The behavioural outcomes of quality improvement teams: the role of team success and team identification.

This study investigates the relationship between hospital quality improvement (QI) team success and changes in empowerment, 'organizational commitment, organizational citizenship behaviour' (OCB) and job behaviour related to QI. Data were collected from administrative staff, healthcare professionals and support staff from four community hospitals. The study involved a field investigation with two data collection points. Structured questionnaires and interviews with hospital management were used to collect data on the study variables. High scores were observed for organizational commitment, OCB and job behaviour related to QI when individuals identified with teams that were successful. Low scores were observed when individuals identified with teams that were unsuccessful. Empowerment was positively related to job behaviour associated with QI. It is concluded that participation on QI teams can lead to organizational learning, resulting in the inculcation of positive 'extra-role' and 'in-role' job behaviour.     

The relationship between hospital unit culture and nurses' quality of work life

Turnover rates for hospital nurses have been increasing in recent years, which is partially a result of increasing pressure on nurses from higher productivity expectations in a managed care environment. Improving nurse retention is a difficult challenge to managers since the bureaucratic cultural norm of hospitals, with its hierarchical structures, rules, and regulations, and heavy emphasis on measurement of outcomes and costs, may not be the culture most conducive to enhancing nurses' job satisfaction and commitment. Accordingly, this study investigates the relationships between unit organizational culture and several important job-related variables for nurse retention in the labor and delivery units of seven hospitals. Data analysis shows that unit organizational culture does affect nurses' quality of work life factors and that human relations cultural values are positively related to organizational commitment, job involvement, empowerment, and job satisfaction, and negatively related to intent to turnover. These findings suggest that although increasing recruitment of nurses and improved compensation and benefits strategies may offset hospital nurse shortages in the short term, improving quality of work life may be a more practical and long-term approach to improving hospital nurse retention.     

An analysis of relationships among transformational leadership,job satisfaction,organizational commitment and organizational trust in two Turkish hospitals

The purpose of this study was to investigate the relationships among employee organizational commitment, organizational trust, job satisfaction and employees' perceptions of their immediate supervisors' transformational leadership behaviors in Turkey. First, this study examined the relationships among organizational commitment, organizational trust, job satisfaction and transformational leadership in two Turkish public hospitals. Second, this investigation examined how job satisfaction, organizational trust and transformational leadership affect organizational commitment. Moreover, it was aimed to investigate how organizational commitment, job satisfaction and transformational leadership affect organizational trust. A quantitative, cross‐sectional method, self‐administered questionnaire was used for this study. Eight hundred four employees from two public hospitals in Turkey were recruited for collecting data. The overall response rate was 38.14%. The measurement instruments of survey were the Job Satisfaction Survey (developed by P. Spector), the Organizational Commitment Questionnaire (developed by J. Meyer and N. Allen), the Organizational Trust Inventory‐short form (developed by L. Cummings and P. Bromiley) and the Transformational Leadership Inventory (TLI) (developed by P. M. Podsakoff). Five‐point Likert scales were used in these measurement instruments. Correlation test (the Pearson's rank test) was used to examine relationships between variables. Also, multiple regression analysis was used to determine the regressors for organizational commitment and organizational trust. There were significant relationships among overall job satisfaction, overall transformational leadership and organizational trust. Regression analyses showed that organizational trust and two job satisfaction dimensions (contingent rewards and communication) were significant predictors for organizational commitment. It was found that one transformational leadership dimension (articulating a vision), two job satisfaction dimensions (pay and supervision) and two organizational commitment dimensions (affective commitment and normative commitment) were significant regressors for organizational trust. There is a lack of research in the health organizations regarding organizational commitment, organizational trust, job satisfaction and transformational leadership. The investigator of the proposed study intends to add to the literature and intends to prove that the proposed study would be important for healthcare organizations. A number of specific measures should be undertaken to reduce factors that negatively affect organizational commitment, organizational trust and job satisfaction of hospital personnel and to improve transformational leadership behaviors of hospital administrators. Copyright © 2012 John Wiley & Sons, Ltd.     

Wraparound Team Composition,Youth Self-determination,and Youth Satisfaction in Transition Services

Wraparound, a team-based planning process for youth and families, has been widely adopted in school-based services for older adolescents and emerging adults with serious mental health conditions transitioning to adulthood. Reservations have been voiced, however, regarding possible drawbacks of teams for these youth, including concerns about difficulties with involving supportive adults, and whether youth might perceive team-based planning as a threat to their developing autonomy. To date, however, no studies have examined the feasibility of involving supports in teams and relationships between team composition and youth’s service experiences. The present study examined the relationships between team composition and youth’s perceptions of self-determination and service satisfaction among 36 youths in seven school-based programs using a specialized form of wraparound for transition services. Findings showed that meeting participation by caregivers and professionals from both inside and outside of schools was common and that regular participation by combinations of these types of adults was related to youth self-determination and satisfaction.     

