| Background. Long-term care organizations have conducted various change initiatives to improve the quality of the workplace environment and the retention of direct care workers. Even within the same general context, some kinds of organizations are better than others at adopting and implementing change. Organizational structure is known to be one of the critical factors in adopting and implementing organizational change. However, neither the structural characteristics of long-term care organizations nor the relationship of those structures to the process of change are well established. In addition, structural differences between facility-based and home-based long-term care organizations remain under-investigated.;Study Objectives. The study examined whether the long-term care service provider organizations are grouped together based on observed (manifest) structural indicators. The six indicators are centralization, formalization, extent of job-related training, vertical communication, horizontal communication, and supervisory span of control. The organizations were designated according to several mutually exclusive latent groups (classes), which were then related to organizational change processes, such as each organizational group's readiness for change, commitment to change, and actual level of implementation.;Hypotheses. Based on Burns and Stalker's typology of organic and mechanistic structure, we hypothesized that long-term care organizations could be classified into more than one group based on their respective structural configurations (H1). We further hypothesized that the grouping pattern would be different within each service provider's setting, such as facility-based vs. home-based settings (H2). Finally, we hypothesized that organic organizations would be more positively related to change outcomes than would mechanistic organizations (H3).;Methods. As structure is not a one-dimensional construct, it is most effectively represented by combinations of several indicators. Latent Class Analysis (LCA), therefore, was used to identify unobserved (latent) classes of organizations, which have a common structure. The study used cross-sectional survey data from 100 long-term care organizations, all of which participated in the Better Jobs Better Care (BJBC) demonstration project from 2003 to 2006. The study variables were mostly from organizational-level survey data, except centralization (aggregated from individual-worker-level data) and span of control (aggregated from middle-supervisor-level data).;Results. Three latent classes (groups) emerged based on the six observed structural indicators, with the reasonable statistical fit indicators. Classes were (1) organic (professional) hierarchy, (2) mechanistic hierarchy, and (3) minimalist. Facility-based settings had a higher probability of membership in the mechanistic class than in other classes, whereas home-based settings had a higher probability of membership in the minimalist and organic classes than in the mechanistic class. In regard to the relationship between organizational change processes and structure, the organic type was positively associated with readiness for change and commitment to change, while the minimalist type was negatively associated with readiness for change and commitment to change, compared to the mechanistic class. Change implementation level, though, was not significantly related to any of the three structures.;Conclusion and implications. The present study will allow managers, researchers, and policy makers to more comprehensively understand structures in various types of long-term care organizations. In addition, the study results provide information regarding which structures are most positive for organizational change, which, in turn, can be an important criteria for evaluating intervention/implementation strategies in long-term care settings. |
