A Vision for the Future: New Care Delivery Models Can Play a Vital Role in Building Tomorrow's Eldercare Workforce.

DISEASE management; DIFFUSION of innovations; FORECASTING; HOME care services; LONG-term care insurance; INTEGRATED health care delivery; LABOR mobility; LABOR supply; LABOR turnover; LONG-term health care; MEDICAID; MEDICAL personnel licenses; MEDICARE; PRIMARY health care; QUALITY assurance; RESPONSIBILITY; WAGES; PATIENT participation; HEALTH care reform; ECONOMICS

While the need to recruit and retain a competent, caring direct care workforce is acute for many long-term care providers, the transformation from hierarchical to empowering work and workplaces is proving difficult. Management practices that are deeply held artifacts of entrenched cultures, absent radical change, tend to change incrementally. Incremental change allows new ideas to infiltrate an organization without completely destroying the established values and assumptions that provide an organization's operating framework. Using the array of incremental changes made in many of the provider organizations that participated in the Better Jobs Better Care demonstration, we suggest several ways that leaders use management practice change to move the organization forward in its effort to change its culture. [ABSTRACT FROM AUTHOR]

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