The relational underpinnings of quality internal auditing in medical clinics in Israel

Internal auditing is a key mechanism in enhancing organizational reliability. However, research on the ways quality internal auditing is enabled through learning, deterrence, motivation and process improvement is scant. In particular, the relational underpinnings of internal auditing have been understudied. This study attempts to address this need by examining how organizational trust, perceived organizational support and psychological safety enable internal auditing. Data collected from employees in medical clinics of one of the largest healthcare organizations in Israel at two points in time six months apart. Our results show that organizational trust and perceived organizational support are positively related to psychological safety (measured at time 1), which, in turn, is associated with internal auditing (measured at time 2).     

Mortality and suicide rates of involuntarily committed patients

The mortality and suicide rates for involuntarily committed patients in Denmark are presented. Two cohorts of psychiatric patients committed to a mental hospital from January 1, 1971 to December 31, 1975 (8322 people) and January 1, 1981 to December 31, 1985 (5253 people) have been followed. The standard mortality rate (SMR) in relation to the total Danish population were 4.9 (4.5–5.4) and 5.2 (4.7–5.8), respectively, for the two cohorts, during the first year after involuntarily commitment to a mental hospital. During the same period, the SMR for suicide among the committed patients were 44.9 (37.1–53.9) and 30.9 (24.2–38.9), respectively. The crude suicide rates among the committed patients during the first year after the commitment were 14.3 and 14.0, respectively, per 1000 years, unchanged between the cohorts. Short length of stay in hospital (< 14 days), a nonpsychotic main diagnosis, male sex, and age 35 years or more were equally related to high risk of suicide in the 1971 cohort as evaluated to proportional hazard methods (Cox regression), and short length of stay and commitment on the danger indication provided the most information in relation to high suicidal risk in the 1981 cohort. Methodological problems and the reasons for the results are discussed.     

Equity/inequity,stress and employee commitment in a health care setting

This article investigates the relationship between perceptions of equity, occupational stress and employee commitment in a health care setting. Significant relationships were found among these variables and implications for the health care field are discussed.     

A human CD4 transgene rescues CD4−CD8+ cells in β2-microglobulin-deficient mice

The specificity of the αβ T cell receptor for class I or class II major histocompatibility complex (MHC) molecules determines whether a mature T cell will be of the CD4^?CD8⁺ or CD4⁺CD8^? phenotype, respectively. We show here that a human CD4 transgene can rescue a significant fraction of CD4^?CD8⁺ T cells in β2-microglobulin-deficient mice. Cells with this phenotype could be induced to become potent killers of targets expressing allogeneic MHC antigens, indicating that lineage commitment can precede the rescue of developing cells by the T cell receptor for antigen and the CD4 coreceptor.     

Commentary: Organizational Culture and Practice Epistemologies

Hemmelgarn, Glisson, and James (2006) provide an excellent review of the impact of organizational culture and climate for the implementation of evidence-based practice (EBP) models within social and mental health services systems. As their article makes clear, the implementation process should address the organizational context, and effectiveness and services research should consider organizational factors in outcome and EBP transport research. This commentary extends discussion of one aspect of organizational culture—the extent to which organizations are driven by an empirical scientific epistemology—and how this may contribute to establishing a context for EBP design, selection, implementation, and sustained evolution in field settings.     

护士组织承诺对医院磁性水平影响的机制研究

目的 探究护士组织承诺、心理韧性对医院磁性水平的影响,为临床护理人力资源管理提供依据.方法 采用护士心理韧性量表、中国职工组织承诺量表、医院磁性要素量表对新疆地区4所三甲综合医院的3047名临床护士开展调查,并建立三者之间的关系模型.结果 护士心理韧性得分64.93士15.73,护士组织承诺得分81.53±16.66,护士感知医院磁性水平得分97.31土21.38.护士心理韧性与组织承诺、护士感知医院磁性水平呈正相关(r=0.492、0.483,均P＜0.01),护士组织承诺与感知医院磁性水平呈正相关(r=0.561,P＜0.01),组织承诺是心理韧性与医院磁性环境的中介变量,中介效应占总效应的55.40％.结论 护士心理韧性、组织承诺处于中等水平,护士感知医院磁性水平处于中等偏低水平,组织承诺在心理韧性与工作环境间起中介作用.医院管理者应重视护士组织承诺的建立和维护,稳定护士队伍,提高护士满意度,从而提高护理质量.     

程序公平对工作满意度、组织承诺的影响:工作不安全感的中介作用

目的:探讨程序公平对工作满意度、组织承诺的影响以及工作不安全感在其中的中介作用。方法:对来自国内某大型国营企业592名员工的关于程序公平、工作满意度、组织承诺和工作不安全感的问卷调查数据进行中介回归分析(Mediatingregressionanalysis)。结果:①程序公平和员工的工作满意度、组织承诺存在显著的正向关系,而和其工作不安全感之间存在显著的负向关系;②工作不安全感部分中介程序公平对整体工作满意度和组织承诺的影响。结论:通过改善程序公平,可以减少员工的工作不安全感,并进而增强其工作满意度和组织承诺。     

Changes of nursing organization in a surgical department: effects on work satisfaction and quality of care

• ? The aim of the study was to evaluate the effects of an organizational change programme in a surgical department in Sweden (the introduction of modular nursing) on the nursing staffs perception of job satisfaction and quality of care, and to identify factors which promote or hinder this organizational change.
• ? Planning and implementation of the change programme took about 1 year and comprised structural changes and staff training.
• ? Assessments of job satisfaction and quality of care were made immediately before, and 1 year after, implementation of the change programme. Data were collected from the staff of two wards.
• ? Virtually no statistically significant changes were found when looking at the department as a whole. However, considerable differences were noted between the two wards, particularly in the following areas: relationships with colleagues, identification and commitment, and perceived quality of care.
• ? The quality of the interpersonal relationships, and the leadership of the wards' head nurses, appeared to be crucial determinants of the outcome.