Schedule Control and Nursing Home Quality: Exploratory Evidence of a Psychosocial Predictor of Resident Care

J Appl Gerontol. 2016 Feb;35(2):244-53. doi: 10.1177/0733464814546895. Epub 2014 Sep 2.

Abstract

Aim: To examine whether nursing homes' quality of care was predicted by schedule control (workers' ability to decide work hours), independently of other staffing characteristics.

Method: Prospective ecological study of 30 nursing homes in New England. Schedule control was self-reported via survey in 2011-2012 (N = 1,045). Quality measures included the prevalence of decline in activities of daily living, residents' weight loss, and pressure ulcers, indicators systematically linked with staffing characteristics. Outcomes data for 2012 were retrieved from Medicare.gov.

Results: Robust Linear Regressions showed that higher schedule control predicted lower prevalence of pressure ulcers (β = -0.51, p < .05). This association was independent of staff mix, staffing ratios, job satisfaction, and turnover intentions.

Conclusion: Higher schedule control might enhance the planning and delivery of strategies to prevent or cure pressure ulcers. Further research is needed to identify potential causal mechanisms by which schedule control could improve quality of care.

Keywords: job flexibility; nursing home quality; pressure ulcers; schedule control; staffing mix.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Female
  • Forecasting
  • Humans
  • Male
  • New England / epidemiology
  • Nursing Homes*
  • Nursing Staff / psychology*
  • Outcome Assessment, Health Care / statistics & numerical data
  • Personnel Turnover
  • Pressure Ulcer / prevention & control
  • Pressure Ulcer / therapy
  • Prospective Studies
  • Quality of Health Care*
  • Weight Loss
  • Work Schedule Tolerance / psychology*