Hsieh, Sheng-Che; Chiu, Herng-Chia; Hsieh, Ya-Hui; Ho, Pei-Shen; Chen, Li-Chin; Chang, Wei-Chou
The labor rights of medical workers in hospitals in Taiwan have been a key issue of discussion and controversy in recent years. Generally, poor work conditions and manpower shortages in hospitals have resulted in a vicious circle of severely overworked medical and healthcare staff and chronically low staffing and retention rates. This study employed corporate social responsibility as the conceptual framework of the social responsibility of hospitals to examine the perceptions and expectations of nurses toward the social responsibility practices of the hospital where they serve and to explore the relationship between these perceptions and organizational commitment (OC). The participants were all nurses who were employed by one medical group in southern Taiwan. Two hundred forty anonymous questionnaires, which included scales that were designed to measure the social responsibility of hospitals and OC, were distributed. Two hundred twenty-seven valid questionnaires were returned. Exploratory factor analysis was used to validate the dimension of the social responsibility of hospitals, and hierarchical multiregression analyses were used to verify the relationship between the perceptions of nurses with regard to the social responsibility practices of the hospital where nurses serve and OC. There were considerable differences between participants' perceptions and expectations toward the social responsibility of hospitals. The nurses with high perceptions toward the social responsibility practices of the hospital where they serve tended to have relatively high OC. Senior nurses who had high perceptions of the legal and rational, ethical, and economic dimensions of the social responsibility practices of the hospital where they serve exhibited relatively strong affective commitment. Nurses in junior positions who had high perceptions of the practices of ethical responsibilities exhibited relatively strong continuance commitment. Senior nurses who had high perceptions of the
Chen, Su-Yueh; Wu, Wen-Chuan; Chang, Ching-Sheng; Lin, Chia-Tzu; Kung, Jung-Yuan; Weng, Hui-Ching; Lin, Yu-Tz; Lee, Shu-I
It is of importance and urgency for hospitals to retain excellent nursing staff in order to improve patient satisfaction and hospital performance. However, it was found that simply increasing the salary is not the best method to resolve the problem of lacking nursing staff; it is necessary to focus on the impact of non-monetary factors. The delicate relationship between organizational justice, organizational trust, organizational identification, and organizational commitment requires investigation and clarification from more studies if application in nursing practice is to be expected. Therefore, this study was to investigate how the organizational justice perception could affect nurses' organizational trust and organizational identification, and whether the organizational trust and organizational identification could encourage nurses to willingly remain in their jobs and commit themselves to the hospitals. A cross-sectional design was used. Questionnaires were distributed in 2013 to a convenience sample of 400 registered nurses in one teaching hospital in Taiwan: 392 were retrieved. Of these, 386 questionnaires were valid, which was a 96.5% response rate. The SPSS 17.0 and Amos 17.0 (structural equation modeling) statistical software packages were used for data analysis. The organizational justice perceived by nurses significantly and positively affects their organizational trust (γ₁₁ = 0.49) and organizational identification (γ₂₁ = 0.58). Organizational trust (β₃₁ = 0.62) and organizational identification (β₃₂ = 0.53) significantly and positively affect organizational commitment. Hospital managers can enhance the service concepts and attitudes of frontline nursing personnel by maximizing organizational justice, organizational trust and organizational identification. Nursing personnel would then be motivated to provide feedback to the attention and care provided by hospital management by demonstrating substantial improvements in
Full Text Available Background: Organizational intelligence has been defined as the capacity of an organization to direct its mental abilities and use these capabilities to achieve its mission and agility means ability to react quickly to environmental changes and it is an important factor for hospital effectiveness. This study was aimed to Evaluate Organizational Intelligence and Organizational learning and Organizational Agility in Teaching Hospitals of Yazd City. Methods: this descriptive, analytical, cross-sectional study was conducted in 2015 .the study population included administrative and medical staff in Shahid Sadoughi,, Shahid Rahnemoon,, Afshar and burning hospital. A total of 370 administrative and medical staff were contributed in the study. We used stratified-random method for sampling. The required data were gathered using 3 valid questionnaires including Albrecht- Organizational Intelligence (2002, organizational learning (neefe2001 and organizational agility questionnaire according to theory Sharifi & Zhang (1999 . data was analyzed by descriptive and inferential statistical methods in SPSS18 . Results: mean Organizational Intelligence scores hospital was 2.29, organizational learning scores hospital was 1.48 and organizational agility scores hospital was 1.52. as well as , hospital variable and Education affect on Organizational Intelligence, organizational learning and organizational agility. Conclusion: Based on the findings it can be concluded that the implementation of appropriate strategies for improving the organizational capacity to direct its employees’ mental abilities, can also improve the ability of organization’s rapid response to surrounding issues which is crucial for its survival and dynamics in today’s changing world
Stordeur, Sabine; D'Hoore, William
This paper contrasts structural and managerial characteristics of low- and high-turnover hospitals, and describes the organizational configuration of attractive hospitals. In countries facing nurse shortages and turnover, some hospitals succeed in recruiting and retaining nurses. In Magnet Hospitals, managerial practices and environmental characteristics increase nurses' job satisfaction and their commitment to the organization, which in turn decreases nurse turnover. Such an approach suggests that organizations are best understood as clusters of interconnected structures and practices, i.e. organizational configurations rather than entities whose components can be understood in isolation. From a sample of 12 hospitals whose nurse turnover was studied for 1 year, structural and organizational features of hospitals in the first and fourth quartiles, i.e. attractive (turnover vs. conventional (turnover >11.8%) were contrasted. A questionnaire, including perceptions of health-related factors, job demands, stressors, work schedules, organizational climate, and work adjustments antecedent to turnover, was received from 401 nurses working in attractive hospitals (response rate = 53.8%) and 774 nurses in conventional hospitals (response rate = 54.5%). Structural characteristics did not differentiate attractive and conventional hospitals, but employee perceptions towards the organization differed strikingly. Differences were observed for risk exposure, emotional demands, role ambiguity and conflicts, work-family conflicts, effort-reward imbalance and the meaning of work, all in favour of attractive hospitals (P organizations. The concept of attractive institutions could serve as a catalyst for improvement in nurses' work environments in Europe.
Mohammad Amin Bahrami
Full Text Available Background: In organizational learning theory, organization is defined as an open system that has the ability to anticipate, identify, define, design, and solve its problems. This study was aimed to examine the relationship between organizational learning and organizational agility in the teaching hospitals of the city of Yazd. Methods: This analytical and cross-sectional study was conducted in 2015 in four teaching hospitals of the city of Yazd. A total of 370 administrative and medical staff contributed in the study. We used stratified-random method for sampling. The required data were gathered using two valid questionnaires including organizational learning questionnaire (Neefe 2001 and organizational agility questionnaire according to the theory of Sharifi & Zhang (1999 being analyzed trough statistical softwares of R and lavaan package, semPlot and semtool for structural equation model and SPSS18 for descriptive statistics. Results: Our results showed a positive significant relationship between organizational learning and organizational agility (0.521. Conclusion: Based on the findings it can be concluded that the implementation of appropriate strategies for improving the organizational capacity to direct its employees’ mental abilities, can improve the ability of organization’s rapid response to surrounding issues which is crucial for its survival and dynamics in today’s changing world.
Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new 'learning organization' and using effective internal marketing. A cross-sectional design was employed. Two hundred questionnaires were distributed to nurses working in either a medical centre or a regional hospital in Taichung City, Taiwan, and 114 valid questionnaires were returned (response rate: 57%). The entire process of distribution and returns was completed between 1 October and 31 October 2009. Hypothesis testing was conducted using structural equation modelling. A significant positive correlation was found between the existence of a 'learning organization', internal marketing, and organizational commitment. Internal marketing was a mediator between creating a learning organization and organizational commitment. Nursing managers may be able to apply the creation of a learning organization to strategies that can strengthen employee organizational commitment. Further, when promoting the creation of a learning organization, managers can coordinate their internal marketing practices to enhance the organizational commitment of nurses.
Hetherington, R W
The purpose of this paper is to explore some aspects of a general theoretical model within which research on the organizational impacts of quality assurance programs in hospitals may be examined. Quality assurance is conceptualized as an organizational control mechanism, operating primarily through increased formalization of structures and specification of procedures. Organizational effectiveness is discussed from the perspective of the problem-solving theory of organizations, wherein effective organizations are those which maintain at least average performance in all four system problem areas simultaneously (goal-attainment, integration, adaptation and pattern-maintenance). It is proposed that through the realization of mutual benefits for both professionals and the bureaucracy, quality assurance programs can maximize such effective performance in hospitals.
Bjerregaard, Toke; Jonasson, Charlotte
This paper examines the role of intraorganizational group and political processes in shaping the institutional forms that emerge in heterogeneous fields. We argue that while the specific institutional oppositions of heterogeneous fields compel organizational changes, the institutional forms....... Moreover, we argue that the boundary between practices in which organizational institutions change and are maintained are blurred. Hence, recruitment practices, which often are understood as carrying an institutional logic into an organization by being adopted in response to a new demand, may lead...... that emerge in such fields cannot easily be predicted. They are effects of indeterminate social processes of regularizations and breakings of co-existing logics. We illuminate the under-explored role of group strategies in moderating organizational response to conflicts in institutional prescriptions...
Top, Mehmet; Tarcan, Menderes; Tekingündüz, Sabahattin; Hikmet, Neşet
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
Bahrami, Mohammad Amin; Montazeralfaraj, Razieh; Gazar, Saeed Hashemi; Tafti, Arefeh Dehghani
Organizational citizenship behavior just referred to a set of discretionary workplace behaviors that exceed one's job requirements. The main objective of this study was to determine the relationship between organizational perceived justice and organizational citizenship behavior. This cross-sectional study was done in Shahid Sadoughi Hospital in Yazd, Iran in 2013. A total of 100 hospital employees contributed in the study. The required data was gathered using 2 valid questionnaires, including the Moorman & Niehoff organizational perceived justice questionnaire and the McKinsey organizational citizenship behavior questionnaire. Data were analyzed using SPSS version 16. Descriptive statistics, Chi square, and Pearson's correlation coefficient were used for data analysis. There was a significant positive relationship between organizational perceived justice and organizational citizenship behavior among the studied hospital's employees (P ≤ 0.05, R = 0.33). This study confirmed that any policy that leads to better organizational justice perception will contribute in better organizational citizenship behavior which will increase the hospital's productivity.
Aiken, L H; Patrician, P A
The organizational context in which nurses practice is important in explaining variation in patient outcomes, but research has been hampered by the absence of instruments to measure organizational attributes empirically. To report on the development and utility of the Revised Nursing Work Index (NWI-R) in measuring characteristics of professional nursing practice environments. The NWI-R was used in a national acquired immunodeficiency syndrome (AIDS) care study. The sample consisted of 40 units in 20 hospitals. Of these 20 hospitals, 10 provided AIDS care in both dedicated AIDS units and general medical units, thus introducing to the design an element of internal control. The remaining 10 hospitals were selected through a matching procedure. Three of the matched control hospitals were magnet hospitals. Nurses were recruited into the study if they worked at least 16 hours per week on the study unit. The nurses completed the NWI-R in addition to other measures. A response rate of 86% was attained. Response rates per unit ranged from 73% to 100%. Cronbach's alpha was 0.96 for the entire NWI-R, with aggregated subscale alphas of 0.84 to 0.91. Validity of the NWI-R was demonstrated by the origin of the instrument, its ability to differentiate nurses who worked within a professional practice environment from those who did not, and its ability to explain differences in nurse burnout. The NWI-R has been found to capture organizational attributes that characterize professional nursing practice environments.
Background Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new ‘learning organization’ and using effective internal marketing. Methods A cross-sectional design was employed. Two hundred questionnaires were distributed to nurses working in either a medical centre or a regional hospital in Taichung City, Taiwan, and 114 valid questionnaires were returned (response rate: 57%). The entire process of distribution and returns was completed between 1 October and 31 October 2009. Hypothesis testing was conducted using structural equation modelling. Results A significant positive correlation was found between the existence of a ‘learning organization’, internal marketing, and organizational commitment. Internal marketing was a mediator between creating a learning organization and organizational commitment. Conclusion Nursing managers may be able to apply the creation of a learning organization to strategies that can strengthen employee organizational commitment. Further, when promoting the creation of a learning organization, managers can coordinate their internal marketing practices to enhance the organizational commitment of nurses. PMID:24708601
Yin, Emily S; Downing, Nicholas S; Li, Xi; Singer, Sara J; Curry, Leslie A; Li, Jing; Krumholz, Harlan M; Jiang, Lixin
Organizational learning, the process by which a group changes its behavior in response to newly acquired knowledge, is critical to outstanding organizational performance. In hospitals, strong organizational learning culture is linked with improved health outcomes for patients. This study characterizes the organizational learning culture of hospitals in China from the perspective of a cardiology service. Using a modified Abbreviated Learning Organization Survey (27 questions), we characterized organizational learning culture in a nationally representative sample of 162 Chinese hospitals, selecting 2 individuals involved with cardiovascular care at each hospital. Responses were analyzed at the hospital level by calculating the average of the two responses to each question. Responses were categorized as positive if they were 5+ on a 7-point scale or 4+ on a 5-point scale. Univariate and multiple regression analyses were used to assess the relationship between selected hospital characteristics and perceptions of organizational learning culture. Of the 324 participants invited to take the survey, 316 responded (98 % response rate). Perceptions of organizational learning culture varied among items, among domains, and both among and within hospitals. Overall, the median proportion of positive responses was 82 % (interquartile range = 59 % to 93 %). "Training," "Performance Monitoring," and "Leadership that Reinforces Learning" were characterized as the most favorable domains, while "Time for Reflection" was the least favorable. Multiple regression analyses showed that region was the only factor significantly correlated with overall positive response rate. This nationally representative survey demonstrated variation in hospital organizational learning culture among hospitals in China. The variation was not substantially explained by hospital characteristics. Organizational learning culture domains with lower positive response rates reveal important areas for
Bahrami, Mohammad Amin; Barati, Omid; Ghoroghchian, Malake-sadat; Montazer-alfaraj, Razieh; Ranjbar Ezzatabadi, Mohammad
Objective The commitment of employees is affected by several factors, including factors related to the organizational climate. The aim of this study was to investigate the relationship between organizational commitment of nurses and the organizational climate in hospital settings. Methods A cross-sectional study was conducted in 2014 at two teaching hospitals in Yazd, Iran. A total of 90 nurses in these hospitals participated. We used stratified random sampling of the nursing population. The ...
Obamiro John Kolade
Full Text Available This study examines the relationship between organizational citizenship behaviour, hospital corporate image and performance. Questionnaires were distributed to 350 patients and 298 usable questionnaires were returned representing a return rate of 85.7%. The study employs a Structural Equation Model to test four hypotheses on organizational citizenship behaviours, hospital corporate image and performance. The findings reveal that hospitals can increase performance through organizational citizenship behaviour and positive corporate image. However, it was also discovered that there is a negative covariance between organizational citizenship behaviour and hospital corporate image despite their individual positive contribution to performance. Therefore, hospital management should develop an organizational climate (such as recognition, additional reward, promotion, etc. that can promote organizational citizenship behaviour and enhance a positive corporate image while preventing situations that will discourage staff from rendering extra positive discretionary work related services.
Møller Larsen, Marcus; Pedersen, Torben
The purpose of this paper is to investigate the effect of the organizational reconfiguration of offshoring on firms’ strategies. A consequence of offshoring is the need to reintegrate the geographically relocated organizational activities into a coherent organizational architecture. In order to do...
Spagnol, Carla Aparecida; Fernandes, Marcia Simoni
This work aims at approaching some theoretical aspects related to organizational structure, focussing on the structure of the nursing service in the majority of hospitals. We found, through a literature, that some hospitals are adopting new management practices, changing rigid hierarchical structures to flexible and well coordinated ones. In this context of organizational changes, nursing needs to discuss its classical organizational structure and management still based on taylorist principles in order to fulfill actual demands and needs of clients and workers.
Stewart, J E; Smith, S N
Measures of expectations, organizational attachment, and job satisfaction were studied among hospital pharmacists. Pharmacists in 42 Chicago-area hospitals were asked to respond to 18 closed-ended statements designed to measure job and profession satisfaction and the degree to which the respondents' expectations of their work and profession had been met. From the sample of 529 pharmacists, 217 (41%) usable responses were received. Pharmacists generally agreed that their expectations toward work, salary, department standards, and use of professional abilities had been met. However, it was found that younger pharmacists and those performing primarily staff duties had lower ratings for met expectations and satisfaction than did their counterparts. Measures of expectations and satisfaction with current jobs consistently outranked similar measures of opinions toward the profession. Organizational attachment appeared to be highly correlated with age and with tenure of employment; younger pharmacists and those with one to seven years of concurrent employment were more predisposed to leaving the organization. It was noted in particular that the factors exerting a strong influence to leave the organization involved management-related activities and responsibilities. Managers can encourage organizational attachment by providing promotion opportunities and leadership in the structure and facilitation of job duties and by responding to individual needs.
Bahrami, Mohammad Amin; Barati, Omid; Ghoroghchian, Malake-Sadat; Montazer-Alfaraj, Razieh; Ranjbar Ezzatabadi, Mohammad
The commitment of employees is affected by several factors, including factors related to the organizational climate. The aim of this study was to investigate the relationship between organizational commitment of nurses and the organizational climate in hospital settings. A cross-sectional study was conducted in 2014 at two teaching hospitals in Yazd, Iran. A total of 90 nurses in these hospitals participated. We used stratified random sampling of the nursing population. The required data were gathered using two valid questionnaires: Allen and Meyer's organizational commitment standard questionnaire and Halpin and Croft's Organizational Climate Description Questionnaire. Data analysis was done through SPSS 20 statistical software (IBM Corp., Armonk, NY, USA). We used descriptive statistics and Pearson's correlation coefficient for the data analysis. The findings indicated a positive and significant correlation between organizational commitment and organizational climate (r = 0.269, p = 0.01). There is also a significant positive relationship between avoidance of organizational climate and affective commitment (r = 0.208, p = 0.049) and between focus on production and normative and continuance commitment (r = 0.308, p = 0.003). Improving the organizational climate could be a valuable strategy for improving organizational commitment.
Wagner, C.; Mannion, R.; Hammer, A.; Groene, O.; Arah, O.A.; DerSarkissian, M.; Suñol, R.
Objective: To better understand associations between organizational culture (OC), organizational management structure (OS) and quality management in hospitals. Design: A multi-method, multi-level, cross-sectional observational study. Setting and participants: As part of the DUQuE project (Deepening
Lee, S Y; Alexander, J A
To examine (1) the degree to which organizational changes affected hospital survival; (2) whether core and peripheral organizational changes affected hospital survival differently; and (3) how simultaneous organizational changes affected hospital survival. AHA Hospital Surveys, the Area Resource File, and the AHA Hospital Guides, Part B: Multihospital Systems. The study employed a longitudinal panel design. We followed changes in all community hospitals in the continental United States from 1981 through 1994. The dependent variable, hospital closure, was examined as a function of multiple changes in a hospital's core and peripheral structures as well as the hospital's organizational and environmental characteristics. Cox regression models were used to test the expectations that core changes increased closure risk while peripheral changes decreased such risk, and that simultaneous core and peripheral changes would lead to higher risk of closure. Results indicated more peripheral than core changes in community hospitals. Overall, findings contradicted our expectations. Change in specialty, a core change, was beneficial for hospitals, because it reduced closure risk. The two most frequent peripheral changes, downsizing and leadership change, were positively associated with closure. Simultaneous organizational changes displayed a similar pattern: multiple core changes reduced closure risk, while multiple peripheral changes increased the risk. These patterns held regardless of the level of uncertainty in hospital environments. Organizational changes are not all beneficial for hospitals, suggesting that hospital leaders should be both cautious and selective in their efforts to turn their hospitals around.
García, I García; Castillo, R F; Santa-Bárbara, E S
Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction. The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals. A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals. A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale. In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate. © The Author(s) 2013.
Rubén Darío Agudelo Loaiza
Full Text Available Objective: To characterize the organizational climate perceived by the assistance and administrative staff members at a public hospital in Quindio-Colombia 2015. Method: A quantitative correlational study, which measures the organizational climate of a low complexity hospital through the characterization of twelve dimensions. The population being studied was conformed by 114 assistance and administrative staff members who belong to a public hospital in Quindío-Colombia. Results: The measurement of the organizational climate provided a result of a global average of 69.81 with a score of 3.9 being classified as a medium level for the organizational climate. There was evidence of a highly meaningful positive bond between the organizational climate and the dimension of interpersonal relationships and between this one with the external coordination. Conclusion: There is evidence of the importance given by the staff members to the “friendly interaction” that is interpreted as a respectful and effective relationship with their co-workers, which is, in turn, necessary for the generation of a teamwork environment. Additionally, it was found that a high degree of importance regarding interpersonal relationships with the external coordination is given; fact that can be understood as the value staff members confere to the participative leadership within their perception of organizational climate.
Full Text Available This study compares the organizational climate differences within professional roles in private and public hospitals. We focused on how physicians, administrative, healthcare and non-healthcare staff either in the public or in the private perceived their work environment and each organizational climate dimension. Data came from organizational-climate questionnaires administered in 2010 and 2012 to 19616 and 1276 health employees in public and private hospitals in the Tuscany Region respectively. We applied exploratory factoranalysis to verify the validity and internal consistency between items in the questionnaire and t-test, one-way analysis of variance to compare mean perceptions regarding to the dimensions across different groups of respondents. We measured four dimensions: “training opportunities”, “managerial tools”, “organization” and “management & leadership style” and overall job satisfaction. Hospital status in the professional roles was found significant in the staff's perceptions (p≤0.05.
A research that relates to strategic human resources management has not been conducted extensively, particularly when it is related to the organizational change and organizational resilience on the hospitality industry. Objective of this research is to analyze the influence of strategic human resources management, organizational change, and organizational resilience on the organization performance. The research was conducted o the hospitality industry, which included 234 hot...
Harrison, Albert A.
Perhaps the most crucial responses to the confirmation of extraterrestrial intelligence will come from organizations, rather than from individual people. Among the key organizations that will help shape humanity's response are political institutions such as the US Congress, administrative bodies such as the US Department of State, security agencies, the military, professional societies, and the media. Although popular culture and individual beliefs will affect organizational performance, organizational reactions will depend also on organizational cultures and traditions, administrative structures, communication patterns, decision-making processes, and the actions of other organizations. Prompt and effective responses may be blocked by sociopolitical constraints, jurisdictional disputes, cumbersome structures and procedures, stresses that frequently slow and distort information processing, and potentially counterproductive efforts to maintain positive organizational images. Efforts undertaken by governmental agencies will be hampered by public perceptions of low credibility. Foresight and advance preparation are among the steps that organizations may take to prepare for contact, but conservative values, skepticism towards SETI, and competing organizational priorities make serious preparation unlikely.
Full Text Available In health care institutions aiming healthy society by the way protecting and promoting human health, reaching information has a vital importance. This descriptive research purposed an evaluation of organizational learning capability of 396 employees working in Gülhane Military Medical Academy Hospital. A questionnaire including socio-demographic characteristics was used along with Organizational Learning Capability scale designed by Ricardo CHIVA and His Friends. Data acquired was analyzed with SPSS 15.0 program. Participants’ Organizational Learning Capability and its subscales means were assessed in terms of their sociodemographic characteristics. Assessing participants’ answers in terms of 5 subscales which are experimentation, risk taking, interaction with the external environment, dialogue and participatory decision-making; for education level and professional groups, statistical significant differences was found between Organizational Learning Capability and its subscales means.
Hospitals developed over the period of time when positivism become a predominant world view. Positivism was founded by four Western trends: preponderance of hierarchy and autocracy, popularization of bureaucracy, extensive application of a machine orientation to work and predominance of "scientific" inquiry. Organizational theory developed largely from quantitative research findings arising from a positivistic world view. A case study, analyzing a current nursing organizational structure at one large hospital, is presented. Nursing management was found to be based upon the positivistic paradigm. The predominance of a machine orientation, and an autocratic and bureaucratic structure are evidence of this. A change to shared governance had been attempted, indicating a shift to a more modern organizational structure based on a different paradigm. The article concludes by emphasizing that managers are largely responsible for facilitating change; change that will meet internal human resource needs and the cost-effectiveness crises of hospitals today through more effective use of human resources.
Rezaee, Rita; Marhamati, Saadat; Nabeiei, Parisa; Marhamati, Raheleh
Organization structure and manpower constitute two basic components of anorganization and both are necessary for stablishing an organization. The aim of this survey was to investigate the type of the organization structure (mechanic and organic) from viewpoint of senior and junior managers in Shiraz teaching hospitals and creativity in each of these two structures. In this cross-sectional and descriptive-analytic study, organization structure and organizational creation questionnaires were filled out by hospital managers. According to the statistical consultation and due to limited target population, the entire study population was considered as sample. Thus, the sample size in this study was 84 (12 hospitals and every hospital, n = 7). For data analysis, SPSS 14 was used and Spearman correlation coefficient and t-test were used. RESULTS showed that there is a negative association between centralization and complexity with organizational creation and its dimensions. Also there was a negative association between formalization and 4 organizational creation dimensions: reception change, accepting ambiguity, abet new view and less control outside (p=0.001). The results of this study showed that the creation in hospitals with organic structure is more than that in hospitals with mechanic structure.
Makhloufi, Imane; Saadi, Janad; El Hiki, Lahcen; El Hassani, Amine
The new system of hospital governance requires health institutions to develop new managerial, financial and social skills beyond their public service duties. As part of this new approach, the organizational modernization of hospitals involves introducing good management practices. However, managing the transition requires taking into account the specificities of existing organizational systems. Organizational systems are generally difficult to model and involve diverse and sometimes competing interests, concerns, habits, languages, cultures, tools and representations. This explains the high failure rate observed in hospital development projects at an organizational level. A number of organizational theories from a range of disciplines (sociology, biology, history, etc.) have examined the question of organization in hospitals. The many theories developed in this area are not incompatible. Rather, they form a set of useful tools for the analysis of organizational management. The purpose of this study was to conduct an organizational analysis of Sheikh Zayed Hospital (Rabat) based on the Mintzberg model as a prerequisite for the development and implementation of a restructuring plan.
Hartmann, Christine W; Meterko, Mark; Rosen, Amy K; Shibei Zhao; Shokeen, Priti; Singer, Sara; Gaba, David M
Improving safety climate could enhance patient safety, yet little evidence exists regarding the relationship between hospital characteristics and safety climate. This study assessed the relationship between hospitals' organizational culture and safety climate in Veterans Health Administration (VA) hospitals nationally. Data were collected from a sample of employees in a stratified random sample of 30 VA hospitals over a 6-month period (response rate = 50%; n = 4,625). The Patient Safety Climate in Healthcare Organizations (PSCHO) and the Zammuto and Krakower surveys were used to measure safety climate and organizational culture, respectively. Higher levels of safety climate were significantly associated with higher levels of group and entrepreneurial cultures, while lower levels of safety climate were associated with higher levels of hierarchical culture. Hospitals could use these results to design specific interventions aimed at improving safety climate.
Fiorio, Carlo V; Gorli, Mara; Verzillo, Stefano
An increasing number of hospitals react to recent demographic, epidemiological and managerial challenges moving from a traditional organizational model to a Patient-Centered (PC) hospital model. Although the theoretical managerial literature on the PC hospital model is vast, quantitative evaluations of the performance of hospitals that moved from the traditional to the PC organizational structure is scarce. However, quantitative analysis of effects of managerial changes is important and can provide additional argument in support of innovation. We take advantage of a quasi-experimental setting and of a unique administrative data set on the population of hospital discharge charts (HDCs) over a period of 9 years of Lombardy, the richest and one of the most populated region of Italy. During this period three important hospitals switched to the PC model in 2010, whereas all the others remained with the functional organizational model. This allowed us to develop a difference-in-difference analysis of some selected measures of efficiency and effectiveness for PC hospitals focusing on the "between-variability" of the 25 major diagnostic categories (MDCs) in each hospital and estimating a difference-in-difference model. We contribute to the literature that addresses the evaluation of healthcare and hospital change by providing a quantitative estimation of efficiency and effectiveness changes following to the implementation of the PC hospital model. Results show that both efficiency and effectiveness have significantly increased in the average MDC of PC hospitals, thus confirming the need for policy makers to invest in new organizational models close to the principles of PC hospital structures. Although an organizational change towards the PC model can be a costly process, implying a rebalancing of responsibilities and power among hospital personnel (e.g. medical and nursing staff), our results suggest that changing towards a PC model can be worthwhile in terms of both
Wagner, C; Mannion, R; Hammer, A; Groene, O; Arah, O A; Dersarkissian, M; Suñol, R
To better understand associations between organizational culture (OC), organizational management structure (OS) and quality management in hospitals. A multi-method, multi-level, cross-sectional observational study. As part of the DUQuE project (Deepening our Understanding of Quality improvement in Europe), a random sample of 188 hospitals in 7 countries (France, Poland, Turkey, Portugal, Spain, Germany and Czech Republic) participated in a comprehensive questionnaire survey and a one-day on-site surveyor audit. Respondents for this study (n = 158) included professional quality managers and hospital trustees. Extent of implementation of quality management systems, extent of compliance with existing management procedures and implementation of clinical quality activities. Among participating hospitals, 33% had a clan culture as their dominant culture type, 26% an open and developmental culture type, 16% a hierarchical culture type and 25% a rational culture type. The culture type had no statistically significant association with the outcome measures. Some structural characteristics were associated with the development of quality management systems. The type of OC was not associated with the development of quality management in hospitals. Other factors (not culture type) are associated with the development of quality management. An OS that uses fewer protocols is associated with a less developed quality management system, whereas an OS which supports innovation in care is associated with a more developed quality management system.
Zhou, Ping; Bundorf, Kate; Le Chang, Ji; Huang, Jin Xin; Xue, Di
To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. © Health Research and Educational Trust.
McCracken, M J; McIlwain, T F; Fottler, M D
One of the major challenges facing health services management researchers is the measurement of various aspects of organizational performance. This challenge is exacerbated by a reluctance of many healthcare organizations to share data with researchers because of a fear of competitor access to these data. Even where objective, reliable and valid measures of organizational performance are available, typically they are available only in aggregate form, rather than for individual organizations. In response to these constraints, researchers have used subjective measures of performance often based on the perception of key executives. This research compares the subjective perceptions of hospital executives to the objective financial performance data of 60 hospitals. While the correlations between the subjective and objective measures vary, return of assets (ROA) and operating margin are the most valid subjective financial measures of hospital performance. Implications for future research are discussed.
Edwards, Nigel; Saltman, Richard B
Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations. While the problems in each of these three dimensions of public hospital organization are well-known, and the first two dimensions clearly affect private as well as publicly run hospitals, insufficient attention has been paid to the combined impact of all three factors in making public hospitals particularly difficult to manage and steer. Further, these three structural dimensions interact in an institutional environment defined by three restrictive context limitations, again two of which also affect private hospitals but all three of which compound the management dilemmas in public hospitals. The first contextual limitation is the inherent complexity of delivering high quality, safe, and affordable modern inpatient care in a hospital setting. The second contextual limitation is a set of specific market failures in public hospitals, which limit the scope of the standard financial incentives and reform measures. The third and last contextual limitation is the unique problem of generalized and localized anxiety , which accompanies the delivery of medical services, and which suffuses decision-making on the part of patients, medical staff, hospital management, and political actors alike. This combination of six institutional characteristics - three structural dimensions and three contextual dimensions - can help explain why
Kobuse, Hiroe; Morishima, Toshitaka; Tanaka, Masayuki; Murakami, Genki; Hirose, Masahiro; Imanaka, Yuichi
To develop a reliable and valid questionnaire that can distinguish features of organizational culture for patient safety across subgroups such as hospitals, professions, management/non-management positions and units/wards. We developed a Hospital Organizational Culture Questionnaire based on a conceptual framework incorporating items from a review of existing literature. The questionnaire was administered to hospital staff including doctors, nurses, allied health personnel, and administrative staff at six public hospitals in Japan. Reliability and validity were assessed through exploratory factor analysis, multitrait scaling analysis, Cronbach's alpha coefficient and multiple regression analysis using staff-perceived achievement of safety as the response variable. Discriminative power across subgroups was assessed with radar chart profiling. Of the 3304 hospital staff surveyed, 2924 (88.5%) responded. After exploratory factor analysis and multitrait analysis, the finalized questionnaire was composed of 24 items in the following eight dimensions: improvement orientation, passion for mission, professional growth, resource allocation prioritization, inter-sectional collaboration, responsibility and authority, teamwork, and information sharing. Construct validity and internal consistency of dimensions were confirmed with multitrait analysis and Cronbach's alpha coefficients, respectively. Multiple regression analysis showed that improvement orientation, passion for mission, resource allocation prioritization and information sharing were significantly associated with higher achievement in safety practices. Our questionnaire tool was able to distinguish features of safety culture among different subgroups. Our questionnaire demonstrated excellent validity and reliability, and revealed distinct cultural patterns among different subgroups. Quantitative assessment of organizational safety culture with this tool may further the understanding of associated characteristics of
Full Text Available IntroductionThe type of patients being treated in our hospitals has changed significantly. Today's patients are much older with more complicated, polypathological problems. As a result, hospital organization and management structures must also change, particularly in Internal Medicine. A widely discussed approach, organization according to “intensity of treatment,” could be an appropriate solution from an organizational viewpoint that would also satisfy these new demands.Materials and methodsWith the aid of a questionnaire sent to internists working in the hospitals of Italy's Emilia-Romagna region and the review of the relevant medical literature, we defined structural, organizational, technological, managerial, and staffing characteristics to better determine and classify this model. We analyzed questionnaire responses of 31 internists heading operative units in their hospitals, a relatively homogeneous subgroup with experience in organizing and managing healthcare as well as its clinical aspects.ResultsAnalysis of these questionnaires revealed important points concerning the model: 1 an accurate identification of the medical care on which to base the model; 2 a well-defined strategy for differentiated allocation of staff to structural and technological areas depending on the level of medical care provided in the area; 3 an accurate definition of the types and features of patients targeted by each level of medical care; 4 an early exchange (starting from the patient's arrival in the Emergency Department of information and medical knowledge among Emergency Department physicians and those present during the initial stages of hospitalization; 5 a precise definition of responsibilities in the different areas, operative and collaborative stages among different physicians and medical staff, the different disciplines involved in the process.ConclusionsAmong the physicians responsible for managing complex areas of Internal Medicine in Emilia
Sung, Wookje; Woehler, Meredith L; Fagan, Jesse M; Grosser, Travis J; Floyd, Theresa M; Labianca, Giuseppe Joe
The authors used pre-post merger data from 599 employees experiencing a major corporate merger to compare 3 conceptual models based on the logic of social identity theory (SIT) and exchange theory to explain employees' merger responses. At issue is how perceived change in employees' own jobs and roles (i.e., personal valence) and perceived change in their organization's status and merger appropriateness (i.e., organizational valence) affect their changing organizational identification, attachment attitudes, and voluntary turnover. The first model suggests that organizational identification and organizational attachment develop independently and have distinct antecedents. The second model posits that organizational identification mediates the relationships between change in organizational and personal valence and change in attachment and turnover. The third model posits that change in personal valence moderates the relationship between changes in organizational valence and in organizational identification and attachment. Using latent difference score (LDS) modeling in an SEM framework and survival analysis, the results suggest an emergent fourth model that integrates the first and second models: Although change in organizational identification during the merger mediates the relationship between change in personal status and organizational valence and change in attachment, there is a direct and unmediated relationship between change in personal valence and attachment. This integrated model has implications for M&A theory and practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Sekyia, Shigeru Ricardo; Luz, Talita Ribeiro da
Empirical evidences have pointed out the relevant role of breastfeeding to diminish infantile mortality. Children-friendly Hospitals (IHAC) is a worldwide action developed by the United Nations Children's Fund - UNICEF and by the World Health Organization, aiming to promote, protect and support breastfeeding and also prevent precocious weaning. The aim of the present study is to identify the main organizational changes which occurred in two hospitals, located in the State of Minas Gerais, Brazil that implemented IHAC. The organizational analysis carried out was based upon six perspectives, according to Motta's analytical chart that includes: strategic, structural, cultural, human, technological and political perspectives. A qualitative research was carried out, by using as a data gathering method the semi-structured interview, applied in all hierarchical levels. In order to interpret data, it was adopted the content analysis. In both cases, it could be concluded that the implementation of IHAC resulted in changes and improvement in the management of the organizations, due to the establishment of procedural patterns and staff training. It was verified that the cultural and technological changes occurred in a more intense manner and that the least perceived were the political and strategic changes.
Lega, Federico; Calciolari, Stefano
Over the last 20 years, hospitals have revised their organizational structures in response to new environmental pressures. Today, demographic and epidemiologic trends and recent technological advances call for new strategies to cope with ultra-elderly frail patients characterized by chronic conditions, high-severity health problems, and complex social situations. The main areas of change surround new ways of managing emerging clusters of patients whose needs are not efficiently or effectively met within traditional hospital organizations. Following the practitioner and academic literature, we first identify the most relevant clusters of new kinds of patients who represent an increasingly larger share of the hospital population in developed countries. Second, we propose a framework that synthesizes the major organizational innovations adopted by successful organizations around the world. We conclude by substantiating the trends of and the reasoning behind the prospective pattern of hospital organizational development.
