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Resource dependence and institutional elements in nursing home TQM adoption
J S Zinn1, R J Weech, D Brannon
1Department of Health Administration, School of Business and Management, Temple University, Philadelphia, PA 19122, USA.
Health Services Research
|June 10, 1998
Summary
Nursing homes adopt Total Quality Management (TQM) influenced by perceived competition and Medicare program factors. Other common adoption factors, like facility size, were not significant in this study.
Area of Science:
- Healthcare Management
- Organizational Behavior
- Gerontology
Background:
- Total Quality Management (TQM) adoption in nursing homes is influenced by various contextual attributes.
- Understanding these influences is crucial for improving quality of care and operational efficiency in long-term care facilities.
Purpose of the Study:
- To investigate the contextual factors affecting nursing home adoption of Total Quality Management (TQM).
- To examine the roles of resource dependence and institutional theories in explaining TQM adoption.
Main Methods:
- A survey of 241 licensed nursing home administrators in Pennsylvania (1994-1995).
- Utilized Medicare and Medicaid Annual Certification Survey (MMACS) and Area Resource File (ARF) data.
- Employed logistic regression analysis due to the dichotomous nature of TQM adoption.
Main Results:
- Perceived competition was a significant predictor of TQM adoption.
- Medicare's market share and a facility's Medicare census significantly influenced TQM adoption.
- Facility size, often a predictor in other industries, did not significantly impact TQM adoption in this nursing home study.
Conclusions:
- Limited support exists for rational adaptive and institutional factors influencing TQM adoption in nursing homes.
- Medicare's influence at both market and facility levels is associated with TQM adoption.
- Nursing home TQM adoption appears distinct from other industries regarding factors like organizational size.