Relationships among leadership practices, work environments, staff communication and outcomes in long-term care.

AIM: To examine the role that work relationships have on two long-term care outcomes: job satisfaction and turnover intention. BACKGROUND: It is easy to overlook the impact that human relations have in shaping work environments that are conducive to organizational effectiveness. Employee job satisfaction and retention are important organizational outcomes. METHODS: Six hundred and seventy-five nursing and other staff from 26 long-term care facilities were surveyed about their work environments, work group relationships, observed leadership practices, organizational support, job satisfaction and turnover intention. RESULTS: Higher job satisfaction was associated with lower emotional exhaustion burnout, higher global empowerment, higher organizational support, higher psychological empowerment, stronger work group cohesion and higher personal accomplishment. Higher turnover intention was associated with lower job satisfaction, higher emotional exhaustion burnout, more outside job opportunities, weaker work group cohesion, lower personal accomplishment and higher depersonalization. CONCLUSIONS: No relationship was found between leadership practices and job satisfaction or turnover intention. Stronger work group relationships, stronger sense of personal accomplishment and lower emotional exhaustion have direct effects on increasing job satisfaction and lowering turnover intention. IMPLICATIONS: To retain long-term care staff, attention should be paid to fostering positive work group cohesion, supporting and acknowledging staff accomplishments and minimizing staff burnout.

Work environments and staff responses to work environments in institutional long-term care.

BACKGROUND: Structures and processes of care such as work environments and care provider responses to work environments have been shown to influence organizational outcomes. To improve health care quality, structures, processes, and outcomes of care should be considered. There is almost no literature reporting on the structural characteristics of work environments and care provider responses to work environments in institutional long-term (chronic) care settings. PURPOSE: The purpose of this article was to report how a convenience sample of multidisciplinary care providers working in institutional long-term (chronic) care settings in Ontario, Canada, evaluated their work environments and their responses to these environments. METHODOLOGY: A sample of multidisciplinary care providers working within six institutional long-term care settings completed a survey rating their work environments (e.g., supervisor support and effectiveness and work empowerment) and responses to work environments (e.g., job satisfaction, burnout, and intention to remain employed). The survey included three well-established instruments: Supervisory Support Scale; Learn, Empower, Achieve, and Produce instrument; and the Maslach Burnout Inventory. Descriptive statistics were used to summarize survey data. To determine whether there were differences in staff characteristics, ratings of work environments, and responses to work environments across the four participant job categories, tests of differences were completed using analyses of variance with Tukey post hoc (continuous variables) and chi-square (categorical variables) tests. FINDINGS: Ratings of the work environment were similar across job categories and indicated opportunities for improvement. Overall job satisfaction was rated between "neutral" and "satisfied." On average, the staff reported moderate levels of emotional exhaustion (burnout). More than one third of all staff members reported planning to leave their employment, including two thirds of allied health professionals. PRACTICE IMPLICATIONS: Strategies are suggested to strengthen institutional long-term care work environments to promote more positive staff responses to work environments, including higher job satisfaction and intention to remain employed.