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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.

Business organizations are evermore expected to behave conscientiously, but a lack of clarity remains regarding this strategy for business-to-business (B2B) brands. This paper aims to develop and validate a B2B brand conscientiousness model that identifies what factors are driving this approach.

The research model is validated through a three-stage study that collects insights from high-level executives, mid-level managers and employees in B2B firms. Whereas the first two exploratory stages follow a qualitative approach to identify what factors motivate B2B firms to be conscientious and develop a model, the third stage empirically tests the proposed model through structural equation modeling.

The results suggest that brand conscientiousness is viewed as an important strategy by B2B stakeholders. Whereas perceived risk discourages, external and internal stakeholder expectations and a firm’s financial commitment to a cause encourage, brands to pursue a conscientious approach. Furthermore, a B2B conscientious strategy must be perceived as authentic. Long-term commitment to the cause, strategic alignment of brand values with the cause and a congruent delivery of the brand’s promise are the drivers of this perceived authenticity.

This paper contributes to the emerging knowledge on B2B conscientious brands by confirming the importance of this approach in a B2B context, identifying the factors that B2B stakeholders – executives, managers and employees – believe are driving it and highlighting the importance and identifying the factors that drive its perceived authenticity.