Kiaei, Mohammad Zakaria; Hasanpoor, Edris; Sokhanvar, Mobin; Mohseni, Mohammad; Ziaiifar, Hajarbibi; Moradi, Mahin
Today, the concept of organizational learning has attracted the attention of many managers and researchers in scientific and research circles as well as those in the organization-related studies. Taking the organizational learning into account might offer a means of organizational effectiveness that has gone unnoticed. Thus the present study aimed at investigating the relationship between the organizational learning in each of its four aspects as independent variables and organizational citizen behavior of the staff as constituting the dependent variable of the study. This was a descriptive-analytical study with a practical approach conducted in 2010. The sample included 167 staff members working in educational health centers affiliated with Qazvin University of Medical Sciences. The data were collected via both the organizational learning questionnaire and organizational citizen behavior questionnaire and analyzed by using SPSS software and Spearman test. The results indicated that the mean of organizational learning indicator was 2.9±0.648 and that of organizational citizen behavior 3.78±0.413. In addition, the spearman correlation coefficient ranging from 0.058 to 0.129 between the elements of the organizational learning and the organizational citizen behavior was not statistically significant (p>0.05). The findings also indicated that the correlation between them was average among the staff of Shahid Raja'ee Educational health center (0.319), thus the relationship between the two sets of variables proved significant (p=0.031). However, the same was not true in other centers. It was concluded that management commitment, open space, transfer of knowledge, and systemic vision could all enhance the level of organizational learning in hospitals which calls for focus on the elements of organizational citizen behavior.
Gallant, Tricia Bertram; Drinan, Patrick
Studies have described and analyzed the problem of student cheating as well as institutional responses to the problem. However, organizational theory has been neglected. Viewing student cheating and institutional responses through the lens of organizational theory can inform strategy and instill fresh approaches to the management of the problem.
Saillour-Glénisson, F; Domecq, S; Kret, M; Sibe, M; Dumond, J P; Michel, P
Although many organizational culture questionnaires have been developed, there is a lack of any validated multidimensional questionnaire assessing organizational culture at hospital ward level and adapted to health care context. Facing the lack of an appropriate tool, a multidisciplinary team designed and validated a dimensional organizational culture questionnaire for healthcare settings to be administered at ward level. A database of organizational culture items and themes was created after extensive literature review. Items were regrouped into dimensions and subdimensions (classification validated by experts). Pre-test and face validation was conducted with 15 health care professionals. In a stratified cluster random sample of hospitals, the psychometric validation was conducted in three phases on a sample of 859 healthcare professionals from 36 multidisciplinary medicine services: 1) the exploratory phase included a description of responses' saturation levels, factor and correlations analyses and an internal consistency analysis (Cronbach's alpha coefficient); 2) confirmatory phase used the Structural Equation Modeling (SEM); 3) reproducibility was studied by a test-retest. The overall response rate was 80 %; the completion average was 97 %. The metrological results were: a global Cronbach's alpha coefficient of 0.93, higher than 0.70 for 12 sub-dimensions; all Dillon-Goldstein's rho coefficients higher than 0.70; an excellent quality of external model with a Goodness of Fitness (GoF) criterion of 0.99. Seventy percent of the items had a reproducibility ranging from moderate (Intra-Class Coefficient between 50 and 70 % for 25 items) to good (ICC higher than 70 % for 33 items). COMEt (Contexte Organisationnel et Managérial en Etablissement de Santé) questionnaire is a validated multidimensional organizational culture questionnaire made of 6 dimensions, 21 sub-dimensions and 83 items. It is the first dimensional organizational culture questionnaire
Full Text Available Background: Hospitals are among the most interactive organizations in which the rate of knowledge transfer and learning is considerably high. The investigation of the level of organizational learning between public and private sector hospitals can be useful for managers to select proper organizational learning strategies aiming at improving service delivery and organizational behaviour (1. This study was carried out to compare the organizational learning capabilities of the personnel in public and private sector hospitals of Kermanshah. Methods: This descriptive survey was performed on the personnel in public and private sector hospitals of Kermanshah. According to Krejcie and Morgan’s table, 175 employees were selected via stratified random sampling from 6 public and 2 private hospitals. The instrument for gathering data was Organizational Learning Capability Questionnaire (OLCQ by Gomez et al. (2005 (2. Data were analysed by inferential statistics (K-S test, Levene’s test, t-test, one-way ANOVA using SPSS software (version 20.00. Results: The level of organizational learning capabilities of personnel was higher in the private hospitals than in public hospitals, indicating a statistically significant difference between them (T (26= 11.779, P0.01، F (3, 68 = 1.859. Conclusion: With regard to the higher average of knowledge transfer and integration than the other capabilities in public and private hospitals, it seems that the managers of hospitals should make use of this component to promote the organizational knowledge of the personnel and improve other organizational learning capabilities too.
Ravaghi, Hamid; Mannion, Russell; Sajadi, Haniye Sadat
The objective was to explore the key factors associated with organizational failure in an NHS Hospital Trust. This case study adopted a qualitative design. Fifty-seven semistructured interviews and document analyses were conducted as well. Data were analyzed using a framework analysis method. A range of symptoms of organizational performance failure was identified. These relate to a financial deficit, lack of good external relationships, inability to meet core targets, a lack of clear management systems, and low staff morale. These markers had not been taken seriously by the previous senior management team. Symptoms of failure were the reflection of presence of secondary and primary causes of failure. Poor managerial leadership, poor financial control and performance management, lack of open culture, distraction by 2 large projects, and the lack of clinician engagement were perceived as internal causes of failure and the high level of policy changes within the NHS as the key external cause. The level of deprivation in the area was also thought to have had a negative impact on performance. The findings reinforce and expand on those of recent studies across the public sector. Tracking an organization's performance and early diagnosis of performance problems, focusing on performance management systems, and taking into account contextual factors are issues that should be considered.
Myrtle, R C; Martinez, C F
This article reports the results of a study designed to examine the relationship of environmental, organizational and structural factors, perceptions of key decision makers about competitive conditions, and changes in operational performance with the level of the marketing activities engaged in by 145 California hospitals. Measures assessing the impact of environmental conditions and the perception of the key decision makers were found to be related to the marketing activities of the organization. However, the relationship between measures which examined the structural and performance impacts on the marketing activities did not demonstrate the same predictive ability. The results suggest that marketing activities were affected by the key decision maker's assessment of the competitive nature of the environment, influence of key stakeholders, and tangible changes in the organization's task environment. Performance and other measures were not found to be as influential in determining these activities.
Karami, Mahtab; Torabi, Mashallah
Hospital is a complex organization rich in intellectual capitals. Effective management of these assets in line with innovating value to reach strategic goals and objectives can lead to increasing organizational IQ. In hospital with high organizational IQ, Increasing syntropy in intellectual capitals can convert it to an agile, learner, innovative, and smart organization.
Alexander, Jeffrey A.; Ye, Yining; Lee, Shoou-Yih D.; Weiner, Bryan J.
This study extends the literature on governing boards and organizational change by examining how governing board configurations have influenced profound organizational change in U.S. hospitals, and the conditions under which such change occurs. Hospitals governed by boards that more closely resembled a corporate governance model were more likely…
Maignan, [No Value; Thorne, D; Krishnan, R; Viswanathan, M
Organizational buying has been scrutinized extensively by marketing scholars (e.g., Barclay 1991; Bunn 1994; Webster and Wind 1972; Wren and Simpson 1996); yet, scant attention has been given to the nature, antecedents, and benefits of socially responsible organizational buying (SRB). The paper
Bahrawar Said; Muzammel Shah
... and as result the organization suffers. A literary gap was identified where the impact of leadership responses and its impacts on communication challenges in organizational development was not previously studied and analyzed empirically...
Witmer, Hope; Mellinger, Marcela Sarmiento
Organizational resilience refers to the ability to respond productively to significant disruptive change and transform challenges into opportunities. There is a gap in the literature about resilient nonprofit organizations and its application for identifying organizational conditions for successful adaption to external variables that threaten their existence. The aim of this study was to identify organizational characteristics that point to the resilience of nonprofit behavioral healthcare organizations as they successfully adapt to funding changes. A multiple case study of two behavioral health nonprofit organizations was conducted. Data was collected through interviews and focus groups, and analyzed through a qualitative content analysis. Using the framework of resilience, six themes that equipped these organizations to successfully adapt to funding changes were identified. They included: commitment to the mission, improvisation, community reciprocity, servant and transformational leadership, hope and optimism, and fiscal transparency. The findings suggest that incorporating these qualities into an organizational system equips it to systematically adapt to funding changes and other disruptive challenges. Using resilience as a process and not simply an outcome after recovery, nonprofit organizations can have the capacity to continuously respond to challenges and provide uninterrupted and valuable services to society.
Palacio, J P; Spears, M C; Vaden, A G; Dayton, A D
All areas of practice in hospital dietetic services include a management component; however, the nature of the managerial role in various areas of dietetic practice has not been identified clearly. The definition of dietetic practice in the Conceptual Framework for the Profession of Dietetics supports the importance of managerial skills. The effect of organizational level and practice area on managerial activities and roles of professional staff in hospital dietetic services was examined in this study. The nationwide sample included professionals in hospitals with 300+ beds. A total of 3,280 dietetic professionals participated. Five groups were defined: low administrative, low clinical, middle administrative, middle clinical, and upper administrative. Mintzberg identified 10 managerial roles and categorized them as interpersonal, informational, or decisional. The 10 roles were used as the basis for developing an 80-item instrument on which respondents rated each item for importance and time demand. Perceived importance of managerial activities tended to be greater at higher organizational levels. The managerial aspects of the lower clinical and upper administrative position were the most clearly defined. The lower clinical group tended to rate all of the managerial roles as significantly less important than did those in other positions; however, the middle clinical position included a substantial managerial responsibility.
Xue, Di; Zhou, Ping; Bundorf, M Kate; Huang, Jin Xin; Chang, Ji Le
The policy environment in China is rapidly changing. Strategic planning may enable hospitals to respond more effectively to changes in their external environment, little evidence exists on the extent to which public hospitals in China adopt different strategies and the relationship between strategic decision-making and hospital performance. The purposes of our study were to determine the extent to which different hospitals adopt different strategies, whether strategies are associated with organizational culture and whether hospital strategies are associated with hospital performance. Presidents (or vice presidents), employees, and patients from 87 public hospitals were surveyed during 2009. Measures of strategic group were developed using cluster analysis based on the three dimensions of product position, competitive posture, and market position. Culture was measured using a tool developed by the investigators. Performance was measured based on profitability, patient satisfaction, and employee satisfaction with overall hospital development in the recent 5 years. The association of strategic group and organizational culture with hospital performance was analyzed using multivariate models. Chinese public general hospitals were classified into five strategic groups that had significant differences in product positioning, competitive posture, and market position. Hospitals of similar types based on regulation adopted different strategies. Organizational culture was not strongly associated with hospital strategic group. Although strategic group was associated with hospital profitability and patient satisfaction in the models with or without control for hospital location, these effects did not persist after controlling for organizational culture, hospital level, and hospital location. It is important for public hospitals in China to make effective strategic planning and align their organizational culture with the strategies for better execution and therefore better
Hesselink, G.J.; Vernooij-Dassen, M.J.F.J.; Pijnenborg, L.; Barach, P.; Gademan, P.; Dudzik-Urbaniak, E.; Flink, M.; Orrego, C.; Toccafondi, G.; Johnson, J.K.; Schoonhoven, L.; Wollersheim, H.C.H.
BACKGROUND: Organizational culture is seen as having a growing impact on quality and safety of health care, but its impact on hospital to community patient discharge is relatively unknown. OBJECTIVES: To explore aspects of organizational culture to develop a deeper understanding of the discharge
Perryman-Starkey, M; Rivers, P A; Munchus, G
The relationship between organizational structure and organizational performance would seem at first to be straightforward and obvious. The more complex organizational structures will result in positive organizational performance (i.e. greater effectiveness or profitability). The premise is that the ability of an organization to achieve its mission successfully should be a result of the organizational structure. It is generally accepted that certain structural configurations are able to achieve certain goals better than others (i.e. a diversified structure as opposed to a simple structure). The research to date indicates that this is not necessarily true. The specific issue examined in this paper will be the effect of structural diversification on performance in industry and healthcare.
Kebriaei, A; Rakhshaninejad, M; Mohseni, M
People within organizations are a key factor for efficiency. Thus employee empowerment has become a popular management strategy. The study aimed to investigate the relationship between psychological empowerment and organizational commitment among medical staff of a hospital in Zahedan city. This cross sectional study was carried out in 2013. A random sample of 172 medical employees in Khatam-ol-Anbia hospital at Zahedan city was selected and responded to items of the questionnaires using a 7-point Likert scale ranging from 1 to 7. For measuring psychological empowerment and organizational commitment, Mishra & Spreitzer's scale and Meyer and Allen's questionnaire were used. A higher score means a higher degree of psychological empowerment or organizational commitment. Analysis was carried out using SPSS. The level of organizational commitment and psychological empowerment significantly were higher than average. There was a significant positive relationship between employees' empowerment and their commitment to organization. Psychological empowerment was a significant predictor of organizational commitment (β = .524). Out of the five dimensions of empowerment three dimensions are significant predictors of commitment and explain 37.1% of the variance in commitment. Due to The positive influence of psychological empowerment on organizational commitment, programs for in-service education should focus on facilitating psychological empowerment to improve and increase organizational commitment. Also, since impact of employees psychological empowerment on organizational commitment partially supported, there are other variables that influence the organizational commitment.
Mohamadzadeh Nojehdehi, Maryam; Ashgholi Farahani, Mansoureh; Rafii, Forough; Bahrani, Nasser
Background: Human resource is the most important factor of performance, success and better revelation of excellence goals of each organization. By performing excellence plan, healthcare organizations improve their organizational climate and play a valuable role in retaining nurses and improving the quality of their services to patients. Objectives: The aim of this study was to compare hospital organizational climate and intention to leave among working nurses in hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences. Patients and Methods: This was a cross-sectional descriptive comparison study. Its population included 248 nurses of the hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences in Iran selected by random sampling. The used instrument had three parts: the first part was related to personal characteristics, the second part was the Munn’s organizational climate questionnaire and the third part was Hinshaw’s questionnaire of “anticipated turnover scale”. Data was analyzed using SPSS software, version 17 and indices of descriptive statistics and inferential statistics. Results: The results of the mean and standard deviation for organizational climate and intention to leave in both performing and non-performing hospitals of the organizational excellence plan were respectively (65.28 ± 19.31 and 56.42 ± 21.36) and (33.64 ± 5.58 and 35.59 ± 4.94). Independent T test revealed a significant difference between the mean scores for organizational climate in both performing and non-performing hospitals, and also a significant difference between the mean scores for intention to leave in both performing and non-performing hospitals (P = 0.004). Moreover, Pearson Correlation test showed a reverse significant correlation between organizational climate and intention to leave in performing hospitals of the organizational excellence plan (r = -0.337) and non
Mohamadzadeh Nojehdehi, Maryam; Ashgholi Farahani, Mansoureh; Rafii, Forough; Bahrani, Nasser
Human resource is the most important factor of performance, success and better revelation of excellence goals of each organization. By performing excellence plan, healthcare organizations improve their organizational climate and play a valuable role in retaining nurses and improving the quality of their services to patients. The aim of this study was to compare hospital organizational climate and intention to leave among working nurses in hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences. This was a cross-sectional descriptive comparison study. Its population included 248 nurses of the hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences in Iran selected by random sampling. The used instrument had three parts: the first part was related to personal characteristics, the second part was the Munn's organizational climate questionnaire and the third part was Hinshaw's questionnaire of "anticipated turnover scale". Data was analyzed using SPSS software, version 17 and indices of descriptive statistics and inferential statistics. The results of the mean and standard deviation for organizational climate and intention to leave in both performing and non-performing hospitals of the organizational excellence plan were respectively (65.28 ± 19.31 and 56.42 ± 21.36) and (33.64 ± 5.58 and 35.59 ± 4.94). Independent T test revealed a significant difference between the mean scores for organizational climate in both performing and non-performing hospitals, and also a significant difference between the mean scores for intention to leave in both performing and non-performing hospitals (P = 0.004). Moreover, Pearson Correlation test showed a reverse significant correlation between organizational climate and intention to leave in performing hospitals of the organizational excellence plan (r = -0.337) and non-performing hospitals (r = -0.282) (P = 0.001). Performing quality
Tyson, Paul D; Pongruengphant, Rana; Aggarwal, Bela
Government cutbacks and anticipated staff reductions were hypothesized to be a unique source of organizational stress. The study focused on how nurses coped with stress and whether any strategy effectively reduced occupational stress. A sample of 107 nurses were asked to rate their occupational stress, job satisfaction, and coping strategies. Avoidance and social support were found to be significantly correlated with stress, but neither of these coping strategies appeared to reduce nurses' level of organizational stress. However, an interaction between problem solving and job satisfaction was found to be highly significant and it added 42% to predicting stress levels. Supporting the stress-buffering hypothesis, nurses with lower intrinsic job satisfaction seemed to benefit from employing problem solving as a coping strategy whereas dissatisfied nurses who infrequently use problem solving reported the highest levels of organizational stress. Paradoxically, intrinsically satisfied nurses who most frequently utilize problem solving experienced heightened organizational stress.
Full Text Available Responsible management of global hospitality companies increasingly recognizes how important are concerns about the society, the environment as well as all stakeholders in maintaining a good market position. In Serbia, the concept of corporate social responsibility is relatively unknown and insufficiently researched in all business areas, especially in the hospitality industry where small businesses are dominated. The papers task is to present particular activities that demonstrate social responsibility to employees, customers-guests, local communities as well as the environment. The paper aims to highlight the benefits of adopting the principles of corporate social responsibility and innovation applied in catering enterprises as an example of good corporate social responsibility practices.
Curry, Leslie A; Linnander, Erika L; Brewster, Amanda L; Ting, Henry; Krumholz, Harlan M; Bradley, Elizabeth H
Improving outcomes for patients with acute myocardial infarction (AMI) is a priority for hospital leadership, clinicians, and policymakers. Evidence suggests links between hospital organizational culture and hospital performance; however, few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with AMI. We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL). This manuscript describes the methodology of LSL, a 2-year intervention study using a concurrent mixed methods design, guided by open systems theory and the Assess, Innovate, Develop, Engage, Devolve (AIDED) model of diffusion, implemented in 10 U.S. hospitals and their peer hospital networks. The intervention has three primary components: 1) annual convenings of the ten intervention hospitals; 2) semiannual workshops with guiding coalitions at each hospital; and 3) continuous remote support across all intervention hospitals through a web-based platform. Primary outcomes include 1) shifts in key dimensions of hospital organizational culture associated with lower mortality rates for patients with AMI; 2) use of targeted evidence-based practices associated with lower mortality rates for patients with AMI; and 3) in-hospital AMI mortality. Quantitative data include annual surveys of guiding coalition members in the intervention hospitals and peer network hospitals. Qualitative data include in-person, in-depth interviews with all guiding coalition members and selective observations of key interactions in care for patients with AMI, collected at three time points. Data integration will identify patterns and major themes in change processes across all intervention hospitals over time. LSL is novel in its use of a longitudinal mixed methods approach in a diverse sample of hospitals, its focus on objective outcome measures of mortality, and its
Eskandari, Fereidoun; Siahkali, Soheila Rabie; Shoghli, Alireza; Pazargadi, Mehrnoosh; Tafreshi, Mansoreh Zaghari
The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care. Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction. The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses. 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010. Tools for data collection were Meyer and Allen's organizational commitment questionnaire and "Conditions for Work Effectiveness Questionnaire-II" (CWEQ-II). Data was analyzed by SPSS16. The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis. According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (15.98±3.29). Nurses believed "opportunity" as the most important element in structural empowerment with the score of 3.18 ±0.79. Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others. There was a significant relationship between structural empowerment and organizational commitment. Generally, structural empowerment (relatively strong) correlates with nurses' organizational commitment. We concluded that a high structural empowerment increases the organizational commitment of nurses.
This thesis investigates the organizational impact of a new medical occupation in Dutch hospitals, i.e. so-called emergency physicians (EPs). These doctors receive a 3-year non-specialist training, aiming to enable them to diagnose and treat patients in emergency care units in hospitals. The study
Kjeldsen, Anne Mette; Jonasson, Charlotte; Ovesen, Maria
conflict, where local managers ‘take the blame’. Hence, the paper concludes that a complex dynamic interrelation of ongoing organizational change and the emergence and boundaries of DL is important to take into consideration in studies of how organizational mergers and change can be managed.......This paper proposes that the emergence and boundaries of distributed leadership (DL) are developed in a dynamic interplay with planned as well as emergent organizational change. The empirical findings are based on a qualitative, longitudinal case study with interviews conducted at two different...... hospital units in the context of a larger hospital merger within the Danish health care system. The paper adds to prior studies arguing that DL contributes positively to planned organizational change by instead providing examples of how ongoing changes in contextual conditions such as routine...
Vina, Ernest R; Rhew, David C; Weingarten, Scott R; Weingarten, Jason B; Chang, John T
The Centers for Medicare & Medicaid Services (CMS)/Premier Hospital Quality Incentive Demonstration (HQID) project aims to improve clinical performance through a pay-for-performance program. We conducted this study to identify the key organizational factors associated with higher performance. An investigator-blinded, structured telephone survey of eligible hospitals' (N = 92) quality improvement (QI) leaders was conducted among HQID hospitals in the top 2 or bottom 2 deciles submitting performance measure data from October 2004 to September 2005. The survey covered topics such as QI interventions, data feedback, physician leadership, support for QI efforts, and organizational culture. More top performing hospitals used clinical pathways for the treatment of AMI (49% vs. 15%, p vs. 18%, p vs. 13%, p vs. 23%, p manage patients with AMI (93% vs. 77%, p vs. 69%, p vs. 64%, p vs. 7.9%, p < 0.05). Finally, more top performers reported having adequate human resources for QI projects (p < 0.01); support of the nursing staff to increase adherence to quality indicators (p < 0.01); and an organizational culture that supported coordination of care (p < 0.01), pace of change (p < 0.01), willingness to try new projects (p < 0.01), and a focus on identifying system errors rather than blaming individuals (p < 0.05). Organizational structure, support, and culture are associated with high performance among hospitals participating in a pay-for-performance demonstration project. Multiple organizational factors remain important in optimizing clinical care.
Kim, Tae Hyun; Thompson, Jon M
Effective leadership in hospitals is widely recognized as the key to organizational performance. Clinical, financial, and operational performance is increasingly being linked to the leadership practices of hospital managers. Moreover, effective leadership has been described as a means to achieve competitive advantage. Recent environmental forces, including reimbursement changes and increased competition, have prompted many hospitals to focus on building leadership competencies to successfully address these challenges. Using the resource dependence theory as our conceptual framework, we present results from a national study of hospitals examining the association of organizational and market factors with the provision of leadership development program activities, including the presence of a leadership development program, a diversity plan, a program for succession planning, and career development resources. The data are taken from the American Hospital Association's (AHA) 2008 Survey of Hospitals, the Area Resource File, and the Centers for Medicare & Medicaid Services. The results of multilevel logistic regressions of each leadership development program activity on organizational and market factors indicate that hospital size, system and network affiliation, and accreditation are significantly and positively associated with all leadership development program activities. The market factors significantly associated with all leadership development activities include a positive odds ratio for metropolitan statistical area location and a negative odds ratio for the percentage of the hospital's service area population that is female and minority. For-profit hospitals are less likely to provide leadership development program activities. Additional findings are presented, and the implications for hospital management are discussed.
Full Text Available For the purpose of enhancing organizational sustainability during a crisis, an organization takes a position in decision-making, how to respond toward its public, and that is supposed to determine which stance or tactic to employ. This study aims to examine whether publics’ perceptions of organizational crisis responsibility affect their expectations that an organization should choose certain stances and strategies toward the public in a crisis. To address these concerns, an experiment was conducted. As the specific public of this research, health journalists were selected, since they affect public perceptions significantly and public opinion can ultimately put pressure on an organization. Results from an analysis of the experimental data with health journalists confirm that they expect a more accommodative stance/strategy when they perceive that the organization is highly responsible for a health-related crisis. Conversely, when the journalists perceive that an organization has a low level of responsibility for a crisis, they expect a more advocative stance/strategy. By taking into account the health journalists’ expectations along with the needs of the organization, public relations practitioners are better able to make optimal decisions regarding their client organizations’ adopted stance and strategy, and finally, enhance organizational sustainability in a crisis.
The author reviews the corporate social responsibility (CSR) literature that includes the individual level of analysis (referred to as micro CSR in the article) based on 166 articles, book chapters, and books. A framework is provided that integrates organizational psychology and CSR, with the purpose of highlighting synergies in order to advance scholarship and practice in both fields. The review is structured so that first, a brief overview is provided. Second, the literatures on organizational psychology and CSR are integrated. Third, gaps are outlined illuminating opportunities for future research. Finally, a research agenda is put forward that goes beyond addressing gaps and focuses on how organizational psychology and CSR can be partners in helping move both fields forward-specifically, through a humanistic research agenda rooted in positive psychology.
The author reviews the corporate social responsibility (CSR) literature that includes the individual level of analysis (referred to as micro CSR in the article) based on 166 articles, book chapters, and books. A framework is provided that integrates organizational psychology and CSR, with the purpose of highlighting synergies in order to advance scholarship and practice in both fields. The review is structured so that first, a brief overview is provided. Second, the literatures on organizational psychology and CSR are integrated. Third, gaps are outlined illuminating opportunities for future research. Finally, a research agenda is put forward that goes beyond addressing gaps and focuses on how organizational psychology and CSR can be partners in helping move both fields forward—specifically, through a humanistic research agenda rooted in positive psychology. PMID:26909055
Full Text Available The author reviews the corporate social responsibility (CSR literature that includes the individual level of analysis (referred to as micro CSR in the article based on 166 articles, book chapters, and books. A framework is provided that integrates organizational psychology and CSR, with the purpose of highlighting synergies in order to advance scholarship and practice in both fields. The review is structured so that first, a brief overview is provided. Second, the literatures on organizational psychology and CSR are integrated. Third, gaps are outlined illuminating opportunities for future research. Finally, a research agenda is put forward that goes beyond addressing gaps and focuses on how organizational psychology and CSR can be partners in helping move both fields forward—specifically, through a humanistic research agenda rooted in positive psychology.
Lee, Chiachi Bonnie; Chen, Michael S; Powell, Michael; Chu, Cordia Ming-Yeuk
The Taiwanese Network of Health Promoting Hospitals (HPH) has been in place since 2006 and developing rapidly. The criticism of inadequate evaluation of the HPH approach taken elsewhere also holds true for the Taiwan HPH Network. Organizational change is a key to sustainable and effective health promotion, and it is also an important aspect in the European HPH movement. Therefore, this study aims to evaluate changes in organizational capacity for the implementation of HPH in Taiwan. All 55 HPH coordinators were invited to participate in the study, and 52 of them completed the questionnaires. The survey covered seven dimensions of HPH organizational capacity, and a total score of each dimension was calculated and converted to a figure on a scale of 10. This study has shown that HPH made a positive impact on HP hospitals in Taiwan regarding organizational change in capacity building for HPH. Leadership, organization culture and mission and strategy received the top three highest mean scores (8.19 ± 1.25, 8.08 ± 1.39, 7.99 ± 1.42), while staff participation received the lowest score (7.62 ± 1.26). The high level of organizational change was associated with the high satisfaction levels of organizational support from the viewpoint of the HPH coordinators. Based on a cluster analysis, a majority of the HP hospitals in Taiwan seemed to have adopted the addition model in putting the HPH initiative into practice; a few hospitals appeared to have accepted HPH initiative well through the integration model. These results presented evidence that HPH contributed to organizational capacity building of hospitals for health promotion.
Pacifici, L E; Riccardo, F; De Rosa, A G; Pacini, A; Nardi, L; Russo, G; Scaroni, E
Recent studies show how in the 2004-2005 period there has been an increase in natural disasters of 18% worldwide. According to a renowned author planning for disaster response is as valid as the starting hypothesis. The study of an inductive mental process in disaster response planning is the key to avoiding the invention and re-invention of the wheel for each emergency. Research in this field however is hampered by different factors one of which is data collection that during disaster response requires specific training. Standardization of data collection models with limitation of the number of variables is required as is taking into account problems related to people migration and subsequent sampling problems and retrospective analysis. Moreover poor attention to the training of the volunteers employed on the field is an issue to be considered.
Nigam, Amit; Huising, Ruthanne; Golden, Brian R
Improving hospital efficiency is a critical goal for managers and policy makers. We draw on participant observation of the perioperative coaching program in seven Ontario hospitals to develop knowledge of the process by which the content of change initiatives to increase hospital efficiency is defined. The coaching program was a change initiative involving the use of external facilitators with the goal of increasing perioperative efficiency. Focusing on the role of subjective understandings in shaping initiatives to improve efficiency, we show that physicians, nurses, administrators, and external facilitators all have differing frames of the problems that limit efficiency, and propose different changes that could enhance efficiency. Dynamics of strategic and contested framing ultimately shaped hospital change commitments. We build on work identifying factors that enhance the success of change efforts to improve hospital efficiency, highlighting the importance of subjective understandings and the politics of meaning-making in defining what hospitals change.
Ko, Yu Kyung
The purpose of this study was to identify factors related to nurses' organizational citizenship behavior using multilevel analysis which included both nurse characteristics at individual levels and nursing unit characteristics at group levels. The sample was composed of 1,996 nurses who were selected from 182 nursing units in 28 hospitals in six metropolitan cities and seven provinces using cluster sampling. Data were collected using self-reported questionnaires from February to March 2006. The results of the study indicated that individual level variables related to organizational citizenship behavior were religion, job position, clinical career, self efficacy, positive affectivity, and supervisor support. The group level variables related to organizational citizenship behavior were collective efficacy, number of nurses in a nursing unit, and the average salary level of a nursing unit. 30.9% of individual level variances of organizational citizenship behavior were explained by the nurses' individual level variables. The explanatory power of group level variables, which is related to group level variances of organizational citizenship behavior, was 75.5%. This research showed that it was necessary to develop appropriate strategies related to not only individual factors, but also higher-level organizational factors such as collective efficacy, to improve individual performances in the hospital.
Full Text Available Organizational deviant behavior is defined as intentionally behavior which is damaging both employees and organization and unsuitable to organization rules, norms, values, expectations and legal regulations.The aim of this study is to determine the level of organizational deviance of nurses, to expose differentiates of this level. according to the descriptive characteristics, to detect the dimensions of organizational deviance and to evaluate the relationship between these dimensions. Population of the study is nurses working at a University Hospital in Ankara. The sample is not selected and tried to reach all the nurses working at this hospital. However, 244 nurses were reached (%48,12. To measure organizational deviance, “Measure of Workplace Deviance Items”which was developed by Bennett and Robinson (2000was used. This scale consists from 15 expressions and 2 dimensions and its’ Cronbach's alpha coefficient was 0,94. As a result of the study, the mean score of nurses’ organizational deviance was found 1.85 ± 0.718. In addition, statistically significant, positive and moderately strong correlation was found between the two dimensions of organizational deviance (R= 0.701 . It can be suggested that health care managers should identify reasons and the ways of preventing of individual deviant behaviour. Thus, managers may prevent behaviour of deviation to the organization.
Bradley, Elizabeth H; Brewster, Amanda L; Fosburgh, Heather; Cherlin, Emily J; Curry, Leslie A
Because organizational culture is increasingly understood as fundamental to achieving high performance in hospital and other healthcare settings, the ability to measure this nuanced concept empirically has gained importance. Aside from measures of patient safety culture, no measure of organizational culture has been widely endorsed in the medical literature, limiting replication of previous findings and broader use in interventional studies. We sought to develop and assess the validity and reliability of a scale for assessing organizational culture in the context of hospitals' efforts to reducing 30-day risk-standardized mortality after acute myocardial infarction. The 31-item scale was completed by 147 individuals representing 10 hospitals during August and September 2014. The resulting organizational culture scale demonstrated high level of construct validity and internal consistency. Factor analyses indicated that the 31 items loaded well (loading values 0.48-0.90), supporting distinguishable domains of (1) learning environment, (2) psychological safety, (3) commitment to the organization, (4) senior management support, and (5) time for improvement efforts. Cronbach α coefficients were 0.94 for the scale and ranged from 0.77 to 0.88 for the subscales. The scale displayed reasonable convergent validity and statistically significant variability across hospitals, with hospital identity accounting for 11.3% of variance in culture scores across respondents. We developed and validated a relatively easy-to-administer survey that was able to detect substantial variability in organizational culture across different hospitals and may be useful in measuring hospital culture and evaluating changes in culture over time as part performance improvement efforts. © 2017 American Heart Association, Inc.
Mojgan Ahmari Nejad
Full Text Available Abstract Background: Internal marketing is one of the applied instruments for managers to plan human force. This study aimed to investigate the effect of internal marketing on organizational commitment in a remedial center. Materials and Methods: This study has an applied purpose and its nature is causal-survey. Statistical population consisted of 450 working employees in Ghods hospital in Arak city. Out of these, 207 samples were selected by available random cluster sampling. Data were gathered by standard questionnaires and the reliability of them validated by Cronbach’s alpha coefficient. Data analysis was performed by linear regression by using SPSS 19 software. Results: The findings of this study showed that internal marketing had an effect on organizational commitment and the value of it was 0.2. Also, reward affected on organizational commitment which was equal to 0.13. The effect of communication on organizational commitment was positive and the value of it was 0.16. Development had an effect on organizational commitment which was equal to 0.16. In addition, safe workplace had an effect on organizational commitment and the value of it was 0.12. Also, the effect of job recruitment and appointment was positive which was equal to 0.11. Conclusion: According to the results, it is essential to pay attention to necessary requirements and conditions for providing an appropriate bed to expand internal marketing and employees’ participation to develop organizational commitment.
Casida, Jesus; Pinto-Zipp, Genevieve
The phenomena of leadership and organizational culture (OC) has been defined as the driving forces in the success or failure of an organization. Today, nurse managers must demonstrate leadership behaviors or styles that are appropriate for the constantly changing, complex, and turbulent health care delivery system. In this study, researchers explored the relationship between nurse managers' leadership styles and OC of nursing units within an acute care hospital that had achieved excellent organizational performance as demonstrated by a consistent increase in patient satisfaction ratings. The data from this study support that transformational and transactional contingent reward leaderships as nurse manager leadership styles that are associated with nursing unit OC that have the ability to balance the dynamics of flexibility and stability within their nursing units and are essential for maintaining organizational effectiveness. It is essential for first-line nursing leaders to acquire knowledge and skills on organizational cultural competence.
Stordeur, S; D'hoore, W; Vandenberghe, C
STUDY'S RATIONALE AND OBJECTIVES: We examined the effect of work stressors and head nurses' transactional and transformational leadership on the levels of emotional exhaustion experienced among their staff. A questionnaire was sent to all nurses of a university hospital. Usable returns were received from 625 nurses, giving a response rate of 39.2%. Data were treated using correlational analyses and multiple regression. The latter modelled stressors and leadership as predictors of nurses' reported emotional exhaustion. Work stressors were assessed using the Nursing Stress Scale (NSS) which comprises 34 items divided into three subscales (referring to stress from the physical, psychological, and social environment), and the role ambiguity (three items) and conflict (three items) scales. Leadership was measured with the Multifactor Leadership Questionnaire. In regression analyses, work stressors as a whole were found to explain 22% of the variance in emotional exhaustion whereas leadership dimensions explained 9% of the variance in that outcome measure. Stress emanating from the physical and social environment, role ambiguity, and active management-by-exception leadership were significantly associated with increased levels of emotional exhaustion. Transformational and contingent reward leadership did not influence emotional exhaustion. A limitation of this study is that it considered only the emotional exhaustion dimension of burnout. Also, as data were cross-sectional in nature, conclusions regarding the direction of causality among variables cannot be drawn. This study provided, for the first time, a test of the influence of leadership on burnout among nurses, taking into account the role of work stressors. Future research is needed to examine if the effects reported herein can be replicated using the two other dimensions of burnout (depersonalization and reduced personal accomplishment).
The author reviews the corporate social responsibility (CSR) literature that includes the individual level of analysis (referred to as micro CSR in the article) based on 166 articles, book chapters, and books. A framework is provided that integrates organizational psychology and CSR, with the purpose of highlighting synergies in order to advance scholarship and practice in both fields. The review is structured so that first, a brief overview is provided. Second, the literatures on organizatio...
