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

This comparative case study explored how the interplay among leadership, communication, and teamwork differed between a highest and lowest performing nursing home (NH). Secondary data were used 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. Study findings suggest nursing leadership played a critical role in influencing communication and teamwork among members of the team. Nursing leadership in the highest performing NH encouraged open communication at the formation of the team which led team members to share their diverse perspectives. An understanding of diverse perspectives, in turn, led to a cohesive, goal directed team environment where effective problem solving occurred. As the team evolved, nursing leadership engaged all members of the team by seeking team member input and feedback to identify and solve problems, and as a result, team members became empowered to influence change. Additionally, the introduction of accurate and timely feedback data further supported team efforts to facilitate improvement. In contrast, nursing leadership in the lowest performing NH discouraged open communication at the formation of the team, and as a result, team members were unable to establish a cohesive relationship which impeded