Abstract
BackgroundA stronger safety climate in nursing homes may reduce avoidable adverse events. Yet efforts to strengthen safety climate may fail if nursing homes are not ready to change. To inform improvement efforts, we examined the link between organizational readiness to change and safety climate.MethodsSeven safety climate domains and organizational readiness to change were measured with validated Community Living Center/CLC Employee Survey of Attitudes about Resident Safety and Organizational Readiness to Change Assessment. Safety climate domains comprised of safety priorities, supervisor commitment to safety, senior management commitment to safety, safety attitudes, environmental safety, coworker interactions around safety, and global rating of CLC. We specified models with and without readiness to change to explain CLC- and person-level variance in safety climate domains.ResultsOne thousand three hundred ninety seven workers (frontline staff and managers) responded from 56 US Veterans Health Administration CLCs located throughout the US. Adding readiness to change reduced baseline CLC-level variance of outcomes (2.3–9.3%) by > 70% for interpersonal domains (co-workers, supervisors, and senior management). Readiness to change explained person-level variance of every safety climate domain (P < 0.05), especially for interpersonal domains.ConclusionsOrganizational readiness to change predicted safety climate. Safety climate initiatives that address readiness to change among frontline staff and managers may be more likely to succeed and eventually increase resident safety.
Highlights
A stronger safety climate in nursing homes may reduce avoidable adverse events
Study design The research design comprised of a cross-sectional survey of all Veterans Affairs (VA) nursing homes in the US (132) using 2 validated survey instruments administered to nursing home employees, the Community Living Centers (CLCs) Employee Survey of Attitudes about Resident Safety [17] and the Organizational Readiness to Change Assessment [18]
ICC comparisons indicated that the staffing ratio and Psychological and Behavioral Readiness to Change domain explained more CLC-level variance in the safety climate domains than any other variable
Summary
A stronger safety climate in nursing homes may reduce avoidable adverse events. Efforts to strengthen safety climate may fail if nursing homes are not ready to change. We examined the link between organizational readiness to change and safety climate. Avoidable safety-related adverse events occur fairly consistently, despite improvement efforts [1] and result in resident morbidity and mortality [2]. Safety climate interventions may hold promise to prevent adverse events, with successful interventions in hospitals citing organizational context as a contributor to their success [6, 7]. Safety climate initiatives in nursing homes are sparse [6], possibly because nursing homes may lack readiness to change [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