Hesselink, Gijs; Vernooij-Dassen, Myrra; Pijnenborg, Loes; Barach, Paul; Gademan, Petra; Dudzik-Urbaniak, Ewa; Flink, Maria; Orrego, Carola; Toccafondi, Giulio; Johnson, Julie K; Schoonhoven, Lisette; Wollersheim, Hub
Organizational culture is seen as having a growing impact on quality and safety of health care, but its impact on hospital to community patient discharge is relatively unknown. To explore aspects of organizational culture to develop a deeper understanding of the discharge process. A qualitative study of stakeholders in the discharge process. Grounded Theory was used to analyze the data. In 5 European Union countries, 192 individual and 25 focus group interviews were conducted with patients and relatives, hospital physicians, hospital nurses, general practitioners, and community nurses. Three themes emerged representing aspects of organizational culture: a fragmented hospital to primary care interface, undervaluing administrative tasks relative to clinical tasks in the discharge process, and lack of reflection on the discharge process or process improvement. Nine categories were identified: inward focus of hospital care providers, lack of awareness to needs, skills, and work patterns of the professional counterpart, lack of a collaborative attitude, relationship between hospital and primary care providers, providing care in a "here and now" situation, administrative work considered to be burdensome, negative attitude toward feedback, handovers at discharge ruled by habits, and appreciating and integrating new practices. On the basis of the data, we hypothesize that the extent to which hospital care providers value handovers and the outreach to community care providers is critical to effective hospital discharge. Community care providers often are insufficiently informed about patient outcomes. Ongoing challenges with patient discharge often remain unspoken with opportunities for improvement overlooked. Interventions that address organizational culture as a key factor in discharge improvement efforts are needed.
The PASS ("Permanence d'Accès aux Soins de Santé") are hospital-based units providing primary care services to patients who lack health care coverage. Using a "whole person" approach and providing a combination of health and social care, the PASS offer an appropriately adapted response to complex health problems within a context of marked social vulnerability and contribute to reducing health inequalities. The PASS are an example of an interdisciplinary approach to health care which contrasts with the segmentary approach typical of conventional hospital departments. Operating at the interface between primary and secondary care, the PASS have the potential to become key players in developing models of patient pathways. Their presence reduces inappropriate emergency attendances and hospitalisation by offering medical care in a timely fashion, in an outpatient-type setting. The PASS can provide a resource for research into optimum models of health care, where the social context of health needs are fully recognized and inform medical treatment appropriately. According to their potential development, PASS are living labs of an innovative organizational model of care. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Khiavi, Farzad Faraji; Shakhi, Kamal; Dehghani, Roohallah; Zahiri, Mansour
Introduction Organizational justice is an intricate concept that refers to fair and ethical conduct of individuals within organizations. No research has been conducted on the variables associated with organizational justice in rehabilitation clinics. Thus, the aim of this research was to determine the correlation between organizational justice and organizational trust among the employees of rehabilitation clinics in hospitals of Ahvaz, Iran. Methods This was a cross-sectional research, and it was conducted on 140 rehabilitation staff members of hospital clinics in Ahvaz. The data were gathered using organizational justice and trust questionnaires. The data were analyzed using the independent-samples t-test, ANOVA, and Pearson’s product-moment correlation SPSS software. Results Significant correlations between procedure and interaction justice and organizational trust were identified (p Organizational justice was significantly associated with organizational trust (r = 0.42, p Organizational justice was not significantly related to any demographic variable (p > 0.05). Conclusion There was a positive, medium, and significant correlation between organizational justice and trust. It is suggested that rehabilitation clinics’ managers develop plans to increase their organizational justice subscales in order to develop organizational trust among their employees. PMID:27053997
Spaulding, Aaron; Edwardson, Nick; Zhao, Mei
The hospital value-based purchasing (HVBP) program of the Centers for Medicare & Medicaid Services challenges hospitals to deliver high-quality care or face a reduction in Medicare payments. How do different organizational structures and market characteristics enable or inhibit successful transition to this new model of value-based care? To address that question, this study employs an institutional theory lens to test whether certain organizational structures and market characteristics mediate hospitals' ability to perform across HVBP domains.Data from the 2014 American Hospital Association Annual Survey Database, Area Health Resource File, the Medicare Hospital Compare Database, and the association between external environment and hospital performance are assessed through multiple regression analysis. Results indicate that hospitals that belong to a system are more likely than independent hospitals to score highly on the domains associated with the HVBP incentive arrangement. However, varying and sometimes counterintuitive market influences bring different dimensions to the HVBP program. A hospital's ability to score well in this new value arrangement may be heavily based on the organization's ability to learn from others, implement change, and apply the appropriate amount of control in various markets.
Jahangir, Fridoon; Shokrpour, Nasrin
To measure the relationship between job satisfaction and the 3 components of organizational commitment. Most of the research conducted in the West has shown a positive relationship between organizational commitment and job satisfaction of nurses; however, the relationship between the components of organizational commitment and job satisfaction is not well established in Iranian samples. This study aimed to investigate the level of organizational commitment and job satisfaction of the hospital nurses in Iran and the interrelationship between the 3 components of commitment and job satisfaction among them. Using the organizational commitment questionnaire developed by Meyer et al (J Appl Psychol. 1993;78:538-551), the 3 components of commitment were measured through a descriptive correlational design. Seven hundred eighty-six licensed nurses working in 12 hospitals participated in the study. One hundred ninety-eight of 220 returned questionnaires were identified as appropriate for the analysis. Affective commitment was positively related to job satisfaction, normative commitment, and experience in nursing, but it was negatively related to continuance commitment. Continuance commitment was negatively related to job satisfaction and affective commitment. Normative commitment was positively related to job satisfaction and affective commitment. The 3 components of commitment are variously related to job satisfaction. Nursing managers should pay attention to different components of commitment variously to promote the appropriate type of commitment needed for specific situation in which they work.
Background Patient satisfaction in health care constitutes an important component of organizational performance in the hospital setting. Satisfaction measures have been developed and used to evaluate and improve hospital performance, quality of care and physician practice. In order to direct improvement strategies, it is necessary to evaluate both individual and organizational factors that can impact patients’ perception of care. The study aims were to determine the dimensions of patient satisfaction, and to analyze the individual and organizational determinants of satisfaction dimensions in hospitals. Methods We used patient and hospital survey data as well as administrative data collected for a 2008 public hospital report in Ontario, Canada. We evaluated the clustering of patient survey items with exploratory factor analysis and derived plausible dimensions of satisfaction. A two-level multivariate model was fitted to analyze the determinants of satisfaction. Results We found eight satisfaction factors, with acceptable to good level of loadings and good reliability. More than 95% of variation in patient satisfaction scores was attributable to patient-level variation, with less than 5% attributable to hospital-level variation. The hierarchical models explain 5 to 17% of variation at the patient level and up to 52% of variation between hospitals. Individual patient characteristics had the strongest association with all dimensions of satisfaction. Few organizational performance indicators are associated with patient satisfaction and significant determinants differ according to the satisfaction dimension. Conclusions The research findings highlight the importance of adjusting for both patient-level and organization-level characteristics when evaluating patient satisfaction. Better understanding and measurement of organization-level activities and processes associated with patient satisfaction could contribute to improved satisfaction ratings and care quality. PMID
Ibrahem, Samaa Z; Elhoseeny, Taghareed; Mahmoud, Rasha A
High-quality patient care depends on a nursing workforce that is empowered to provide care according to professional nursing standards. Numerous studies have established positive relationships between empowerment and important nursing outcomes such as work effectiveness, job satisfaction, and organizational commitment. A cross-sectional study design was used to assess the relationships between structural and psychological empowerment and their effects on hospital nurses' organizational commitment at the Main University Hospital in Alexandria governorate. The total number of nurses who participated in the study was 150 nurses, and four interview questionnaires were used to measure the study variables. The mean score percentage was higher for overall psychological empowerment (68.75%) than for overall structural empowerment (46.25%). There was a significant direct intermediate correlation between nurses' perceptions of overall structural and psychological work empowerment and their overall organizational commitment. There was no significant relationship between structural and psychological empowerment, organizational commitment and sociodemographic characteristics of nurses except for the overall organizational commitment with age (r=0.260), overall structural empowerment in the working department (P=0.031), and overall organizational commitment with nursing experience (significance=0.025). Overall psychological empowerment achieved a higher mean score percentage compared with overall structural empowerment. Changing workplace structures is within the mandate of nurses' managers in their roles as advocates for and facilitators of high-quality care. The most significant opportunity for improvement is in the area of formal power, including flexibility, adaptability, creativity associated with discretionary decision-making, visibility, and centrality to organizational purpose and goals.
Reme, Silje Endresen; Shaw, William S; Boden, Leslie I; Tveito, Torill H; O'Day, Elizabeth Tucker; Dennerlein, Jack T; Sorensen, Glorian
Hospital patient care (PC) workers have high rates of workplace injuries, particularly musculoskeletal injuries. Despite a wide spectrum of documented health hazards, little is known about the association between psychosocial factors at work and OSHA-recordable musculoskeletal injuries. PC-workers (n = 1,572, 79%) completed surveys assessing a number of organizational, psychosocial and psychological variables. Associations between the survey responses and injury records were tested using bivariate and multivariate analyses. A 5% of the PC-workers had at least one OSHA-recordable musculoskeletal injury over the year, and the injuries were significantly associated with: organizational factors (lower people-oriented culture), psychosocial factors (lower supervisor support), and structural factors (job title: being a patient care assistant). The results show support for a multifactorial understanding of musculoskeletal injuries in hospital PC-workers. An increased focus on the various dimensions associated with injury reports, particularly the organizational and psychosocial factors, could contribute to more efficient interventions and programs. © 2014 Wiley Periodicals, Inc.
Fasoli, Dijon R
The purpose of this study was to measure the influence of professional nursing practice (PNP) on global hospital performance (GHP). Evidence links PNP and positive outcomes for patients and nurses, however, little is known about PNP influence on GHP measures used for patient decision-making and hospital management resource allocation decisions. A quantitative study using multiple regression analysis to predict a composite measure of GHP was conducted. Two survey instruments measuring perspectives of the PNP environment were completed by 1815 (31.3%) Registered Nurses (RN) and 28 (100%) Senior Nurse Executives (SNE) at 28 northeastern US hospitals. Secondary data provided organizational attributes. The degree of PNP was consistently reported by RNs and SNEs. When regressed with organizational factors, PNP was not a significant predictor of GHP. Better GHP was associated with lower lengths of stay, lower profitability, less admission growth, and non-health system affiliation. Further research is needed to define a nursing-sensitive GHP measure.
Raadabadi, Mehdi; Fayaz-Bakhsh, Ahmad; Nazari, Aslan; Mousavi, Seyed Masood; Fayaz-Bakhsh, Mohammadali
Due to rapid changes of technology and scientific advances in health systems and need for fast planning in health care, entrepreneurial spirit among employers and employees is a crucial element. According to the field of entrepreneurship research has not been solved and where learning and innovation for healthcare organizations due to the nature of the work required. This study aims to examine the entrepreneurial activities within the hospitals affiliated to Tehran University of Medical Sciences, Iran. To achieve the aim of the study, a questionnaire containing 29 items regarding the areas of innovation, creative behavior, flexibility, empowerment, rewarding systems and the management support was distributed among the hospitals' managers. Establishment of a culture of entrepreneurship in healthcare organizations led to the development unit controlled, changing the culture of the hospital. The analysis of the data showed that the majority of the managers agreed with all five areas of entrepreneurship namely the existence of innovation and innovative behavior, flexibility, decision making, rewarding and encouraging system, as well as management supportive system of personnel's new ideas. In fact, the managers generally had positive attitude towards entrepreneurship in their organizations The Pearson correlation test also showed that there is a significant relationship between the areas of entrepreneurship and the managers' age as well as their working experience (P<0.05). Entrepreneurial activities in healthcare can be improved through providing a suitable environment, adjusting reward and encouragement systems, giving more authority to subordinates, promoting awareness and education, and mobilizing managers to attract appropriate opportunities for organization. Further active involvement of employees, more stable in front of changes and increased ability managers to capture opportunities in domestic and foreign situation.
Rocha, Fernanda Ludmilla Rossi; Gaioli, Cheila Cristina Leonardo de Oliveira; Camelo, Silvia Helena Henriques; Mininel, Vivian Aline; Vegro, Thamiris Cavazzani
to analyze the organizational culture of a psychiatric hospital and identify the capacity of resilience of nursing workers. quantitative research. For data collection, were used the Brazilian Instrument for Evaluation of Organizational Culture (IBACO - Instrumento Brasileiro para Avaliação da Cultura Organizacional) and the Resilience Scale (RS). participants reported the existence of centralization of power and devaluation of workers, despite recognizing the existence of collaboration at work and practices for improving interpersonal relations. In relation to the capacity of resilience, 50% of workers showed high level, and 42.9% a medium level of resilience. The correlation tests revealed negative values between the IBACO and RS domains, indicating that the lower the appreciation of individuals in the institution, the greater their capacity of resilience. the organizational values reflect the work organization model in the institution that devalues the workers' needs and requires greater capacity of resilience.
Gladys Y. Hernández Hernández
Full Text Available This paper aims to determine the impact of Social Responsibility (SR as a trigger strategy of organizational commitment of workers in a company in the food sector. Focusing on the need to create links between company-worker to minimize this conflict given the set of state policies aimed at weakening the current capitalist system. The positivist approach is, of qualitative and quantitative court and field. We conclude that RS applied processes generate a high level of identification, belonging and membership, positive impact on the level of employee commitment to the company.
Raadabadi, Mehdi; Fayaz-Bakhsh, Ahmad; Nazari, Aslan; Mousavi, Seyed Masood; Fayaz-Bakhsh, MohammadAli
Due to rapid changes of technology and scientific advances in health systems and need for fast planning in health care, entrepreneurial spirit among employers and employees is a crucial element. According to the field of entrepreneurship research has not been solved and where learning and innovation for healthcare organizations due to the nature of the work required. This study aims to examine the entrepreneurial activities within the hospitals affiliated to Tehran University of Medical Sciences, Iran. To achieve the aim of the study, a questionnaire containing 29 items regarding the areas of innovation, creative behavior, flexibility, empowerment, rewarding systems and the management support was distributed among the hospitals’ managers. Establishment of a culture of entrepreneurship in healthcare organizations led to the development unit controlled, changing the culture of the hospital. The analysis of the data showed that the majority of the managers agreed with all five areas of entrepreneurship namely the existence of innovation and innovative behavior, flexibility, decision making, rewarding and encouraging system, as well as management supportive system of personnel’s new ideas. In fact, the managers generally had positive attitude towards entrepreneurship in their organizations The Pearson correlation test also showed that there is a significant relationship between the areas of entrepreneurship and the managers’ age as well as their working experience (P<0.05). Entrepreneurial activities in healthcare can be improved through providing a suitable environment, adjusting reward and encouragement systems, giving more authority to subordinates, promoting awareness and education, and mobilizing managers to attract appropriate opportunities for organization. Further active involvement of employees, more stable in front of changes and increased ability managers to capture opportunities in domestic and foreign situation. PMID:24762370
Kim, Eun Kyung; Kim, Se Young; Lee, Eunpyo
The purpose of the study was to examine mission statements and their elements and to investigate correlations between mission statements and organizational performance. The current research was a descriptive study based on the examination of mission statements of 353 hospitals that posted mission statements on their webpage and 92 hospitals that made their income statements public. The most common mission element was 'identification of principal services', which accounted for 92.6%. Mission statements of hospitals included the average of 4.82 mission elements out of 9, and the objective of medical quality improvement was 0.81 among 6 objectives of IOM (Institute of Medicine). Net profit of hospitals with mission statements that have above average number of mission elements were significantly higher (t=2.71, p=.008) than those of other hospitals. Net profit was significantly correlated with mission statements (r=.26, porganizational performance. That is, better organizational performance is shown for hospitals with better, more diversified, and more firmly stated mission statements which include identification of target customers, identification of principal services, contribution to society as a non-profit organization, and concern for employees.
Moylan, Carrie A; Lindhorst, Taryn; Tajima, Emiko A
Multidisciplinary coordinated Sexual Assault Response Teams (SARTs) are a growing model of providing health, legal, and emotional support services to victims of sexual assault. This article conceptualizes SARTs from an organizational perspective and explores three approaches to researching SARTs that have the potential of increasing our understanding of the benefits and challenges of multidisciplinary service delivery. These approaches attend to several levels of organizational behavior, including the organizational response to external legitimacy pressures, the inter-organizational networks of victim services, and the negotiation of power and disciplinary boundaries. Possible applications to organizational research on SARTs are explored. © The Author(s) 2015.
Cristiano Molinari Bispo
Full Text Available The quality of work in a team and the general environment of an organization is influenced by lots of things. One of them is the ability some workers have when they are in the position of making their subjects work towards goals and needs set. It is difficult to identify which one is related to that ability. This study tries to help the investigation based on the analysis of factors related to the perception of individuals concerning the work conditions in four hospitals in southern Brazil kept by non-profit organizations. The research analyses lots of cases, trying to identify similarities in seventeen independent situations concerning “leadership”, as an ability for mobilizing people. This study can be classified as descriptive and non-experimental, based on a survey which shows about 64.5% of the population researched, or 1408 people. According to what we have presented, it is a study mainly quantitative; the data are focused on the study of the correlations. Among the independent situations in the questionnaire, some of them presented important correlation (more than 0.5: “oral clearness”, “justice”, “clearness concerning the work methods” and “stimulus for participating”. By having in mind the leadership concepts and management styles, this article presents some motivation, productivity and commitment of the work teams in formal organizations, from analysis of the empirical evidences.
Koelewijn, Wout T; Ehrenhard, Michel L; Groen, Aard J; van Harten, Wim H
During the past decade, entrepreneurship in the healthcare sector has become increasingly important. The aging society, the continuous stream of innovative technologies and the growth of chronic illnesses are jeopardizing the sustainability of healthcare systems. In response, many European governments started to reform healthcare during the 1990s, replacing the traditional logic of medical professionalism with business-like logics. This trend is expected to continue as many governments will have to reduce their healthcare spending in response to the current growing budget deficits. In the process, entrepreneurship is being stimulated, yet little is known about intra-hospital dynamics leading to entrepreneurial behavior. The purpose of this article is to review existing literature concerning the influence of intra-organizational dynamics on entrepreneurship among physicians and managers in hospitals of Western countries. Therefore, we conducted a theory-led, systematic review of how intra-organizational dynamics among hospital managers and physicians can influence entrepreneurship. We designed our review using the neo-institutional framework of Greenwood and Hinings (1996). We analyze these dynamics in terms of power dependencies, interest dissatisfaction and value commitments. Our search revealed that physicians' dependence on hospital management has increased along with healthcare reforms and the resulting emphasis on business logics. This has induced various types of responses by physicians. Physicians can be pushed to adopt an entrepreneurial attitude as part of a defensive value commitment toward the business-like healthcare logic, to defend their traditionally dominant position and professional autonomy. In contrast, physicians holding a transformative attitude toward traditional medical professionalism seem more prone to adopt the entrepreneurial elements of business-like healthcare, encouraged by the prospect of increased autonomy and income. Interest
Noh, Yoon Goo; Jung, Myun Sook
The purpose of this study was to analyze the paths of influence that a hospital's ethical climate exerts on nurses' organizational commitment and organizational citizenship behavior, with supervisor trust as the mediating factor, and verify compatibility of the models in hospital nurses. The sample consisted of 374 nurses recruited from four hospitals in 3 cities in Korea. The measurements included the Ethical Climate Questionnaire, Supervisor Trust Questionnaire, Organizational Commitment Questionnaire and Organizational Citizenship Behavior Questionnaire. Ethical Climate Questionnaire consisted of 6 factors; benevolence, personal morality, company rules and procedures, laws and professional codes, self-interest and efficiency. Data were analysed using SPSS version 18.0 and AMOS version 18.0. Supervisor trust was explained by benevolence and self-interest (29.8%). Organizational commitment was explained by benevolence, supervisor trust, personal morality, and rules and procedures (40.4%). Organizational citizenship behavior was explained by supervisor trust, laws and codes, and benevolence (21.8%). Findings indicate that managers need to develop a positive hospital ethical climate in order to improve nurses' trust in supervisors, organizational commitment and organizational citizenship behavior.
Parviz Aghaie Borzabad
Full Text Available Background and Aim: Identifying factors associated with employees empowerment of their working centers can promote organizational performance of hospitals. The current study aimed at investigating the relationship of both organizational climate and organizational silence with psychological empowerment in the public hospitals affiliated with Birjand University of Medical Sciences (BUMS. Materials and Methods: This cross-sectional and correlational study was carried out in 2015. Using a stratified randomized sampling, 400 employees were selected from the public. hospitals affiliated with BUMS. Data collection tools were. three self-administered questionnaires including organizational climate, organizational silence, and psychological empowerment. . Validity and reliability of the questionnaires were verified using experts judgment and Cronbach alpha coefficients more than 0.7, respectively. Data analysis was done by means of SPSS (V: 18 software using one sample t test, independent t test, Pearson correlation coefficient, and one-way ANOVA. The cut-off point of 70%.of Likert-type scale (3.5 was considered as an acceptable mean for each variable. Results: The mean organizational climate and organizational silence was 2.45 and 3.18, respectively which did not correspond with an acceptable mean (P<0.05. Although the mean psychological construct which was 3.6 had an acceptable value, mean of the two other sub-variables i.e. “trust to others” and “self-determination” were 3.2±0.83 and 3.42±0.67, respectively; and they were not at an acceptable level (P<0.05. It is observed that both organizational climate and organizational silence were positively correlated to psychological empowerment with 0.6 and 0.58 coefficients, respectively (P<0.05. Conclusion: It is suggested that the hospitals administrators should promote the psychological empowerment of their employees through improving organizational climate and decreasing organizational
Hudek-Knežević, Jasna; Kalebić Maglica, Barbara; Krapić, Nada
Aim To examine to what extent personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness), organizational stress, and attitudes toward work and interactions between personality and either organizational stress or attitudes toward work prospectively predict 3 components of burnout. Methods The study was carried out on 118 hospital nurses. Data were analyzed by a set of hierarchical regression analyses, in which personality traits, measures of organizational stress, and attitudes toward work, as well as interactions between personality and either organizational stress or attitudes toward work were included as predictors, while 3 indices of burnout were measured 4 years later as criteria variables. Results Personality traits proved to be significant but weak prospective predictors of burnout and as a group predicted only reduced professional efficacy (R2 = 0.10), with agreeableness being a single negative predictor. Organizational stress was positive, affective-normative commitment negative predictor, while continuance commitment was not related to any dimension of burnout. We found interactions between neuroticism as well as conscientiousness and organizational stress, measured as role conflict and work overload, on reduced professional efficacy (βNRCWO = -0.30; ßcRCWO = -0.26). We also found interactions between neuroticism and affective normative commitment (β = 0.24) and between openness and continuance commitment on reduced professional efficacy (β = -0.23), as well as interactions between conscientiousness and continuance commitment on exhaustion. Conclusion Although contextual variables were strong prospective predictors and personality traits weak predictors of burnout, the results suggested the importance of the interaction between personality and contextual variables in predicting burnout. PMID:21853549
Zhang, Yanchun; Zou, Dejian; Zheng, Junwei; Fang, Xiaoping; Luo, Haijuan
.... Based on the perspective of inter-organizational collaboration, this article examines the formation mechanism of quick emergency response capability of urban rail transit and proposes the concept...
Rivers, P A; Woodard, B; Munchus, G
The purpose of this paper is to provide a critical review of organizational power and conflict regarding the hospital-physician relationship. The issue of power being symbolic and/or substantive is discussed. The classification (Mintzberg Model) of organizations as simple structures, machine bureaucracies, professional bureaucracies, divisionalized forms and adhocracies are reviewed. Also, the issue of whether the perceived autonomy that professional employees enjoy increases the likelihood that an executive level manager in a professional bureaucracy (hospital entity) will devote substantial attention to influencing symbolic outcomes as opposed to substantive outcomes in a machine bureaucracy is discussed. In conclusion, conflicts between hospitals and physicians can be resolved in two ways: (1) by avoiding controversial decisions that might threaten the powers and prerogatives of professional groups; and (2) by agreeing to decisions that hold something for everyone involved in the hospital-physician power relationship.
Tveito, T H; Sembajwe, G; Boden, L I; Dennerlein, J T; Wagner, G R; Kenwood, C; Stoddard, A M; Reme, S E; Hopcia, K; Hashimoto, D; Shaw, W S; Sorensen, G
This study aimed to assess relationships between perceptions of organizational practices and policies (OPP), social support, and injury rates among workers in hospital units. A total of 1230 hospital workers provided survey data on OPP, job flexibility, and social support. Demographic data and unit injury rates were collected from the hospitals' administrative databases. Injury rates were lower in units where workers reported higher OPP scores and high social support. These relationships were mainly observed among registered nurses. Registered nurses perceived coworker support and OPP as less satisfactory than patient care associates (PCAs). Nevertheless, because of the low number of PCAs at each unit, results for the PCAs are preliminary and should be further researched in future studies with larger sample sizes. Employers aiming to reduce injuries in hospitals could focus on good OPP and supportive work environment.
Tyagi, Rajesh K; Cook, Lori; Olson, John; Belohlav, James
Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was co...
Nasirpour, Amir Ashkan; Gohari, Mahmoud Reza; Moradi, Saied
One of the main problems in the efficiency and efficacy of an organization is its structural issue. Organizational culture is also considered as an effective factor in the performance of many organizations. The main goal of the present study was to determine the relationship of Centralization and organizational culture and performance indexes in Teaching Hospitals affiliated to Tehran University of Medical Sciences. This correlation study was performed in the year 2007. The population studied consisted of 4408 personnel from 13 hospitals among whom 441 subjects were selected and studied via a class sampling method. Data was compiled using a check list concerning the evaluation status of Centralization and another form concerning performance indexes as well as Robbin's organizational culture questionnaire. Data were obtained from the subjects by self answering and analyzed by using descriptive statistical indexes, T- test and Fisher's exact tests. Among the organizational culture indexes of the hospitals studied, control and organizational identity was better as compared to others (mean=3.32 and 3.30). Concerning the extent of Centralization in the hospitals studied, 53.85 % and 46.15 % were reported to have upper and lower organizational Centralization, respectively. Mean ratio of surgical operations to inpatients was 40%, the mean rate of admissions per active bed was 60.83, mean bed occupancy coefficient was 70.79%, average length of stay was 6.96 days, and mean net death rate was 1.41%. No significant correlation was seen between Centralization degree, organizational culture and performance indexes in teaching hospitals Tehran university of medical sciences. (with 95% confidence interval). Due to the fact that first grade Teaching hospitals use board certified members, expert personnel, and advanced equipments and because of the limitation of patients choice and, the extent of Centralization and many organizational culture components have no significant
Managers' experiences of radical change were studied in a Norwegian university hospital, which was relocated from a traditional building to a new, high-tech building. The university hospital was also accredited as a health promoting hospital. Thirteen managers at different levels in the organization and a personnel safety representative were interviewed as part of a trailing research project. The aim of the study was to elucidate the managers' value orientation and strategies for dealing with value tensions. A combination of a hermeneutical, reflective method and a template for quality, efficiency and integrity guided the analysis. The template was based not only on the main findings but also on the core values of a model of organizational health. The results show that clinical managers focus on quality and top managers, not unexpectedly, focus on efficiency. Managers at both levels were concerned about their own integrity, and also about the integrity of their clinician colleagues, as well as showing concern for the hospital's mission, in terms of organizational effectiveness. The discussion was conducted in terms of dominance, cycling and balancing strategies, of which the last was the most prevalent. However, sustainable strategies for dealing with value tensions also call for value-based management and value-conscious leadership. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne
Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective
Full Text Available Introduction: Establishment of patient safety culture is the first step in the improvement of patient safety. As such, assessment of patient safety culture in hospitals is of paramount importance. Patient safety culture is an inherent component of organizational culture, so that the study of organizational culture is required in developing patient safety. This study aimed to evaluate patient safety culture among the clinical staff of a hospital in Jakarta, Indonesia and identify organizational culture profile. Materials and Methods: This cross-sectional, descriptive, qualitative study was conducted in a hospital in Jakarta, Indonesia in 2014. Sample population consisted of nurses, midwives, physicians, pediatricians, obstetrics and gynecology specialists, laboratory personnel, and pharmacy staff (n=152. Data were collected using the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality (AHRQ and Organizational Culture Assessment Instrument (OCAI. Results: Teamwork within units” was the strongest dimension of patient safety culture (91.7%, while “staffing” and “non-punitive response to error” were the weakest dimensions (22.7%. Moreover, clan culture was the most dominant type of organizational culture in the studied hospital. This culture serves as a guide for the changes in the healthcare organization, especially in the development of patient safety culture. Conclusion: According to the results of this study, healthcare providers were positively inclined toward the patient safety culture within the organization. As such, the action plan was designed through consensus decision-making and deemed effective in articulating patient safety in the vision and mission of the organization.
Bozaykut, Tuba; Gurbuz, F Gulruh
Given the salience of the interplay between trust and power relations in organizational settings, this paper examines the perceptions of social power and its effects on trust in supervisors within the context of public hospitals. Following the theoretical background from which the study model is developed, the recent situation of hospitals within Turkish healthcare system is discussed to further elucidate the working conditions of physicians. Sample data were collected employing a structured questionnaire that was distributed to physicians working at seven different public hospitals. The statistical analyses indicate that perceptions of supervisors' social power affect subordinates' trust in supervisors. Although coercive power is found to have the greatest impact on trust in supervisors, the influence of the power base is weak. In addition, the results show that perceptions of social power differ between genders. However, the results do not support any of the hypotheses regarding the relations between trust in supervisors and the examined demographic variables. Copyright © 2014 John Wiley & Sons, Ltd.
Moghaddasi, Hamid; Hosseini, Azamossadat; Sheikhtaheri, Abbas
The organizational structure of medical record departments in Iran is not appropriate for the efficient management of healthcare information. In addition, there is no strong information management division to provide comprehensive information management services in hospitals in Iran. Therefore, a suggested model was designed based on four main axes: 1) specifications of a Health Information Management Division, 2) specifications of a Healthcare Information Management Department, 3) the functions of the Healthcare Information Management Department, and 4) the units of the Healthcare Information Management Department. The validity of the model was determined through use of the Delphi technique. The results of the validation process show that the majority of experts agree with the model and consider it to be appropriate and applicable for hospitals in Iran. The model is therefore recommended for hospitals in Iran.
de Waard, E.; Volberda, H.W.; Soeters, J.M.M.L.
The topic of organizational responsiveness – where organizations need to flexibly react to strategic and operational demands simultaneously – has been under-explored in strategic management research. Our study was initiated to shed more light on this topic, primarily by studying an organization
Stratos E. Ramoglou
Metatheoretical dilemmas about the nature of the social world often animate organizational theorists who purport to dissolve pertinent controversies along truth-laden lines of philosophical argumentation...
Full Text Available Background: The employees' understanding of the organization in fact forms organizational climate. One of the most common internal factors affecting the organizational climate is the employees' personality characteristics. Therefore, the aim of this study is to determine the relationship between organizational climate and the personality characteristics of the Fatemeh Alzahra hospital's employees located in Mehriz, Yazd (Iran. Methods: This study is descriptive and correlational carried out cross sectionally. The research population is the various sectors' staff of the teaching hospital in Mehriz that 140 of them were selected randomly. In order to collect data, the two organizational climate questionnaires of Sam Deep and Lyle Sussman and Eysenck Personality Questionnaire were used. Data using Spss16 software and T-test and Pearson correlation tests were analyzed. Results: According to our findings, there is no relation between the personality traits of employees and organizational climate. As well as among each of the personality dimensions and organizational climate there are no relationships. Only observed relationship among the employees' personality characteristics and one of the dimensions of organizational climate was as the organizational climate based on agreement on procedures (P<0.01. Conclusion: The findings show that there is a significant relationship between organizational climate based on agreement on procedures and the employees' personality characteristics of the hospital, Therefore, it is recommended that managers and planners by providing required and healthy human force in terms of personality type and determining the procedures appropriate and targeted for the personnel working in this hospital, help the Organization achieve its excellent goals.
Intaraprasong, Bhusita; Dityen, Warunee; Krugkrunjit, Peera; Subhadrabandhu, Thanya
To investigate the relationship between job satisfaction and Organizational Citizenship Behavior (OCB) of the personnel at one university hospital in Thailand. This cross-sectional descriptive study was conducted on 296 respondents who worked in the Office of the Dean, 13 departments and 2 Offices of Research Center and Office of Community Medicine Center. All of them were personnel in one university hospital in Thailand. The Organizational Citizenship Behavior Questionnaire of Niehoff and Moorman using the five dimensions scale developed by Podsakoff and Mackenzie and Job Descriptive Index (JDI) were used for assessing job satisfaction. For inferential statistics, Pearson's product moment correlation coefficient was used for correlation. The percentage mean score of job satisfaction was 58.67 and subscale of job satisfaction was found that satisfaction with supervision held the highest of the mean score, while satisfaction with pay and promotion had the lowest and low of the mean score. The mean score of OCB was high and the facets of OCB was found that conscientiousness had the highest mean score and sportsmanship had the lowest. By using Pearson's Product Moment Correlation Coefficient to analyze the relationships between satisfaction and OCB, it showed that there were statistically significant low positive correlations between job satisfaction and OCB (r = 0.173, p < 0.01). The one university hospital executives should promote the pay, promotion and supervision factors which encourage personnel to be satisfied and demonstrate their OCB as their reciprocal reaction.
Tromp, D.M.; Rheede, van A.; Blomme, R.J.
Turnover of highly educated employees in the hospitality industry is growing rapidly. A predictor of turnover in the hospitality industry recently put forward, but not yet fully researched, is psychological strain. This chapter investigates the role of psychological strain and organizational support
Lack of existing literature on the correlation among organizational justice, organizational support, and organizational citizenship behaviors has created a research gap in previous evidence-based practice (EBP) studies on nursing personnel. To investigate whether organizational justice among nurses has a moderating effect between their organizational support and organizational citizenship behaviors in order to bridge such a gap of existing literature with the EBP study on nursing personnel. Nursing staff of one large and influential hospital in Taiwan was surveyed. Four hundred questionnaires were distributed, and 386 were collected with a valid response rate of 96.50%. SPSS 17.0 and Amos 17.0 statistical software packages were used for data analysis. Nurses' organizational support positively influences their organizational citizenship behaviors, and their organizational justice perception has a positive moderating effect between organizational support and organizational citizenship behaviors. Results call hospitals' attention to the type of individual behaviors that may improve organizational performance. When nursing staff perceive fair and impartial treatment by the organization and supportive emotional attachment, behaviors beneficial for the organization are expressed in return. Subjective perceptions of nursing staff play an important role in organizational exchange relationship; the higher the degree of nursing staff's perceived organizational justice, the higher the degree of their organizational support, perception, and exhibition of organizational citizenship behaviors such as altruistic behavior and dedication to the work. © 2014 Sigma Theta Tau International.
Jeannine A. Gailey
Full Text Available The present study is an exploratory examination of the influence of social and organizational features on respondents’ attributions of responsibility for wrongdoing within an organization. Respondents read a vignette of organizational wrongdoing that included the manipulation of social features, such as whether the organizational actor was following orders or acting on his volition (social role and if the actor tried to cover up his actions or not (deed, and organizational features, such as standard operating procedures (SOP and institutionalized mental schemas. Following the vignette, respondents made attributional judgments to both the individual actor and organization based on a multidimensional measure of responsibility. Results indicated that the actor’s role within the organization, his actions or deeds, and organizational SOP significantly impacted how respondents attributed responsibility (on multiple dimensions to either the individual or organization. Moreover, results indicated that women and men tended to attribute responsibility differently. Recommendations are made to improve future tests of the integrated model.
Smith, Patricia L; McSweeney, Jean
Understanding how an organization determines structure and function of a rapid response team (RRT), as well as cost evaluation and implications, can provide foundational knowledge to guide decisions about RRTs. The objectives were to (1) identify influencing factors in organizational development of RRT structure and function and (2) describe evaluation of RRT costs. Using a qualitative, ethnographic design, nurse executives and experts in 15 moderate-size hospitals were interviewed to explore their decision-making processes in determining RRT structure and function. Face-to-face interviews were audio recorded and transcribed verbatim and verified for accurateness. Using content analysis and constant comparison, interview data were analyzed. Demographic data were analyzed using descriptive statistics. The sample included 27 participants from 15 hospitals in 5 south-central states. They described a variety of RRT responders and functions, with the majority of hospitals having a critical care charge nurse attending all RRT calls for assistance. Others described a designated RRT nurse with primary RRT duties as responder to all RRT calls. Themes of RRT development from the data included influencers, decision processes, and thoughts about cost. It is important to understand how hospitals determine optimal structure and function to enhance support of quality nursing care. Determining the impact of an RRT on costs and benefits is vital in balancing patient safety and limited resources. Future research should focus on clarifying differences between team structure and function in outcomes as well as the most effective means to estimate costs and benefits.
Hearld, Larry R; Alexander, Jeffrey A; Fraser, Irene; Jiang, H Joanna
Interest in organizational contributions to the delivery of care has risen significantly in recent years. A challenge facing researchers, practitioners, and policy makers is identifying ways to improve care by improving the organizations that provide this care, given the complexity of health care organizations and the role organizations play in influencing systems of care. This article reviews the literature on the relationship between the structural characteristics and organizational processes of hospitals and quality of care. The review uses Donabedian's structure-process-outcome and level of analysis frameworks to organize the literature. The results of this review indicate that a preponderance of studies are conducted at the hospital level of analysis and are predominantly focused on the organizational structure-quality outcome relationship. The article concludes with recommendations of how health services researchers can expand their research to enhance one's understanding of the relationship between organizational characteristics and quality of care.
