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The Gerontologist Advance Access originally published online on March 18, 2009
The Gerontologist 2009 49(1):68-80; doi:10.1093/geront/gnp011
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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.

Daily Practice Teams in Nursing Homes: Evidence From New York State

Helena Temkin-Greener, PhD, MPH1,2, Shubing Cai, MS2, Paul Katz, MD3, Hongwei Zhao, ScD4 and Dana B. Mukamel, PhD5

2 Department of Community and Preventive Medicine, University of Rochester, New York
3 Department of Medicine, University of Rochester, New York
4 Department of Epidemiology and Biostatistics, Texas A&M University, College Station, Texas
5 Department of Medicine, Center for Health Policy Research, University of California, Irvine

1 Address correspondence to Helena Temkin-Greener, PhD, Department of Community and Preventive Medicine, University of Rochester School of Medicine, Box 644, 601 Elmwood Avenue, Rochester, NY 14642. E-mail: helena_temkin-Greener{at}urmc.rochester.edu


  Abstract

Purpose: Most health care organizations, including nursing homes, report having teams. However, little is known about everyday practice teams among staff providing direct resident care. We assess the prevalence of such teams in nursing homes as reported by direct care staff and administrators, and examine characteristics of facilities that foster these teams. Design and Methods: The analytical model is based on 149 nursing homes. Data sources include surveys of administrators (n = 292) and direct care staff (n = 6,867), and Online Survey Certification and Reporting System. Linear regression with robust standard errors and sampling probability weights is used to examine the relationship between daily practice teams and facility characteristics. Results: On average, 16% of workers per facility report practicing in formal multidisciplinary teams providing daily resident care. Team prevalence is 3.3% higher when managers view teams as very important for clinical care quality, 2.6% higher when the directors of nursing report formally organized teams, 2.5% higher for each 10% increase in workers' involvement in teams other than the daily practice teams, and 1.95% higher for each 1-hr increase in nursing hours. Implications: Our study shows that multidisciplinary daily practice teams can be found in most facilities in our large sample, but their penetration within nursing homes is far from pervasive; in 72% of facilities, staff report team prevalence of less than 25%. Given that the majority of managers report teamwork as very important to their facilities' operations, we discuss why only a relatively small proportion of daily care is provided in this fashion.

Keywords: Long-term care, Workforce, Teamwork

Received January 8, 2008; Accepted June 16, 2008

Decision Editor: William J. McAuley, PhD


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