Observational studyThe Gerontologist2015
Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.
Observational study in The Gerontologist, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementing Dementia Care Mapping as a practice development tool in dementia care services: a systematic review.Clinical interventions in aging · 2018Pooled it
- Nursing home performance in a trial to reduce hospitalizations: Implications for future trials.Journal of the American Geriatrics Society · 2021Trial
- A framework for cross-cultural development and implementation of complex interventions to improve palliative care in nursing homes: the PACE steps to success programme.BMC health services research · 2019Trial
- Bridging Perspectives: Guiding the Selection of Patient-Centered Outcomes in Rehabilitation Learning Health Systems.Archives of physical medicine and rehabilitation · 2026Article
- Associations between nursing home leadership turnover and resident satisfaction.The Gerontologist · 2026Article
- Family perceptions of palliative care consultations for nursing home residents.BMC palliative care · 2026Article
- Behavior change techniques in a care partner-assisted oral health intervention for people with mild dementia: a secondary mixed-methods analysis.Innovation in aging · 2026Article
- Exploring leadership skills development in nursing: a qualitative investigation into the excellence in care program in the Kingdom of Saudi Arabia.BMC nursing · 2025Article
- Microbiological diagnostics and their impact on hematology nursing.Folia microbiologica · 2025Review
- The role of food as part of person-centred palliative care: An exploratory ethnographic study.Palliative care and social practice · 2025Article
- With COVID Comes Complexity: Assessing the Implementation of Family Visitation Programs in Long-Term Care.The Gerontologist · 2023Article
- Development and validation of the adaptive leadership behavior scale (ALBS).Frontiers in psychology · 2023Article
- Social determinants of health: critical consciousness as the core to collective impact.Frontiers in research metrics and analytics · 2023Article
- Leading by example: Nursing home staff experiences of what facilitates them to meaningfully engage with residents with advanced dementia.International journal of geriatric psychiatry · 2022Article
- Social Isolation and Nursing Leadership in Long-Term Care: Moving Forward After COVID-19.The Nursing clinics of North America · 2022Review
- Applying the principles of adaptive leadership to person-centred care for people with complex care needs: Considerations for care providers, patients, caregivers and organizations.Health expectations : an international journal of public participation in health care and health policy · 2021Review
- Appropriate leadership in nursing home care: a narrative review.Leadership in health services (Bradford, England) · 2021Review
- Identifying the Implementation Conditions Associated With Positive Outcomes in a Successful Nursing Facility Demonstration Project.The Gerontologist · 2020Article
- Leadership, Staff Empowerment, and the Retention of Nursing Assistants: Findings From a Survey of U.S. Nursing Homes.Journal of the American Medical Directors Association · 2020Article
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purpose of the studyTo describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. DESIGN AND
methodsThe study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership.
resultsSix key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. IMPLICATIONS: Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.