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Publication date: 7 February 2024

Tory H. Hogan, Larry R. Hearld, Ganisher Davlyatov, Akbar Ghiasi, Jeff Szychowski and Robert Weech-Maldonado

High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented…

Abstract

High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented regulations to target critical components of NH care outcomes. Simultaneously, our delivery system continues to change the role of NHs in patient care. For example, more acute patients are cared for in NHs, and the Center for Medicare and Medicaid Services (CMS) has implemented value payment programs targeting NH settings. As a part of these growing pressures from the broader healthcare delivery system, the culture-change movement has emerged among NHs over the past two decades, prompting NHs to embody more person-centered care as well as promote settings which resemble someone's home, as opposed to institutionalized healthcare settings.

Researchers have linked culture change to high-quality outcomes and the ability to adapt and respond to the ever-changing pressures brought on by changes in our regulatory and delivery system. Making enduring culture change within organizations has long been a challenge and focus in NHs. Despite research suggesting that culture-change initiatives that promote greater resident-centered care are associated with several desirable patient outcomes, their adoption and implementation by NHs are resource intensive, and research has shown that NHs with high percentages of low-income residents are especially challenged to adopt these initiatives.

This chapter takes a novel approach to examine factors that impact the adoption of culture-change initiatives by assessing knowledge management and the role of knowledge management activities in promoting the adoption of innovative care delivery models among under-resourced NHs throughout the United States. Using primary data from a survey of NH administrators, we conducted logistic regression models to assess the relationship between knowledge management and the adoption of a culture-change initiative as well as whether these relationships were moderated by leadership and staffing stability. Our study found that NHs 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 adoption in NHs that struggle with leadership and nursing staff instability. Our findings support the notion that knowledge management activities can help NHs acquire and mobilize informational resources to support the adoption of care delivery innovations, thus highlighting opportunities to more effectively target efforts to stimulate the adoption and spread of these initiatives.

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Article
Publication date: 26 February 2024

Tamara Hoefer and Laura Polley

Avoidable voluntary turnover negatively impacts an organisation’s workforce and decreases its sustainability and productivity. His Majesty’s Prison and Probation Service’s (HMPPS…

Abstract

Purpose

Avoidable voluntary turnover negatively impacts an organisation’s workforce and decreases its sustainability and productivity. His Majesty’s Prison and Probation Service’s (HMPPS) leaving rates are among the highest in the public sector. The purpose of this study is, thus, to support HMPPS in improving Band 3 prison officers’ (POs) retention and in developing an effective employee retention strategy.

Design/methodology/approach

Grounded in retention literature, the present study uses a mixed-methods, cross-sectional, phenomenological research design. Primary data was gathered using an online qualitative survey, which was sent to POs working at a public sector prison in the Northwest of England with less than five years of work experience.

Findings

The results highlight the impact of career development and training and development due to their importance to POs in comparison to the POs’ dissatisfaction with HMPPS’ performance in both factors. Furthermore, most expectations of retention factors were only partially met, illustrating the need to reform the existing recruitment process and the translation of expectations into the reality of the role. In conclusion, HMPPS should focus attention on performance-improvement, especially in relation to career development and training and development, as well as investigating and reforming the current recruitment processes.

Practical implications

Recommendations to improve the retention of POs include the improved management of career plans, an increased selection of managers based on their management abilities, increasing training opportunities and equating staff's access to them, and evaluating the effect of payment boosts.

Originality/value

The role of POs and their professional environment has not previously been combined with contemporary retention literature. To the best of the authors’ knowledge, this research paper is the first of its kind using qualitative data to understand retention in the English and Welsh prison service.

Details

Journal of Criminological Research, Policy and Practice, vol. 10 no. 1
Type: Research Article
ISSN: 2056-3841

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