Leadership, communication, and teamwork : differences between high and low performing nursing homes

Abstract

This comparative case study explored how the interplay among leadership, communication, and teamwork differed between the highest and lowest performing nursing homes (NH) from a previous AHRQ intervention study to explore the impact of technology and focused quality improvement teams on medication safety practices in five Midwestern NHs. Findings suggest nursing leadership in the highest performing NH encouraged open communication leading team members to share diverse perspectives resulting in a cohesive, goal directed team where effective problem solving occurred. Nursing leadership sought team member input resulting in team empowerment to influence change. In contrast, nursing leadership in the lowest performing NH discouraged open communication which impeded cohesive relationships. Nursing leadership valued input and feedback from select team members rather than the entire team leading team members to disengage from the team process, subsequently impeding team efforts to achieve improvement. As this study suggests, nursing leadership was an influencing factor in NH performance and should be further explored as a key variable to organizational improvement across healthcare settings.