Burke, Ronald J
This study examines correlates of 4 archetypal survivor responses to organizational restructuring and downsizing proposed by Mishra and Spreitzer: hopeful, obliging, cynical, and fearful. Data were collected from 744 long-term nursing staff survivors of hospital restructuring and downsizing using questionnaires. Three types of correlates were considered: work outcomes, indicators of psychologic well-being, and perceptions of hospital functioning. Greater endorsement of cynical and fearful restructuring responses was associated with more negative work outcomes and lower psychologic well-being. Greater endorsement of both cynical and fearful responses was also found to be associated with more negative perceptions of hospital functioning and effectiveness.
Farzianpour, Fereshteh; Abbasi, Mahya; Foruoshani, Abbas Rahimi; Pooyan, Ebrahim Jafari
Organizational culture plays a supportive role in modification of structure and implementation of new management systems. So, the management of organizational culture with cultural elements recognition plays an important role in improving the efficacy and effectiveness of the organization. On the other hand, the health sector requires healthy and motivated practitioners and staff to achieve these goals. Job burnout as a response to environmental stressors causes some changes in attitude and behavior towards work and work environment, and factors such as organizational culture effect on it. This study aimed to clarify the relationship between organizational culture and employee's burnout. This is a descriptive and cross-sectional study. The study population included all clinical staff (physicians and nurses) and nonclinical (administrative and financial) in hospitals affiliated to Tehran University of Medical Sciences in 2014-2015. Among them, 387 participants were selected using simple stratified random sampling. In order to collect the required data, the Maslach Burnout Inventory (1981) and Hofstede's organizational cultural questionnaire (1988) were used. Also Cronbach's alpha obtained 0.836 and 0.913 for them, respectively. In order to analyze the data, the Kolmogorov-Smirnov test, multiple regression, independent t-test and binomial test were performed using SPSS 20. Results showed that organizational culture in studied population were masculine, collectivism with high uncertainty avoidance and relatively equitable power distance. Mean score for emotional exhaustion was (31.4) and most of participants 315 (40.6%) had average emotional exhaustion. Mean score for depersonalization was (21.16) and most of participants 315 (82.1%) had high depersonalization. Mean score for personal accomplishment was (30.02) and most of participants 280 (73.2%) had high personal accomplishment. Multiple correlation coefficient showed that there is a significant relationship between
Yaghoubi, Maryam; Afshar, Mina; Javadi, Marzieh
Numerous researches have been carried out to indicate that organizational justice (OJ) is a variable that anticipates many other variables in organizations, especially in hospitals. Organizational behavior (OCB) is one of the most important variables. We aimed to study the relationship between OJ and OCB of nurses in selected hospitals in Isfahan. This was a descriptive correlational study. The research was conducted among nurses of selected hospitals in Isfahan. Data were gathered using two questionnaires of OJ, and OCB. The t-test, chi-square, and Pearson correlation test were used to analyze the data through SPSS version 13. In general, the mean score (SD) of OJ among nurses was 41.2 (16.2) and the mean score of OCB was 57.7 (18). Finally, there was no significant relationship between OJ, civil virtue, and sportsmanship. There was a significant relationship between OJ, OCB, courtesy, and conscientiousness. As the scores of OCB and OJ among nurses were average in selected hospitals, the managers of the hospitals should improve the perception of justice among nurses. Today, organizations need efficient and expert workers to achieve their goals, and to grow and improve in all aspects. In fact, the efficiency and effectiveness of organizations depend on the staffs, especially in hospitals.
Gabilondo Navarro, Fernando
In order to primarily encourage medical care, teaching and research activities in high specialty regional hospitals (HSRH), a number of strategies are explored to increase the number of patients cared for, improve the quality and timeliness of care and successfully integrate the function of these hospitals within the care and patient flow model expected by the Federal Government. These strategies include the use of information technology systems as platforms for telemedicine, including tele-imaging, tele-education and telepathology, thus fostering the quality and timeliness of medical care and narrow the relationship between these HSRH with the National Health Institutes. Other strategies such as extra-mural surgery, specific theme workshops, resident rotations, the use of simulators and "Science Weeks" are also explored so as to promote teaching and research. Finally, the reference and counter-reference system and the introduction of pension programs are evaluated as possible strategies supporting resource management.
Ahmadi, Hossein; Nilashi, Mehrbakhsh; Ibrahim, Othman
This study mainly integrates the mature Technology-Organization-Environment (TOE) framework and recently developed Human-Organization-Technology (HOT) fit model to identify factors that affect the hospital decision in adopting Hospital Information System (HIS). Accordingly, a hybrid Multi-Criteria-Decision-Making (MCDM) model is used to address the dependence relationships of factors with the aid of Analytic Network Processes (ANP) and Decision Making Trial and Evaluation Laboratory (DEMATEL) approaches. The initial model of the study is designed by considering four main dimensions with 13 variables as organizational innovation adoption factors with respect to HIS. By using DEMATEL, the interdependencies strength among the dimensions and variables are tested. The ANP method is then adopted in order to determine the relative importance of the adoption factors, and is used to identify how these factors are weighted and prioritized by the public hospital professionals, who are wholly familiar with the HIS and have years of experience in decision making in hospitals' Information System (IS) department. The results of this study indicate that from the experts' viewpoint "Perceived Technical Competence" is the most important factor in the Human dimension. In the Technology dimension, the experts agree that the "Relative Advantage" is more important in relation to the other factors. In the Organization dimension, "Hospital Size" is considered more important rather than others. And, in the Environment dimension, according to the experts judgment, "Government Policy" is the most important factor. The results of ANP survey from experts also reveal that the experts in the HIS field believed that these factors should not be overlooked by managers of hospitals and the adoption of HIS is more related to more consideration of these factors. In addition, from the results, it is found that the experts are more concerned about Environment and Technology for the adoption HIS. The
Sharkey, Amanda J
Extant research in organizational and economic sociology posits that organizations derive status from their prior demonstrations of quality, as well as their affiliations with high-status alters. Yet there are also indications that organizations may acquire status by virtue of their membership in salient social categories that are themselves status valued. In this article, the author explicitly theorizes and measure the concept of categorical status among organizations and test whether it influences the evaluation of organizational actions. More concretely, she develops a measure of industry status and test whether it affects the market reaction to U.S. firms announcing earnings restatements between 2000 and 2009. Results of the empirical analyses indicate that investors react less negatively to earnings restatements announced by firms from higher-status industries, supporting the argument that category status acts as a lens that shapes the extent to which an organization's actions are viewed favorably.
Sepahvand, Faribah; Atashzadeh-Shoorideh, Foorozan; Parvizy, Soroor; Tafreshi, Mansoureh Zagheri
Reduction in organizational commitment of nurses results in deficiency of care services. Some demographic factors affect organizational commitment. The present study is intended to determine the organizational commitment of nurses and its relationship with demographic characteristics. This study was a descriptive correlation (cross-sectional) study in January and February of 2016 on 126 nurses who held Bachelor of Science (B.Sc.) or Master of Science (M.Sc.) and at least one year of work experience in the Social Security Hospital of Khorramabad, selected using the census method. Data collection tools included a demographic characteristics form and Allen and Meyer questionnaire. Data analysis was performed using SPSS 20. Independent-samples t-test and one-way ANOVA were used to determine the relationship between organizational commitment and demographic characteristics. The majority of nurses had moderate organizational commitment, the highest score belonging to the continuance commitment (22.33%), and the lowest score belonging to the normative commitment (19.16%). Also, there was a significant correlation between the continuance commitment and work experience (p=0.001), the staff posts (p=0.01) and shifts (p=0.04). Considering the moderate level of subjects' organizational commitment in the present study, managers should take necessary measures to increase the attachment and organizational commitment of nurses and provide the ground for improving nursing services.
Zenaida Solís Chuquiyaur
Full Text Available Objective: To determine the relationship between organizational climate and Burnout Syndrome among nursing professionals of the Emergency Service in a Hospital Category III-2. Material and methods: quantitative, prospective, correlational cross-sectional study. The sample consisted of 43 nurses, using a non-probability sampling for convenience. For analysis and study of the variables, Rensis Likert scale and Maslach Burnout Inventory were used. Results: The organizational climate was average level (81.4% followed by a high level (18.6% and the Burnout Syndrome corresponds to low level (86% and medium (14% level. The relationship between organizational climate and Burnout Syndrome was low (rho = -0.11. Conclusions: In the Emergency Service, the level of organizational climate was fairly favorable with absence of Burnout Syndrome among nursing professionals. There is not significant relationship between the two variables.
Singurdsson, Sigurdur Oli; Austin, John
A review of the "Journal of Organizational Behavior Management" (1991-2002) was conducted to determine to what extent researchers in OBM programmed for "institutionalization" of applied interventions. Criteria for the term "institutionalization" were derived from McSween and Matthews (2001), and Grindle, Dickinson, and Boettcher (2000). Four…
Restelli, Umberto; Faggioli, Paola; Scolari, Francesca; Gussoni, Gualberto; Valerio, Antonella; Sciascera, Alba; Croce, Davide; Mazzone, Antonino
Purpose: The study aims at assessing the organizational and economic impact related to the use of a new portable syringe pump (Pompa Infonde®, Italfarmaco S.p.A., Cinisello Balsamo, Italy) at a hospital level. Methodology: Based on the HTA approach, the analysis assessed the organizational and economic impact of the new device at hospital level, using the traditional methods of Iloprost infusion as comparator. After a pilot evaluation, the organizational impact was assessed within 24 Italian hospitals. Structured interviews were conducted with clinicians and nurses. According to the Hospital-Based HTA approach, a questionnaire assessed the impact on human resources, training activities, internal meetings, spaces needed, facilities, clinical practice implications. Using Activity Based Costing approach, the economic evaluation was performed within the pilot center “Ospedale Civile” of Legnano, Italy. Findings: The new device leads to a positive managerial impact, with a substantial reduction of time to monitor patients by nurses. This resulted in a better management of human resources and in a reduction in nursing cost. Although a mild negative impact on training time for personnel, the structured interviews allowed the identification of three main areas of positive impact: (i) efficiency of internal processes, (ii) clinical pathways, (iii) synergies between wards. Originality: The organizational impact of Pompa Infonde®, showed that it is an efficient alternative to traditional methods, with benefits in the management of patients administered with Iloprost.
Koelewijn, Wout Theodoor; de Rover, Matthijs; Ehrenhard, Michel Léon; van Harten, Willem H.
Background Challenges brought about by developments such as continuing market reforms and budget reductions have strained the relation between managers and physicians in hospitals. By applying neo-institutional theory, we research how intra-organizational dynamics between physicians and managers
Blomme, R.J.; Sok, J.; Tromp, D.M.
An issue which has recently come to the fore in studies conducted among hospitality industry employees is the effect of negative work-home interference on the turnover of highly educated employees. This article examines the role of organizational culture with regard to negative work-home
Full Text Available With its large footprint in terms of employment and consumption of natural resources, the hospitality is often at the forefront of social responsibility practices. From environmental to social causes, brands must make sure that their corporate social responsibility practices are both genuine and align with business strategy.
Full Text Available The main aim of this study is to determine the views of employees and managers working at the hospitality industry in Safranbolu towards the social responsibility of tourism enterprises, social responsibility activities carried out by the hotel enterprises, and their views on the advantages and contributions of social responsibility projects to the hotel business. This study will make contributions to the related literature on social responsibility at the hospitality industry by means of identifying the social responsibility activities of hotel enterprises, of which there is relatively limited number of studies.Within this context, a structured survey was conducted with 152 respondents including employees, managers and owners of the hotel enterprises through face to face interviews in order to determine the perceptions of employees towards social responsibility. SPSS 15 for Windows was used to analyze the data. The research has found that the employees working at hospitality industry in Safranbolu are sensitive to the social responsibilities and they act socially responsible in their activities. Additionally the results show that the respondents behave socially responsible towards guests, society and natural environment, but that they are less responsible towards the suppliers.
Recently, hospitals that have been successful in preventing infections have labeled their improvement approaches as either the Toyota Production System (TPS) approach or the Positive Deviance (PD) approach. PD has been distinguished from TPS as being a bottom-up approach to improvement, as against top-down. Facilities that have employed both approaches have suggested that PD may be more effective than TPS for infection prevention. This article integrates organizational learning, institutional, and knowledge network theories to develop a theoretical framework for understanding the structure and evolution of effective knowledge-sharing networks in health care organizations, that is, networks most conducive to learning and improvement. Contrary to arguments put forth by hospital success stories, the framework suggests that networks rich in brokerage and hierarchy (ie, top-down, "TPS-like" structures) may be more effective for learning and improvement in health care organizations, compared with a networks rich in density (ie, bottom-up, "PD-like" structures). The theoretical framework and ensuing analysis help identify several gaps in the literature related to organization learning and improvement in the infection prevention context. This, in turn, helps put forth recommendations for health management research and practice.
Sadoughi, Farahnaz; Ebrahimi, Kamal
Self esteem (SE) and organizational commitment (OC)? have significant impact on the quality of work life. This study aims to gain a better understanding of the relationships between SE and OC among health information management staff in tertiary care hospitals in Tehran (Iran). This was a descriptive correlational and cross sectional study conducted on the health information management staff of tertiary care hospitals in Tehran, Iran. A total of 155 participants were randomly selected from 400 staff. Data were collected by two standard questionnaires. The SE and OC was measured using Eysenck SE scale and Meyer and Allen's three component model, respectively. The collected data were analyzed with the SPSS (version 16) using statistical tests of of independent T-test, Pearson Correlation coefficient, one way ANOVA and F tests. The OC and SE of the employees' were 67.8?, out of 120 (weak) and 21.0 out of 30 (moderate), respectively. The values for affective commitment, normative commitment, and continuance commitment were respectively 21.3 out of 40 (moderate), 23.9 out of 40 (moderate), and 22.7 out of 40 (moderate). The Pearson correlation coefficient test showed a significant OC and SE was statistically significant (Porganizational improvement. Therefore, applying appropriate human resource policies is crucial to reinforce these measures.
Shin, Marlena H; Sullivan, Jennifer L; Rosen, Amy K; Solomon, Jeffrey L; Dunn, Edward J; Shimada, Stephanie L; Hayes, Jennifer; Rivard, Peter E
Increasing use of Agency for Healthcare Research and Quality's Patient Safety Indicators (PSIs) for hospital performance measurement intensifies the need to critically assess their validity. Our study examined the extent to which variation in PSI composite score is related to differences in hospital organizational structures or processes (i.e., criterion validity). In site visits to three Veterans Health Administration hospitals with high and three with low PSI composite scores ("low performers" and "high performers," respectively), we interviewed a cross-section of hospital staff. We then coded interview transcripts for evidence in 13 safety-related domains and assessed variation across high and low performers. Evidence of leadership and coordination of work/communication (organizational process domains) was predominantly favorable for high performers only. Evidence in the other domains was either mixed, or there were insufficient data to rate the domains. While we found some evidence of criterion validity, the extent to which variation in PSI rates is related to differences in hospitals' organizational structures/processes needs further study. © The Author(s) 2014.
Alharbi, Tariq Saleem J; Ekman, Inger; Olsson, Lars-Eric; Dudas, Kerstin; Carlström, Eric
Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Mohebbifar, Rafat; Hashemi, Hassan Jahani; Rajaee, Roya; Najafi, Marziye; Etedal, Mahbobeh G H
Organizational learning has been identified as necessary for different organizations to improve their performance in the changing and competitive environment. The main purpose of this research was to specify the learning organization profile of educational and health centers of Tehran and Qazvin Universities of Medical Sciences in Iran. The present research was conducted using a cross-sectional method in the academic year of 2013-2014. A staff of 530 from educational hospitals subordinated to Tehran and Qazvin universities of medical sciences participated in the research. The participants were selected using stratified random sampling. That is to say, a random sample of a proportionate size was selected from each hospital. The instrument for data collection was a Likert-scale questionnaire involving 50 items. The statistical techniques of ANOVA, t-test, Chi-square, correlation coefficients (Pearson and Spearman), and regression were utilized to analyze the data. All of them were performed using the Statistical Package for Social Sciences (SPSS) 16.0 for windows. the results indicated that 449 of participants (84.7%) had a B.S. degree and 78 of them (14.7%) had an M.S. or a Ph.D. degree. Among the fivefold dimensions of "Learning Organization" model (Learning, Organization, People, Knowledge, and Technology) in comparison of the two universities, the "people" dimension was the highest-rated dimension with the mean rating of 25.71±8.36 and the "learning" dimension was the lowest-rated dimension with the mean of 25.35±8.04. Comparison between the two universities yielded the result that educational hospitals in Tehran University of medical sciences with the rating of 126.56 had a more complete profile than that of educational hospitals in Qazvin university of medical sciences with the rating of 122.23. The hospitals of the two above-mentioned universities were, to a great extent, far from the characteristics of Learning Organization. In light of the massive mission
private business logic. Under such paradoxical situations, a political decision may cause an unexpected result. Keywords: local public hospital closure, publicness, organizational life cycle, South Korea
Mohebbifar, Rafat; Hashemi, Hassan Jahani; Rajaee, Roya; Najafi, Marziye; Etedal, Mahbobeh GH
Background: Organizational learning has been identified as necessary for different organizations to improve their performance in the changing and competitive environment. Purpose: The main purpose of this research was to specify the learning organization profile of educational and health centers of Tehran and Qazvin Universities of Medical Sciences in Iran. Methodology: The present research was conducted using a cross-sectional method in the academic year of 2013-2014. A staff of 530 from educational hospitals subordinated to Tehran and Qazvin universities of medical sciences participated in the research. The participants were selected using stratified random sampling. That is to say, a random sample of a proportionate size was selected from each hospital. The instrument for data collection was a Likert-scale questionnaire involving 50 items. The statistical techniques of ANOVA, t-test, Chi-square, correlation coefficients (Pearson and Spearman), and regression were utilized to analyze the data. All of them were performed using the Statistical Package for Social Sciences (SPSS) 16.0 for windows. Result: The results indicated that 449 of participants (84.7%) had a B.S. degree and 78 of them (14.7%) had an M.S. or a Ph.D. degree. Among the fivefold dimensions of “Learning Organization” model (Learning, Organization, People, Knowledge, and Technology) in comparison of the two universities, the “people” dimension was the highest-rated dimension with the mean rating of 25.71±8.36 and the “learning” dimension was the lowest-rated dimension with the mean of 25.35±8.04. Comparison between the two universities yielded the result that educational hospitals in Tehran University of medical sciences with the rating of 126.56 had a more complete profile than that of educational hospitals in Qazvin university of medical sciences with the rating of 122.23. Conclusion: The hospitals of the two above-mentioned universities were, to a great extent, far from the
As a means of sustainability achievement and balanced assessment of positive and negative impact of tourism and hospitality industry, taking responsibility towards the silent stakeholder (environment) emerged as a new phenomenon in the late 1980s. The main concern of this paper is to identify the environmental ...
Koelewijn, Wout T; de Rover, Matthijs; Ehrenhard, Michel L; van Harten, Wim H
Challenges brought about by developments such as continuing market reforms and budget reductions have strained the relation between managers and physicians in hospitals. By applying neo-institutional theory, we research how intra-organizational dynamics between physicians and managers induce physicians to become entrepreneurs by starting a specialty clinic. In addition, we determine the nature of this change by analyzing the intra-organizational dynamics in both hospitals and clinics. For our research, we interviewed a total of fifteen physicians and eight managers in four hospitals and twelve physicians and seven managers in twelve specialty clinics. We found evidence that in becoming entrepreneurs, physicians are influenced by intra-organizational dynamics, including power dependence, interest dissatisfaction, and value commitments, between physicians and managers as well as among physicians' groups. The precise motivation for starting a new clinic can vary depending on the medical or business logic in which the entrepreneurs are embedded, but also the presence of an entrepreneurial nature or nurture. Finally we found that the entrepreneurial process of starting a specialty clinic is a process of sedimented change or hybridized professionalism in which elements of the business logic are added to the existing logic of medical professionalism, leading to a hybrid logic. These findings have implications for policy at both the national and hospital level. Shared ownership and aligned incentives may provide the additional cement in which the developing entrepreneurial values are 'glued' to the central medical logic.
Background Challenges brought about by developments such as continuing market reforms and budget reductions have strained the relation between managers and physicians in hospitals. By applying neo-institutional theory, we research how intra-organizational dynamics between physicians and managers induce physicians to become entrepreneurs by starting a specialty clinic. In addition, we determine the nature of this change by analyzing the intra-organizational dynamics in both hospitals and clinics. Methods For our research, we interviewed a total of fifteen physicians and eight managers in four hospitals and twelve physicians and seven managers in twelve specialty clinics. Results We found evidence that in becoming entrepreneurs, physicians are influenced by intra-organizational dynamics, including power dependence, interest dissatisfaction, and value commitments, between physicians and managers as well as among physicians’ groups. The precise motivation for starting a new clinic can vary depending on the medical or business logic in which the entrepreneurs are embedded, but also the presence of an entrepreneurial nature or nurture. Finally we found that the entrepreneurial process of starting a specialty clinic is a process of sedimented change or hybridized professionalism in which elements of the business logic are added to the existing logic of medical professionalism, leading to a hybrid logic. Conclusions These findings have implications for policy at both the national and hospital level. Shared ownership and aligned incentives may provide the additional cement in which the developing entrepreneurial values are ‘glued’ to the central medical logic. PMID:24885912
Full Text Available This study investigated the moderating effects of person–corporate social responsibility (CSR-fit for the relationships between CSR participation and job satisfaction, organizational identification, and organizational commitment. The study was conducted in South Korea and sampled 393 full-time employees from several conglomerates. The study found CSR participation to be positively related with job satisfaction, organizational identification, and organizational commitment. Furthermore, person–CSR fit significantly moderated the relationships between CSR participation and job satisfaction, organizational identification, and organizational commitment. These findings suggest that CSR participation positively affects organizational outcomes and that person–CSR fit enhances the relationships between CSR participation and the organizational outcomes. Therefore, the study suggests the importance of CSR participation and person–CSR fit in CSR initiatives, as CSR participation and person–CSR can promote a healthy work environment.
Full Text Available With the rapid development of urban rail transit in China recently, improving its quick emergency response capability is becoming an important issue. Based on the perspective of inter-organizational collaboration, this article examines the formation mechanism of quick emergency response capability of urban rail transit and proposes the concept model hypothesis, in order to highlight the inter-organizational emergency collaboration relationships and the quick emergency response capability. According to site surveys and analysis of the elements of inter-organizational collaboration in emergency rescue and the meaning of quick emergency response capability, the scale of emergency collaboration and emergency response capability is designed, and the hypothetical concept model is tested by structural equation model. The results indicate that the emergency collaboration can be realized mainly through emergency organizations, resources, plans, and information. These elements interact with each other; the quick emergency response capability includes fast reaction and emergency disposal capability, emergency decision and execution capability, and coordination and joint action capability. These capabilities restrict each other. Moreover, emergency collaboration has significant but different influence on different dimensions of quick emergency response capability. Therefore, allocating and controlling emergency elements are pivotal to realizing inter-organizational emergency collaboration and generating the quick emergency response capability of urban rail transit.
Amalie Martinus Hauge
Full Text Available This paper is about the interplay between multiple modes of valuation. The paper engages with the question of how a valuation device intersects with the working values of an organization. While the many studies of valuation practices have drawn attention to the pervasive effects of valuation devices, only a few studies have taken into account the fact that many spaces, including organizations, are already filled with practices and ideas that constitute what is valuable. Revisiting classical organization theory, this paper shows that organizations comprise multiple, more - or less - integrated modes of valuation. Empirically, the paper draws on an ethnographic study of Lean management at a children's hospital, which is presented through analytical snapshots. The paper suggests that an organizational turn is relevant for valuation studies, as this fi rst allows an analytical expansion to include less 'deviced' valuations, contributes to the ongoing culture vs. device debate offering an alternative to the causal analysis of devices and effects without making the 'ineffable culture' what makes or breaks the causality.
Neda Khodadadei; Behrooz Rezaei; Shayesteh Salehi
Human resources committed to the organization not only reduces absence, delay, and replacement, but also causes the increase of organizational performance, employees’ mental freshness, better attainment to organizational excellent goals, and achieving individual’s objectives. Hence, organizational commitment has special importance among the employees of hospital. The nurses’ competence is an important criterion required for providing patients’ health-cares. The change in nurses’ r...
Najmi Kamariah, M.S. Idrus, M. Asdar, Indrianty Sudirman
Organizational dynamic capability and entrepreneurship strategy are two aspects that have contribution in affecting organizational performances particularly by means of knowledge management and strategic leadership. There is a need to identify this presumption, thus current research in this paper were employed in the General Public Hospitals in Makassar in the Provinces of South Sulawesi (Indonesia). Previous research has uncovered important factors of organizational performance such as knowl...
Stratos E. Ramoglou
Full Text Available Metatheoretical dilemmas about the nature of the social world often animate organizational theorists who purport to dissolve pertinent controversies along truth-laden lines of philosophical argumentation. The present paper acknowledges the inescapable uncertainty at this level of discourse to nonetheless resist taking the usual step according to which metatheoretical discourse should be abandoned as unhelpful, if not misleading, metaphysics. However, it also parts from traditional modes of metatheoretical defense to instead try to identify whether metatheoretical frameworks, beyond considerations of any possible cognitive merit in deciphering the nature of the world, may be of any use in making a desirable difference in the world. In developing a pragmatist defense of realist metatheories, we may explicitly value metatheoretical discourse from a novel standpoint and further delineate subtle conceptual relations between metatheory, theory, phenomenological acceptance, action and epistemic ethics.
Thulth, Ahida Saleem; Sayej, Sumaya
Background: Organizational factors are considered to be the cornerstone in achieving psychological and professional security at work, which in turn are positively reflected in job performance both quantitatively and qualitatively. Aim of the Study: The study aimed to assess of selected organizational factors (workload, available recourses and…
Di Fabio, Annamaria; Palazzeschi, Letizia
The purpose of this study was to investigate the role of personality traits and emotional intelligence in relation to organizational justice. The Organizational Justice Scale, the Eysenck Personality Questionnaire-Revised Short Form, and the Bar-On Emotional Quotient Inventory were administered to 384 Italian nurses. The emotional intelligence…
Chen, I-Chi; Ng, Hui-Fuang; Li, Hung-Hui
As health-care organizations endeavor to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. The main objective of this study was to investigate the cross-level influences of organizational culture on patient safety behavior in Taiwan's hospitals. The authors measured organizational culture (bureaucratic, supportive and innovative culture), patient safety culture and behavior from 788 hospital workers among 42 hospitals in Taiwan. Multilevel analysis was applied to explore the relationship between organizational culture (group level) and patient safety behavior (individual level). Patient safety culture had positive impact on patient safety behavior in Taiwan's hospitals. The results also indicated that bureaucratic, innovative and supportive organizational cultures all had direct influence on patient safety behavior. However, only supportive culture demonstrated significant moderation effect on the relationship between patient safety culture and patient safety behavior. Furthermore, organizational culture strength was shown correlated negatively with patient safety culture variability. Overall, organizational culture plays an important role in patient safety activities. Safety behaviors of hospital staff are partly influenced by the prevailing cultural norms in their organizations and work groups. For management implications, constructed patient priority from management commitment to leadership is necessary. For academic implications, research on patient safety should consider leadership, group dynamics and organizational learning. These factors are important for understanding the barriers and the possibilities embedded in patient safety. Copyright © 2011 John Wiley & Sons, Ltd.
J Alharbi, Tariq Saleem; Olsson, Lars-Eric; Ekman, Inger; Carlström, Eric
To measure the effect of organizational culture on health outcomes of patients 3 months after discharge. a quantitative study using Organizational Values Questionnaire (OVQ) and a health-related quality of life instrument (EQ-5D). A total of 117 nurses, 69% response rate, and 220 patients answered the OVQ and EQ-5D, respectively. The regression analysis showed that; 16% (R(2) = 0.02) of a decreased health status, 22% (R(2) = 0.05) of pain/discomfort and 13% (R(2) = 0.02) of mobility problems could be attributed to the combination of open system (OS) and Human Relations (HR) cultural dimensions, i.e., an organizational culture being dominated by flexibility. The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.
Methner, Lynn M.
This study investigated the relationship between organizational culture and the implementation of Response to Intervention in one elementary school. It examined issues corresponding to change within a system, with particular attention to those relating to school culture. An ethnographic approach was used to gather data, including the collection of…
S.J. Magala (Slawomir)
textabstractEthical control is based on transparent access to the accounts of responsible behaviour on the part of individual and organizational actors. It is usually linked to the idea of a checkpoint: where celibate rules, no sexual interaction can be allowed. However, organizing and managing
Whetten, David A.
Reviews theoretical and empirical information on organizational retrenchment and educational administrators' responses to the current decline in education. Argues that administrators must (1) adopt a more open and political administrative orientation to benefit from necessary retrenchments, (2) spur innovation, and (3) improve organizational…
Full Text Available The paper delineates a heuristic device comprising relationships between levels of instrumentality towards Corporate Social Responsibility (CSR implicit in differential theoretical organizational approaches, associated managerial freedom in ethical decision making, and corresponding managerial moral orientations. Prominent theoretical approaches to CSR including: criticalism, fundamentalism, social corporatism, social institutionalism and moralism identified in the extant literature are delineated. These approaches are synthesised and articulated with the concepts of degrees of CSR instrumentality, ethical freedom and managerial moral orientations to produce a composite heuristic device with specific potential practical implementations. Ramifications of the analysis in terms of developing managers with ethical acumen and providing organizational circumstances allowing this to flourish are briefly discussed.
Roch, Geneviève; Dubois, Carl-Ardy; Clarke, Sean P
Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11% of the variation in RNs' reported frequency of caring practices. Qualitative data suggested that caring practices were affected by the interplay of organizational climate dimensions with patients and nurses characteristics. Workload intensity and role ambiguity led RNs to leave many caring practices to practical nurses and assistive personnel. Systemic interventions are needed to improve organizational climate and to support RNs' involvement in a full range of caring practices. © 2014 Wiley Periodicals, Inc.
Demonstrating socially responsible behaviour has become increasingly important for corporations. The study identifies the extent of participation of the banking industries in corporate social responsibility, the bank policies as it affects CRS and the impact of the bank the on the practice of CRS. The study utilized primary ...
Full Text Available Corporate social responsibility (CSR research is not new, but its importance to today’s socially conscious market environment is even more evident in recent years. This study moves beyond CSR as simply the socially responsible actions and policies of organizations and focuses on the complex psychology of CSR as it relates to individuals within the organization. Given CSR can positively affect both the individuals within the organization and the organization itself, better understanding and leveraging the mechanisms and conditions of CSR that facilitate desired employee outcomes is crucial for organizational performance. However, scholars lack consensus in determining a theoretical framework for understanding how and under what conditions CSR will make an impact on employees and ultimately organizational performance. This study adds clarity by exploring the effect of perceived CSR on a more comprehensive set of employees’ attitudinal and behavioral reactions (i.e., turnover intention, in-role job performance, and helping behavior via the mediating mechanism of organizational identification and the moderating condition of moral identity. Hypotheses were derived using social identity theory. Results were based on data obtained from 340 Chinese manufacturing employee-supervisor dyads. This study found that employees’ perceived CSR had an indirect relationship via organizational identification with each of the variables: (1 turnover intention, (2 in-role job performance, and (3 helping behavior. Specifically, the negative relationship between perceived CSR and turnover intention was stronger when employees had higher moral identity and the positive relationship between perceived CSR and in-role job performance and helping behavior was amplified by moral identity. Our findings show how the mediating mechanism of organizational identity and the moderating condition of moral identity work together to improve organizational effectiveness. The
Wang, Wei; Fu, Ying; Qiu, Huiqing; Moore, James H; Wang, Zhongming
Corporate social responsibility (CSR) research is not new, but its importance to today's socially conscious market environment is even more evident in recent years. This study moves beyond CSR as simply the socially responsible actions and policies of organizations and focuses on the complex psychology of CSR as it relates to individuals within the organization. Given CSR can positively affect both the individuals within the organization and the organization itself, better understanding and leveraging the mechanisms and conditions of CSR that facilitate desired employee outcomes is crucial for organizational performance. However, scholars lack consensus in determining a theoretical framework for understanding how and under what conditions CSR will make an impact on employees and ultimately organizational performance. This study adds clarity by exploring the effect of perceived CSR on a more comprehensive set of employees' attitudinal and behavioral reactions (i.e., turnover intention, in-role job performance, and helping behavior) via the mediating mechanism of organizational identification and the moderating condition of moral identity. Hypotheses were derived using social identity theory. Results were based on data obtained from 340 Chinese manufacturing employee-supervisor dyads. This study found that employees' perceived CSR had an indirect relationship via organizational identification with each of the variables: (1) turnover intention, (2) in-role job performance, and (3) helping behavior. Specifically, the negative relationship between perceived CSR and turnover intention was stronger when employees had higher moral identity and the positive relationship between perceived CSR and in-role job performance and helping behavior was amplified by moral identity. Our findings show how the mediating mechanism of organizational identity and the moderating condition of moral identity work together to improve organizational effectiveness. The findings reveal several
Wang, Wei; Fu, Ying; Qiu, Huiqing; Moore, James H.; Wang, Zhongming
Corporate social responsibility (CSR) research is not new, but its importance to today’s socially conscious market environment is even more evident in recent years. This study moves beyond CSR as simply the socially responsible actions and policies of organizations and focuses on the complex psychology of CSR as it relates to individuals within the organization. Given CSR can positively affect both the individuals within the organization and the organization itself, better understanding and leveraging the mechanisms and conditions of CSR that facilitate desired employee outcomes is crucial for organizational performance. However, scholars lack consensus in determining a theoretical framework for understanding how and under what conditions CSR will make an impact on employees and ultimately organizational performance. This study adds clarity by exploring the effect of perceived CSR on a more comprehensive set of employees’ attitudinal and behavioral reactions (i.e., turnover intention, in-role job performance, and helping behavior) via the mediating mechanism of organizational identification and the moderating condition of moral identity. Hypotheses were derived using social identity theory. Results were based on data obtained from 340 Chinese manufacturing employee-supervisor dyads. This study found that employees’ perceived CSR had an indirect relationship via organizational identification with each of the variables: (1) turnover intention, (2) in-role job performance, and (3) helping behavior. Specifically, the negative relationship between perceived CSR and turnover intention was stronger when employees had higher moral identity and the positive relationship between perceived CSR and in-role job performance and helping behavior was amplified by moral identity. Our findings show how the mediating mechanism of organizational identity and the moderating condition of moral identity work together to improve organizational effectiveness. The findings reveal
Romenti, Stefania; Valentini, Chiara
This study intends to explore Alitalia's crisis response strategies implemented in 2008 to understand Alitalia's approach in communicating with stakeholders as a way to preserve the company's image and reputation. Our intent is to explain Alitalia's crisis response strategies by using an integrated...... model of crisis response strategies based on categories as identified by Benoit's, Sturges's, Coombs's, Bradford and Garret's and Huang's studies. This integrated model was used to perform qualitative content analyses of 77 press releases published by Alitalia's Media Department and by the Italian...
Nicoleta Camelia Cicioc; Ramona Gabrea
... they belong and where they operate. Many national and international organizations invest considerable amounts of money in actions of corporate social responsibility because they are aware that the result is not in vain, the result will obtain...
When a computer security attack on an organization occurs, an intrusion is recognized, or some other kind of computer security incident occurs, it is...response capability or a Computer Security Incident Response Team (CSIRT). When an incident occurs, the goal of the CSIRT is to control and minimize...disadvantages and the kinds of incident management services that best fit with it. An earlier SEI publication, the Handbook for Computer Security Incident
Battard, Nicolas; Donnelly, Paul F.; Mangematin, Vincent
The literature on organizational responses to institutional pressures describes responses ranging from compliance to resistance via different modes of decoupling. However, although these studies provide a greater understanding of the phenomenon, they tend to be disparate and to consider the different elements separately. Through a comparative case study of six research teams in the area of nanosciences and nanotechnologies, we offer three contributions. Our first is to the decoupling literatu...
Schoenfisch, Ashley L; Myers, Douglas J; Pompeii, Lisa A; Lipscomb, Hester J
Work focused on understanding implementation and adoption of interventions designed to prevent patient-handling injuries in the hospital setting is lacking in the injury literature and may be more insightful than more traditional evaluation measures. Data from focus groups with health care workers were used to describe barriers and promoters of the adoption of patient lift equipment and a shift to a "minimal-manual lift environment" at two affiliated hospitals. Several factors influencing the adoption of the lift equipment and patient-handling policy were noted: time, knowledge/ability, staffing, patient characteristics, and organizational and cultural aspects of work. The adoption process was complex, and considerable variability by hospital and across units was observed. The use of qualitative data can enhance the understanding of factors that influence implementation and adoption of interventions designed to prevent patient-handling injuries among health care workers. Copyright © 2011 Wiley Periodicals, Inc.
