Organizational readiness to change as a leverage point for improving safety: a national nursing home survey

Table 3 Safety climate domain outcomes regressed on Psychological and Behavioral Readiness to Change Domain, controlling for person- and CLC-level characteristics

	Safety climate domains
	Safety priorities	Supervisor commitment to safety	Senior management commitment to safety	Attitudes towards safety	Environmental safety	Co-worker interactions around safety	Global rating of the CLC
	B (SE)	B (SE)	B (SE)	B (SE)	B (SE)	B (SE)	B (SE)
Person-level variables
Occupation type
Nursing assistants	1.72*** (0.46)		3.64*** (0.58)	−0.38 (0.48)		0.52 (0.51)	1.46* (0.58)
Clinicians/specialists	−0.52 (0.56)		3.00***	−3.61***(0.60)		1.34* (0.63)	0.99 (0.74)
Administrative/support	0.13 (1.03)		3.47** (1.32)	−2.99** (1.07)		2.92* (1.13)	2.85* (1.32)
Senior managers	1.15 (0.81)		6.02*** (1.03)	2.09* (0.85)		4.17*** (0.90)	5.14*** (1.03)
Licensed nurses	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
CLC Tenure
< 2 years			1.73* (0.66)	3.03*** (0.55)			−0.15 (0.68)
≥ 2 years- < 5 years			−0.58 (0.69)	−1.78** (0.58)			−1.82* (0.71)
≥ 5 years- < 10 years			−1.69* (0.71)	− 1.27* (0.60)			−0.68 (0.73)
≥ 10 years	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Work shift
Day/Night		1.0* (0.48)	1.84*** (0.51)
Work hours per week
≤ 40 versus > 40 h		1.01 (0.53)
CLC-level variables
Occupation: licensed nurses (%)
Tenure: ≥ 5 years (%)	4.14** (1.52)	7.57** (2.36)
Work shift: day shift (%)
Work hours: ≤ 40 h/week (%)
CLC size
Job satisfaction/ engagement	1.52 (1.09)				4.62* (2.07)	0.42 (1.29)	3.70 (1.97)
Nursing ratio	−0.01 (0.14)	−0.12 (0.22)	−0.19 (0.21)	0.18 (0.17)	0.43 (0.28)	0.01 (0.17)	0.25 (0.26)
Psychological and Behavioral Readiness to Change	2.77*** (0.65)	7.46*** (1.01)	7.86*** (0.93)	2.12** (0.75)	2.51 (1.30)	6.15*** (0.79)	5.03*** (1.23)

Note: Variables specified in each Step 4 model were based on Steps 1–3 models as follows. Step 1 models contained only person-level covariates. Step 2 models contained all person-level covariates and all CLC-level variables except job satisfaction/engagement, nursing ratio, and Psychological and Behavioral Readiness to Change Domain. Step 3 included all Step 2’s significant covariates and job satisfaction/engagement. Step 4 contained all Step 3’s significant covariates and nursing ratio and Psychological and Behavioral Readiness to Change Domain. All outcome variables (safety climate domains) were standardized to a mean of 50 and standard deviation of 10. Range for job satisfaction/engagement and Psychological and Behavioral Readiness to Change Domain was 1–5
* P < .05; ** P < .01; *** P < .001; B regression coefficient, SE Standard error
Psychological and Behavioral Readiness to Change was consistently and strongly associated with all safety climate domains in CLCs

ISSN: 1472-6963