A person-centered workplace: the foundation for person-centered caregiving in long-term care

J Am Med Dir Assoc. 2007 Jan;8(1):46-54. doi: 10.1016/j.jamda.2006.09.009.


Objective: This study seeks to understand what role managers and the work setting they create play in a nursing facility that seeks to make a transition to person-centered care.

Design: The study uses a human-relations framework to test 3 propositions: Managers play a critical role in the satisfaction, loyalty and commitment (ie, the engagement) of their staff; managers construct a person-centered workplace that deepens staff engagement; and engaged staff promote the well-being of the residents.

Setting and participants: The study draws on responses of Certified Nurse Assistants (CNAs) and families of residents collected in 2 satisfaction surveys conducted in 156 nursing facilities. It also uses state inspection survey data from the same facilities.

Measurements: The analysis uses measures of satisfaction, loyalty, and commitment as well as 6 scales of quality; 3 as they pertain to staff and 3 as they pertain to families. Data reduction, correlational, and risk analyses assess how managers and the work environment affect CNA engagement and the quality of caregiving.

Results: Management approach and the work environment are powerful predictors of CNA satisfaction, loyalty, and commitment. The work environment also correlates with how families and state surveyors evaluate quality in a nursing facility.

Conclusion: The managers and the work setting they create hold primacy in the work life of the CNAs. Caring managers fashion a person-centered workplace conducive to turn workers into devoted caregivers. When the workplace adds quality to the life of caregivers, the caregivers add quality to the life of the resident.

MeSH terms

  • Analysis of Variance
  • Attitude of Health Personnel*
  • Attitude to Health
  • Empathy
  • Family / psychology
  • Health Facility Environment / organization & administration
  • Humans
  • Interprofessional Relations
  • Job Satisfaction*
  • Nurse Administrators / organization & administration
  • Nurse Administrators / psychology
  • Nurse's Role / psychology
  • Nursing Assistants* / organization & administration
  • Nursing Assistants* / psychology
  • Nursing Homes / organization & administration*
  • Nursing, Supervisory / organization & administration
  • Occupational Health*
  • Organizational Culture
  • Patient-Centered Care / organization & administration
  • Personnel Loyalty
  • Quality of Health Care
  • Quality of Life / psychology
  • Social Support
  • Southeastern United States
  • Surveys and Questionnaires
  • Workplace* / organization & administration
  • Workplace* / psychology