Beyond ‘unloving care’: linking human resource management and patient care quality in nursing homes

Abstract

This study examines the link between human resource management, (HRM), work organization and patient care quality in US long-term care settings, proposing a key role for both management philosophy and improved front-line staffing arrangements in delivering consistently higher quality care, defined to include both physical and psychological outcomes. Using the ‘high performance’ model from industrial relations as a lens, the paper identifies three distinct systems of HR and nursing-home management: traditional low-service quality, high service quality medical rehabilitative and ‘new paradigm regenerative’. The original research includes case studies conducted in twenty facilities in California and Pennsylvania, USA.