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Supporting employees’ work-family needs improves health care quality: longitudinal evidence from long-term care
  • Published Date:
    Mar 24 2016
  • Source:
    Soc Sci Med. 157:111-119.


Public Access Version Available on: May 01, 2017 information icon
Please check back on the date listed above.
Details:
  • Pubmed ID:
    27082022
  • Pubmed Central ID:
    PMC4848161
  • Funding:
    F31 AG050385/AG/NIA NIH HHS/United States
    L60 MD003645/MD/NIMHD NIH HHS/United States
    U01 AG027669/AG/NIA NIH HHS/United States
    U01 HD051256/HD/NICHD NIH HHS/United States
    U01 OH008788/OH/NIOSH CDC HHS/United States
    U19 OH008861/OH/NIOSH CDC HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    We analyzed qualitative and quantitative data from U.S.-based employees in 30 long-term care facilities. Analysis of semi-structured interviews from 154 managers informed quantitative analyses. Quantitative data include 1214 employees' scoring of their supervisors and their organizations on family supportiveness (individual scores and aggregated to facility level), and three outcomes: (1), care quality indicators assessed at facility level (n = 30) and collected monthly for six months after employees' data collection; (2), employees' dichotomous survey response on having additional off-site jobs; and (3), proportion of employees with additional jobs at each facility. Thematic analyses revealed that managers operate within the constraints of an industry that simultaneously: (a) employs low-wage employees with multiple work-family challenges, and (b) has firmly institutionalized goals of prioritizing quality of care and minimizing labor costs. Managers universally described providing work-family support and prioritizing care quality as antithetical to each other. Concerns surfaced that family-supportiveness encouraged employees to work additional jobs off-site, compromising care quality. Multivariable linear regression analysis of facility-level data revealed that higher family-supportive supervision was associated with significant decreases in residents' incidence of all pressure ulcers (-2.62%) and other injuries (-9.79%). Higher family-supportive organizational climate was associated with significant decreases in all falls (-17.94%) and falls with injuries (-7.57%). Managers' concerns about additional jobs were not entirely unwarranted: multivariable logistic regression of employee-level data revealed that among employees with children, having family-supportive supervision was associated with significantly higher likelihood of additional off-site jobs (RR 1.46, 95%CI 1.08-1.99), but family-supportive organizational climate was associated with lower likelihood (RR 0.76, 95%CI 0.59-0.99). However, proportion of workers with additional off-site jobs did not significantly predict care quality at facility levels. Although managers perceived providing work-family support and ensuring high care quality as conflicting goals, results suggest that family-supportiveness is associated with better care quality.

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