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Unpacking the Relationship between Operational Efficiency and Quality of Care in Ontario Long-Term Care Homes*

Published online by Cambridge University Press:  07 December 2010

Whitney Berta ,
Audrey Laporte  and
Natasha Kachan
Whitney Berta*
Affiliation:
Faculty of Medicine; Department of Health Policy, Management, and Evaluation; University of Toronto
Audrey Laporte
Affiliation:
Faculty of Medicine; Department of Health Policy, Management, and Evaluation; University of Toronto
Natasha Kachan
Affiliation:
Leslie Dan Faculty of Pharmacy, University of Toronto
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Whitney Berta, Ph.D., Faculty of Medicine, Department of Health Policy, Management, and Evaluation, University of Toronto, 155 College Street, Ste. 425 Toronto, Ontario, Canada M5T 3M6 (whit.berta@utoronto.ca)
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Abstract

In this multiple-case study, we engaged directors of care of Ontario long-term care (LTC) homes in semi-structured interviews designed to increase our understanding of the influence exerted by organizational and extra-organizational factors on two key aspects of organizational performance: operational efficiency and quality of care. We also examined the influence of these factors on the relationship between efficiency and quality. Through a review of the health services and organization and management literatures, four broad factors identified a priori as influential for one or both performance outcomes were used to guide our data collection: staff characteristics, facility characteristics, extra-organizational influences, and the function of volunteers. Our findings suggest that while both high efficiency and high quality of care are achievable, there are aspects of a home’s operations and realities associated with the LTC sector in Ontario that can make achieving both, simultaneously, exceedingly challenging.

Résumé

Dans cette étude de cas multiples, nous avons retenu les administrateurs des maisons de soins de longue durée (SLD) dans les entretiens semi-structurés afin d’accroître notre compréhension de l’influence exercée par les facteurs organizationnels et extra-organisationnels sur deux aspects clés de la performance organizationnelle : l’efficacité operationnelle et la qualité des soins. Nous avons aussi examiné l’influence de ces facteurs sur la relation entre l’efficacité et la qualité. Grace à un examen de la littérature de soins de santé et de l’organisation de gestion, quatre grands facteurs ont été identifiés a priori comme influents pour un ou deux résultats de rendement et ont été utilisés pour guider notre collecte de données : les caractér-istiques du personnel, les caractéristiques de l’établissement, les influences extra-organisationnelles, et les fonction de bénévoles.

Nos résultats suggèrent que, alors que tous les deux, haut rendement et haut qualité des soins, sont réalisables, il y a des aspects de la fonctionnement d’une maison et les réalités associés au secteur des soins de longue durée en Ontario qui peut faire atteindre tous les deux à la fois, simultanément, excessivement difficile.

Keywords

soins de longue duréemaisons de soins infirmiersqualité des soinsl’efficacité organizationnellelongterm carenursing homesquality of careoperational efficiency
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 29 , Issue 4 , December 2010 , pp. 543 - 556
Copyright
Copyright © Canadian Association on Gerontology 2010

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Footnotes

*

This study was funded by the Ontario Ministry of Health and Long-Term Care. The study protocol received approval from the University of Toronto’s Ethics Review Board.

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