质量指标呈正相关，以及在何种程度的人员流动与质量指标呈负相关。