Organizational position and perceptions of problems in a nursing home.

This paper examines perceptions of problems expressed by persons living and working in a 100-bed skilled nursing home. Data were obtained from administrative staff, professional and nonprofessional nursing staffs, therapy staff, auxiliary staff, and residents by means of interview, observation, and analyses of records. The relationship between perceptions of problems and location within the organization and the scope and content of roles played was studied. We sought to ascertain the extent to which members agree or disagree with one another as to what are problems, to locate areas of agreement and disagreement, and to relate the results to the broader issue of the quality of care provided elderly institutionalized persons. Position and associated roles of members were found to be related to perceptions of problems. Differential perceptions of the numbers of problems and their priority were observed. Some problems were mentioned more frequently than others. Perceptions of problems varied both within and between organizational units. A person's location within the nursing home was related to the identification of problems as important and the frequency with which different problems were mentioned.