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Associations Among Health Care Workplace Safety, Resident Satisfaction, and Quality of Care in Long-Term Care Facilities

Boakye-Dankwa, Ernest MSc, MPH; Teeple, Erin MD, MPH; Gore, Rebecca PhD; Punnett, Laura ScDProcare Research Team

Journal of Occupational and Environmental Medicine: November 2017 - Volume 59 - Issue 11 - p 1127–1134
doi: 10.1097/JOM.0000000000001163

Objective: We performed an integrated cross-sectional analysis of relationships between long-term care work environments, employee and resident satisfaction, and quality of patient care.

Methods: Facility-level data came from a network of 203 skilled nursing facilities in 13 states in the eastern United States owned or managed by one company. K-means cluster analysis was applied to investigate clustered associations between safe resident handling program (SRHP) performance, resident care outcomes, employee satisfaction, rates of workers’ compensation claims, and resident satisfaction.

Results: Facilities in the better-performing cluster were found to have better patient care outcomes and resident satisfaction; lower rates of workers compensation claims; better SRHP performance; higher employee retention; and greater worker job satisfaction and engagement.

Conclusion: The observed clustered relationships support the utility of integrated performance assessment in long-term care facilities.

College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Drs Boakye-Dankwa, Teeple, Gore, Punnett); and Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia (Dr Boakye-Dankwa).

Address correspondence to: Erin Teeple, MD, MPH, University of Massachusetts Lowell, Lowell, MA 01854 (

The work is supported by Grant No. U19-OH008857 from the U.S. NIOSH (NIOSH/CDC). This work is solely the responsibility of the authors and does not necessarily represent the official views of NIOSH.

The authors have no conflicts of interest to declare.

Copyright © 2017 by the American College of Occupational and Environmental Medicine