Strategies for improving nursing home care: a research roundtable

The findings reported here are from a group of researchers identified by the authors for their leadership in the advancement of knowledge about nursing homes as organizations. Three themes were identified from the current research presented at the Roundtable. The first was a recognition of the pervasive which society's conflicting expectations about nursing homes create for those who staff them. The second related to the central, at times unsupervisable, role of non-professional staff. The third theme called attention to the reinforcement power of supervision and leadership in bringing about positive change in care giving staff. These issues and the research described had implications for both policy and practice. While far from a comprehensive treatment of organizational and managerial issues, the observations reported here represent new research interest in nursing homes be considered simple organizations with stable and predictable inputs. The processes of care and the way those processes are implemented vary from one facility to another and, indeed, among nursing units within the same facility. Broadbased practitioner-researcher collaborations are needed to promote usable research on the internal processes of nursing homes. Future collaborations will probably focus on how and why some procedures and structures produce better results for residents and others. Policy makers and administrators will benefit as the tools and methods of organizational research are used to identify the best structures and practices in the nursing home industry. Similarly, the knowledge base of long-term care administration will be enriched by contemporary reconsideration of the structure and processes of nursing homes as organizations.