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Article Abstract
The association of organizational context with quality of care in nursing homes is not well understood at the clinical microsystem (care unit) level. This cross-sectional study examined the associations of unit-level context with 10 unit-level quality indicators derived from the Minimum Data Set 2.0. Study settings comprised 262 care units within 91 Canadian nursing homes. We assessed context using unit-aggregated care-aide-reported scores on the 10 scales of the Alberta Context Tool. Mixed-effects regression analysis showed that structural resources were negatively associated with antipsychotics use (B = -.06; = .001) and worsened late-loss activities of daily living (B = -.03, = .04). Organizational slack in time was negatively associated with worsened pain (B = -.04, = .01). Social capital was positively associated with delirium symptoms (B = .12, = .02) and worsened depressive symptoms (B = .10, = .01). The findings suggested that targeting interventions to modifiable contextual elements and unit-level quality improvement will be promising.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693724 | PMC |
| http://dx.doi.org/10.1177/07334648231200110 | DOI Listing |
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