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Sustaining Culture Change: Experiences in the Green House Model
Author(s) -
Bowers Barbara,
Nolet Kimberly,
Jacobson Nora
Publication year - 2016
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12428
Subject(s) - grounded theory , culture change , organizational culture , data collection , theory of change , sustainability , perspective (graphical) , qualitative research , sample (material) , qualitative property , change management (itsm) , nursing , knowledge management , public relations , psychology , sociology , medicine , marketing , business , management , computer science , social science , political science , economics , chemistry , chromatography , artificial intelligence , biology , lean manufacturing , ecology , machine learning
Objective To describe conditions that influence how Green House ( GH ) organizations are sustaining culture change principles and practices in a sample of GH skilled nursing homes. Data Sources/Study Setting Primary data were collected at 11 skilled nursing GH organizations from 2012 to 2014. These organizations have adopted the comprehensive and prescriptive GH model of culture change. Study Design To develop an understanding of sustainability from the perspective of staff who are immersed in GH daily work, grounded theory qualitative methods were used. Data Collection Methods Data were collected using semi‐structured interviews with 166 staff and observation of house meetings and daily operations. Data were analyzed using grounded dimensional analysis. Principal Findings Organizations varied in their ability to sustain GH principles and practices. An organization's approach to problem solving was central to sustaining the model. Key conditions influenced reinforcement or erosion of GH principles and practices. Conclusions Reinforcing the GH model requires a highly skilled team of staff with the ability to frequently and collaboratively solve both mundane and complex problems in ways that are consistent with the GH model. This raises questions about the type of human resources practices and policy supports that could assist organizations in sustaining culture change.