Transformational Leadership at Heart of LTC Successes Amid COVID-19

A transformational leadership style was common among senior leaders at all 10 Missouri long-term care (LTC) facilities identified as exemplars with stable staffing and low COVID-19 rates during the pandemic, according to a study published in the Journal of Nursing Care Quality.

“They did not lay blame, they were the first to suit up, and they all had an open and consistent communication style that provided their staff with comfort knowing they were valued,” wrote corresponding author Nicky Martin, MPA, LNHA, QCP, CDP, IP, of the University of Missouri School of Nursing in Columbia, Missouri, and study coauthors.

The 10 exemplar LTC facilities were identified after a statewide survey in February 2022 gathered data on leadership turnover, use of agency staff, COVID-19 cases, and vaccination rates. Among 91 nursing homes and eight assisted living facilities that participated in the survey, seven nursing homes and three assisted living facilities were deemed standout successes. Senior leaders from those facilities participated in on-site qualitative interviews to share strategies they believe led to their victories.

Trusting, supportive staff relationships were key, according to the study.

“We saw what was happening to the facilities around us, so we planned for what would happen to us too,” one skilled nursing facility administrator told interviewers. “We educated, shared information timely, and didn't lose their trust.”

Consistent staffing assignments as well as positive presence and communication were other top strategies credited by leaders. One administrator explained that charge nurses tried to personally thank each certified nursing assistant at the end of shifts.

“Caring for staff, going the extra mile to support them, and being flexible with staff's situations generated reciprocity,” researchers wrote. “Staff, in turn, took the extra shifts to cover for workmates and pitched in to make each day work. Leaders’ commitment generated staff's commitment.”

Reference

Martin N, Frank B, Farrell D, et al. Sharing lessons from successes: long-term care facilities that weathered the storm of COVID-19 and staffing crises. J Nurs Care Qual. 2023;38(1):19-25. doi: 10.1097/NCQ.0000000000000662