Confronting challenges in collaboration: examples from the nursing home industry.

Details

• Personal Author:
  Williams J
• Description:
  Problem. Industry-wide adoption of TWH approaches offers a promising comprehensive strategy to address elevated health risks among nursing home workers. Yet, the degree to which the industry's existing programs, policies, and practices align with the Total Worker Health® approach is unknown. In order to determine whether scarce resources should be allocated to implementing TWH, it is important to understand if this approach is associated with a reduction in occupational injuries and/or with improvements in patient outcomes. The primary goal of the Enterprise Outcomes study is to promote the health and safety of workers in the nursing home industry through understanding of TWH approaches in the industry. The central hypothesis of the Enterprise Outcomes study is that nursing homes whose programs, policies, and practices align more closely with TWH as measured by the Workplace Integrated Health Assessment will have better outcomes with respect to occupational injury and quality of patient care compared to worksites less aligned with TWH approaches. Procedures. The project combines three types of organizational level data: (1) survey of Directors of Nursing in nursing homes in three states; (2) quality of care from an administrative database housed at Harvard Medical School; and (3) facility level data on occupational injury rates, which will come directly from state workers compensation boards. To obtain the necessary data for the study, extensive partnerships were sought among several states (MA, NY, OH, CA, and OR). Potential partners included nursing home professional associations and State Worker's Compensation Boards. The goal was to have nursing home associations inform their members of the survey with letters of support or to send out the survey to increase salience for respondents. Facility level data on injuries were needed from the State Worker's Compensation Boards. Ideally, there would be functioning partnerships of both types in each state. Crucially though, we could not do the research without the Worker's Compensation data on injuries, making their participation a binding constraint. For the state worker's compensation boards, state practice regarding data access and our assessment of data quality drove the relationship process. Several methods were used to build partnerships with nursing home associations. These included both email and phone contact, with and without preexisting relationships and referrals from colleagues. Results. The level of identifiers for the nursing homes was the major determinant of whether relationships with state worker's compensation boards could move forward (all states). However, institutional changes, such as in personnel and management structure were also important. In some states the attempted methods worked to build relationships with nursing homes associations, resulting in successful collaborations, while in others they were insufficient to induce participation. In all states, political and policy concerns were important to partner organizations. The perceived heightened scrutiny surrounding nursing homes and pending legislation were insurmountable barriers in some states. There was also a great degree of concern for the workload of the directors of nursing-our intended respondents. There was also concern about the level of shared value for the individual nursing homes as the survey did not itself address patient care-a primary motivator. Additionally, management and other changes within organizations made building relationships difficult as personnel, goals, and priorities changed between grant submission and project period. In working with nursing homes associations, the value of the information, training opportunities, and building networks for future collaboration were all central benefits for the associations. Pervious exposure to research seemed to be an important factor in the decision-making process for the potential partner organizations. Despite a lengthy process to build relationships, the partnerships took different forms in each state, with only one state having both types. Practical implications. Establishing shared value for nursing home workers in general was a key part of the original research proposal. Outcomes, such as injury and patient safety were to be evaluated along with testing the Workplace Integrated Health Assessment measure developed by the Center for Work, Health, and Well-being. However, the value to the nursing home associations was more difficult to establish and was balanced by the perceived reputational risks inherent in organizational research. [Description provided by NIOSH]
• Subjects:
  Database Health Personnel Occupational Health Safety
• Keywords:
  TWH; Total Worker Health; Work organization; Worker safety; Health care workers; Injuries; Nurses; Databases
• Publisher:
  American Psychological Association
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  Kansas ; Massachusetts ; New York ; Ohio ; Oregon ; OSHA Region 1 ; OSHA Region 10 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 7 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  209-210
• NIOSHTIC Number:
  nn:20065684
• Citation:
  Work, Stress and Health 2019, November 6-9, 2019, Philadelphia, Pennsylvania. Washington, DC: American Psychological Association, 2019 Nov; :209-210
• Federal Fiscal Year:
  2020
• Performing Organization:
  Harvard University, Boston, Massachusetts
• Peer Reviewed:
  False
• Start Date:
  20070901
• Source Full Name:
  Work, Stress and Health 2019, November 6-9, 2019, Philadelphia, Pennsylvania
• End Date:
  20260831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2ac5389ec4e422e57d9ffbb5fca1211815fc5fc4828fab234c7b8dcc2c0067b45b4f0edf7b4d1cb1a69aeb44130c341229fb7419c94b72f3825fc4c2681f99ac
• Download URL:
  https://stacks.cdc.gov/view/cdc/248820/cdc_248820_DS1.pdf
• File Type:
  [PDF - 111.84 KB ]