Abstract
Consistent staff assignment is a cornerstone of culture transformation in long-term care settings. By minimizing the number of different staff who provide care during a resident’s stay, consistent staff assignment promotes more resident-centered care and is thought to result in improved resident functioning and quality of life. This study assessed the extent and stability of consistent staff assignment in 199 of the 335 organizational units that comprise the Veterans Health Administration national network of nursing homes (called Community Living Centers or CLCs). A survey completed by staff schedulers in each of these CLC units retrospectively assessed levels of consistent staff assignment over a one-year period and unit characteristics that have been hypothesized to facilitate successful implementation of consistent staff assignment in long-term care settings. Over a one-year period, 38% of CLC units had stable high, 29% had stable low, and 33% had variable levels of consistent staff assignment. Characteristics that distinguished the units with stable high consistent staff assignment were use of fixed care teams and greater staff input for care assignments. Schedulers in these units reported more positive experiences linked with consistent staff assignment and better unit functioning in terms of staff absences, workload complaints, and scheduling problem resolution. Contrary to expectation, implementation of consistent staff assignment was not related to unit size, staffing level, or unit care specialization (e.g., dementia, geropsychiatric care). Findings from this study may be helpful to long-term care providers planning, or having difficulty sustaining, successful implementation of consistent staff assignment in their care settings.