Organizational culture: does it affect employee and organizational outcomes?

This study determined the type of organizational culture (bureaucratic, innovative, or supportive), and determined the relationships among organizational commitment, and behavioural outcomes (turnover, absenteeism, and productivity) in hospital foodservice departments. The sample included 423 foodservice employees from nine hospitals in eastern Canada and nine hospitals in East Tennessee. Two research instruments were used for data collection. The historical data instrument, completed by the department director, obtained data to calculate productivity, turnover, and absenteeism rates. The four-part employee instrument included the 24-item Organizational Culture Index, the 15-item Organizational Commitment Questionnaire, five questions to determine perceptions of job satisfaction, and demographic items. Multiple linear regression analysis tested relationships among variables. The predominant culture was bureaucratic (14.9 +/- 4.3 of a possible 24). Means were lower for innovative (13.2 +/- 4.3) and supportive (12.7 +/- 5.0) cultures. Supportive and innovative cultures had positive relationships with both job satisfaction and organizational commitment. Organizational culture was not related to turnover, absenteeism, or productivity. Mean productivity was 3.8 +/- 3.2 meals per labour hour, ranging from 0.8 to 15.1. Employees rated satisfaction with co-workers highest, and satisfaction with pay lowest. These findings will help hospital foodservice managers understand the relationship of culture to organizational and employee outcomes; changing culture may improve desired outcomes.     

Influence of job characteristics and organizational commitment on job satisfaction of hospital foodservice employees

The purpose of this study was to determine the relationships among job characteristics, organizational commitment, job satisfaction, and demographic variables for hospital foodservice employees. Questionnaires including 30 items on job characteristics, 15 items on organizational commitment, 6 items related to job satisfaction, and 7 demographic items were administered to 45 supervisory and 172 nonsupervisory employees of 11 randomly selected hospitals. The reliability for the total instruments, using Cronbach's alpha, was 0.87 and 0.89, respectively, for the supervisory and nonsupervisory employee questionnaires. Organizational commitment and job satisfaction were related positively, with an r2 of 0.38. For supervisors, job characteristics related positively (p = .019) to organizational commitment, with variety being the only significant individual characteristic. For nonsupervisory employees, the model was also significant (p = .0001), with variety and feedback being the only significant individual characteristics. For all employees, there was a positive relationship between job characteristics and job satisfaction, with variety and feedback being the significant individual characteristics. Age was the only demographic variable related to organizational commitment; older employees had higher commitment scores. Demographic variables were not related to job satisfaction. Supervisors had higher perceived variety, autonomy, feedback, dealing with others, and friendship opportunities scores and higher commitment and satisfaction scores than did nonsupervisory employees. The findings indicate that dietitians and foodservice managers may increase organizational commitment and job satisfaction by increasing the variety and feedback in employees' jobs.     

监狱干警组织支持感与工作满意度关系

目的探讨监狱干警组织支持感与工作满意度的关系,以及组织承诺在两者之间的中介作用。方法采用整群抽样的方法对辽宁省3所监狱的1 048名干警进行问卷调查,采用SPSS 17.0和Amos 7.0软件进行数据分析。结果监狱警察的组织支持感与工作满意度呈明显正相关(β=0.621,P<0.001),其对工作满意度的变异解释度为38.1%;组织承诺与工作满意度也呈明显的正相关(β=0.287,P<0.001),其对工作满意度的变异解释度为7.6%;组织支持感对工作满意度的直接效应为0.53,间接效应为0.13,总效应为0.66。结论组织支持感和组织承诺是工作满意度的重要预测变量,组织承诺在组织支持与工作满意度的关系中起部分中介作用,组织支持对工作满意度的直接作用大于间接作用。     