Antônio João Hocayen-da-Silva
Full Text Available Hospitality business in Curitiba City (Parana State, Brazil turned to be a good investment for national and international hotel chains due to the settlement of assembly industries as well as several multinational companies in the dwellings, which increased demand for hospitality services. This study sought to examine the inter-organizational relationships held by hospitality business companies in Curitiba. To achieve that goal semi-structured interviews with owners, directors and managers were conducted in two hotels belonging to locals, either persons or groups. Secondary data were collected in printed or on line newspapers and magazines. It was possible to note the absence of formal practices of alliances and partnerships between companies of the analyzed sector, which hinders the achievement of sustainable competitive advantage.
Pati, Debajyoti; O'Boyle, Michael; Hou, Jiancheng; Nanda, Upali; Ghamari, Hessam
To examine whether exposure to curve versus sharp contours in the built healthcare setting produces systematic and identifiable patterns of amygdala activation and behavioral response in healthy adults. Recent studies in cognitive neuroscience suggest that humans prefer objects with a curved contour compared with objects that have pointed features and a sharp-angled contour. An implicit perception of threat represented by sharp objects, in humans, was hypothesized to explain this bias. The study adopted a within-subject experimental design, where 36 subjects (representing three age-groups and both sexes) were exposed to a randomized order of 312 real-life images (objects, interiors, exteriors, landscape, and a set of control images). Amygdala activation was simultaneously captured using functional magnetic resonance imaging technology. Subjects' preference (like/dislike) data were also collected while in the scanner. Data were collected in 2013. In case of images depicting landscape and healthcare objects, brain scans show significant higher amygdala activation associated with sharp contours. However, in relation to images depicting hospital interiors and exterior envelops, brain scans show significant higher amygdala activation associated with curve contours. These activations pertain to exposure during the precognitive stages of the subjects' perception. Hospital forms do have systematic impact on fear response during precognitive stages of human perception. Whether this first impression colors the subsequent experience of an actual patient with real illness or injury is unknown. © The Author(s) 2016.
Social science studies of bioethics demonstrate that ethics are highly contextual, functioning differently across local settings as actors make daily decisions "on the ground." Sociological studies that demonstrate the key role organizations play in shaping ethical decision-making have disproportionately focused on physicians and nurses working in hospital settings where they contend with life and death issues. This study broadens our understanding of the contexts of ethical decision-making by empirically examining understudied healthcare professionals - pharmacists - working in two organizational settings, retail and hospital, where they act as gatekeepers to regulated goods and services as they contend with ethical issues ranging from the serious to the mundane. This study asks: How do organizations shape pharmacists' identification, negotiation, and resolution of ethical challenges; in other words, how do organizations shape pharmacists' gatekeeping processes? Based on 95 semi-structured interviews with U.S. pharmacists practicing in retail and hospital pharmacies conducted between September 2009 and May 2011, this research finds that organizations influence ethical decision-making by shaping how pharmacists construct four gatekeeping processes: medical, legal, fiscal, and moral. Each gatekeeping process manifests differently across organizations due to how these settings structure inter-professional power dynamics, proximity to patients, and means of accessing information. Findings suggest new directions for theorizing about ethical decision-making in medical contexts by drawing attention to new ethical actors, new organizational settings, an expanded definition of ethical challenges, and a broader conceptualization of gatekeeping. Copyright © 2012 Elsevier Ltd. All rights reserved.
Mehmet Arcan TUZCU
Full Text Available Corporate social responsibility activities influence the stakeholders in the first place, hence the employees, one of the vital stakeholders of the organizations. Social responsibility activities can have a direct effect on the job satisfaction and organizational commitment of employees. This paper investigates the employees’ perception on corporate social responsibility, and examines the effect of this perception on organizational commitment and job satisfaction. Hence, the individual factors that have an impact on this perception, namely gender, age, education level, the hierarchical position in the organization, the working time and the participation to the company’s social responsibility projects, are considered. The data collection is through a survey conducted among the employees of Turkish Petroleum Refineries Corporation (TUPRAS, the third most profitable and the largest private firm quoted to the Borsa Istanbul. From the findings obtained through chi square, t-test and ANOVA, one can observe an insignificant relation between organizational commitment and job satisfaction, and perceptions of corporate social responsibilities.
McGregor, Margaret J.; Baumbusch, Jennifer; Abu-Laban, Riyad B.; McGrail, Kimberlyn M.; Andrusiek, Dug; Globerman, Judith; Berg, Shannon; Cox, Michelle B.; Salomons, Kia; Volker, Jan; Ronald, Lisa
Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with…
Bobbio, Andrea; Bellan, Maria; Manganelli, Anna Maria
A strong nursing leadership that instills trust in the leader and in the organization is an important component for an effective leadership, particularly for health care organizations, because trust defines the heart of health care workplaces by promoting patient safety, excellence in care, recruitment, and retention of the nursing staff. This study aimed to test the impact of perceived empowerment leadership style expressed by the nurse supervisor, nurses' perceived organizational support, trust in the leader, and trust in the organization on nurses' job burnout. A group of 273 nurses from an Italian public general hospital took part in a cross-sectional study on a voluntary basis by filling out an anonymous questionnaire. Empowering leadership was an important predictor of trust in the leader. Trust in the organization was influenced by perceived organizational support and by the Informing dimension of the empowering leadership style. Trust in the leader and trust in the organization showed a negative impact on job burnout and also mediated the effects of some empowering leadership dimensions and perceived organizational support on job burnout. The central role of trust in health care organizations was corroborated, as well as the beneficial effects of adopting specific features of empowerment leadership behaviors toward the nursing staff. Empowering leadership could be successfully proposed in training programs directed to nurses' supervisors and health care managers.
Diana Andreia HRİSTACHE; Claudia Elena PAİCU; Nilgün İSMAİL
Today, building up organizational identity in post-crisis economy becomes a bet, as we are looking for new interpretative coordinates. First of all, we have to take into account the ability to communicate. Second in line, as an extension of the above mentioned ability, we have to highlight the corporate social responsibility (CSR). Nowadays, the road map of modern business environment can be identified only by a new philosophy of business administration. This is the result of try and error an...
Every organization searches for best conditions for development. Higher education institutions, based on the significance of a human factor, undertake many social responsibility activities. Finding the key to create a positive organization which is a motivator for employees would be a good example of applying the Positive Organizational Scholarship idea in practice. An additional consequence of the positive influence would be the perception of the higher education institution as an example of...
Turk, Meral; Davas, Asli; Tanik, Feride A; Montgomery, Anthony J
In the framework of the EU project 'Improving quality and safety in the hospital: The link between organizational culture, burnout and quality of care', focus groups (FGs) were conducted to explore hospital environment stressors and their relationship with health care professional (HP) well-being and quality of care. Semi-structured interviews and FGs were used. Three mixed FGs with 23 health care workers, two FGs with 12 nurses, and another one with nine physicians were conducted. Thematic analyses were performed. Data were coded into main themes and subthemes. Three themes emerged from the discussions: (1) Organizational stressors associated with working conditions concerning the nature of the job, workload and working schedule, unclear role definition, lack of time for personal development, interpersonal relationships at work, changes in health policy, (2) work-family spillover and (3) the gendered nature of health care work and of patients' expectations, and the gendered character of the workplace. Health care professionals are faced with numerous challenges that create stress affecting their daily life. Job stressors related to working conditions, the negative and positive spillover of work-family interference and the gendered nature of health care work emerged as important issues for Turkish HPs. What is already known on this subject? In Turkey, gender has rarely been considered in the healthcare studies. Rapid changes in health reforms are making healthcare professionals more vulnerable to stress. The deteriation in the health system impacts women more than men, as higher ratios work in outsourced services. What does this study add? Despite signifcant changes in attitudes towards women, nurses are treated as "mothers" of the clinics. Women as health workers are particularly exposed to multiple stressors, that are rooted in ideals about gender. Understanding the way healthcare is organized along gendered lines is a precusor to any real organizational change
Trierweiller, Andréa Cristina; Peixe, Blênio César Severo; Tezza, Rafael; Pereira, Vera Lúcia Duarte do Valle; Pacheco, Waldemar; Bornia, Antonio Cezar; de Andrade, Dalton Francisco
The aim of this paper is to measure the effectiveness of the organizations Information and Communication Technology (ICT) from the point of view of the manager, using Item Response Theory (IRT). There is a need to verify the effectiveness of these organizations which are normally associated to complex, dynamic, and competitive environments. In academic literature, there is disagreement surrounding the concept of organizational effectiveness and its measurement. A construct was elaborated based on dimensions of effectiveness towards the construction of the items of the questionnaire which submitted to specialists for evaluation. It demonstrated itself to be viable in measuring organizational effectiveness of ICT companies under the point of view of a manager through using Two-Parameter Logistic Model (2PLM) of the IRT. This modeling permits us to evaluate the quality and property of each item placed within a single scale: items and respondents, which is not possible when using other similar tools.
Podsevatkin, V G; Blinov, D S; Podsevatkin, D V; Podsevatkina, S V; Smirnova, O A
The new technology of hospital psychiatric care, developed and implemented in the Mordovia republican clinical hospital, permits resolving problems of hospitalism, lethality, pharmaceutical resistance and others. The essence of this technology is in staging of hospital care under condition of intensification and standardization of curative diagnostic process, implementation of complex approach to treatment of psychiatric disorders. The patient sequentially passes through three stages: intensive diagnostics and intensive treatment (intensive care department, intensive therapy department), supportive therapy (general psychiatric department); rehabilitation measures (curative rehabilitative department). The concentration of resources at the first stage, application of intensive therapy techniques permit in the shortest period to arrest acute psychotic symptomatic. The described new technology of hospital psychiatric care permits enhancing effectiveness of treatment, significantly shorten period of hospitalization (37.5 days), to obtain lasting and qualitative remission, to rehabilitate most fully social working status of patient and to significantly decrease lethality.
Saillour-Glénisson, Florence; Kret, Marion; Domecq, Sandrine; Sibé, Matthieu; Daucourt, Valentin; Migeot, Virginie; Veillard, David; Michel, Philippe
To identify managerial and organizational characteristics of multi-specialty medicine wards and individual characteristics of health professionals that are most strongly associated with clinical practice guidelines (CPG) adherence. Cross-sectional stratified cluster sample design. Data were gathered from 36 randomly selected multi-specialty medicine wards. The study population included all health professionals involved in patient care working in the participating wards. The degree of CPG adherence was measured using clinical vignettes on three topics: pain management, managing heart failure and managing diabetes. Responses from each professional to each clinical case were quantified using a 10-point scale. Managerial and organizational characteristics of medical department and individual characteristics of health professionals were obtained using three questionnaires. The study sample consisted of 859 professionals (362 orderlies, 361 nurses and 136 physicians). Factors independently and positively associated with CPG adherence were (i) individual factors: low age of professionals, expertise in diabetology and activity in cardiology; (ii) organizational and managerial factors: good understanding between physicians and other personnel; and (iii) structural factors: computer-based test results and prescriptions, presence of medical specialists, inter-department mobility of orderlies, medium-length stay (between 7 and 10 days) and large bed capacity. Good CPG adherence in general medicine needs institutional dynamism, availability of clinical competence and team culture based on cooperation.
Gorji, Hassan Abolghasem; Etemadi, Manal; Hoseini, Fatemeh
Background and Objectives: Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them. Materials and Methods: This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test. Results: Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029). Discussion: The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always
Gorji, Hassan Abolghasem; Etemadi, Manal; Hoseini, Fatemeh
Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them. This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test. Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029). The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always considered by managers to improve job involvement.
Full Text Available Introduction: If the patients are not satisfied with the hospital, this results in switching behavior of patients. In this situation, among different hospitals, the patients choose the hospital with higher level of service quality. So, the main aim of this paper is investigating the effect of hospital's service quality on switching behavior of inpatients in Shahid Sadoughi Hospital of Yazd. Methods: This study was a descriptive, cross-sectional and applied which was done in 2016. The statistical population of this research was the inpatients of Shahid Sadoughi Hospital of Yazd. A sample comprising of 196 members was selected using simple random sampling method. The statistical instruments consisted of two questionnaires for measuring hospital's service quality and switching behavior of patients. Reliability of the scales was confirmed by Cronbach’s Alfa and validity of the scales was confirmed by content validity. Data were analyzed using SPSS 19 software. For analyzing data, Pearson correlation and Regression tests were employed. Results: In this research, the mean of hospital's service quality variable was 3.508±1.025 and the mean of switching behavior variable was 2.186± 0.997. The result of Pearson correlation test showed that there is a negative and significant relationship (r = - 0.746 and p-value = 0.000 between hospital's service quality and switching behavior. Among the six dimensions of service quality, the courtesy dimension had the highest correlation coefficient. Also, the result of Regression test showed that hospital's service quality has negative and significant influence on switching behavior. Conclusion: Since hospital's service quality had negative and significant influence on switching behavior, we can say that the higher the service quality of hospital, the lower the switching behavior of patients. According to high level of Pearson correlation the courtesy dimension with service quality, it is understood that the level
Frisch, P H; Stone, B; Booth, P; Lui, W
Over the last decade the changing healthcare environment has required hospitals and specifically Biomedical Engineering to critically evaluate, optimize and adapt their operations. The focus is now on new technologies, changes to the environment of care, support requirements and financial constraints. Memorial Sloan Kettering Cancer Center (MSKCC), an NIH-designated comprehensive cancer center, has been transitioning to an increasing outpatient care environment. This transition is driving an increase in-patient acuity coupled with the need for added urgency of support and response time. New technologies, regulatory requirements and financial constraints have impacted operating budgets and in some cases, resulted in a reduction in staffing. Specific initiatives, such as the Joint Commission's National Patient Safety Goals, requirements for an electronic medical record, meaningful use and ICD10 have caused institutions to reevaluate their operations and processes including requiring Biomedical Engineering to manage new technologies, integrations and changes in the electromagnetic environment, while optimizing operational workflow and resource utilization. This paper addresses the new and expanding responsibilities and approach of Biomedical Engineering organizations, specifically at MSKCC. It is suggested that our experience may be a template for other organizations facing similar problems. Increasing support is necessary for Medical Software - Medical Device Data Systems in the evolving wireless environment, including RTLS and RFID. It will be necessary to evaluate the potential impact on the growing electromagnetic environment, on connectivity resulting in the need for dynamic and interactive testing and the growing demand to establish new and needed operational synergies with Information Technology operations and other operational groups within the institution, such as nursing, facilities management, central supply, and the user departments.
Kimmerly, David P
This article is a summary based on a December 2007 paper prepared by the author in partial fulfillment of the requirements for a master's degree in business and organizational security management at Webster University. The project described was intended to assess Chicago-area healthcare organization security departments' preparedness and response capabilities for a potential influenza pandemic. While the author says healthcare organizations are learning from the pandemics of the past, little research has been conducted on the requirements necessary within hospital security departments. The article explores staffing, planning, preparation and response capabilities within a healthcare security context to determine existing resources available to the healthcare security community. Eleven completed surveys were received from hospital security managers throughout the geographical Chicago area. They reveal that hospital security managers are conscious of the risks of a pandemic influenza outbreak. Yet, it was found that several gaps existed within hospital security department staffing and response capabilities, as hospital security departments may not have the available resources necessary to adequately maintain their operations during a pandemic incident.
Dorel Mihai Paraschiv
Full Text Available Creating a sustainable development strategy is essential for organizations that seek to reduce risks associated with tightening legislation, increased energy prices and natural resources and growing customer demands. Sustainability requires the full integration of social and environmental aspects into the vision, culture and operations of an organization, a profound process of organizational change being essential. The purpose of this paper is to present the main drivers of corporate sustainability, illustrating – after a thorough literature review – the link between the following elements: corporate sustainability – a necessity in the current global context; eco-innovation – as a way to implement sustainability in an organization; responsible leadership – as the art of building and maintaining strong and moral relationships with all stakeholders; organizational culture and organizational change – the basic elements through which organizations continuously renew their processes and products, adapting them to the new context. Furthermore, the paper provides an overview of organizations active in Romania in terms of sustainability practices, in general, and the ecological component of sustainable development, in particular, by presenting the results of an exploratory questionnaire-based research. The research reflects the importance of visionary management in adopting and implementing sustainability in the responding organizations.
Skela Savic, Brigita; Pagon, Milan
To investigate how nurses and physicians perceive organizational culture, their integration into the organizational processes, and relations within a health care team. We performed a cross-sectional study that included 106 physicians and 558 nurses from 14 Slovenian hospitals in December 2005. The hospitals were randomly selected. We distributed the questionnaires on the same day to physicians and nurses during a morning shift. The total number of distributed questionnaires represented a 20% of each personnel category at each hospital. The following variables were studied: organizational culture, integration of nurses and physicians in hospital processes, and subordination of nurses to physicians. Physicians and nurses favored a culture of internal focus, stability, and control. Both groups estimated that they had a low level of personal involvement in their organizations and indicated insufficient involvement in work teams, while nurses also felt that they were subordinated (mean+/-standard deviation, 3.6+/-0.9 on a scale from 1 to 5) to physicians (2.7+/-1.0; Porientation correlated positively with the subordination of nurses (PPmarket culture, level of personal involvement, and the level of education. Our research showed that the professional growth of nurses was mainly threatened by organizational factors such as hierarchy, control orientation, a lack of cooperation and team building between physicians and nurses, as well as insufficient inclusion of both physicians and nurses into change implementation activities.
[CC BY 4.0] (http://creativecommons.org/licenses/by/4.0). Introduction. Within the hospitality industry, as in other industries, attention is given to environmental sustainability. Unfortunately, however, most hospitality companies are lagging behind in the process of becoming more sustainable (van Rheede & Blomme, 2012a).
How does the current paradigm of the host-guest relationship cause the hospitality industry to lag behind in sustainable development? Hospitality is often defined as “a feeling of being welcome”. It is about “welcoming the stranger: a person who comes today and stays tomorrow”, or “a stranger who is treated like a god”.
Natasha Dejigov Monteiro da Silva
Full Text Available Abstract OBJECTIVE To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. METHOD A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. RESULTS According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. CONCLUSION Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety.
O'Donnell, Lolita T
To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the
Full Text Available Background: The man-made and natural disasters have adverse effects with sound, apparent, and unknown consequences. Among various components of disaster management in health sector, the most important role is performed by health-treatment systems, especially hospitals. Therefore, the present study aimed to evaluate the surge capacity of hospitals of Kerman Province in disaster in 2015. Materials and Methods: This is a quantitative study, conducted on private, military, and medical sciences hospitals of Kerman Province. The sampling method was total count and data collection for the research was done by questionnaire. The first section of the questionnaire included demographic information of the studied hospitals and second part examined the hospital capacity in response to disasters in 4 fields of equipment, physical space, human resources, and applied programs. The extracted data were analyzed by descriptive statistics. Results: The mean capability of implementing the surge capacity programs by hospitals of Kerman Province in disasters and in 4 fields of equipment, physical space, human resources, and applied programs was evaluated as 7.33% (weak. The surge capacity capability of state hospitals in disasters was computed as 8% and compared to private hospitals (6.07% had a more suitable condition. Conclusion: Based on the results of study and significance of preparedness of hospitals in response to disasters, it is proposed that managers of studied hospitals take measures to promote the hospital response capacity to disasters based on 4 components of increasing hospital capacity.
Mehlum, Lars; Jørgensen, Trond; Diep, Lien My; Nrugham, Latha
The objective of this study was to examine predictors for readmissions in patients admitted to a general hospital emergency ward for suicide attempts before and after organizational changes potentially affecting the chain of care. Socio-demographic and clinical variables were collected by clinicians from 1997 thru 2007. Data from the periods before and after 2004--when the hospital changed its catchment area--were compared. A substantial increase in readmission rates in the period after the organizational change was observed. This increase was not associated with any of the socio-demographic or clinical patient characteristics. Although no causal connection can be inferred, the observed association between organizational change and readmission rates could indicate that established post-discharge care systems for suicide attempters may be vulnerable to such change.
Ariel C. Avgar; Rebecca Kolins Givan; Mingwei Liu
Hospitals are increasingly experimenting with workplace innovations designed to improve the quality of patient care, alleviate financial pressures, and retain staff. The authors examine one such innovation, patient-centered care (PCC), and its effects on clinical and employee outcomes in hospitals in the United Kingdom. Employing PCC entails a shift from an institutional and physician focus to one that emphasizes patients' needs and references. Drawing on a combined dataset covering the perio...
Corsini, Filippo; Rizzi, Francesco; Frey, Marco
Extended Producer Responsibility (EPR) has been the backbone of product life cycle management in Europe since the 2000s. Unfortunately, EPR implementation has multiple impacts on the supply chain and, thus, its consequences are not always easily manageable. Although several studies have explored various examples within the EU, the determinants of the effectiveness of EPR management are still not fully understood. This research seeks to bridge this gap by making use of quantitative analyses to investigate how key issues related to: WEEE Directive transposition and organizational settings adopted by each Member State, influenced the results achieved in those Member States in terms of collection from households. In details, a latent class analysis (LCA) has been used to analyse different EPR management strategies based on the policy set, the supply chain structure, and the performance of the household collection of electronic waste. Results highlight the strong connection between allocation of responsibility and organizational model adopted in Member States and performance related to small households equipment's. Conclusions shows the need for stronger coordination of EPR and waste policies in order to achieve adequate levels of Waste Electrical and Electronic Equipment (WEEE) collection, the need of a clear delineation of the responsibilities of each subject of the supply chain and also the importance of "clearing houses" in moderating the impacts of short-sighted competition between collective schemes. Copyright © 2016 Elsevier Ltd. All rights reserved.
Lin, Chia-Tzu; Chang, Ching-Sheng
Because nurses deliver care to patients on behalf of hospitals, hospitals should enhance the spontaneous organizational citizenship behaviors of front-line nurses to increase patient satisfaction and, hence, to increase the competitiveness of the hospital. However, a major gap in the literature is the lack of evidence-based studies of the correlations among job satisfaction, organizational commitment, and organizational citizenship behaviors in nursing personnel. Therefore, this study performed a cross-sectional survey of nurses in 1 large hospital in Taiwan; out of 400 questionnaires distributed, 386 valid questionnaires were collected, which was a valid response rate of 96.50%. The survey results revealed that organizational commitment has a significant positive effect on organizational citizenship behaviors (γ11 = 0.57, p citizenship behaviors (Δχ2 = 26.397, p citizenship behaviors.
O'Donnell, Lolita T
The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between
Abad-Corpa, E; Molina-Durán, F; Vivo-Molina, M C; Moya-Ruiz, B; Martínez-Hernández, A; Romero-Pelegrín, J M; Leal-Llopis, J; Hernández-Méndez, S; García-Arsac, I; Muñoz-Sánchez, M; Rodríguez-Ródenas, J M; Iniesta-Sánchez, J; García-Jiménez, C; Caravaca-Alcaraz, B; Fuentelsaz-Gallego, C; Moreno-Casbas, T; González-María, E
To determine the profile of nurses in public hospitals in Murcia and to assess how they perceive their work environment, the quality of care and their level of burnout (the RN4CAST project repetition). A cross-sectional descriptive study was carried out in 8 hospitals in Murcia. Data were collected between 2009 and 2010 from 687 nurses (stratified by the type of unit) using a self-completed questionnaire with 149 items covering variables related to sociodemographics; work; perception of the work place (PES-NWI); burnout (Maslach Burnout Inventory); and the quality of patient care, and patient safety. Non parametric tests, for two samples or k samples according to the comparison. A total of 495 questionnaires were collected (72%). Most respondents were female (80.4%) having a mean age of 34.1 (SD=7.1) years, and they had been working for 9.4 (SD=7.4) years. Just over one-quarter (25.7%) had carried out more than 300 hours of training in the previous 24 months. The patient/nurse ratio was 11.7 (SD=3.6), varying between hospitals. The nurses reported 25% of hospitals as having an unfavorable work environment, whereas 37.5% had favorable ones; large hospitals were less highly valued. Few respondents intended to give up their jobs (16.8%). Burnout levels revealed emotional exhaustion in 18.4% of respondents; depersonalization in 7.5%, and personal fulfillment in 28.8%. Perception of quality varied between centers and the perception of adverse effects was more favorable in small hospitals. Our professionals were generally satisfied, but given the unfavorable work environment, measures should be adopted for improving well-being and reducing weaknesses. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.
Boerner, S; Dütschke, E; Schwämmle, A
The study compares physicians and the nursing staff of a hospital in terms of their extra-role behavior. Matters of interest include the extent of Organizational Citizenship Behavior (OCB) shown on the one hand and on the other hand which conditions stimulate the OCB of both physicians and nurses, respectively. The comparison was conducted by applying a questionnaire on n = 70 physicians and n = 112 nurses in a nursing department of a municipal hospital. The results can be summarized as follows: (1) The extra-role behavior in terms of sportsmanship, individual initiative, and conscientiousness show equally high values with respect to physicians as well as nurses. In contrast, nurses rate their own helping behavior towards colleagues higher than the physicians do. Therefore, the extent of OCB does not seem to be job-specific in the narrower sense. (2) Differences between physicians and nurses exist indeed with respect to the conditions for the occurrence of OCB: Although the extent of OCB shown by physicians and nurses is independent from age, department tenure, and organizational tenure, job experience does play a role for the degree of conscientiousness (physicians) and individual initiative (nurses). Furthermore, gender affects the sub dimension sportsmanship (nurses). (3) While job characteristics (job control and stress) play a certain role for the degree of nurses' OCB, the physicians' extra-role behavior is independent from job control and strain. Vice versa, the analyzed person-related characteristics job insecurity and strain play a role for the extra-role behavior of physicians, while the behavior of nurses remains unaffected hereof. In other words: Nurses show the same OCB at high and low levels of strain and job insecurity, while physicians lower their OCB when strain and job insecurity rise. (4) For both physicians and nurses, job satisfaction is the most important predictor for extra-role behavior. When trying to enhance the extent of OCB within a
Full Text Available Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized.This study uses the information theory index (ITI and the Herfindahl-Hirschman index (HHI to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care.The results show that a focused strategy (high HHI improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds. In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care.
Gardner, John Wallace
This dissertation examines the effects of safety culture, including operational climate and practices, as well as the adoption and use of information systems for delivering high quality healthcare and improved patient experience. Chapter 2 studies the influence of both general and outcome-specific hospital climate and quality practices on process…
Within the hospitality industry, as in other industries, attention is given to environmental .... satisfaction of basic needs, self-reliance (including political freedom) and local ..... Food and Beverage voucher, while they save up to. 49.2 gallons of ...
Situational leadership styles, staff nurse job characteristics related to job satisfaction and organizational commitment of head nurses working in hospitals under the jurisdiction of the Royal Thai Army.
Intaraprasong, Bhusita; Potjanasitt, Sureporn; Pattaraarchachai, Junya; Meennuch, Chavalit
To analyze the relationships between the situational leadership styles, staff nurse job characteristic with job satisfaction and organizational commitment of head nurses working in hospitals under the jurisdiction of the Royal Thai Army The cross-sectional analytical study was conducted in 128 head nurses working in hospitals under the jurisdiction of the Royal Thai Army. Data were collected by mailed questionnaires. A total of 117 completed questionnaires (91.4%) were received for analysis. Statistical analysis was done using Pearson's Product Moment Correlation Coefficient. It was found that situational leadership styles were not correlated with job satisfaction and organizational commitment of head nurses. Staff nurse job characteristics had a low level of positive correlation with job satisfaction and organizational commitment of head nurses at 0.05 level of significance (r = 0.202 and 0.189 respectively). The hospital administrators should formulate policy to improve working system, human resource management and formulate policies and strategies based on situational leadership. In addition, they should improve the characteristics of staff nurse job by using surveys to obtain job satisfaction and organizational commitment.
Trybou, Jeroen; De Caluwé, Gaelle; Verleye, Katrien; Gemmel, Paul; Annemans, Lieven
Hospitals face increasingly competitive market conditions. In this challenging environment, hospitals have been struggling to build high-quality hospital-physician relationships. In the literature, two types of managerial strategies for optimizing relationships have been identified. The first focuses on optimizing the economic relationship; the second focuses on the noneconomic dimension and emphasizes the cooperative structure and collaborative nature of the hospital-physician relationship. We investigate potential spillover effects between the perceptions of physicians of organizational exchange and their customer-oriented behaviors. A cross-sectional study was conducted on 130 self-employed physicians practicing at six Belgian hospitals. Economic exchange was measured using the concept of distributive justice (DJ); noneconomic exchange was measured by the concept of perceived organizational support (POS). Our outcomes consist of three types of customer-oriented behaviours: internal influence (II), external representation (ER), and service delivery (SD). Our results show a positive relationship between DJ and II (adjusted R(2) = 0.038, t = 2.35; p = 0.028) and ER (adjusted R(2) = 0.15, t = 4.59; p customer-oriented behaviours. Fostering organizational identification could enhance this reciprocity dynamic.
Spiri, W C
The aim of this study is to identify how a new team of the surgical center staff in a specialized hospital perceive the organization climate. A qualitative approach was utilized. As a theoretical reference to measure the organization climate, we have used CHIAVENATO, that defines organization climate as the interior of an organization that influences its members behavior. The organization climate could be favourable, unfavourable or neutral. The speeches showed a favourable organization climate considering the adopted methodology.
Hick, John L; Chipman, Jeffery; Loppnow, Gregory; Conterato, Marc; Roberts, David; Heegaard, William G; Beilman, Greg; Clark, Michael; Pohland, Jonathan; Ho, Jeffrey D; Brunette, Douglas D; Clinton, Joseph E
We describe the hospital system response to the Interstate 35W bridge collapse in Minneapolis into the Mississippi River on August 1, 2007, which resulted in 13 deaths and 127 injuries. Comparative analysis of response activities at the 3 hospitals that received critical or serious casualties is provided. First-hand experiences of hospital physicians, issues identified in after-action reports, injury severity scores, and other relevant patient data were collected from the 3 hospitals that received seriously injured patients, including the closest hospitals to the collapse on each side of the river. Injuries were consistent with major acceleration/deceleration force injuries. The most critical patients arrived first at each hospital, suggesting appropriate prehospital triage. Capacity of the health care system was not overwhelmed and the involved hospitals generally reported an overresponse by staff. Communication and patient tracking problems occurred at all of the hospitals. Situational awareness was limited due to the scope of structural collapse and incomplete information from the scene. Hospitals were generally satisfied with their surge capacity and incident management plan activation. Issues such as communications, patient tracking, and staff overreporting that have been identified in past incidents also were problematic in this event. Hospitals will need to address deficiencies and build on successful actions to cope with future, potentially larger incidents.
Full Text Available In recent years, there has been a noticeable increase in scholarly interest in corporate social responsibility and its impact on employee attitudes. We intend to add to this literature by introducing unique explanatory and contextual variables. The study explains the impact of Corporate Social Responsibility (CSR on employee attitudes through justice within the context of cooperative employee relations. We argue that the concept of justice, which is implied in both socially responsible organizational policies and cooperative employee-employer relations, may be an important addition as a mediating variable. In essence, the study explores the mediating effects of the two primary types of justice, i.e., distributive and procedural, on the relationship between perceived corporate social responsibility, and job satisfaction, and affective commitment. Additionally, we introduce ethics-based psychological foundations, i.e., heuristic and deontic fairness theories to explain the studied relationship. The study also examines the moderated mediation effects of the cooperative industrial relations climate on perceived corporate social responsibility and justice perceptions. Our analysis supports the mediating role of both distributive and procedural justice perceptions. However, a moderated mediation role of the industrial relations climate was only found in the relationship between perceived corporate social responsibility, procedural justice, and employee attitudes. Implications of the study are discussed.
McGaughey, Jennifer; O'Halloran, Peter; Porter, Sam; Trinder, John; Blackwood, Bronagh
To test the Rapid Response Systems programme theory against actual practice components of the Rapid Response Systems implemented to identify those contexts and mechanisms which have an impact on the successful achievement of desired outcomes in practice. Rapid Response Systems allow deteriorating patients to be recognized using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. Realist evaluation. The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation. We used various mixed methods including individual and focus group interviews, observation of nursing practice between June-November 2010 and document analysis of Early Warning Systems audit data between May-October 2010 and hospital acute care training records over 4.5 years from 2003-2008. Data were analysed using NiVivo8 and SPPS. A cross-case analysis highlighted similar patterns of factors which enabled or constrained successful recognition, referral and response to deteriorating patients in practice. Key enabling factors were the use of clinical judgement by experienced nurses and the empowerment of nurses as a result of organizational change associated with implementation of Early Warning System protocols. Key constraining factors were low staffing and inappropriate skill mix levels, rigid implementation of protocols and culturally embedded suboptimal communication processes. Successful implementation of Rapid Response Systems was dependent on adopting organizational and cultural changes that facilitated staff empowerment, flexible implementation of protocols and ongoing experiential learning. © 2017 John Wiley & Sons Ltd.
Full Text Available The purpose of this study was to examine the role of organizational culture in helping to translate corporate social responsibility (CSR into firm performance. We employed arguments from the CSR strategy view to highlight the effectiveness of CSR and the contingency approach to explain the vertical fit between CSR and the organizational culture in a firm. Furthermore, we examined the moderating influence of organizational culture on the CSR–firm performance linkage. The results suggest that some organizational cultures moderate the relationship between CSR and financial outcomes, and that organizational culture may play an important role in enhancing a positive relationship between CSR and firm performance.
Brandão, Cristina; Rego, Guilhermina; Duarte, Ivone; Nunes, Rui
Changes in modern societies originate the perception that ethical behaviour is essential in organization's practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of social responsibility. Recently the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health has addressed this concept of social responsibility in the context of health care delivery suggesting a new paradigm in hospital governance. The objective of this paper is to address the issue of corporate social responsibility in health care, namely in the hospital setting, emphasising the special governance arrangements of such complex organisations and to evaluate if new models of hospital management (entrepreneurism) will need robust mechanisms of corporate governance to fulfil its social responsiveness. The scope of this responsible behaviour requires hospitals to fulfil its social and market objectives, in accordance to the law and general ethical standards. Social responsibility includes aspects like abstention of harm to the environment or the protection of the interests of all the stakeholders enrolled in the deliverance of health care. In conclusion, adequate corporate governance and corporate strategy are the gold standard of social responsibility. In a competitive market hospital governance will be optimised if the organization culture is reframed to meet stakeholders' demands for unequivocal assurances on ethical behaviour. Health care organizations should abide to this new governance approach that is to create organisation value through performance, conformance and responsibility.
Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England.
Takian, Amirhossein; Sheikh, Aziz; Barber, Nicholas
To explore the role of organizational learning in enabling implementation and supporting adoption of electronic health record systems into two English hospitals. In the course of conducting our prospective and sociotechnical evaluation of the implementation and adoption of electronic health record into 12 "early adopter" hospitals across England, we identified two hospitals implementing virtually identical versions of the same "off-the-shelf" software (Millennium) within a comparable timeframe. We undertook a longitudinal qualitative case study-based analysis of these two hospitals (referred to hereafter as Alpha and Omega) and their implementation experiences. Data included the following: 63 in-depth interviews with various groups of internal and external stakeholders; 41-h on-site observation; and content analysis of 218 documents of various types. Analysis was both inductive and deductive, the latter being informed by the "sociotechnical changing" theoretical perspective. Although Alpha and Omega shared a number of contextual similarities, our evaluation revealed fundamental differences in visions of electronic health record and the implementation strategy between the hospitals, which resulted in distinct local consequences of electronic health record implementation and impacted adoption. Both hospitals did not, during our evaluation, see the hoped-for benefits to the organization as a result of the introduction of electronic health record, such as speeding-up tasks. Nonetheless, the Millennium software worked out to be easier to use at Omega. Interorganizational learning was at the heart of this difference. Despite the turbulent overall national "roll out" of electronic health record systems into the English hospitals, considerable opportunities for organizational learning were offered by sequential delivery of the electronic health record software into "early adopter" hospitals. We argue that understanding the process of organizational learning and its
Full Text Available Human resources committed to the organization not only reduces absence, delay, and replacement, but also causes the increase of organizational performance, employees’ mental freshness, better attainment to organizational excellent goals, and achieving individual’s objectives. Hence, organizational commitment has special importance among the employees of hospital. The nurses’ competence is an important criterion required for providing patients’ health-cares. The change in nurses’ roles and duties has changed the job to a complicated one and requires having various skills, and has caused the clinical competence to be considered more. The present study was performed with the aim of investigating the relationship of organizational commitment and clinical competence in nurses. The research was descriptive correlation type, and the statistical population was all nurses (176 persons working in Montazeri Hospital, Najafabad city, selected by Census method and 135 persons were investigated. The data collection tool included three questionnaires of personal information, Allen and Meyer’s questionnaire of organizational commitment, and questionnaire of clinical competence, that their validity and reliability were confirmed. Data was analyzed with independent t-test, ANOVA, Mann-Whitney, and Pearson’s correlation coefficient using the software SPSS 17. The average score of organizational commitment was 91± 10.76, and at medium level. The average score of clinical competence was 74.42±11.69, and at good level. There was no significant relationship between organizational commitment and clinical competence in the nurses. Only, the emotional commitment dimension had significant relationship with the quality assurance area of clinical competence (P<0.05. Organizational commitment of nurses did not have significant relationship with demographic variables under investigation, while their clinical competence had significant relationship with age
Full Text Available Background: High turnover intention rate is one of the most common problems in healthcare organizations throughout the world. There are several factors that can potentially affect the individuals’ turnover intention; they include factors such as work-family conflict, family-work conflict, and organizational commitment. The aim of this research was to determine the relationship between family-work and work-family conflicts and organizational commitment and turnover intention among nurses and paramedical staff at hospitals affiliated to Shiraz University of Medical Sciences (SUMS and present a model using SEM. Methods: This is a questionnaire based cross-sectional study among 400 nurses and paramedical staff of hospitals affiliated to SUMS using a random-proportional (quota sampling method. Data collection was performed using four standard questionnaires. SPSS software was used for data analysis and SmartPLS software for modeling variables. Results: Mean scores of work-family conflict and desertion intention were 2.6 and 2.77, respectively. There was a significant relationship between gender and family-work conflict (P=0.02. Family-work conflict was significantly higher in married participants (P=0.001. Based on the findings of this study, there was a significant positive relationship between work-family and family-work conflict (P=0.001. Also, work-family conflict had a significant inverse relationship with organizational commitment (P=0.001. An inverse relationship was seen between organizational commitment and turnover intentions (P=0.001. Conclusion: Thus, regarding the prominent and preventative role of organizational commitment in employees’ desertion intentions, in order to prevent negative effects of staff desertion in health sector, attempts to make policies to increase people’s organizational commitment must be considered by health system managers more than ever.
