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.