护理人员职业倦怠与组织承诺、工作满意度的关系研究

目的研究职业倦怠与组织承诺、工作满意度的关系。方法采用整群随机抽样的方法,选取黑龙江省3家三级甲等公立医院660护理人员进行职业倦怠、组织承诺、工作满意度问卷调查。结果 (1)护理人员组织承诺、工作满意度和职业倦怠的平均分依次为(3.87±0.62)分、(3.24±0.71)分、(3.12±0.58)分,(2)工作满意度、组织承诺与职业倦怠分别为低度负相关关系,(3)福利待遇、规范承诺、排班、年龄、专业发展机会、婚姻状况、学历、家庭和工作平衡对职业倦怠的联合解释量为19.9%。结论护理人员组织承诺好工作满意度处于较高水平,职业倦怠比较严重,组织承诺、工作满意度对护理人员职业倦怠有负向预测作用。     

Primary care multidisciplinary teams in practice: a qualitative study

Background

Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care team designs, primary care professionals’ perceptions of ideal team designs, and perceived facilitating factors and barriers to implementing ideal team-based care.

Methods

Qualitative study of 44 health care professionals at 6 primary care practices in North Carolina using focus group discussions and surveys. Data was analyzed using framework content analysis.

Results

Practices used a variety of multidisciplinary team designs with the specific design being influenced by the social and policy context in which practices were embedded. Practices overwhelmingly located barriers to adopting ideal multidisciplinary teams as being outside of their individual practices and outside of their control. Participants viewed internal organizational contexts as the major facilitators of multidisciplinary primary care teams. The majority of practices described their ideal team design as including a social worker to meet the needs of socially complex patients.

Conclusions

Primary care multidisciplinary team designs vary across practices, shaped in part by contextual factors perceived as barriers outside of the practices’ control. Facilitating factors within practices provide a culture of support to team members, but they are insufficient to overcome the perceived barriers. The common desire to add social workers to care teams reflects practices’ struggles to meet the complex demands of patients and external agencies. Government or organizational policies should avoid one-size-fits-all approaches to multidisciplinary care teams, and instead allow primary care practices to adapt to their specific contextual circumstances.

     

The Effects of Teamwork on Staff Perception of Empowerment and Job Satisfaction

Rosabeth Moss Kanter's¹ model of organizational empowerment was used to examine the effects of a multidisciplinary teamwork project initiated in preparation for a 1995 Canadian Council on Health Services Accreditation survey. Kanter¹ maintains that work structures such as teams foster opportunities to learn and grow, provide access to information, support and resources, empower employees, and result in increased work satisfaction and effectiveness. Staff who participated on multidisciplinary teams to prepare for the accreditation survey (n = 210) and a random sample of staff who did not participate on the teams (n = 348) were surveyed to ascertain their perceptions of work-related empowerment and job satisfaction. Consistent with Kanter's propositions, members participating on teams had higher empowerment scores and perceived access to empowerment structures to be more important than members not participating on these teams. Overall, perceived access to empowerment structures was found to be significantly lower than perceived importance of access to the empowerment structures. The results of this study support the use of multidisciplinary teams as one work redesign strategy for enhancing work effectiveness in the health care environment.     

Team-based participation in the hiring process

In most health care settings today, effective patient service results from medical staff members working together as a high performance team. These teams evolve through the process of hiring employees who combine the necessary technical skills, knowledge, and abilities (SKAs) to perform the job and whose interpersonal attributes will add value to services provided by the team. This article promotes the concept that those who are in the best position to determine whether a job candidate will become a productive team member are, in most cases, the team members themselves. Discussion includes types of teams and degree of member involvement. For those health care professionals interested in using greater team-based participation in employment matters, specific advantages and realistic challenges are provided.     

Employee reactions to managed care.

Employee reactions to managed care get less managerial and research attention than organizational reactions to it. This article examines the manner in which health services employees react to managed care and finds that their reaction affects perceived job insecurity, organizational commitment, and job satisfaction. Organization-based self-esteem, role conflict, and supervisory support moderate these relationships. The managerial implications of these findings are discussed.     

A configurational approach to the relationship between high-performance work practices and frontline health care worker outcomes

Objective

To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care.

Methods

Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis.

Principal Findings

Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers.

Conclusions

High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices.     

Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment

Background  

The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. Despite the fact that there have been plenty of studies on job satisfaction, none was specifically addressed to integrate the relational model of job rotation, role stress, job satisfaction, and organizational commitment among nurses.     

