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Leadership Plays Key Role in Staff Behaviors Affecting Quality in LTC

March 25, 2021

Leadership sets the tone for staff behaviors that promote quality of care in long-term care facilities, suggests a study published in the International Journal of Nursing Studies. 

“Leaders (at all levels) through their role-modeling behaviors can use organizational resources to endorse and encourage relationships (at all levels) between staff, residents, coworkers, and family (relationship-centered care) that constitute learning opportunities for staff, and encourage quality as experienced by residents and families,” advised a team of researchers from the United Kingdom and the Netherlands. 

The recommendation stems from a realist evidence synthesis of 66 studies concerning staff behaviors that promote care quality for older people in long-term care facilities. Although adequate staffing is important, the research team aimed to understand more about staff behaviors that support quality. 

The review identified several key findings. First, staff behaviors influence long-term care facility quality. Second, the facility’s environment and culture affect staff behavior.  

And third, researchers continued, “leadership has an important influence on how organizational resources (sufficient staff effectively deployed, with the knowledge, expertise, and skills required to meet residents’ needs) are used to generate and sustain quality-promoting relationships.” 

Jolynn Tumolo


Haunch K, Thompson C, Arthur A, et al. Understanding the staff behaviours that promote quality for older people living in long term care facilities: A realist review [published online ahead of print, 2021 Feb 20]. Int J Nurs Stud. 2021;117:103905. doi:10.1016/j.ijnurstu.2021.103905

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