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The Gerontologist Advance Access published online on August 19, 2009
The Gerontologist, doi:10.1093/geront/gnp123
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org.

Role for a Labor–Management Partnership in Nursing Home Person-Centered Care

Walter Leutz, PhD2, Christine E. Bishop, PhD1,2 and Lisa Dodson, PhD3

2 The Heller School for Social Policy and Management, Schneider Institutes for Health Policy, Brandeis University, Waltham, Massachusetts
3 Department of Sociology, Boston College, Chestnut Hill, Massachusetts

1 Address correspondence to Christine E. Bishop, PhD, The Heller School for Social Policy and Management, Room 214, Schneider Institutes for Health Policy, Brandeis University, Mailstop 035, 415 South Street, P.O. Box 549110, Waltham, MA 02454-9110. E-mail: bishop{at}brandeis.edu


  Abstract

Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes participating in a partnership between a labor union and a provider coalition. The study was designed to reveal whether and how the labor–management partnership supported PCC and to identify challenges to overcome in the future. Results: The partnership provided training and follow-up support to member homes to implement PCC. Management and worker participants used the partnership as a learning collaborative to acquire PCC knowledge and to share implementation experience. Key elements of the implementation in each nursing home were translation of the larger labor–management partnership to each member nursing home, management innovations that developed and supported PCC, and conduct of union actors in each nursing home that supported PCC while maintaining traditional union protections. Frontline workers exhibited strong engagement in PCC practices. Implications: A partnership between labor and management can foster changes in the organization of frontline work aimed at improving nursing home residents’ quality of life and care.

Keywords: Management, Labor unions, Qualitative research, Workforce

Received March 1, 2009; Accepted July 16, 2009

Decision Editor: Nancy Schoenberg, PhD


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