Knowledge Management and the Adoption of Culture Change Initiatives by High-Medicaid Census Nursing

Abstract

There is longstanding interest in identifying ways to support culture change initiatives in nursing homes given their association with a number of desirable outcomes, including fewer health-related deficiency citations and better psychosocial outcomes. However, the adoption and implementation of these initiatives are resource intensive and research has shown that nursing homes with high percentages of Medicaid residents are especially challenged to adopt these initiatives. The purpose of this study was to investigate one potential means of overcoming the obstacles to adopting culture change initiatives by these nursing homes – the use of knowledge management activities. Based on a survey of nursing home administrators, the results of our analysis suggest that nursing homes were more likely to adopt a culture change initiative when they had more robust knowledge management activities. Moreover, knowledge management activities were particularly effective at promoting these initiatives in nursing homes that struggle with leadership and nursing staff instability.