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）：认为员工流失会影响质量的信念无处不在。确实，疗养院的员工营业额通常被用作质量指标。但是，基于文献中的实证研究，这可能为时过早，因为营业额和质量之间的关联通常尚无定论。在这一领域进行了进一步的研究。在其他行业中设定的营业额研究的结果还表明，某些员工营业额是有益的，并且更高的营业额会对绩效产生负面影响。显然，如果营业额确实会根据观察到的水平影响不同方向的质量，则可以通过使用一种线性度量的离职量来掩盖效果。在这一领域的疗养院中，也有一些进一步的研究也可以清楚地保证。在此计划中，我们建议使用先前从2,127个护理设施收集的数据，并检查员工营业额与质量之间的关联。护理劳动力主要由提供80％至90％的居民护理的护士助手（NAS）组成，但还包括持牌实践护士（LPN）和注册护士（RNS）。这些是我们检查的员工。作为正在进行的研究的一部分，收集了有关员工营业额的信息，该研究调查了疗养院的营业额报告的准确性。我们建议在疗养院使用五个公认的护理质量指标。这些是物理约束使用，尿道导管插入术，压疮，精神活性药物的使用和持续疼痛的速度。我们相信：（1）检查不同级别的营业额；（2）使用我们的精确衡量营业额；（3）使用有关质量和案例组合的最小数据集（MDS）居民级数据 - 这项拟议的研究代表了对先前工作的可观改进。因此，使用先前收集的主要数据与二级数据源（例如MDS）相匹配，我们建议检查：（1）护理人员周转率（RNS，LPN和NAS）与疗养院中的质量指标之间的关联；（2）不同护理人员（RN，LPN和NAS）对营业额和质量指标之间的关联的贡献；（3）一定程度的营业额是否与质量指标呈正相关，而在什么时候营业额与质量指标负相关。