基层军医工作满意度、组织承诺结构模型研究及激励对策

本文对基层军医工作满意度、组织承诺及离职意向进行实证研究,运用因子分析法验证了工作满意度、组织承诺的经典三因素模型,并对各因素进行分析探讨,找出影响基层军医工作满意度、组织承诺的因素并提出改进建议,为军队决策管理提供有益参考。     

Hospital nurses' intentions to remain: exploring a northern context

Retaining nurses is of significant concern to all hospitals but even more of a concern to northern and rural hospital managers. This study provides insights into factors related to nurses' intentions to remain. A sample of 122 nurses from 13 northern hospitals in Western Canada participated in the study. The nurses completed questionnaires and participated in structured interviews. A model was proposed which suggested that work experiences (job and decision latitude, feedback, perceptions of how viewed and treated by others, fairness of policies, and safety of the job environment) would be related to job satisfaction and then affective commitment. Age and tenure, and ties to the community were proposed as predictors of continuance commitment. Both affective and continuance commitments were expected to be related to intention to remain in the hospital. The model was partially supported by regression analyses. Work experiences predicted job satisfaction and affective commitment. Affective commitment, continuance commitment, and ties to the community are related to nurses' intentions to remain. Supplemental analyses indicated that the strongest relationships were found for management's views and treatment of nurses, knowledge and ability utilization, safe environment, and fairness of organizational policies.     

Correlates of employees' perceptions of a healthy work environment

PURPOSE: This study analyzed correlates of workers' perceptions of the extent to which their work environment is healthy and how these perceptions influence job satisfaction, employee commitment, workplace morale, absenteeism, and intent to quit. DESIGN: One-time cross-sectional telephone survey. SETTING: Canadian employees in 2000. SUBJECTS: A randomly chosen, nationally representative sample of 2500 employed respondents, using a household sampling frame. The response rate was 39.2%. Self-employed individuals were excluded, leaving a subsample of 2112 respondents. MEASURES: The dependent variable was the response to the item, "The work environment is healthy" (5-point strongly agree-strongly disagree Likert scale). Independent variables used in bivariate and ordinary least-squares regression analyses included sociodemographic characteristics, employment status, organizational characteristics, and scales that measured job demands, intrinsic rewards, extrinsic rewards, communication/social support, employee influence, and job resources. Perceptions of a healthy work environment were related to job satisfaction, commitment, morale (measured on a 5-point scale), number of self-reported absenteeism days in the past 12 months, and whether or not the respondent had looked for a job with another employer in the past 12 months. RESULTS: The strongest correlate of a healthy work environment was a scale of good communication and social support (beta = .27). The next strongest was a job demands scale (beta = -.15.) Employees in self-rated healthier work environments had significantly (p < 0.01) higher job satisfaction, commitment and morale, and lower absenteeism and intent to quit. CONCLUSIONS: The study supports a comprehensive model of workplace health that targets working conditions, work relationships, and workplace organization for health promotion interventions.     

Organizational socialization of employees with disabilities: Critical issues and implications for workplace interventions

Organizational socialization is the process whereby newcomers to work organizations become insiders. The socialization process has been linked to various outcomes including newcomer job satisfaction, organizational commitment, job knowledge and performance, promotion and advancement rate, salary, and turnover. The purpose of the present paper is threefold: (1) to examine issues facing persons with disabilities during organizational socialization in order to help guide future research on this topic; (2) to provide an awareness of potential aditional barriers (unrealistic newcomer expectations, interaction avoidance, norm to be kind, low work group expectations) that face newcomers with disabilities as they begin jobs; and (3) to suggest some possible policies, programs, and interventions that might help persons with disabilities to overcome those barriers.     

A nursing shortage: building organizational commitment among nurses

As a major nursing shortage threatens healthcare organizations, the views of 30 staff nurses are examined to determine factors that contribute to their commitment, or lack of commitment, to their employing hospital. Content analysis identified that organizational commitment is most related to personal factors, opportunities for learning, job satisfaction, plan for retirement, monetary benefits, patient care, coworkers, cultural factors, and job security, in that order. Lack of organizational commitment is most related to conflict with personal needs. However, lack of learning, lack of appreciation and fairness, inadequate monetary benefits, patient care situations, poor relations with coworkers, career developmental stage, and lack of job security are also discussed. Application of these findings to healthcare administration is discussed, with strategies for building organizational commitment among nurses.     

The quality of working life for allied health professionals in an HMO

Two hundred seventy-six allied health professionals were surveyed about their levels of job satisfaction, organizational commitment, and job tension in order to assess the quality of working life in a large west coast health maintenance organization. The results suggest that this HMO contributed slightly to these allied health professionals' level of job satisfaction and organizational commitment. Job tension did not appear to be excessive in the HMO. Personal characteristics and facts relating to an allied health professional's environment did not surface as major predictors of the quality of working life for this sample. The implications of these findings for allied health professionals and HMOs are presented.