Hatam, Nahid; Jalali, Marzie Tajik; Askarian, Mehrdad; Kharazmi, Erfan
High turnover intention rate is one of the most common problems in healthcare organizations throughout the world. There are several factors that can potentially affect the individuals' turnover intention; they include factors such as work-family conflict, family-work conflict, and organizational commitment. The aim of this research was to determine the relationship between family-work and work-family conflicts and organizational commitment and turnover intention among nurses and paramedical staff at hospitals affiliated to Shiraz University of Medical Sciences (SUMS) and present a model using SEM. This is a questionnaire based cross-sectional study among 400 nurses and paramedical staff of hospitals affiliated to SUMS using a random-proportional (quota) sampling method. Data collection was performed using four standard questionnaires. SPSS software was used for data analysis and SmartPLS software for modeling variables. Mean scores of work-family conflict and desertion intention were 2.6 and 2.77, respectively. There was a significant relationship between gender and family-work conflict (P=0.02). Family-work conflict was significantly higher in married participants (P=0.001). Based on the findings of this study, there was a significant positive relationship between work-family and family-work conflict (P=0.001). Also, work-family conflict had a significant inverse relationship with organizational commitment (P=0.001). An inverse relationship was seen between organizational commitment and turnover intentions (P=0.001). Thus, regarding the prominent and preventative role of organizational commitment in employees' desertion intentions, in order to prevent negative effects of staff desertion in health sector, attempts to make policies to increase people's organizational commitment must be considered by health system managers more than ever.
Full Text Available Pope Francis is the first Jesuit pope and has made economic inequality a theme of his pontificate. This article shows that Pope Francis diagnoses economic inequality as both a structural problem and a problem of virtue, and that the virtue he calls for in response is what James F. Keenan, SJ has called Jesuit hospitality. Reviewing contemporary theological work on hospitality, I show that Francis’ Jesuit hospitality shares many features with hospitality as described by feminist theologians. Namely, it is risky, takes place across difference, acknowledges the marginality of both host and guest, and promises mutual benefit to each party. Francis’ account of the spiritual practice of encounter provides a concrete vision of Jesuit hospitality in action. This article contributes to existing literature on the uniquely Jesuit nature of Francis’ theology and to work showing the resonance of his intellectual standpoint with feminist approaches. It proposes a Christian virtue response to the pressing contemporary problem of economic inequality.
Babyak, Jonathan M; Sharp, Claire R
OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.
Pasquali, Sara; Capitoni, Enrica; Tiraboschi, Giuseppina; Alborghetti, Adriana; De Luca, Giuseppe; Di Mauro, Stefania
Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being. Data were processed through Microsoft Excel. Among Units analysed ,all Units in levels of care and one organized by the departmental model systematically evaluate nursing complexity. Registered Nurses (RN) and Health Care Assistants (HCA) are on average numerically higher in Units that measure complexity (0.55/ 0.49 RN, 0.38/0.23 HCA - ratio per bed). Adopted measures in relation to changes in complexity are:rewarding systems, supporting interventions, such as moving personnel within different Units or additional required working hours; reduction in number of beds is adopted when no other solution is available. Patient satisfaction is evaluated through Customer Satisfaction questionnaires. Turnover, stress and rate of absenteeism data are not available in all Units. Complexity evaluation through appropriate methods is carried out in all hospitals organized in levels of care with personalized nursing care models, though complexity is detected with different methods. No significant differences in applied managerial strategies are present. Patient's satisfaction is evaluated everywhere. Data on staffing wellbeing is scarcely available. Coordinated regional actions are recommended in order to gather comparable data for research, improve decision making and effectiveness of Nursing care.
Leyla Amin Bandar Cham Khaleh
Full Text Available Organizational commitment has been considered as the most important concept in organizational behavior dimensions and human resources management. In all of the organizations, organizational commitment exerts a positive effect on the staff members’ performance. Therefore, the organizations are in need of committed and responsible workforce. The current study has dealt with the survey of the extent the organizational commitment components relate to the organizational citizenship behavior among the nursing staff in Al-Zahra (May God give her best of regards hospital in 2015. The current study is a descriptive-correlation research and it is an applied research from the objective point of view. The study population includes Al-Zahra (May God give her best of regards nursing hospital staff in 2015 and they were selected based on an availability method and the total study sample volume reaches to about 130 individuals. To collect the demographic characteristics information there was made use of Allen-Mayer organizational commitment questionnaire and Podsakoff’s organizational citizenship behavior questionnaire was also applied. Data analysis was conducted through descriptive statistics includes frequency, mean and percentage and inferential statistics including Mann-Whitney, X2 and Pierson correlation coefficient by taking advantage of SPSS 20. The results of the present study indicated that there is no significant relationship between affective and normative commitment components and the employees’ organizational citizenship behavior. According to the relationship between organizational commitment and nursing staff organizational citizenship behavior staff members should be selected from among the committed and responsible individuals in order for the organizational objectives and goals to be advanced and the managers should set the ground for the staff progress and sublimation.
Full Text Available Basic purpose of this study is about investigating the effects of intellectual capital on job satisfaction and organizational attractiveness during the person-organization fit on employees of university hospital. For this purpose; questi on form, which created with personal information form, job satisfaction scale, organizational attractiveness scale, capital perception scale and person-organization fit scale, was applied on 330 persons, who work for university hospital. The statistical technics was used for testing the hypotheses, which were created for this study; “Pearson Correlation Analysis Linear” and “Multivariate Regression Models”. The results of study put forward that the intellectual capital structure of health establishment is effective on health employees to get job satisfaction and to find their establishment as attractive.
Gromulska, Lucyna; Supranowicz, Piotr; Wysocki, Mirosław Jan
The health system responsiveness, defined as non-medical aspect of treatment relating to the protection of the patients' legitimate rights, is the intrinsic goal of the WHO strategy for 21st century. To describe the patients' opinions on treatment they received in hospital, namely: admission to hospital, the role of patient in hospital treatment, course of treatment, medical workforce attitude, hospital environment, contact with family and friends, and the efficacy of hospital treatment in respect to responsiveness to patient's needs and expectations (dignity, autonomy, confidentiality, communication, prompt attention, social support, basic amenities and choice of provider). The data were collected in 2012 from 998 former patients of the randomly selected 73 hospital in Poland. Dignity: Over 80% of patients experienced kindness, empathy, care and gentleness, and over 90% of them had the sense of security in hospital, met with friendliness during the admission to hospital and never encountered inappropriate comments from medical staff. Autonomy: About 80% of patients accepted the active role of patients in hospital, they perceived they had influence on procedures related to hospitalization and course of treatment, and they felt medical staff responded to their requests and concerns. Over 90% of them had opportunity to communicate their concerns to medical staff and to discuss the course of treatment. On the other hand, the explanation of the reason for the refusal to meet their requests was given to only 23% of the patients interested. Confidentiality: 70-80% of patients declared the respect for privacy and confidentiality during collecting the health information and during medical examinations, and were not examined in presence of other people. Nevertheless, only 23% of patients examined so were asked of their consent. Communication: About 90% of patients declared they trusted their physician, received from him explanation regarding the course of treatment and
Dorel Mihai Paraschiv; Estera Laura Nemoianu; Claudia Adriana Langa; Tünde Szabó
.... Sustainability requires the full integration of social and environmental aspects into the vision, culture and operations of an organization, a profound process of organizational change being essential...
Full Text Available Nowadays, due to globalization and intensified market competition, management attention has to be focussed on efforts where they will do the most good. In order to survive, especially in the service industry, Managers in the new business environment need more relevant cost and performance information on the organization’s activities, processes, products/services and customers. The task of management accounting is to prepare this accounting information, which has the possibility to indicate what costs, revenues and results should be. Responsible accounting is an underlying concept of accounting performance measurement systems. The basic idea is that large diversified organizations are difficult, if not impossible to manage as a single segment, thus they must be decentralized or separated into manageable parts. These parts or segments are referred to as responsibility centers that include: revenue centers, cost centers, profit centers and investment centers. This approach allows responsibility to be assigned to the segment managers that have the greatest amount of influence over the key elements to be managed. These elements include revenue for a revenue center, costs for a cost center, a measure of profitability for a profit center and return on investment for an investment center.
Shigeru Ricardo Sekyia
Full Text Available Evidências empíricas apontam o relevante papel do aleitamento materno para a redução da mortalidade infantil. A Iniciativa Hospital Amigo da Criança (IHAC é uma ação mundial, idealizada pelo Fundo das Nações Unidas para a Infância (UNICEF e pela Organização Mundial da Saúde (OMS, que visa promover, proteger e apoiar a prática do aleitamento materno e a prevenção do desmame precoce. O objetivo deste artigo é identificar as principais mudanças organizacionais ocorridas em duas instituições hospitalares, localizadas em Minas Gerais, que implementaram a IHAC. A análise realizada baseou-se em seis perspectivas, tomando como base o quadro analítico de Motta: estratégica, estrutural, cultural, humana, tecnológica e política. Realizou-se uma pesquisa qualitativa, utilizando-se como método de coleta de dados a entrevista semiestruturada, aplicada em todos os níveis hierárquicos. Para a interpretação dos dados, adotou-se a análise de conteúdo. Nos casos estudados, concluiu-se que a implantação da IHAC implicou mudanças e melhorias na gestão, principalmente pelo estabelecimento de padronização de procedimentos e de treinamento de pessoal. Verificou-se que as mudanças culturais e tecnológicas ocorreram de forma mais intensa e que as menos percebidas foram as mudanças políticas e as estratégicas.Empirical evidences have pointed out the relevant role of breastfeeding to diminish infantile mortality. Children-friendly Hospitals (IHAC is a worldwide action developed by the United Nations Children's Fund - UNICEF and by the World Health Organization, aiming to promote, protect and support breastfeeding and also prevent precocious weaning. The aim of the present study is to identify the main organizational changes which occurred in two hospitals, located in the State of Minas Gerais, Brazil that implemented IHAC. The organizational analysis carried out was based upon six perspectives, according to Motta's analytical
Diana Andreia HRİSTACHE
Full Text Available Today, building up organizational identity in post-crisis economy becomes a bet, as we are looking for new interpretative coordinates.First of all, we have to take into account the ability to communicate. Second in line, as an extension of the above mentioned ability, we have to highlight the corporate social responsibility (CSR.Nowadays, the road map of modern business environment can be identified only by a new philosophy of business administration. This is the result of try and error and/or success of companies, greater or smaller companies, about their ability to develop a dialogue with their own audience and corporate communities.This dialogue involves approaching the role of the social corporate responsibility (CSR, to create the fundamentals of public policies of modern organizations.Therefore, the new corporate identity, which is the object of our study, we believe it to be the result of the intensive development of corporate communication and the responsible approach of companies to the global issues of the world.
Silva, Natasha Dejigov Monteiro da; Barbosa, Antonio Pires; Padilha, Kátia Grillo; Malik, Ana Maria
To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety. Identificar percepções das lideranças sobre as dimensões da cultura de segurança do paciente no cotidiano de hospitais de diferentes perfis administrativos: públicos, organizações sociais e privados, e realizar correlação entre as instituições participantes, de acordo com as dimensões da cultura de segurança do paciente utilizadas. Estudo transversal de aspecto quantitativo obtido por meio da aplicação do instrumento Self Assessment Questionnaire 30, traduzido para a língua portuguesa. Os dados foram tratados com análise de variância (ANOVA), além das estatísticas descritivas, considerando como de significância estatística valores de p-valor ≤ 0,05. Segundo a percepção dos participantes do estudo, as dimensões significativas para a cultura de segurança do paciente foram Ambiente de
Justenlund, Anders; Rebelo, Sofia
The intention of this work in progress paper is to provide an understanding of corporate social responsibility with a particular focus on social issues in relation to human resource management. The understanding of CSR shall be used to create a theoretical analytical framework that will provide...... how CSR is practiced by corporations, in order to provide a deeper understanding of the human interaction that affect how the individual person perceive CSR. The CSR discussion is followed by methodological reflections on how interpretation of future empirical data should be conducted. A hermenutical...
Myeongju Lee; Hyunok Kim
The purpose of this study was to examine the role of organizational culture in helping to translate corporate social responsibility (CSR) into firm performance. We employed arguments from the CSR strategy view to highlight the effectiveness of CSR and the contingency approach to explain the vertical fit between CSR and the organizational culture in a firm. Furthermore, we examined the moderating influence of organizational culture on the CSR–firm performance linkage. The results suggest that ...
E.J. Waard (Erik)
textabstractIn the academic debate on dealing with environmental turbulence survival or organizational success is being presented as a result of activating dynamic capabilities to repetitively create temporary advantages. A practical question left open in this debate is which organizational
Jafree, Sara Rizvi; Zakar, Rubeena; Zakar, Muhammad Zakria; Fischer, Florian
There is an absence of formal error tracking systems in public sector hospitals of Pakistan and also a lack of literature concerning error reporting culture in the health care sector. Nurse practitioners have front-line knowledge and rich exposure about both the organizational culture and error sharing in hospital settings. The aim of this paper was to investigate the association between organizational culture and the culture of error reporting, as perceived by nurses. The authors used the "Practice Environment Scale-Nurse Work Index Revised" to measure the six dimensions of organizational culture. Seven questions were used from the "Survey to Solicit Information about the Culture of Reporting" to measure error reporting culture in the region. Overall, 309 nurses participated in the survey, including female nurses from all designations such as supervisors, instructors, ward-heads, staff nurses and student nurses. We used SPSS 17.0 to perform a factor analysis. Furthermore, descriptive statistics, mean scores and multivariable logistic regression were used for the analysis. Three areas were ranked unfavorably by nurse respondents, including: (i) the error reporting culture, (ii) staffing and resource adequacy, and (iii) nurse foundations for quality of care. Multivariable regression results revealed that all six categories of organizational culture, including: (1) nurse manager ability, leadership and support, (2) nurse participation in hospital affairs, (3) nurse participation in governance, (4) nurse foundations of quality care, (5) nurse-coworkers relations, and (6) nurse staffing and resource adequacy, were positively associated with higher odds of error reporting culture. In addition, it was found that married nurses and nurses on permanent contract were more likely to report errors at the workplace. Public healthcare services of Pakistan can be improved through the promotion of an error reporting culture, reducing staffing and resource shortages and the
Carbapenem-resistant Enterobacteriaceae carriers in acute care hospitals and postacute-care facilities: The effect of organizational culture on staff attitudes, knowledge, practices, and infection acquisition rates.
Fedorowsky, Rina; Peles-Bortz, Anat; Masarwa, Samira; Liberman, Dvora; Rubinovitch, Bina; Lipkin, Valentina
Carbapenem-resistant Enterobacteriaceae (CRE) carriers are frequently transferred between acute care hospitals (ACHs) and postacute-care facilities (PACFs). Compliance of health care workers with infection prevention guidelines in both care settings may be influenced by the institution's organizational culture. To assess the association between organizational culture and health care workers' attitudes, knowledge, practices, and CRE acquisition rate and to identify differences between different care settings and health care workers' sectors. Cross-sectional descriptive design. Self-administered questionnaires were distributed to a sample of 420 health care workers from 1 ACH and 1 PACF belonging to the same health maintenance organization located in central Israel. The organizational culture factor known as staff engagement was positively correlated with infection prevention attitudes and compliance with contact precaution protocols and negatively correlated with CRE acquisition rate. In the 2 care settings, health care workers' attitudes, knowledge, and practices were found to be similar, but CRE acquisition rate was lower in PACFs. Compliance with contact precaution protocols by physicians was lower than compliance reported by other health care workers. Auxiliary staff reported lower knowledge. In a setting of endemic CRE where a multifaceted intervention is already being implemented, organizational culture variables can predict health care workers' attitudes, knowledge, and practices and in turn can affect CRE acquisition rates. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Patterson, Mark E; Pace, Heather A
Underreporting near-miss errors undermines hospitals' ability to improve patient safety. The objective of this analysis was to determine the extent to which punitive work climate, inadequate error feedback to staff, or insufficient preventative procedures are associated with decreased frequency of near-miss error reporting among hospital pharmacists. Survey data were obtained from the Agency of Healthcare Research and Quality 2010 Hospital Survey on Patient Safety Culture. Near-miss error reporting was defined using a Likert scale response to the question, "When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?" Work climate, error feedback to staff, and preventative procedures were defined similarly using responses to survey questions. Multivariate ordinal regressions estimated the likelihood of agreeing that near-miss errors were rarely reported, conditional upon perceived levels of punitive work climate, error feedback, or preventative procedures. Pharmacists disagreeing that procedures were sufficient and that feedback on errors was adequate were more likely to report that near-miss errors were rarely reported (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.7-3.8; OR, 3.5; 95% CI, 2.5-5.1). Those agreeing that mistakes were held against them were equally likely as those disagreeing to report that errors were rarely reported (OR, 0.84; 95% CI, 0.61-1.1). Inadequate error feedback to staff and insufficient preventative procedures increase the likelihood that near-miss errors will be underreported. Hospitals seeking to improve near-miss error reporting should improve error-reporting infrastructures to enable feedback, which, in turn, would create a more preventative system that improves patient safety.
Chervenak, Frank A; McCullough, Laurence B
The relationship between medical schools and their teaching hospitals involves a complex and variable mixture of monopoly and monopsony power, which has not been previously been ethically analyzed. As a consequence, there is currently no ethical framework to guide leaders of both institutions in the responsible management of this complex power relationship. The authors define these two forms of power and, using economic concepts, analyze the nature of such power in the medical school-teaching hospital relationship, emphasizing the potential for exploitation. Using concepts from both business ethics and medical ethics, the authors analyze the nature of transparency and co-fiduciary responsibility in this relationship. On the basis of both rational self-interest, drawn from business ethics, and co-fiduciary responsibility, drawn from medical ethics, they argue for the centrality of transparency in the medical school-teaching hospital relationship. Understanding the ethics of monopoly and monopsony power is essential for the responsible management of the complex relationship between medical schools and their teaching hospitals and can assist the leadership of academic health centers in carrying out one of their major responsibilities: to prevent the exploitation of monopoly power and monopsony power in this relationship.
Yaghoubi, Maryam; Asgari, Hamed; Javadi, Marzieh
One of the challenges in the fiercely competitive space of health organizations is responding to customers and building trust and satisfaction in them in the shortest time, with best quality and highest productivity. Hence the aim of this study is to survey the impact of customer relationship management (CRM) on organizational productivity, customer loyalty, satisfaction and trust in selected hospitals of Isfahan (in Iran). This study is a correlation descriptive research. Study population was the nurses in selected hospitals of Isfahan and the sampling has been conducted using stratified random method. Data collection tool is a researcher-made questionnaire of CRM and its effects (organizational productivity, customer loyalty, satisfaction and trust) which its validity and reliability has been confirmed by researchers. Structural equation method was used to determine the impact of variables. Data analysis method was structural equation modeling and the software used was SPSS version 16 (IBM, SPSS, 2007 Microsoft Corp., Bristol, UK) and AMOS version 18 (IBM, SPSS, 2010 Microsoft Corp, Bristol, UK). Among the dimensions of CRM, diversification had the highest impact (0.83) and customer acquisition had the lowest (0.57) CRM, had the lowest impact on productivity (0.59) and the highest effect on customer satisfaction (0.83). For the implementation of CRM, it is necessary that the studied hospitals improve strategies of acquiring information about new customers, attracting new customers and keeping them and communication with patients outside the hospital and improve the system of measuring patient satisfaction and loyalty.
Glisson, Charles; Hemmelgarn, Anthony; Green, Philip; Dukes, Denzel; Atkinson, Shannon; Williams, Nathaniel J.
Objective: Evidence-based Practice (EBP) implementation is likely to be most efficient and effective in organizations with positive social contexts (i.e., organizational culture, climate, and work attitudes of clinicians). The study objective was to test whether an organizational intervention labeled Availability, Responsiveness and Continuity…
Nora Liliana Gorrochategui
Full Text Available The aim of this work is to conceptually define the dimensions of organizational climate within the framework of the RSP and move forward in the identification of the variables that can be a reference in the designing of a tool that is directed exclusively to the highest authorities of the apex of public organizations.Thus, the integration of transdisciplinary conceptual frameworks is used to create reflections that support the selection of dimensions. It is assumed that the sustainable development agenda imposes a new form of reflective and accountable governance. It is claimed that the public bureaucratic model is depleted; proposing as an alternative the public organization metaphor as a "structurally determined and autopoeitic system". In such a way, people become the center of the transformations required by the RSP for the realization of a sustainable society; hence the importance of studying climate like that proposed arises.Additionally, dimensions corresponding to the principles of the RS such as: Ethical behavior, Respect for stakeholder, Accountability and Transparency, are identified. Each of them offers a conceptual development that identifies variables based on offering conceptual definitions that serves for the development of a methodology to implement the study on public organizations.Key words: Public Policy, Social Responsibility, personnel management.
Bonifacius Riwi Wijayanto
Nurses (N = 170 and their immediate supervisors ( N = 41 from five privately owned hospital in Jogjakarta participated in this study. Of 340 questionnaires distributed to the respondents, 339 were returned yielding a response rate of 99 percent. Of those returned, 300 questionnaires were available for further analyses. Nurses were asked to respond to a questionnaire of 40 items concerning perception of embeddedness and 4 item concerning sense of responsibility to their employing organization. Nurses’ citizenship behavior were measured using 12 items as rated by their immediate supervisors. The results support the hypothesis that job embeddedness correlates positively with OCB. However, our result failed to support the prediction of the mediating effect of employees’ sense of responsibility in causal relationship between job embeddedness and OCB. The implications of the findings for further research on relationship between job embeddedness and OCB research are discussed.
Tsai, Yafang; Wu, Shih-Wang
The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82.3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with SPSS 12.0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
Jolita Vveinhardt; Regina Andriukaitiene
.... The article presents passages of an interview with the top managers of the six companies, revealing management culture as part of the formal organizational culture expression aiming to implement...
Ravangard, Ramin; Sajjadnia, Zahra; Jafari, Abdosaleh; Shahsavan, Najme; Bahmaie, Jamshid; Bahadori, Mohammadkarim
In order to achieve success in today's competitive world, organizations should adapt to environmental changes. On the other hand, managers should have a set of values and ethical guidelines for their administrative and organizational functions. This study aimed to investigate the association between work ethics and attitudes towards organizational changes among the administrative, financial and support employees of general teaching hospitals affiliated to Shiraz University of Medical Sciences. This was an applied, cross-sectional and descriptive-analytic study conducted in 2013. A sample of 124 employees was selected using stratified sampling proportional to size and simple random sampling methods. Data were collected using 2 questionnaires measuring the dimensions of employees' work ethics (four dimensions) and attitudes towards organizational changes (three dimensions). The collected data were analyzed using SPSS 18.0 and statistical tests, including ANOVA, independent samples t-test, and Pearson's correlation coefficient. A P work ethic dimensions were related to being cooperative (4.60 ± 0.38) and dependable (4.29 ± 0.39) respectively. On the other hand, the maximum and minimum score of attitudes towards the various dimensions of organizational changes were related to the behavioral (3.83 ± 0.70) and the affective (3.55 ± 0.88) dimensions respectively. Furthermore, there was a significant relationship between the work ethics and education levels of the employees in this study (P = 0.003). Also, among work s dimensions, only being considerate had a significant association with attitudes towards organizational changes (P = 0.014) and their cognitive dimension (P = 0.005). To improve employees' work ethics and attitudes towards organizational changes, the following suggestions can be offered: training hospitals managers in participative management style and its application, as well as the importance of meeting the employees' needs and expectations based on
Hunt, E; Jones, N; Hastings, V; Greenberg, N
A major incident involving multiple fatalities occurred in Cumbria, England on 2 June 2010. The Cumbrian Constabulary deployed an organizational peer support response for personnel involved known as trauma risk management (TRiM). To examine data routinely gathered during the TRiM process to evaluate the relationship of the intervention to sickness absence. Using incident databases, details were gathered regarding exposure to the murders and type of TRiM intervention, including an assessment of the psychological risk to the individual of developing a trauma-related mental health problem. Sociodemographic information was collated by the occupational health department. Cumulative sickness absence data in the 2 months following the murders were used as a proxy for mental health status. A total of 717 police officers and civilian support staff were identified. High levels of traumatic exposure were associated with subsequent receipt of a TRiM intervention. The majority of psychological risk indices reduced between the initial and subsequent evaluation. Greater traumatic exposure was associated with longer sickness absence lengths. Engagement in the TRiM process was associated with a reduction in sickness absence especially in more junior ranks. In this study, we found that TRiM deployed within a police force responding to a major event offered a way of structuring a response for those involved. Our data suggest that TRiM may offer a way of assessing psychological risk so that officers can be offered early supportive interventions. Our data suggest that TRiM may help to ameliorate some of the negative effects of high trauma exposure.
Sexual Assault Response Teams (SARTs) are multidisciplinary teams that coordinate multiple systems (e.g., medical, law enforcement, prosecutors, and rape crisis center advocates) to provide comprehensive care to victims and to collect high-quality forensic evidence to facilitate investigation and prosecution. Relatively little guidance is provided about effective teamwork strategies in resources on forming SARTs. Using in-depth surveys with the SART coordinators and telephone surveys (including close-ended and open-ended questions) with 79 professionals involved in three active, formal SARTs in one state, this study examined structural, organizational, and interpersonal factors that influence interprofessional collaboration on SART. Study findings indicate that perceived structural factors and interpersonal factors were significantly associated with SART members'/responders' perceptions of the quality of interprofessional collaboration on their SART. Findings suggest that individuals' perceptions of professionalization and power disparities between professions pose challenges to perceived interprofessional collaboration on SART. Compared with criminal justice and medical professionals, victim advocacy rated the level of collaboration on their SART significantly lower. The overall picture from the data was that SART professionals perceived mutual respect, trust, and commitment to collaboration to be pervasive on their SARTs, even though recognition of professional conflicts was also prevalent, suggesting that professionals understood that interpersonal conflict was distinct from professional conflict. Initial SART trainings should address the benefits of the team response, professional roles, and communication and conflict resolution skills, and ongoing training should provide professionals the opportunity to raise positive and negative examples of their collaborative efforts to explore existing tensions and constraints on the team for conflict resolution. © The
Triolo, P K; Allgeier, P A; Schwartz, C E
In 1991, our University Hospital initiated a series of strategic changes designed to increase organizational effectiveness and efficiency, foster a culture of commitment to customer-driven service, and flatten the organizational structure, pushing decision making closer to the point of service. These events, although proactive and positive in their intent, triggered a significant, debilitating response among many members of the nursing staff. The authors discuss the experience of this organization, examines the process of transition and the responses of staff members to change, and provides recommendations for minimizing the sequelae of organizational transformation.
Waage, S; Poole, J C; Thorgersen, E B
Civilian mass casualty incidents may occur infrequently and suddenly, and are caused by accidents, natural disasters or human terrorist incidents. Most reports deal with trauma centre management in large cities, and data from small local hospitals are scarce. A rural hospital response to a mass casualty incident caused by a terrorist shooting spree was evaluated. An observational study was undertaken to evaluate the triage, diagnosis and management of all casualties received from the Utøya youth camp in Norway on 22 July 2011 by a local hospital, using data from the hospital's electronic records. Descriptive data are presented for patient demographics, injuries and patient flow. The shooting on Utøya youth camp left 69 people dead and 60 wounded. A rural hospital (Ringerike Hospital) triaged 35 patients, of whom 18 were admitted. During the main surge, the hospital triaged and treated 22 patients within 1 h, of whom 13 fulfilled the criteria for activating the hospital trauma team, including five with critical injuries (defined as an Injury Severity Score above 15). Ten computed tomography scans, two focused assessment with sonography for trauma (FAST) scans and 25 conventional X-rays were performed. During the first 24 h, ten surgical procedures were performed and four chest drains inserted. No patient died. Critical deviation from the major incident plan was needed, and future need for revision is deemed necessary based on the experience. Communication systems and the organization of radiological services proved to be most vulnerable. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Mackrill, J B; Jennings, P A; Cain, R
Work on the perception of urban soundscapes has generated a number of perceptual models which are proposed as tools to test and evaluate soundscape interventions. However, despite the excessive sound levels and noise within hospital environments, perceptual models have not been developed for these spaces. To address this, a two-stage approach was developed by the authors to create such a model. First, semantics were obtained from listening evaluations which captured the feelings of individuals from hearing hospital sounds. Then, 30 participants rated a range of sound clips representative of a ward soundscape based on these semantics. Principal component analysis extracted a two-dimensional space representing an emotional-cognitive response. The framework enables soundscape interventions to be tested which may improve the perception of these hospital environments.
Yaghoubi, Maryam; Raeisi, Ahmad Reza; Afshar, Mina; Yarmohammadian, Mohammad Hossein; Hasanzadeh, Akbar; Javadi, Marzi; Ansary, Maryam
Old methods of administrating can't cover the rapid changes of today. These changes redounded new organizations like learning organizations to be formed. The purpose of this research was to study the relationship between learning organization and organizational commitment among nursing managers. This was a descriptive analytic survey. The population of study included 90 nursing managers of 9 educational hospitals. Data gathering was done via learning organizational (LO) and organizational commitment (OC) questionnaires. Data analysis was done using SPSS software. The mean score of LO was 56.9 ± 18.1 among nursing mangers, and the mean score of OC was 62.3 ± 10.1. In general, there was a significant relationship between LO and OC and there was a significant relationship between LO and job experience based on ANOVA test. In today's changing environment of very rapid changes which have been seen in different areas of science and technology and the increasing complexity and dynamics of environmental factors, only organizations with active adaptation (dynamic equilibrium) can survive and remain capable of growth. This aim can be fulfilled just in learning organizations.
Demir, Cesim; Sahin, Bayram; Teke, Kadir; Ucar, Muharrem; Kursun, Olcay
An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report, cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics.
Bahrami, Mohammad Amin; Kiani, Mohammad Mehdi; Montazeralfaraj, Raziye; Zadeh, Hossein Fallah; Zadeh, Morteza Mohammad
Objectives Organizational learning is defined as creating, absorbing, retaining, transferring, and application of knowledge within an organization. This article aims to examine the mediating role of organizational learning in the relationship of organizational intelligence and organizational agility. Methods This analytical and cross-sectional study was conducted in 2015 at four teaching hospitals of Yazd city, Iran. A total of 370 administrative and medical staff contributed to the study. We...
J. del Llano
executive officers (CEOs and physicians in public hospitals concerning new managerial trends. Methods: We performed a qualitative study designed to determine the opinion of CEOs and physicians on the organizational innovations that affect more than one level of health management intervention. In-depth semi-structured interviews were conducted to identify behavior, experiences, opinions, knowledge and other personal and institutional aspects related to the study's aim. Focus groups (two study groups and one control group were also used. Interaction between groups was used to obtain different types of information on the development of ideas, operational capacity, and the degree of consensus and disagreement on the subjects discussed Results: Comparison between the control and the study groups revealed that the new management trends added value in the following areas: economy of contracts, delegation, administrative decentralization, incentives, risk avoidance, process re-engineering, heath care continuity, competitiveness, leadership, information systems and client centeredness. Conclusions: Physicians are showing increased interest in organizational innovations while CEOs are ambivalent about their changing role and respective responsibilities. There is evidence of resistance to change. There is no single institutional model; institutional design depends on internal factors (cohesion and leadership and external factors (environment, size and technology. The incipient development of innovations reveals the need for changes in the style and characteristics of management structure (composition, functions, responsibilities.
Foss, Nicolai Juul; Klein, Peter G.
This chapter reviews and discusses rational-choice approaches to organizational governance. These approaches are found primarily in organizational economics (virtually no rational-choice organizational sociology exists), particularly in transaction cost economics, principal-agent theory, and the ......This chapter reviews and discusses rational-choice approaches to organizational governance. These approaches are found primarily in organizational economics (virtually no rational-choice organizational sociology exists), particularly in transaction cost economics, principal-agent theory...
Hildebrandt, Thomas; Mukkamala, Raghava Rao; Slaats, Tijs
technique in praxis on a timed extension of a cross-organizational case management process arising from a previous case study. The example shows how a timed DCR Graph can be used to describe the global contract for a timed workflow process involving several organizations, which can then be distributed...
Prenkert, F; Ehnfors, M
This paper presents an empirical study of the influences of transactional (TA) and transformational (TF) leadership on organizational effectiveness (OE), measured as the degree of goal attainment and the quality of nursing care (NQ). The study subjects were all head-nurses and assistant head-nurses at a medium-sized hospital in Sweden (n = 23). The methods used were questionnaires and interviews. The multi-leadership questionnaire earlier developed by Bass was modified and named the Leadership Nursing-Effectiveness Questionnaire (LNEQ), comprising 84 items using Likert-type scales. The study showed low mean scores on OE (2.19) and TA (1.05) but high mean scores on NQ (3.17) and TF (3.84). The results suggest that the degree of TA and TF leadership had a low and insignificant connection with OE in this hospital organization. The study did not support the statement that organizational units exposed to a higher degree of TA and TF leadership at the same time show a high degree of OE, as has been shown in studies in other cultural contexts and organizations.
Yaghoubi, Maryam; Asgari, Hamed; Javadi, Marzieh
Context: One of the challenges in the fiercely competitive space of health organizations is responding to customers and building trust and satisfaction in them in the shortest time, with best quality and highest productivity. Hence the aim of this study is to survey the impact of customer relationship management (CRM) on organizational productivity, customer loyalty, satisfaction and trust in selected hospitals of Isfahan (in Iran). Materials and Methods: This study is a correlation descriptive research. Study population was the nurses in selected hospitals of Isfahan and the sampling has been conducted using stratified random method. Data collection tool is a researcher-made questionnaire of CRM and its effects (organizational productivity, customer loyalty, satisfaction and trust) which its validity and reliability has been confirmed by researchers. Structural equation method was used to determine the impact of variables. Data analysis method was structural equation modeling and the software used was SPSS version 16 (IBM, SPSS, 2007 Microsoft Corp., Bristol, UK) and AMOS version 18 (IBM, SPSS, 2010 Microsoft Corp, Bristol, UK). Results: Among the dimensions of CRM, diversification had the highest impact (0.83) and customer acquisition had the lowest (0.57) CRM, had the lowest impact on productivity (0.59) and the highest effect on customer satisfaction (0.83). Conclusions: For the implementation of CRM, it is necessary that the studied hospitals improve strategies of acquiring information about new customers, attracting new customers and keeping them and communication with patients outside the hospital and improve the system of measuring patient satisfaction and loyalty. PMID:28546971
Fisher, D W
Organizational development (OD) stresses the involvement of staff members in improving organizational effectiveness. It is a management strategy well-suited to the people-intentive hospital organization. This review of OD, its principles and objectives, the assumptions underlying its use, and the conditions necessary for success provides a picture of its application in the hospital.
Takahashi, Toshiro; Ellen, Moriah; Brown, Adalsteinn
This paper examines the role that corporate social responsibility can play in advancing hospital management. Corporate social responsibility is the integration of social and environmental concerns within business operations. The authors discuss how corporate social responsibility can help hospitals and provide suggestions to hospitals in deciding which corporate social responsibility initiatives to pursue.
A. G. Cherniy
Full Text Available The objective - to study the psychological characteristics of response to the stress associated with hospitalization in patients with injuries admitted to the emergency or the purpose of perform routine reconstructive plastic surgery for the consequences of injuries. Material and methods. The assessment of emotional response to the hospitalization stress was performed in 60 patients with injuries and its consequences. The study was carried out using Spielberger - Hanin scale, Luscher eight-color test, the scales of Covey and Tsung. The levels of personal and reactive anxiety, and the presence of somatoform disorders were determined. Results. When emergency and planned hospital admissions for injuries and its consequences the level of personality anxiety was corresponded to parameters of the «moderate anxiety», but the definition of the level of reactive anxiety showed a statistically significant increase in the index in the study group - 44,4 ± 6,5 in comparison with 39,9 ± 4,0 (p = 0.034. There was a significant number of patients in the main group with somatic diseases (headaches, dizziness, tachycardia, extremity tremor, etc.. Conclusions. It is advisable to take into account the significant influence of psychogenic factors and psychosomatic disorders on treatment outcomes and to consider the psycho-emotional profile of patients with trauma and orthopedic diseases. If necessary, the methods of psychological correction should be applied.
