Profile of Lisa Cranley

Nursing researcher receives SSHRC grant to assess resident well-being, worker engagement in long-term care

13 September 2022

Canada’s aging population means that demand for long-term care has increased, while COVID-19 has also had a devastating impact, exposing long-standing deficiencies in the long-term care sector.

Associate Professor Lisa Cranley of the Lawrence Bloomberg Faculty of Nursing and an interdisciplinary team of researchers from the University of Toronto, are the successful recipients of a Social Sciences and Humanities Council (SSHRC) grant that will support the exploration of relational coordination among staff in long-term care homes, and its impact on the well-being of long-term care residents.

While the concept of relational coordination, specifically relational processes for coordinating work, has been studied in other health care sectors, and in long-term care in the United States, the work of Cranley and her research team is likely the first time a study examining relational coordination in long-term care is being conducted in a Canadian context.

“Relational coordination focuses on communication and relationships among workers in a team and could have a positive impact on worker outcomes such as reducing burnout,” says Cranley. “Relational coordination among workers has also been shown to improve the quality and efficiency of work processes in health care settings.”

Diverse group of young doctors interns discussing the patient's medical condition while talking in a meeting room in a hospital. Surgery, medicine concept. Focus on a african american female doctor.

Relational coordination is a theory developed by Jody Gittell originally for the airline industry to assess efficiency in work processes and performance. The concept has been applied to health care settings in recent decades to assess its impact on performance, as well as worker, and patient outcomes, with key dimensions centered around communication and relationships.

Cranley and her team’s mixed methods study will include interviews and surveys of health care workers, residents and family caregivers from 15 long-term care homes across Ontario, giving each participant a voice and opportunity to share their perspectives. In addition to understanding the impact of relational coordination on resident and worker outcomes, the study will also contribute to understanding new ways of building capacity among staff and new models of care delivery in long-term care.

“We will be looking at interactions and relationships between health care workers and what relational coordination looks like including how it is achieved in the long-term care work environment. We will also be exploring its impact on health care worker outcomes, such as work engagement, job satisfaction, and burnout, in addition to resident well-being says Cranley.

How well staff achieve relational coordination can effectively improve processes of care coordination, something that is particularly urgent during staffing shortages. In long-term care specifically, Cranley recognizes there is a significant need for relational coordination to be better understood to support relational work processes that could lead to improved care quality.

“Throughout the pandemic, long-term care homes have acquired new staff, including unregulated health care providers. If these individuals are not well integrated into a team, continuity of care for residents and information exchange among staff can be significantly impacted,” says Cranley.

Cranley’s study will enable researchers to better understand how care teams work together and communicate to coordinate care for residents, such as when a resident has experienced a fall, and how staff relational coordination impacts the personhood and well-being of residents.

“This study is novel in the long-term care sector and gaining an understanding of relational coordination in long-term care, can lead to ways to build capacity in the sector enabling it to be more responsive to outbreaks of any kind of disease, or significant staffing shortages,” adds Cranley.

Though this is but one study, it is foundational work that could subsequently inform interventions to strengthen teams and practices in long-term care.

“With this work, I’m looking forward to exploring how we can achieve high performing team environments, continuity and coordination of care, and improved information exchange among long-term care staff,” says Cranley, “there is so much work to do in long-term care and I remain passionate about improving the sector.”