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Elizabeth Bradley, Leslie Curry, Shoba Ramanadhan, Laura Rowe, Ingrid Nembhard, H. Krumholz (2009)
Research in action: using positive deviance to improve quality of health careImplementation Science : IS, 4
Ruth Anderson, Natalie Ammarell, D. Bailey, C. Colón-Emeric, K. Corazzini, M. Lillie, M. Piven, Q. Utley-Smith, R. McDaniel (2005)
Nurse Assistant Mental Models, Sensemaking, Care Actions, and Consequences for Nursing Home ResidentsQualitative Health Research, 15
G. Wunderlich, P. Kohler (2001)
Improving the Quality of Long-Term Care
H. Luft (2010)
Data and methods to facilitate delivery system reform: harnessing collective intelligence to learn from positive deviance.Health services research, 45 5 Pt 2
I. Prigogine (1997)
The end of certainty
Blake Ashforth, Fred Mael (1989)
Social identity theory and the organizationOrganizational Psychology, 2
B. Kash, G. Naufal, Leslie Cortés, C. Johnson (2009)
Exploring Factors Associated With Turnover Among Registered Nurse (RN) Supervisors in Nursing HomesJournal of Applied Gerontology, 29
M. Schmitt (2010)
High Performance Healthcare: Using the power of relationships to achieve quality, efficiency, and resilienceJournal of Interprofessional Care, 24
C. Salvato (2009)
Capabilities Unveiled: The Role of Ordinary Activities in the Evolution of Product Development ProcessesOrgan. Sci., 20
H. Tsoukas (2009)
Craving for generality and small-N studies : a Wittgensteinian approach towards the epistemology of the particular in organization and management studies
(2009)
An Analysis of National Level Data
Ruth Anderson, B. Crabtree, D. Steele, R. McDaniel (2005)
Case Study Research: The View From Complexity ScienceQualitative Health Research, 15
(2010)
Report of findings, 2008 nursing facility staff vacancy, retention and turnover survey
N. Castle, Michael Lin (2010)
Top management turnover and quality in nursing homesHealth Care Management Review, 35
C. Lindberg, T. Clancy (2010)
Positive Deviance: An Elegant Solution to a Complex ProblemJONA: The Journal of Nursing Administration, 40
B. Kash, N. Castle, G. Naufal, C. Hawes (2006)
Effect of staff turnover on staffing: A closer look at registered nurses, licensed vocational nurses, and certified nursing assistants.The Gerontologist, 46 5
Ruth Anderson, K. Corazzini, R. McDaniel (2002)
Complexity science and the dynamics of climate and communication: reducing nursing home turnover.The Gerontologist, 44 3
N. Castle, Ruth Anderson (2011)
Caregiver Staffing in Nursing Homes and Their Influence on Quality of Care: Using Dynamic Panel Estimation MethodsMedical Care, 49
N. Castle (2006)
Measuring staff turnover in nursing homes.The Gerontologist, 46 2
Ruth Anderson, L. Issel, R. McDaniel (2003)
Nursing Homes as Complex Adaptive Systems: Relationship Between Management Practice and Resident OutcomesNursing Research, 52
M. Mumford, Tamara Friedrich, Jay Caughron, Alison Antes (2009)
Leadership research : traditions, developments and current directions
C. Donoghue (2010)
Nursing Home Staff Turnover and RetentionJournal of Applied Gerontology, 29
D. Plowman, Stephanie Solansky, Tammy Beck, LaKami Baker, Mukta Kulkarni, Deandra Travis (2007)
The role of leadership in emergent, self-organizationLeadership Quarterly, 18
D. Buchanan, A. Bryman (2009)
The SAGE handbook of organizational research methods
S. Kaiser, Gordon Müller-Seitz, Max Ringlstetter (2007)
Positive Organizational Scholarship
M. Miles, A. Huberman (1994)
An expanded sourcebook qualitative data analysis
P. Cilliers (1998)
Complexity and PostmodernismJournal of Artificial Societies and Social Simulation
Georg Schreyögg, Martina Kliesch-Eberl (2007)
How dynamic can organizational capabilities be? Towards a dual-process model of capability dynamizationSouthern Medical Journal, 28
N. Castle, L. Shugarman (2005)
The Effects of Top Management Professional Development on Administrator TurnoverThe Journal of Applied Gerontology, 24
(2012)
Title 42-Public Health Chapter IV: Centers for Medicare and Medicaid Services, Department of Health and Human Services
N. Castle, J. Engberg, Aiju Men (2007)
Nursing home staff turnover: impact on nursing home compare quality measures.The Gerontologist, 47 5
Sarah Forbes-Thompson, B. Gajewski, Jill Scott-Cawiezell, N. Dunton (2006)
An Exploration of Nursing Home Organizational ProcessesWestern Journal of Nursing Research, 28
B. Crabtree, W. Miller, Melinda Swenson (1999)
Doing Qualitative Research
Quality Series (2004)
Keeping Patients Safe: Transforming the Work Environment of NursesJournal for Healthcare Quality, 26
Ann Page (2011)
Keeping patients safe.Consumer reports, 76 5
C. Colón-Emeric, D. Plowman, D. Bailey, K. Corazzini, Q. Utley-Smith, Natalie Ammarell, M. Toles, Ruth Anderson (2010)
Regulation and Mindful Resident Care in Nursing HomesQualitative Health Research, 20
N. Castle (2005)
Turnover begets turnover.The Gerontologist, 45 2
B. Kash, G. Naufal, R. Dagher, C. Johnson (2010)
Individual factors associated with intentions to leave among directors of nursing in nursing homes.Health care management review, 35 3
M. Baucus (1985)
American Health Care Association
Paul Moe (1989)
Designing Qualitative Research
Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided.
Journal of Applied Gerontology – SAGE
Published: Feb 1, 2014
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