Gorrochategui, Nora Liliana
The aim of this work is to conceptually define the dimensions of organizational climate within the framework of the RSP and move forward in the identification of the variables that can be a reference in the designing of a tool that is directed exclusively to the highest authorities of the apex of public organizations.Thus, the integration of transdisciplinary conceptual frameworks is used to create reflections that support the selection of dimensions. It is assumed that the sustainable develo...
Arnetz, Bengt B; Lucas, Todd; Arnetz, Judith E
To determine whether the relationship between organizational climate and employee mental health is consistent (ie, invariant) or differs across four large hospitals, and whether organizational efficiency mediates this relationship. Participants (total N = 5316) completed validated measures of organizational climate variables (social climate, participatory management, goal clarity, and performance feedback), organizational efficiency, occupational stress, and mental health. Path analysis best supported a model in which organizational efficiency partially mediated relationships between organizational climate, occupational stress, and mental health. Focusing on improving both the psychosocial work environment and organizational efficiency might contribute to decreased employee stress, improved mental well-being, and organizational performance.
Grande, Bård; Sørensen, Ole Henning
The paper focuses on the concept of organizational networks. Four different uses of the concept of organizational network are identified and critically discussed. Special focus is placed on how information and communication technologies as communication mediators and cognitive pictures influence...
Simons, T.; Vermeulen, P.A.M.; Knoben, J.
This study highlights the importance of communities for explaining organizational resistance to institutional pressures. Examining the active resistance of small bars to smoking regulations in 427 Dutch municipalities (communities), we argue that the likelihood of organizational resistance to
Simons, T.; Vermeulen, P.A.M.; Knoben, J.
This study highlights the importance of communities in explaining organizational resistance to institutional pressures. Examining the active resistance of small bars to smoking regulations in 427 Dutch municipalities (communities), we argue that the likelihood of organizational resistance to
Chang, Ching Sheng; Chen, Su-Yueh; Lan, Yi Ting
Because nurses deliver care to patients on behalf of hospitals, hospitals have to enhance first-line nurses' patient-oriented perception and spontaneous organizational citizenship behaviors for the sake of higher patient satisfaction and better patient care. The purpose of this study was to investigate how patient-oriented perception among nurses could affect their organizational citizenship behaviors and job satisfaction. SPSS 12.0 and Amos 7.0 (structural equation modeling) statistical software packages were used for data analysis and processing. Of the 500 questionnaires distributed, 232 valid ones were collected, with a valid response rate of 46.4%. Nurses' patient-oriented perception has a positive influence on organizational citizenship behaviors (γ11 = .795, p organizational citizenship behaviors (β21 = .681, p behavior but the least positive influence on organizational public welfare behavior.
accommodate the increasing emphasis on outpatient activity, the measure is still somewhat limited ( Serway , Strum & Haug, 1987). The raw number of FTEs...Services •llm•J~i•,32, 403.415. Serway , G. D., Strum, D. W. & Haug, W. F. (1987). Alternative indicators for measuring hospital productivity. Hosi"l
Literature review Approach This paper explores a new idea presenting the possible relationship between organizational learning and organizational design. The establishment of this relation is based upon extensive literature review. Findings Organizational learning theory has been used to understand several organizational phenomena, like resources and competencies, tacit knowledge or the role of memory in the organization; however, it is difficult to identify fits and consequent misf...
Doris Verónica Ortega-Altamirano
Full Text Available OBJETIVO: Identificar los modelos de cultura organizacional, dominante y preferido, en enfermería en el segundo nivel de atención a la salud. MATERIAL Y MÉTODOS: Entre abril y junio de 2008 se hizo un estudio transversal con personal de enfermería de los Servicios de Salud del Estado de Morelos. Se obtuvo información sobre los datos sociodemográficos y la cultura organizacional. Se hicieron pruebas de ji² y de correlación Kappa, y se usó Stata v.10. RESULTADOS: Se entrevistó a 30 enfermeras seleccionadas aleatoriamente de un total de 397, con al menos un año de antigüedad laboral. Se identificó que la cultura organizacional dominante es la del poder y la preferida es la del desempeño. El coeficiente Kappa positivo de 0.17 (p= 0.047 entre lo que domina y el modelo del desempeño que se prefiere. CONCLUSIONES: Identificar estos modelos de la cultura organizacional permite entender los diferenciales de desempeño en la gestión del cuidado enfermero a los usuarios hospitalarios y plantearse aspiraciones de mejoras en el propio servicio.OBJECTIVE: To identify dominant and preferred organizational culture models at second level nursing services in Morelos. MATERIAL AND METHODS: A cross-sectional study was conducted between April and June, 2008. Nursing caregivers from Public Health Services of Morelos State participated. We gathered and analyzed data about socioeconomic characteristics and organizational culture, and we applied the Xi² and Kappa coefficient statistical tests using Stata version 10 software. RESULTS: We interviewed 30 nurses, randomly selected from a total of 397, with at least one year of seniority. It was identified that the dominant organizational culture is one of power and the preferred culture is one of performance. A Kappa positive coefficient of 0.17 (p = 0.047 was found between the dominant model and the preferred performance model. CONCLUSIONS: Identifying said organizational culture models helps to understand
Van Trijp, J. M P; Ulieru, Mihaela; Van Gelder, Pieter H A J M
Resilience of an Emergency Response Organization is an important concept to determine how well a Dutch Emergency Response Safety Region behaves under stress. The main objective of this study is to determine the intrinsic value "Resilience" in case of a Dutch Emergency Response Safety Region. In this
Font, Sarah A; Gershoff, Elizabeth T; Taylor, Catherine A; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa; Foster, Rebecca H; Budzak Garza, Ann; Olson-Dorff, Denyse
Physical punishment of children is a prevalent practice that is condemned by most medical professionals given its link with increased risk of child physical abuse and other adverse child outcomes. This study examined the prevalence of parent-to-child hitting in medical settings and the intervention behaviors of staff who witness it. Staff at a children's medical center and a general medical center completed a voluntary, anonymous survey. We used descriptive statistics to examine differences in the experiences of physicians, nurses, and other medical staff. We used logistic regression to predict intervention behaviors among staff who witnessed parent-to-child hitting. Of the hospital staff who completed the survey (N = 2863), we found that 50% of physicians, 24% of nurses, 27% of other direct care staff, and 17% of nondirect care staff witnessed parent-to-child hitting at their medical center in the past year. A majority of physicians, nurses, and other direct care staff reported intervening sometimes or always. Nondirect care staff rarely intervened. Believing staff have the responsibility to intervene, and having comfortable strategies with which to intervene were strongly predictive of intervention behavior. Staff who did not intervene commonly reported that they did not know how to respond. Many medical center staff witness parent-to-child hitting. Although some of the staff reported that they intervened when they witnessed this behavior, the findings indicate that staff may need training to identify when and how they should respond.
Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B
During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.
Wakeam, Elliot; Asafu-Adjei, Denise; Ashley, Stanley W; Cooper, Zara; Weissman, Joel S
Critical care is often an integral part of rescue for patients with surgical complications. We sought to understand critical care characteristics predictive of failure-to-rescue (FTR) performance at the hospital level. Using 2009 to 2011 FTR data from Hospital Compare, we identified 144 outlier hospitals with significantly better/worse performance than the national average. We surveyed intensive care unit (ICU) directors and nurse managers regarding physical structures, patient composition, staffing, care protocols, and rapid response teams (RRTs). Hospitals were compared using descriptive statistics and logistic regression. Of 67 hospitals completing the survey, 56.1% were low performing, and 43.9% were high performing. Responders were more likely to be teaching hospitals (40.9% vs 25.0%; P=.05) but were similar to nonresponders in terms of size, region, ownership, and FTR performance. Poor performers were more likely to serve higher proportions of Medicaid patients (68.4% vs 20.7%; PHospitals with high Medicaid burden fare poorly on the FTR metric. Copyright © 2014 Elsevier Inc. All rights reserved.
Koelewijn, Wout Theodoor; Ehrenhard, Michel Léon; Groen, Arend J.; van Harten, Willem H.
During the past decade, entrepreneurship in the healthcare sector has become increasingly important. The aging society, the continuous stream of innovative technologies and the growth of chronic illnesses are jeopardizing the sustainability of healthcare systems. In response, many European
Tata, Jasmine; Rhodes, Susan R.
Examines relationships among impression-management messages, evaluations of reward allocations (fairness and responsibility), and reaction to rewards (anger, approval of manager, and overall job satisfaction). Finds that impression-management messages directly influence fairness and responsibility, and indirectly influence anger and approval. (SR)
Clegg, Stewart; Mikkelsen, Elisabeth Naima; Sewell, Graham
This article examines four contemporary treatments of the problem of organizational conflict: social psychological, anthropological, neo-Darwinian, and neo-Machiavellian. Social psychological treatments of organizational conflict focus on the dyadic relationship between individual disputants....... In contrast, anthropological treatments take a more socially and historically embedded approach to organizational conflict, focusing on how organizational actors establish negotiated orders of understanding. In a break with the social psychological and anthropological approaches, neo-Darwinians explain...... the characteristics of organizational conflict by appealing to the concept of natural selection: all forms of organizational behavior, including conflictual relations, stem from the effects of heritable traits associated with a universal human nature. Finally, this article proposes a neo-Machiavellian view...
Ghoddoosi-Nejad, D; Baghban Baghestan, E; Janati, A; Imani, A; Mansoorizadeh, Z
The current research aimed to investigate the link between the quality of working life and the systematic commitment of nurses in the teaching hospitals in Tabriz. The methodology used was functional regarding the purpose and the proportional allocation as far as the stratified sampling method was concerned. The study population consisted of all the nurses in Tabriz. The instrument used in this study was a standard questionnaire, whose reliability was approved in national and international studies. Also data were collected and inserted into SPSS 20 software and a statistical analysis was performed. The results showed that the individuals’ quality of working life had a direct effect on their action in the organization. PMID:28316742
This paper examines the dynamic and multi-level relationship between organization and innovation from three different but interdependent perspectives: a) the relationship between organizational structural forms and innovativeness; b) innovation as a process of organizational learning and knowledge creation; and c) organizational capacity for change and adaptation. It provides a critical review of the literature, focusing especially on the question of whether organizations can change and adapt...
Organizational development is a widely used concept in industry and the NHS. It tends to be associated with the softer side of management, and this often masks the complex set of ideas it represents. Its currency in the NHS has risen, especially in the last decade, because its application in practice is closely linked to the process of managing change. This article reviews the definitions of organizational development and explains how the concept can be used to underpin organizational change.
Lancman, S; Barros, J O; Silva, M D; Pereira, A R; Jardim, T A
Introduction The process of returning to work, especially for individuals with labor restrictions, impacts work teams and interferes with the labor reinsertion process. In this study, we aimed to understand the impact of these situations on a nursing team from both organizational and relational perspectives. Methods We conducted a qualitative research study at a university hospital in the municipality of São Paulo using three strategies: documentary analysis; semi-structured interviews with pairs of workers returning to a labor situation; and a focus group with nursing managers. Results Medical leaves of absence overburden the employees who remain working. Regarding the return to work, the participants reported both positive and negative aspects. One positive aspect reported was that those who return to work contribute to the division of labor, generating solidarity and cooperation. The negative aspects reported were related to the return of workers with labor restrictions who do not fully resume their activities, consequently generating conflicts within the work teams that interfere with the reintegration processes. The supervisors reported difficulties reorganizing work on a broad scale and assessing the workers' diagnoses and symptoms and the workers themselves in terms of the necessity of their leaves and the validity of their labor restrictions. Conclusion The organization of labor and social relationships among peers and supervisors is a significant contributor to the success or failure of the work reintegration process and therefore should be considered. We aimed to address this issue by highlighting the complexity of the return-to-work process among health workers.
The purpose of this study was to determine the most appropriate organizational structure and alignment for a managed care office at Keller Army...and aligned as a separate entity under the Deputy Commander for Administration (DCA). This recommended organizational structure and alignment will...observations. I used the Structural Design Model designed by Jan Galbraith (1971) and Richard Daft (1989) to determine the most appropriate organizational
Arnulf, Jan Ketil; Larsen, Kai Rune; Martinsen, Øyvind Lund; Bong, Chih How
Some disciplines in the social sciences rely heavily on collecting survey responses to detect empirical relationships among variables. We explored whether these relationships were a priori predictable from the semantic properties of the survey items, using language processing algorithms which are now available as new research methods. Language processing algorithms were used to calculate the semantic similarity among all items in state-of-the-art surveys from Organisational Behaviour research. These surveys covered areas such as transformational leadership, work motivation and work outcomes. This information was used to explain and predict the response patterns from real subjects. Semantic algorithms explained 60–86% of the variance in the response patterns and allowed remarkably precise prediction of survey responses from humans, except in a personality test. Even the relationships between independent and their purported dependent variables were accurately predicted. This raises concern about the empirical nature of data collected through some surveys if results are already given a priori through the way subjects are being asked. Survey response patterns seem heavily determined by semantics. Language algorithms may suggest these prior to administering a survey. This study suggests that semantic algorithms are becoming new tools for the social sciences, opening perspectives on survey responses that prevalent psychometric theory cannot explain. PMID:25184672
Jan Ketil Arnulf
Full Text Available Some disciplines in the social sciences rely heavily on collecting survey responses to detect empirical relationships among variables. We explored whether these relationships were a priori predictable from the semantic properties of the survey items, using language processing algorithms which are now available as new research methods. Language processing algorithms were used to calculate the semantic similarity among all items in state-of-the-art surveys from Organisational Behaviour research. These surveys covered areas such as transformational leadership, work motivation and work outcomes. This information was used to explain and predict the response patterns from real subjects. Semantic algorithms explained 60-86% of the variance in the response patterns and allowed remarkably precise prediction of survey responses from humans, except in a personality test. Even the relationships between independent and their purported dependent variables were accurately predicted. This raises concern about the empirical nature of data collected through some surveys if results are already given a priori through the way subjects are being asked. Survey response patterns seem heavily determined by semantics. Language algorithms may suggest these prior to administering a survey. This study suggests that semantic algorithms are becoming new tools for the social sciences, opening perspectives on survey responses that prevalent psychometric theory cannot explain.
Arnulf, Jan Ketil; Larsen, Kai Rune; Martinsen, Øyvind Lund; Bong, Chih How
Some disciplines in the social sciences rely heavily on collecting survey responses to detect empirical relationships among variables. We explored whether these relationships were a priori predictable from the semantic properties of the survey items, using language processing algorithms which are now available as new research methods. Language processing algorithms were used to calculate the semantic similarity among all items in state-of-the-art surveys from Organisational Behaviour research. These surveys covered areas such as transformational leadership, work motivation and work outcomes. This information was used to explain and predict the response patterns from real subjects. Semantic algorithms explained 60-86% of the variance in the response patterns and allowed remarkably precise prediction of survey responses from humans, except in a personality test. Even the relationships between independent and their purported dependent variables were accurately predicted. This raises concern about the empirical nature of data collected through some surveys if results are already given a priori through the way subjects are being asked. Survey response patterns seem heavily determined by semantics. Language algorithms may suggest these prior to administering a survey. This study suggests that semantic algorithms are becoming new tools for the social sciences, opening perspectives on survey responses that prevalent psychometric theory cannot explain.
The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components - management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure. The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument. Findings - In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p Six Sigma methods was also not significant, F(3, 100)=1.34, p=0.26, η2=0.04. Post hoc analysis identified group and development cultures having significant interactions with management support. The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation. Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm's influence can utilize strategies to better implement Lean Six Sigma.
Pouraghaei, Mahboub; Jannati, Ali; Moharamzadeh, Peyman; Ghaffarzad, Amir; Far, Moharram Heshmati; Babaie, Javad
As the cornerstone of any health system, hospitals have a crucial role in response to disasters. Because hospital experiences in disaster response can be instructive, this study examined the challenges of hospital response to the twin earthquakes of 2012 in East Azerbaijan, Iran. In this qualitative study, the challenges of hospital response in the East Azerbaijan earthquakes were examined through focus group discussions. Participants were selected purposefully, and focus group discussions continued until data saturation. The data were manually analyzed by using Strauss and Corbin's recommended method. Hospitals were faced with 6 major challenges: lack of preparedness, lack of coordination, logistic deficiencies, patient/injured management, communication management, and other smaller challenges that were categorized in the "other challenges" category. The main theme was the lack of preparedness for disasters. Although hospital preparedness is emphasized in credible references, this study showed that lack of preparedness is a major challenge for hospitals during disasters. Thus, it seems that hospital officials' disaster risk perception and hospital preparedness should be improved. In addition, hospital preparedness assessment indexes should be included in the hospital accreditation process. (Disaster Med Public Health Preparedness. 2017;11:422-430).
This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.
Wickert, C.M.J.; Scherer, A. G.; Spence, L.
In this paper we address two interrelated research gaps in the Corporate Social Responsibility (CSR) literature. The first results from a lack of understanding of different patterns of CSR engagement with respect to CSR talk (impression management and the creation of symbolic images and
Sørensen, Ole Henning; Grande, Bård
The paper focuses on the concept of organizational networks. Four different uses of the concept are identified and critically discussed.......The paper focuses on the concept of organizational networks. Four different uses of the concept are identified and critically discussed....
Helping principals understand the importance of organizational justice is the first step in enhancing learning outcomes for all learners, regardless of their social class, race, abilities, sex, or gender. In schools, organizational justice may be defined as teachers' perceptions of fairness, respect, and equity that relate to their interactions…
Beriwal, Madhu; Clegg, Stewart; Collopy, Fred; McDaniel, Reuben, Jr.; Morgan, Gareth; Sutcliffe, Kathleen; Kaufman, Roger; Marker, Anthony; Selwyn, Neil
Scholars representing the field of organizational science, broadly defined as including many fields--organizational behavior and development, management, workplace performance, and so on--were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might…
Liu, Wenbin; Shi, Lizheng; Pong, Raymond W; Chen, Yingyao
Hospital social responsibility is receiving increasing attention, especially in China where major changes to the healthcare system have taken place. This study examines how patients viewed hospital social responsibility in China and explore the factors that influenced patients' perception of hospital social responsibility. A cross-sectional survey was conducted, using a structured questionnaire, on a sample of 5385 patients from 48 public hospitals in three regions of China: Shanghai, Hainan, and Shaanxi. A multilevel regression model was employed to examine factors influencing patients' assessments of hospital social responsibility. Intra-class correlation coefficients (ICCs) were calculated to estimate the proportion of variance in the dependent variables determined at the hospital level. The scores for service quality, appropriateness, accessibility and professional ethics were positively associated with patients' assessments of hospital social responsibility. Older outpatients tended to give lower assessments, while inpatients in larger hospitals scored higher. After adjusted for the independent variables, the ICC rose from 0.182 to 0.313 for inpatients and from 0.162 to 0.263 for outpatients. The variance at the patient level was reduced by 51.5 and 48.6 %, respectively, for inpatients and outpatients. And the variance at the hospital level was reduced by 16.7 % for both groups. Some hospital and patient characteristics and their perceptions of service quality, appropriateness, accessibility and professional ethics were associated with their assessments of public hospital social responsibility. The differences were mainly determined at the patient level. More attention to law-abiding behaviors, cost-effective health services, and charitable works could improve perceptions of hospitals' adherence to social responsibility.
Edward WONG SEK KHIN
Full Text Available Effective communication within an organization as part of CSR benchmarking factor that helps align employee expectations facilitates problem solving, builds cooperative relationships and channels employee efforts to achieve common goals. This paper seeks to determine how CSR benchmarking factors of the organizational environment (such as management style, organizational structure and workplace culture affect the effectiveness of intra-organizational communication and to examine the moderating effect of supervisor – subordinate guanxi. Data for the study was collected using self-administered questionnaires from working respondents in Kuala Lumpur in Selangor State, Malaysia. This study found that a more participative management style, less formalized organizational structure of SMEs and a healthier workplace culture are positively related to intra-organizational communication effectiveness. It was also discovered that the supervisor – subordinate relationship known as guanxi, has a positive moderating effect on all three relationships between management style, organizational structure and workplace culture with intra-organizational communication effectiveness. This study concludes that an organization’s management attitude towards employee participation, formalization of structure and healthiness of culture play important roles in encouraging effective communication and close supervisor – subordinate guanxi and further promotes communication, in addition to the mentioned environmental conditions.
Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...
There is a growing literature on corporate social responsibility (CSR) and gender issues, which draws upon a range of feminist theory and perspectives. However,research in this field appears to have been somewhat hampered by a lack of systematic engagement with ‘gendered organizations’ studies (GOS), and with a broad range of CSR theory, in particular that related to governance. This thesis sets out to address these gaps in the literature. It opens up new dialogue between the fields of GOS an...
Ahrens, W D
Major organizational change frequently results in fear, anxiety, and resistance. Change is often initiated in response to a perceived threat. However, intentional changes to historical patterns of nursing care delivery are now more prevalent, in the absence of crisis, as leaders anticipate new challenges and fulfill today's nurses' need for high-level professional satisfaction. This essay describes factors which inspired nursing organizational restructure at a naval hospital. The specific modifications made and strategies for managing them are reviewed in the context of using planned change principles and risk-taking behavior to achieve organizational growth.
Keyvanara, Mahmoud; Sajadi, Haniye Sadat
Changes in modern societies develop the perception that the external environment is essential in organization's practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. The mean score of hospitals' social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals' ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals' social responsibility level, especially through concentrating on their staff's working environment. © 2015 by Kerman University of Medical Sciences.
Lee, Romeo B; Baring, Rito V; Sta Maria, Madelene A
The study seeks to estimate gender variations in the direct effects of (a) number of organizational memberships, (b) number of social networking sites (SNS), and (c) grade-point average (GPA) on global social responsibility (GSR); and in the indirect effects of (a) and of (b) through (c) on GSR. Cross-sectional survey data were drawn from questionnaire interviews involving 3,173 Filipino university students. Based on a path model, the three factors were tested to determine their inter-relationships and their relationships with GSR. The direct and total effects of the exogenous factors on the dependent variable are statistically significantly robust. The indirect effects of organizational memberships on GSR through GPA are also statistically significant, but the indirect effects of SNS on GSR through GPA are marginal. Men and women significantly differ only in terms of the total effects of their organizational memberships on GSR. The lack of broad gender variations in the effects of SNS, organizational memberships and GPA on GSR may be linked to the relatively homogenous characteristics and experiences of the university students interviewed. There is a need for more path models to better understand the predictors of GSR in local students.
Lee, Romeo B.; Baring, Rito V.; Sta. Maria, Madelene A.
The study seeks to estimate gender variations in the direct effects of (a) number of organizational memberships, (b) number of social networking sites (SNS), and (c) grade-point average (GPA) on global social responsibility (GSR); and in the indirect effects of (a) and of (b) through (c) on GSR. Cross-sectional survey data were drawn from questionnaire interviews involving 3,173 Filipino university students. Based on a path model, the three factors were tested to determine their inter-relationships and their relationships with GSR. The direct and total effects of the exogenous factors on the dependent variable are statistically significantly robust. The indirect effects of organizational memberships on GSR through GPA are also statistically significant, but the indirect effects of SNS on GSR through GPA are marginal. Men and women significantly differ only in terms of the total effects of their organizational memberships on GSR. The lack of broad gender variations in the effects of SNS, organizational memberships and GPA on GSR may be linked to the relatively homogenous characteristics and experiences of the university students interviewed. There is a need for more path models to better understand the predictors of GSR in local students. PMID:27247700
Full Text Available Background and objectives: Social responsibility is one of the most important parts of an organization’s existence. The aim of this study was assessing the social responsibility of Tabriz University educational hospitals from managers’ perspective. Material and Methods: This cross-sectional descriptive study was conducted in 2012. 40 managers of educational hospitals have been selected through census sampling method. Data were collected through Ministry of Health and Medical education (MOHME valid and reliable questionnaire and analyzed by spss software package and descriptive statistics. Results : From the managers’ perspective, patients are the most effective group on hospital activities (48.5 percent, international standards are the most important motivation for hospitals (27.5 percent, the implementation of the organization’s legal obligations is the most important definition of social responsibility (27.5 percent. To be ensured a fair and ethical behavior, hospitals have benefited greatly from the workplace and employees (30 percent. Managers (90 percent emphasized that corporate social responsibility activities have a positive effect on hospital financial performance. Conclusion: The findings indicated that managers have no unique definition of social responsibility and it is difficult for them to understand the concept of social responsibility and there is no special policy or process in hospitals to understand this concept. They have introduced social responsibility as compliance with obligations of the organization.
Full Text Available According to the World Health Report 2000, health system responsiveness is proposed as one of the three key objectives of any health system. This multi-domain concept describes how well a health system responds to the expectations of their users concerning the non-health enhancing aspects of care. In this study we aim to compare the levels of responsiveness experienced by users of private and publicly managed hospitals in Nigeria, and through these insights, to propose recommendations on how to improve performance on this measure. This quantitative, cross-sectional study uses a questionnaire that is adapted from two responsiveness surveys designed by the World Health Organization (WHO. Researchers collected responses from 520 respondents from four hospitals in Lagos, Nigeria. Analysis of the data using statistical techniques found that significant differences exist between the performance of public and private hospitals on certain domains of responsiveness, with privately operated hospitals performing better where differences exist. Users of private hospitals also reported a higher level of overall satisfaction. Private hospitals were found to perform particularly better on the domains of dignity, waiting times, and travel times. These findings have implications for the management of public hospitals in focusing their efforts on improving their performance in low scoring domains. Performance in these hospitals can be improved by emphasis on staff training and demand management.
Adesanya, Tomilola; Gbolahan, Olayinka; Ghannam, Obadah; Miraldo, Marisa; Patel, Bhavesh; Verma, Rishi; Wong, Heather
According to the World Health Report 2000, health system responsiveness is proposed as one of the three key objectives of any health system. This multi-domain concept describes how well a health system responds to the expectations of their users concerning the non-health enhancing aspects of care. In this study we aim to compare the levels of responsiveness experienced by users of private and publicly managed hospitals in Nigeria, and through these insights, to propose recommendations on how to improve performance on this measure. This quantitative, cross-sectional study uses a questionnaire that is adapted from two responsiveness surveys designed by the World Health Organization (WHO). Researchers collected responses from 520 respondents from four hospitals in Lagos, Nigeria. Analysis of the data using statistical techniques found that significant differences exist between the performance of public and private hospitals on certain domains of responsiveness, with privately operated hospitals performing better where differences exist. Users of private hospitals also reported a higher level of overall satisfaction. Private hospitals were found to perform particularly better on the domains of dignity, waiting times, and travel times. These findings have implications for the management of public hospitals in focusing their efforts on improving their performance in low scoring domains. Performance in these hospitals can be improved by emphasis on staff training and demand management.
Lee, Romeo B.; Baring, Rito V.; Sta. Maria, Madelene A.
The study seeks to estimate gender variations in the direct effects of (a) number of organizational memberships, (b) number of social networking sites (SNS), and (c) grade-point average (GPA) on global social responsibility (GSR); and in the indirect effects of (a) and of (b) through (c) on GSR. Cross-sectional survey data were drawn from questionnaire interviews involving 3,173 Filipino university students. Based on a path model, the three factors were tested to determine their inter-relatio...
McMurray, Adela J.; Scott, D. R.; Pace, R. Wayne
The purpose of this study was to explore the relationship between organizational commitment and organizational climate. Subjects were chosen from three large Australian automotive component manufacturing companies. A questionnaire was administered to 1,413 employees from forty-two countries of origin. A 97.8 percent response rate yielded 1,382…
Bulut, Cagri; Culha, Osman
This empirical study investigated the impact of organizational training on employee commitment focusing on employees' emotional and affective responses towards their organization. Organizational training is conceptualized within a multidimensional framework consisting of motivation for training, access to training, benefits from training and…
Bahrami, Mohammad Amin; Kiani, Mohammad Mehdi; Montazeralfaraj, Raziye; Zadeh, Hossein Fallah; Zadeh, Morteza Mohammad
Organizational learning is defined as creating, absorbing, retaining, transferring, and application of knowledge within an organization. This article aims to examine the mediating role of organizational learning in the relationship of organizational intelligence and organizational agility. This analytical and cross-sectional study was conducted in 2015 at four teaching hospitals of Yazd city, Iran. A total of 370 administrative and medical staff contributed to the study. We used stratified-random method for sampling. Required data were gathered using three valid questionnaires including Alberkht (2003) organizational intelligence, Neefe (2001) organizational learning, and Sharifi and Zhang (1999) organizational agility questionnaires. Data analysis was done through R and SPSS 18 statistical software. The results showed that organizational learning acts as a mediator in the relationship of organizational intelligence and organizational agility (path coefficient = 0.943). Also, organizational learning has a statistical relationship with organizational agility (path coefficient = 0.382). Our findings suggest that the improvement of organizational learning abilities can affect an organization's agility which is crucial for its survival.
Trabalhando a missão de um hospital como facilitador da mudança organizacional: limites e possibilidades Developing the hospital's mission to facilitate organizational change: limits and possibilities
Luiz Carlos de Oliveira Cecilio
Full Text Available O autor, inicialmente, apresenta algumas considerações encontradas no campo da Teoria Geral da Administração, sobre o papel da definição de "objetivos organizacionais" em um processo de mudança das organizações em geral. Mesmo reconhecendo a validade de parte do questionamento feito por certos autores que, no limite, negam a possibilidade de se imprimir "uma" direcionalidade para a organização com base na explicitação dos seus objetivos formais ou oficiais, o autor apresenta e discute sua experiência, no setor saúde, de definição da missão (uma forma de "tradução" de objetivos organizacionais como estratégia de melhorar a comunicação dentro da equipe e da criação de uma cultura de responsabilidade frente ao usuário.The author begins by discussing the field of General Administration Theory vis-à-vis the defining role of "organizational goals" within an overall change process in organizations. While admitting the validity of some challenges raised by certain authors who deny the possibility of establishing a "single" direction for the organization by explicitly outlining its formal or official goals, the author presents and discusses his experience in defining the mission in the health sector as a way to implement organizational goals. This definition is meant as a strategy to improve communications among health team members and to a culture of responsibility when dealing with health service users.
This paper provides an analysis of strategic uses of ignorance or not-knowing in one of the most secretive industries within the financial sector. The focus of the paper is on the relation between imitation and ignorance within the organizational structure of high-frequency trading (HFT) firms...... is replicated within the organizational setting of these firms and re-enacted by the traders. Towards the end of the paper the politics of the relationship between imitation and ignorance is discussed....
The purpose of this paper is to address and discuss implications of blog usage in a corporate communication context from an employees’ perspective by analyzing the local context and the underlying motivations of corporate blogging as they are being discursively constructed by a group of organizat...... of organizational bloggers. The paper presents findings from a case study of a government agency’s corporate blogging activity, traced through focus group interviews with the organizational bloggers....
information systems, coupled with powerful comuters using problem solving algoriths, we can literally compute mathematically opt imal solutions...Differences in the Process Organizational and Human Decision Processes Chapter 2 METHODS AN D ODELS Prescription Versus Description METHODS Mathemat ico...Introduct ion Analogic aand Mathematical Aids Sensitivity of N.bdels Linear Programning Mhltiple Utility Theory Team Theo r" 2/7/82 Contents Organizational
Lee, Soo-Jeong; Lee, Joung Hee
The study aim was to examine the relationships of organizational safety practices with nurses' perceptions about job and risk and experiences of work-related injury and symptoms. Nursing professions report high rates of work-related injuries. Organizational safety practices have been linked to workers' safety outcomes and perceptions about work. This study analyzed data from a random sample of 280 California RNs in a cross-sectional statewide survey. Data were collected by both postal and online surveys. Higher perceptions of organizational safety practices (safety climate, ergonomic practices, people-oriented culture) were significantly associated with lower physical workload, lower job strain, higher job satisfaction, lower risk perception, and lower work-related injury and symptom experiences. Ergonomic practices and people-oriented culture were associated with less intention of leaving job. Organizational safety practices may play a pivotal role in improving positive perceptions about jobs, reducing injury risks, and promoting nurse retention.
, and documenting best practices and potential difficulties. Practical implications. For the purposes of the present research, the level of organizational project management maturity of the enterprise in question is evaluated according to the three-level model developed by H. Кеrzner. The conclusion is made that project management maturity of this enterprise corresponds to maturity level 2. Besides, the defined maturity level is specified in more detail along the life cycle phases in order to determine more precisely the position of project management activity of the enterprise within the maturity model. Potential problems (the so-called “bottlenecks” of the enterprise in the field of project management are identified. Based on the results of the analysis, a number of recommendations are suggested for further development of the corporate system of project management at the given enterprise. The results of the research showed that in order to achieve a higher level of maturity, it is necessary to create a project team, organize a project office, and distribute project management functions among the team members, develop a procedure of involving experts with different professional backgrounds into the project implementation, improve the procedure of creating project teams, ensure the accumulation of best practices of project implementation, establish the corporate standard of project management, and improve the strategic planning for project management, project implementation control, managing changes, labour resources and communication. The suggested guidelines are expected to facilitate the achievement of a higher level of maturity. They also envisage the terms of this transition and the responsible executives. Further enhancement of maturity level is achieved by means of performing a set of activities for improving and aligning various project management sub-processes aimed at managing costs, time, quality, and risks. Another important condition of enhancing
Foroozan Atashzadeh Shoorideh; Zohreh Nabizadeh; Nahid Khazaei; Hamid Alavi-Majd
The aim of this study is to determine the correlation between nurse managers’ delegation and nurses’ organizational commitment in the view of nurses. Nowadays improvement of the performance, efficiency, and effectiveness of organizations require capable and committed employees. In Iran, there is not any survey of the correlation between delegation and organizational commitment. This study is a descriptive – correlation study. Statistical data in this research includes nurses (2120 members) of...
To understand the types of organizational change that will best help them meet strategic goals, hospitals and health systems are: Projecting their quality and savings goals for the coming years and weighing their ability to meet them. Looking for partner organizations that share their culture, goals, and capabilities. Assessing the types of organizational arrangements that will provide the desired benefits. Determining the key components needed to make the arrangement fit their goals and culture.
Cárdenas Niño, Lucila; Universidad Pedagógica y Tecnológica de Colombia, Facultad de Ciencias de la Salud, Escuela de Psicología, Hospital Antiguo, Carrera 10 No 16ª05; Arciniegas Rodríguez, Yuly Cristina; Universidad Pedagógica y Tecnológica de Colombia, Facultad de Ciencias de la Salud, Escuela de Psicología, Hospital Antiguo, Carrera 10 No 16ª05; Barrera Cárdenas, Mónica; Universidad Pedagógica y Tecnológica de Colombia, Facultad de Ciencias de la Salud, Escuela de Psicología, Hospital Antiguo, Carrera 10 No 16ª05
The aim of this study was to assess whether the intervention model in organizational climate PMCO, was effective in the Hospital of Yopal, Colombia. The following five phases, proposed by the model, were implemented: 1) problem analysis, 2) awareness, 3) strategies design and planning, at the individual, intergroup, and organizational levels, 4) implementation of the strategy, and 5) process evaluation. A design composed of two groups, experimental and control, was chosen, analyzing whether t...
Engbers, R.; Caluwe, L.I. de; Stuyt, P.M.J.; Fluit, C.R.M.G.; Bolhuis, S.
Literature shows that faculty development programmes are not organizationally embedded in academic hospitals. This leaves medical teaching a low and informal status. The purpose of this article is to explore how organizational literature can strengthen our understanding of embedding faculty
... Recovery of Past Response Costs; Piqua Hospital Site AGENCY: Environmental Protection Agency. ACTION... Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of past response costs concerning the...
Davis, Matthew L; Wehbe-Janek, Hania; Subacius, Haris; Pinto, Ruxandra; Nathens, Avery B
The Trauma Center Organizational Culture Survey (TRACCS) instrument was developed to assess organizational culture of trauma centers enrolled in the American College of Surgeons Trauma Quality Program (ACS TQIP). The objective is to provide evidence on the psychometric properties of the factors of TRACCS and describe the current organizational culture of TQIP-enrolled trauma centers. A cross-sectional study was conducted by surveying a sampling of employees at 174 TQIP-enrolled trauma centers. Data collection was preceded by multistep survey development. Psychometric properties were assessed by an exploratory factor analysis (construct validity) and the item-total correlations and Cronbach alpha were calculated (internal reliability). Statistical outcomes of the survey responses were measured by descriptive statistics and mixed effect models. The response rate for trauma center participation in the study was 78.7% (n = 137). The factor analysis resulted in 16 items clustered into three factors as described: opportunity, pride, and diversity, trauma center leadership, and employee respect and recognition. TRACCS was found to be highly reliable with a Cronbach alpha of 0.90 in addition to the three factors (0.91, 0.90, and 0.85). Considerable variability of TRACCS overall and factor score among hospitals was measured, with the largest interhospital deviations among trauma center leadership. More than 80% of the variability in the responses occurred within rather than between hospitals. TRACCS was developed as a reliable tool for measuring trauma center organizational culture. Relationships between TQIP outcomes and measured organizational culture are under investigation. Trauma centers could apply TRACCS to better understand current organizational culture and how change tools can impact culture and subsequent patient and process outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.
