The accreditation process for Australian residential aged care homes: an institutional theory and quality perspective

"A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy""Submitted March 2013"Includes bibliographical references.1. Introduction -- 2. Ageing population and the Australian aged care system -- 3. The nature of quality management and accreditation -- 4. Theoretical frameworks -- 5. Research method -- 6. Results and findings: quality and accreditation -- 7. Results and findings: new institutional theory -- 8. Conclusions and recommendations -- 9. Appendix.The purpose of this research is to determine the reasons why Residential Aged Care Homes (RACHs) undertake the accreditation process, and to evaluate the influence that the accreditation process has on the quality of services provided by RACHs. Therefore, this research addresses two research questions: 1) In addition to government funding, why do RACHs adopt accreditation standards? 2) What perceived influence does the adoption of accreditation standards have on the quality of RACHs? How is this viewed by different staff members of RACHs?This research is exploratory in nature, using a descriptive research design with multiple case studies (six) conveniently sampled from New South Wales, Australia. Data collection from RACHs, using in-depth interviews, review of available RACH documentation, and surveys were applied in this research. This facilitated an examination of the data from two different perspectives: 1) from staff directly involved with the accreditation process, and 2) from general RACH staff. The data was analysed from institutional theory and quality perspectives, and propositions were mostly supported.Findings demonstrate that the main reasons why RACHs adopt the accreditation program include: to improve the quality of services provided to residents, to respond to coercive pressures from the government, an RACH’s commitment to quality management, for legitimacy reasons, and to ensure accountability. Concerning whether the adoption of accreditation standards does have an influence on the quality of services provided by RACHs, staff had diverse views. For instance, some staff believes that quality of care has improved, yet others believe that the accreditation process is purely for legitimacy purposes and that the workload resultant from accreditation can negatively affect the care provided to residents. Similarly, there was no consensus whether staff education has or has not increased. Nonetheless, quality of life appears to have been enhanced. Thus, based on the results, whether RACHs being legitimate with the accreditation standards also results in RACHs being legitimate by the government, other RACHs, staff, or residents and their families with regards to the quality of services provided to their residents, is evident only as it relates to quality of life.Mode of access: World Wide Web.1 online resources (x, 254 pages) illustrations, graphs,chart