CONSEQUENCES OF EMPOWERED CNA TEAMS IN NURSING HOME SETTINGS: A LONGITUDINAL ASSESSMENT Running Head: Empowered CAN Teams in Nursing Homes Authors:

Purpose of the study: Recent studies have concluded that there is a lack of “patient-centered” care in nursing homes (NHs) and subsequently a need for NH culture change. As a result, there has been the introduction of a variety of new, promising initiatives with most of these incorporating the use of “empowered” employees. The purpose of this study was to evaluate the effects of empowered work teams (EWTs)—a work design specifically established to empower certified nurse aides (CNAs) within the long-term care setting. Design and Methods: A multimethod, pre-post design was used to examine the effects of these teams. The qualitative analysis included observations of over 270 team meetings. The quantitative analyses included five pairs of NHs, with five implementing EWTs and five acting as comparisons. Results: The quantitative as well as qualitative analyses indicate that the EWTs had a variety of modest, positive effects: increased CNA empowerment; better CNA performance; improved resident care and choices; improved procedures, coordination, and cooperation between CNAs and nurses; and possibly reduced turnover. There appeared to be mixed effects on work attitudes. Implications: As new initiatives strive to move away from the medical model and toward a person-centered model, the data suggest that empowered CNA work teams can help.