Johnson, Susan L; Boutain, Doris M; Tsai, Jenny H-C; de Castro, Arnold B
To explore how workplace bullying is addressed by hospital nursing unit managers and organizational policies. Although workplace bullying is costly to organizations, nurses report that managers do not consistently address the issue. This study used discourse analysis to analyze interview data and policy documents. There were differences in the manner in which managers and the policy documents labeled bullying-type behaviors and discussed the roles and responsibilities of staff and managers. Policies did not clearly delineate how managers should respond to workplace bullying. These differences can allow management variation, not sanctioned by policy. Unclear policy language can also offer insufficient guidance to managers, resulting in differential enforcement of policies.
Full Text Available To determine whether inflammatory and hemostasis response in patients hospitalized for pneumonia varies by age and whether these differences explain higher mortality in the elderly.In an observational cohort of subjects with community-acquired pneumonia (CAP recruited from emergency departments (ED in 28 hospitals, we divided subjects into 5 age groups (85% subjects, older subjects had modestly increased hemostasis markers and IL-6 levels (p<0.01.Modest age-related increases in coagulation response occur during hospitalization for CAP; however these differences do not explain the large differences in mortality. Despite clinical recovery, immune resolution may be delayed in older adults at discharge.
Albu, Oana Brindusa; Flyverbom, Mikkel
Transparency is an increasingly prominent area of research that offers valuable insights for organizational studies. However, conceptualizations of transparency are rarely subject to critical scrutiny and thus their relevance remains unclear. In most accounts, transparency is associated...... with the sharing of information and the perceived quality of the information shared. This narrow focus on information and quality, however, overlooks the dynamics of organizational transparency. To provide a more structured conceptualization of organizational transparency, this article unpacks the assumptions...... that shape the extant literature, with a focus on three dimensions: conceptualizations, conditions, and consequences. The contribution of the study is twofold: (a) On a conceptual level, we provide a framework that articulates two paradigmatic positions underpinning discussions of transparency, verifiability...
This conference paper will explore the difference between communicating changes and changing communication. Based on a case study in which a manager applies two quite different approaches to organizational communication in order to change the organization he is leading. The first and failing...... approach will in be named: organizational campaigning and means (e.g. Kotter, 2012, p. 9 and Clegg, Kornberger & Pitsis, 2009) that the manager takes control with communication and communication cannels in order to ensure successful organizational changes. Since the changes were not succeeding the approach...... is replaced with a new approach which will be named organizing communication. During the case analysis we will see that this change in approach not only change the managers perception of communication but also his perception of the organization he is leading....
Yang, Feng-Hua; Chang, Chen-Chieh
According to Hochschild's (1983. The Managed Heart. Berkeley: University of California Press) classification of emotional labour, nursing staff express high emotional labour. This paper investigates how nursing staff influence job satisfaction and organizational commitment when they perform emotional labour. This paper examines the relationship between emotional labour, job satisfaction, and organizational commitment from the perspective of nursing staff. A questionnaire survey was carried out to explore these interrelationships. Teaching hospital in Taiwan. Questionnaires were distributed to 500 nursing staff; 295 valid questionnaires were collected and analysed-a 59% response rate. The questionnaires contained items on emotional labour, job satisfaction, and organizational commitment as well as some basic socio-demographics. In addition, descriptive statistics, correlation and linear structure relation (LISREL) were computed. Emotional display rule (EDR) was significantly and negatively related to job satisfaction. Surface acting (SA) was not significantly related to job satisfaction but demonstrated a significantly negative relationship with organizational commitment. Deep acting (DA) significantly and positively correlated with job satisfaction but demonstrated no significance with organizational commitment. The variety of emotions required (VER) was not significantly related to job satisfaction; frequency and duration of interaction (FDI) and negatively related to job satisfaction; and job satisfaction significantly and positively correlated with organizational commitment. We found that some dimensions of emotional labour significantly relate to job satisfaction. Job satisfaction positively affects organizational commitment and has an intervening effect on DA and organizational commitment.
Huang, Chun-Chen; You, Ching-Sing; Tsai, Ming-Tien
The high turnover of nurses has become a global problem. Several studies have proposed that nurses' perceptions of the ethical climate of their organization are related to higher job satisfaction and organizational commitment and thus lead to higher organizational citizenship behaviors. This study uses hierarchical regression to understand which types of ethical climate, facets of job satisfaction, and the three components of organizational commitment influence different dimensions of organizational citizenship behaviors. Questionnaires were distributed to 450 nurses, and 352 usable questionnaires were returned. The findings of the article suggest that hospitals can increase organizational citizenship behaviors by influencing an organization's ethical climate, job satisfaction, and organizational commitment. Hospital administrators can foster within organizations, the climate types of caring, law and code and rules climate, satisfaction with coworkers, and affective commitment and normative commitment that increase organizational citizenship behavior, while preventing organizations from developing the type of instrumental climate and continuance commitment that decreases it.
Full Text Available Cultural orientations of an organization can be its greatest strength, providing the basis for problem solving, cooperation, and communication. Culture, however, can also inhibit needed changes. Cultural changes typically happen slowly – but without cultural change, many other organizational changes are doomed to fail. The dominant culture of an organization is a major contributor to its success. But, of course, no organizational culture is purely one type or another. And the existence of secondary cultures can provide the basis for change. Therefore, organizations need to understand the cultural environments and values.
Hatch, Mary Jo; Schultz, Majken
This text presents the classic works on organizational identity alongside more current thinking on the issues. Ranging from theoretical contributions to empirical studies, the readings in this volume address the key issues of organizational identity, and show how these issues have developed through...... contributions from such diverse fields of study as sociology, psychology, management studies and cultural studies. The readings examine questions such as how organizations understand who they are, why organizations develop a sense of identity and belonging, where the boundaries of identity lie...... and the implications of postmodern and critical theories' challenges to the concept of identity as deeply-rooted and authentic....
Detwiller, L F
Government-sponsored health care programs must have limits if they are to be effective and cost-cutting. Canada's experience with a national health insurance plan indicates that long-range planning, a measurable definition of health, and consumer responsibility are necessary ingredients.
Kontos, Nicholas; Freudenreich, Oliver; Querques, John
To identify scenarios in which consultation psychiatrists encounter difficulty reconciling their clinical role with consultees' expectations and to suggest concepts that help navigate these situations. The authors' clinical experiences are used to generate and discuss three major categories of situations that require psychiatric consultants to thoughtfully adjust the breadth and depth of their obligation to patients and consultees. "Occam's razor 'dulled," "Conflation of the psychosocial with the psychiatric" and "Disposition preoccupation" are proposed as the major categories leading to conflicting patient management views between consultant and consultee. Each has, at its core, a compromise of patient ownership that blurs the boundaries of the consulting psychiatrist's responsibility. Understanding and channeling ownership back to the consultee, while appropriately gauging and embracing one's responsibility, form a two-pronged approach to clarifying one's role in consultations.
Crise organizacional e sensemaking: o caso de um hospital público no contexto da pandemia de influenza A (H1N1 Organizational crisis and sensemaking: the case of a public hospital within the context of the influenza A (H1N1 pandemic
André Davi Eberle
Full Text Available Esta pesquisa é um estudo de caso no qual se analisou uma situação de crise organizacional ocorrida em um hospital público de grande porte no contexto da pandemia de influenza A (H1N1 de 2009. O objetivo da pesquisa foi analisar o processo de crise organizacional, considerando os processos de sensemaking realizados pelos funcionários do hospital durante a crise. O referencial teórico foi construído com base nas temáticas da crise organizacional e do processo de sensemaking. Realizou-se a coleta de dados por meio de entrevistas individuais semiestruturadas, grupos focais e análise documental. Os dados foram submetidos à técnica de análise de conteúdo. A análise do processo de crise organizacional ocorrido no hospital foi realizada a partir da caracterização dos seguintes períodos: (I o período anterior à ruptura da crise, no qual se verificou a ocorrência de sinais de alerta e de vulnerabilidade; (II o momento de ruptura, relacionado à ocorrência do evento desencadeador da crise; (III a fase aguda da crise. Os resultados da pesquisa indicaram que os processos de sensemaking realizados pelos funcionários exerceram influência no modo como eles agiram na crise organizacional.This research is a case study in which an organizational crisis that occurred in a large public hospital within the context of the influenza A (H1N1 pandemic of 2009 was analyzed. This research aimed to analyze the process of organizational crisis, taking into account the sensemaking processes carried out by hospital professionals during the crisis. The theoretical framework was constructed with the themes of organizational crisis and sensemaking as a basis. Data collection was achieved through semi-structured individual interviews, focus groups, and documentary analysis. Content analysis was then carried out. The analysis of the organizational crisis process which occurred in the hospital was performed according to the characterization of the following
Engbers, Rik; de Caluwé, Léon I A; Stuyt, Paul M J; Fluit, Cornelia R M G; Bolhuis, Sanneke
Literature shows that faculty development programmes are not organizationally embedded in academic hospitals. This leaves medical teaching a low and informal status. The purpose of this article is to explore how organizational literature can strengthen our understanding of embedding faculty development in organizational development, and to provide a useful example of organizational development with regards to medical teaching and faculty development. Constructing a framework for organizational development from the literature, based on expert brainstorming. This framework is applied to a case study. A framework for organizational development is described. Applied in a context of medical teaching, these organizational insights show the process (and progress) of embedding faculty development in organizational development. Organizational development is a necessary condition for assuring sustainable faculty development for high-quality medical teaching. Organizational policies can only work in an organization that is developing. Recommendations for further development and future research are discussed.
treatment modality. Design: It is a retrospective study of all conﬁrmed. Burkitt's lymphoma of the head and neck region seen at the Obafemi Awolowo University Teaching Hospital Ile. Ife (OAUTHC) between 1986 and 2002. Patients and methods: The medical records of all the patients with the histopathologically conﬁrmed ...
Bahadori, Mohammadkarim; Khankeh, Hamid Reza; Zaboli, Rouhollah; Ravangard, Ramin; Malmir, Isa
Coordination is a major challenge in the field of health in disasters, mostly because of the complex nature of health-related activities. This was a qualitative study based on the grounded theory approach. A total of 22 experts in the field of health in disasters participated in the study. The data were collected through in-depth interviews and literature review. The collected data were then analyzed by use of MAXQDA 2010 software (VERBI Software GmbH). The lack of a strategic view in the field of health in disasters, a lack of coordination of necessities and infrastructures, insufficient enforcement, a higher priority given to an organizational approach rather than a national approach, and the field of disasters not being a priority in the health system were noted as barriers to inter-organizational coordination. The facilitators of inter-organizational coordination noted were the importance of public participation in the field of health in disasters, having a process and systematic view in the field of health in disasters, the necessity of understanding and managing resources and information in the field of health in disasters, and having a feedback and evaluation system in the health system after disasters. It is recommended that developing common beliefs and goals be given priority in making plans and policies in the field of health in disasters. (Disaster Med Public Health Preparedness. 2017;11:318-325).
Broekhuis, Manda; Vos, Janita F.J.
This article derives lessons from the quality approach for further developing the organizational sustainability approach. Taking a responsibility perspective on organizational sustainability, four issues emerge that need to be resolved, i.e. what is the responsibility?, what is the responsibility
Chang, Ching Sheng; Chang, Hae Ching
This paper is a report of a study to determine whether a favourable perception of internal marketing is associated with increased organizational commitment. The role of nurses in healthcare treatment is expanding, and becoming more important as time progresses. Therefore, the primary concern of business of health care is to use internal marketing strategies effectively to enhance and develop nurses' organizational commitment and reduce turnover to promote competitive advantages for the organization. A cross-sectional design was used. Questionnaires were distributed in 2006 to a convenience sample of 450 Registered Nurses in two teaching hospitals in Taiwan, and 318 questionnaires were returned. Eighteen were excluded because of incomplete answers, which left 300 usable questionnaires (response rate 66.7%). Validity and reliability testing of the questionnaire proved satisfactory and Structural Equation Modeling was used to analyse the data. A favourable perception of internal marketing was associated with increased organizational commitment. Communication management had the greatest influence on organizational commitment and external activity had the smallest impact. Hospital managers need to recognize the importance of internal marketing for staff retention and the survival of their organizations as competitive pressure increases. As a great deal of time and costs are involved in educating nurses, the best way to retain outstanding nurses and reduce turnover costs and personnel problems is for employers to understand the needs and expectations of their nursing staff.
Lok, Peter; Rhodes, Jo; Westwood, Bob
This study aims to investigate the mediating role of organizational subculture between job satisfaction, organizational commitment (dependent variables) and leadership, culture (independent variables) in health care organizations. A survey on nurses from 26 wards from various types of hospital was used. A total of 251 usable returns were collected for the analysis (i.e. response rate of 63 per cent). Structural equation analysis was conducted to obtain the best fit model and to determine the direction of the causal effect between job satisfaction and commitment, and the role of subculture as a mediating variable, between commitment of its other antecedents. Comparisons with alternative models confirmed satisfaction as an antecedent of commitment and the role of subculture as a mediating variable. The results of this study contribute to the clarification of the causal relations of the antecedents of commitment, and highlight the important role of local leadership and subculture in determining employees' job satisfaction and commitment. The results of this study should not be generalized to other industries and other national cultural context. Furthermore, a longitudinal study may be necessary to determine the causal relationship of variables used in this study. The findings could provide managers with valuable insight to focus their limited resources on improving the level of organizational commitment via the mediating role of organizational culture. The research findings provide managers with a new lens to examine organizational culture using the three perspectives of: bureaucratic, supportive, and innovative. Furthermore, the results could renew interest in developing other organizational subculture models that determine the relationship between organizational subculture and commitment
Renata Peregrino de Brito
Full Text Available This paper presents a theoretical and empirical analysis of the relationship between human resource management (HRM and organizational performance. Theoretically, we discuss the importance of HRM for the development of resources and its impact on business performance. Empirically, we evaluated articles published on Brazilian academic journals that addressed such relationships. The results showed a lack of studies conducted at this intersection. From the universe of 2,469 articles, only 16 (0.6% sought to relate HRM and organizational performance. We observed a dominance of isolated HR practices, which does not consider HRM as a system, and of operational performance measures, relative to financial and efficiency variables. Most studies show a positive relationship between HRM practices and performance, in line with the literature. However, we point out some methodological issues, such as the difficulty of isolating the HR practices from its context, the failure to consider the temporality of this relationship, and the comparison between companies from different industries.
In France, the delayed development of day surgery compared to other countries led the ANAP and the HAS in 2011 to enter into a joint work program to provide some reference guide for hospitals to change their practices to outpatient. In this context, organizational guidelines and operational tools were published in May 2013. The method of construction of the recommendations resulting from an original work that combined a three-fold approach: field vision by identifying the highlights of 15 hospitals selected for their representative performance and analyzing the risks of five voluntary hospitals, mobilization organizational theories from the social sciences, using 53 professional experts. The work concluded on 16 organizational recommendations under four forms (basic principles, strategic elements, operational elements and perspectives). These recommendations are accompanied by tools and guides diagnosis and implementation, as well as productions for further reflection. These organizational recommendations confirmed the specificity of day surgery, which is not related to the act, but to the organization, management and optimization of different flows of a hospital (patient flow, professional flows, logistical, informational…). The performance of a day surgery organization is linked to its ability to control its flow and anticipation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Mira, José Joaquín; Lorenzo, Susana; Navarro, Isabel; Pérez-Jover, Virtudes; Vitaller, Julián
To design and validate a scale (CSR-Hospital-SP) to determine health professionals' views on the approach of management to corporate social responsibility (CSR) in their hospital. The literature was reviewed to identify the main CSR scales and select the dimensions to be evaluated. The initial version of the scale consisted of 25 items. A convenience sample of a minimum of 224 health professionals working in five public hospitals in five autonomous regions were invited to respond. Floor and ceiling effects, internal consistency, reliability, and construct validity were analyzed. A total of 233 health professionals responded. The CSR-Hospital-SP scale had 20 items grouped into four factors. The item-total correlation was higher than 0.30; all factor loadings were greater than 0.50; 59.57% of the variance was explained; Cronbach's alpha was 0.90; Spearman-Brown's coefficient was 0.82. The CSR-Hospital-SP scale is a tool designed for hospitals that implement accountability mechanisms and promote socially responsible management approaches. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.
Wang, Hui; Jiang, Nan; Shao, Sicong; Zheng, Tao; Sun, Jianzhong
The objective of this study is to establish a comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Literature research and Delphi method were utilized to establish the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Questionnaires were designed and used to survey the status quo of 134 military hospitals' response capability to bio-terrorism. Survey indicated that factor analysis method was suitable to for analyzing the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. The constructed evaluation system was consisted of five first-class and 16 second-class indexes. Among them, medical response factor was considered as the most important factor with weight coefficient of 0.660, followed in turn by the emergency management factor with weight coefficient of 0.109, emergency management consciousness factor with weight coefficient of 0.093, hardware support factor with weight coefficient of 0.078, and improvement factor with weight coefficient of 0.059. The constructed comprehensive assessment model and system are scientific and practical.
Jeong, Seok Hee; Lee, Taewha; Kim, In Sook; Lee, Myung Ha; Kim, Mi Ja
This paper is a report of a study to describe the effect on organizational effectiveness of nurses' use of the principles of learning organization. Since Senge proposed the learning organization model in 1990, the principles of learning organization have been considered as a new organizational vision. However, there is little empirical evidence that shows how nurses' use of the principles of learning organization affects organizational effectiveness in healthcare settings. A cross-sectional survey was used and the data were collected in 2003. Participants were 629 professional nurses who had worked full-time for more than 1 year in the general units of nine tertiary medical hospitals in South Korea. A questionnaire was distributed to nurse managers of nine hospitals, who distributed it to 665 nurses, 635 of whom responded (response rate 95.5%). Six returns were discarded due to incomplete responses, leaving 629 for data analysis. There was a statistically significant positive relationship between nurses' use of the principles of learning organization and organizational effectiveness. Hierarchical multiple regression analysis revealed that the concept explained an additional 24.9% of organizational commitment and a further 22.6% of job satisfaction. The learning organization principles of shared vision and team learning were statistically significant predictors for organizational effectiveness. Individual nurses can use the principles of learning organization to enhance organizational effectiveness. Intervention programmes that integrate and strengthen shared vision and team learning may be useful to enhance organizational effectiveness. Further research is required to identify other factors related to the principles of learning organization.
. Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... in treating disease can be supported by architecture which is sensitive to the contextual conditions of healing in health facilities. It is not the intention to supplant technology, but a question of supplementing the incredible advances that have been made in medicine in recent decades. The central premise......- sick-leave and work-related injuries....
Katrinli, Alev; Atabay, Gulem; Gunay, Gonca; Guneri, Burcu
This paper is a report of a study to explore the relationship between leader-member exchange quality and organizational identification and the mediating role of job involvement in this relationship. As a result of the fast-changing structures and increasing competition, healthcare organizations increasingly demand highly qualified nurses who also have positive work attitudes towards the job and the organization. Among these positive work attitudes, organizational identification affects nurses' job performance and, in turn, the quality of care and patient satisfaction. The quality of the relationship between nurse supervisors and nurses, which is examined in the leader-member exchange context, can be an important determinant for organizational identification. This relationship is also affected by nurses' job involvement. The sample consisted of 148 nurses working in a private general hospital. Questionnaires, which included measures for organizational identification, level of leader-member exchange quality, job involvement and questions about the demographic characteristics of the sample, were distributed in 2007. The response rate was 87%. A statistically significant and positive relationship was found between leader-member exchange quality and organizational identification. The results also reveal that job involvement mediates the positive effects of leader-member exchange quality on organizational identification. If nurse supervisors increase their awareness of the effects of their behaviours towards their nurses, they can increase the nurses' performance and achieve desired results through increasing job involvement and organizational identification.
Chang, Ching Sheng; Chang, Hae Ching
There is a gap in the literature about the influence of customer-oriented perception on nursing personnel's organizational citizenship behaviors. Organizational citizenship behaviors are the type of contextual behaviors that are difficult to observe and measure as such behaviors are usually generated in quite subtle and unpredictable ways. This study tested the hypothesis: Customer-oriented perception is associated with increased organizational citizenship behaviors for nurses. If nursing personnel's customer-oriented perception can increase their willingness to display organizational citizenship behaviors, it may facilitate hospital operation and enhance organizational effectiveness. A cross-sectional design using a questionnaire survey of nurses in 10 medical centers was used. Five hundred copies of the questionnaire were distributed, and 232 effective copies were retrieved, with a valid response rate of 46.4%. Structural equation modeling was performed in SPSS 11.0 and Amos 7.0 (SPSS Inc., Chicago, IL, USA) statistical software packages. The main finding was that favorable customer-oriented perception is associated with increased organizational citizenship behaviors for nurses. Extensive training and customer-oriented performance evaluation are proposed in the hope of creating customer-oriented perception among nursing personnel and subsequently inspiring the display of organizational citizenship behaviors. ©2010 Sigma Theta Tau International.
Catalia Rafsiah Sari Sari
relationship Perceived Organizational Support on Organizational Citizenship Behavior through Organizational Commitment. Keywords: Perceived Organizational Support, Organizational Citizenship Behavior,Organizational Commitment
Society 14 6. Ethical Responsibilities for Organizational Leaders 15 7. Communications Process 20 8. Johari Window 69 9. Effect of Feedback 70 10...and those approaching flag rank teach professional ethics by the example they provide and the policies they promulgate.ŗ A leader who "bends the truth...military community . The ethical conduct of an organization in a societal context becomes important to the leader of the military organization that
Othman, Rozhan; Hashim, Noor Azuan
This article proposes that a major problem limiting an organization's ability to develop organizational learning capacity is of organizational amnesia. To understand organizational amnesia, it is necessary to look at the various ways that organizational learning is defined. Organizational learning is not merely the process of acquiring knowledge.…
Singer, Sara J; Falwell, Alyson; Gaba, David M; Meterko, Mark; Rosen, Amy; Hartmann, Christine W; Baker, Laurence
Safety climate refers to shared perceptions of what an organization is like with regard to safety, whereas safety culture refers to employees' fundamental ideology and orientation and explains why safety is pursued in the manner exhibited within a particular organization. Although research has sought to identify opportunities for improving safety outcomes by studying patterns of variation in safety climate, few empirical studies have examined the impact of organizational characteristics such as culture on hospital safety climate. This study explored how aspects of general organizational culture relate to hospital patient safety climate. In a stratified sample of 92 U.S. hospitals, we sampled 100% of senior managers and physicians and 10% of other hospital workers. The Patient Safety Climate in Healthcare Organizations and the Zammuto and Krakower organizational culture surveys measured safety climate and group, entrepreneurial, hierarchical, and production orientation of hospitals' culture, respectively. We administered safety climate surveys to 18,361 personnel and organizational culture surveys to a 5,894 random subsample between March 2004 and May 2005. Secondary data came from the 2004 American Hospital Association Annual Hospital Survey and Dun & Bradstreet. Hierarchical linear regressions assessed relationships between organizational culture and safety climate measures. Aspects of general organizational culture were strongly related to safety climate. A higher level of group culture correlated with a higher level of safety climate, but more hierarchical culture was associated with lower safety climate. Aspects of organizational culture accounted for more than threefold improvement in measures of model fit compared with models with controls alone. A mix of culture types, emphasizing group culture, seemed optimal for safety climate. Safety climate and organizational culture are positively related. Results support strategies that promote group orientation and
Cummings, Greta; Hayduk, Leslie; Estabrooks, Carole
A decade of North American hospital restructuring in the 1990s resulted in the layoff of thousands of nurses, leading to documented negative consequences for both nurses and patients. Nurses who remained employed experienced significant negative physical and emotional health, decreased job satisfaction, and decreased opportunity to provide quality care. To develop a theoretical model of the impact of hospital restructuring on nurses and determine the extent to which emotionally intelligent nursing leadership mitigated any of these impacts. The sample was drawn from all registered nurses in acute care hospitals in Alberta, Canada, accessed through their professional licensing body (N = 6,526 nurses; 53% response rate). Thirteen leadership competencies (founded on emotional intelligence) were used to create 7 data sets reflecting different leadership styles: 4 resonant, 2 dissonant, and 1 mixed. The theoretical model was then estimated 7 times using structural equation modeling and the seven data sets. Nurses working for resonant leaders reported significantly less emotional exhaustion and psychosomatic symptoms, better emotional health, greater workgroup collaboration and teamwork with physicians, more satisfaction with supervision and their jobs, and fewer unmet patient care needs than did nurses working for dissonant leaders. Resonant leadership styles mitigated the impact of hospital restructuring on nurses, while dissonant leadership intensified this impact. These findings have implications for future hospital restructuring, accountabilities of hospital leaders, the achievement of positive patient outcomes, the development of practice environments, the emotional health and well-being of nurses, and ultimately patient care outcomes.
Jacobsen, Christian Bøtcher; Jakobsen, Mads Leth
perceived organizational red tape among managers and frontline staff relates to objectively measured performance. The data consists of survey responses from teachers and principals at Danish upper secondary schools combined with grade-level administrative performance data. Based on theories of red tape......The claim that perceived organizational red tape hampers public services has become a central theme in public administration research. Surprisingly, however, few scholars have empirically examined the impact of perceived red tape on organizational performance. This study empirically analyzes how...... and motivation crowding, we hypothesize that perceived organizational red tape reduces performance within such organizations. The empirical result is a small, negative relationship between staff perception of red tape and performance, and no relationship between manager-perceived red tape and performance....
King, Eden B.; Dawson, Jeremy; West, Michael; Gilrane, Veronica; Peddie, Chad I.; Bastin, Lucy
Integrating sociological and psychological perspectives, this research considers the value of organizational ethnic diversity as a function of community diversity. Employee and patient surveys, census data, and performance indexes relevant to 142 hospitals in the United Kingdom suggest that intraorganizational ethnic diversity is associated with reduced civility toward patients. However, the degree to which organizational demography was representative of community demography was positively re...
FROWEIN, JC; POSTMA, TJBM
Information technology in relation to organizational diagnosis and organizational change is the subject of extensive and increasing discussion. A condition for change is insight into organizational problems. This paper discusses the relation between the concepts ''problem'', ''decision making'' and
Beard, Courtney; Stein, Aliza T; Hearon, Bridget A; Lee, Josephine; Hsu, Kean J; Björgvinsson, Thröstur
Despite the effectiveness of cognitive behavioral therapy (CBT) for depression, a significant number of patients do not respond. Data examining predictors of treatment response in settings in which CBT is delivered naturalistically are lacking. Treatment outcome data collected at a CBT-based partial hospital (n = 956) were used to examine predictors of two types of treatment response: (a) a reliable and clinically significant change in depressive symptoms and (b) a self-rating of "very much" or "much" improved. In multiple logistic regression models, we examined predictors of response in the total sample and separately for patients with a primary diagnosis of major depressive disorder (MDD) versus patients with other primary diagnoses. In the total sample, higher treatment outcome expectations and fewer past hospitalizations predicted clinically significant improvement in depression symptoms, and higher treatment expectations and ethnoracial minority background predicted global improvement. In patients with primary MDD, higher treatment outcome expectations and being referred from the community (vs. inpatient hospitalization) predicted better depression response, and higher treatment outcome expectations predicted global improvement. In patients with other primary diagnoses, higher treatment outcome expectations and fewer borderline personality disorder traits predicted depression reduction, and higher treatment outcome expectations, less relationship difficulty, and female gender predicted global improvement. Results are generally consistent with data from randomized controlled trials on longer term outpatient CBT. Interventions that increase treatment expectancy and modifications to better target men may enhance treatment outcome. Future research should include objective outcome measures and examine mechanisms underlying treatment response. © 2016 Wiley Periodicals, Inc.
John P. Ulhøi
Full Text Available This paper calls for the need to address climate change within the concept of sustainable development, in recognition of the interrelationships between environmental, economic and social systems. So far, health- providing organizations such as hospitals have paid surprisingly little attention to the relationships between environmental change (e.g. climate change and human health, or between hospitals (as professional organizations and their impact on sustainable development. Although it is usually such industries as the chemical, extractive and metal industries, etc., that are associated with environmentally harmful activities, there is also an urgent need to emphasize the roles and responsibilities of hospitals and their embeddedness in a wider ecological, economic and social context. The key objective here is to discuss the relevance of sustainability and environmental management issues in a sector that until now has conveniently ignored its roles and responsibilities in relation to sustainability issues. The paper concludes that arguments based on systems theory, environment, medicine, economics and innovation strongly urge hospitals to reconsider their present roles and environmental responsibilities.
Arbabisarjou, Azizollah; Hajipour, Reza; Sadeghian, Mahdi
"The correlation between justice and organizational citizenship behavior and organizational identity among the nurses", aimed to correlate different aspects of personal feelings and organizational identity in a population of nurses. The population included all nurses working at hospitals affiliated to administry of health, treatment and medical education in Shahre-Kord (Iran) 2009. A sample consisting of 168 nurses was randomly selected out of the population. The study adopted a descriptive-correlative method. The Organizational Justice Questionnaire (1998), the Organizational Citizenship Questionnaire, and Organizational Identity Questionnaire (1982) were used for gathering data. Data was analyzed through multiple regression analysis. The findings revealed that 4 dimensions of organizational citizenship behavior (altruism, civic virtue, conscientiousness, and self-development) are correlated with organizational identity (R² = 0.612); and loyalty and obedience are correlated with distributional justice (R² = 0.71). Also, loyalty, altruism, and obedience are correlated with procedural justice (R² = 0.69) and loyalty and self-development are correlated with distributional justice (R² = 0.89). A correlation was also detected between interactional justice and organizational identity (R² = 0.89). The findings of the study could serve to identify the factors contributing to the creation and recreation of organizational identity, citizenship behavior and justice among nurses, to promote the performance of the organization, and to achieve organizational goals.
The link between information systems (IS) and organizational change has been well established in the IS literature. This dissertation introduces the Complex Responsive Processes perspective as a novel approach to the study of IS-related organizational change. By combining insights from complexity...... this novel approach to the study of IS-related organizational change, the dissertation identifies the role of conflict as a potential driver of IS-related organizational change as well as the need for ongoing initiatives to ensure the needed local changes. Further, power is emphasized as a relational...... science with insights from social science, attention is directed to differences, and the related conflict and power balance as the basis of change. An interpretive case study was conducted of a process towards realizing the digital school unfolding within a Danish municipality. Through observations...
Costello, M M
With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.
Leach, Linda Searle
To investigate the relationship between nurse executive leadership and organizational commitment among nurses in acute care hospitals. A key challenge for organizations is to maximize the contributions of all workers by cultivating their commitment. Nurse leaders are in a position to influence organizational commitment among nurses. The theoretical constructs underlying this study are the transformational leadership theory and the Etzioni's organizational theory. A cross-sectional, field survey of nurse executives, nurse managers, and staff nurses was conducted to assess nurse executive transformational and transactional leadership and their relationship to organizational commitment. Hypotheses were tested using correlational analysis, and univariate statistics were used to describe the sample. An inverse relationship between nurse executive transformational and transactional leadership and alienative (highly negative) organizational commitment was statistically significant. A positive association was demonstrated between nurse executive leadership and nurse manager leadership. This study supports the effect of nurse executive leadership on nurse manager leadership and on organizational commitment among nurses despite role distance. To the extent that transformational leadership is present, alienative organizational commitment is reduced. This relationship shows the importance of nurse executive leadership in organizational involvement among nurses in the dynamic context of contemporary hospital settings.
Alecxandrina DEACONU; Lavinia RASCA
Organizational performance has, over time, become a fundamental objective of managerial strategies. Its achievement is conditioned by thorough scientific research concerning the context in which it is obtained as well as the analysis of the concept of Organizational Citizenship Behaviour (OCB) and the way it influences different dimensions of organizational involvement, organizational climate, work satisfaction and, consequently, business results. This study has a two-part structure: the firs...
Vladimir Nikiforovich Belkin
Full Text Available In the article, the main theoretical questions of the organizational capital of the enterprise are considered. The concept of «organizational capital of the enterprise» as a system consisting of three subsystems (organization of production, labour organization and management is introduced. It is shown that the organizational capital forms the labour relations system at the enterprise consisting of the cooperation, technological, economic, moral labour relations and the relations of workers’ responsibility. The model of cyclic evolution of crisis at the enterprise caused by shortcomings of the organizational capital is revealed. It is shown that the organizational capital is a basis for the realization of the human capital, which creates value added. A considerable attention is paid to the experience of the creation and functioning of the organizational capital at the enterprises of the Japanese corporation «Toyota». The Russian economic literature on crisis management quite often considers only the financial aspects of diagnostics, proposing the optimization of cash flows, elimination of excess stocks, transition to the medium-term budgeting and others. However, the deep reasons of crisis need to be found not only in financial streams, but also in the system of the work relationships. The shortcomings in the development of technological, cooperation, economic, moral labour relations and the relations of responsibility directly reflects the shortcomings in the development of the elements of the organizational capital as they «are adjusted» by these elements. In turn, organizational problems affect the product quality leading to the customer attrition and decrease in the enterprise’s financial performance. The lack of financial resources cause the need to save costs (first of all, on personnel, that was brightly shown by the economic crisis of 2009 that even more weakens the enterprise and system of labour relations. Finally, the
Archana Shrestha Joshi
Conclusions: Since both support from boss and training program were found to be positive and significant with affective commitment, hospitals must encourage supervisors to provide more assistance to the subordinate nurses. Moreover, hospitals should develop more training programs to keep nurses motivated. Keywords: nursing management; organizational commitment; organizational characteristics; retention.
Purpose: The aim of this paper is to investigate how organizational socialization tactics affect newcomers' organizational commitment and learning processes. Design/methodology/approach: A survey was conducted using a measurement tool based on Van Maanen and Schein's theory on organizational socialization tactics and Kuvaas' measurement tools of…
Background Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days. Methods The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation. Results The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators. Conclusions The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels. PMID:21575233
Full Text Available Abstract Background Earthquakes are renowned as being amongst the most dangerous and destructive types of natural disasters. Iran, a developing country in Asia, is prone to earthquakes and is ranked as one of the most vulnerable countries in the world in this respect. The medical response in disasters is accompanied by managerial, logistic, technical, and medical challenges being also the case in the Bam earthquake in Iran. Our objective was to explore the medical response to the Bam earthquake with specific emphasis on pre-hospital medical management during the first days. Methods The study was performed in 2008; an interview based qualitative study using content analysis. We conducted nineteen interviews with experts and managers responsible for responding to the Bam earthquake, including pre-hospital emergency medical services, the Red Crescent, and Universities of Medical Sciences. The selection of participants was determined by using a purposeful sampling method. Sample size was given by data saturation. Results The pre-hospital medical service was divided into three categories; triage, emergency medical care and transportation, each category in turn was identified into facilitators and obstacles. The obstacles identified were absence of a structured disaster plan, absence of standardized medical teams, and shortage of resources. The army and skilled medical volunteers were identified as facilitators. Conclusions The most compelling, and at the same time amenable obstacle, was the lack of a disaster management plan. It was evident that implementing a comprehensive plan would not only save lives but decrease suffering and enable an effective praxis of the available resources at pre-hospital and hospital levels.
Jericó, Marli Carvalho; Peres, Aida Maris; Kurcgant, Paulina
This study addresses the culture and power influencing the organizational structure of the nursing services at a teaching hospital. The Nursing Service organizational structure (organization chart) was outlined due to the need of the general management of the hospital to standardize the nursing procedures. Due to this situation, the nursing managers' interest has arisen to widen the power setting, strengthening nursing in an intra-institutional environment.
Gray, Erika; Currey, Judy; Considine, Julie
To obtain an understanding of how Hospital in the Home (HITH) nurses recognise and respond to clinical deterioration in patients receiving care at home or in their usual place of residence. Recognising and responding to clinical deterioration is an international safety priority and a key nursing responsibility. Despite an increase in care delivery in home environments, how HITH nurses recognise and respond to clinical deterioration is not yet fully understood. A prospective, descriptive exploratory design was used. A survey containing questions related to participant characteristics and 10 patient scenarios was used to collect data from 47 nurses employed in the HITH units of three major health services in Melbourne, Australia. The 10 scenarios reflected typical HITH patients and included medical history and clinical assessment findings (respiratory rate, oxygen saturation, heart rate, blood pressure, temperature, conscious state and pain score). The three major findings from this study were that: (i) nurse and patient characteristics influenced HITH nurses' assessment decisions; (ii) the cues used by HITH nurses to recognise clinical deterioration varied according to the clinical context; and (iii) although HITH nurses work in an autonomous role, they engage in collaborative practice when responding to clinical deterioration. Hospital in the Home nurses play a fundamental role in patient assessment, and the context in which they recognise and respond to deterioration is markedly different to that of hospital nurses. The assessment, measurement and interpretation of clinical data are a nursing responsibility that is crucial to early recognition and response to clinical deterioration. The capacity of HITH services to care for increasing numbers of patients in their home environment, and to promptly recognise and respond to clinical deterioration should it occur, is fundamental to safety within the healthcare system. Hospital in the Home nurses are integral to a
Full Text Available Designing organizations in the present economic context should take into account organizational learning, as knowledge is considered to be one of the most important resources to the creation of sustainable competitive advantage. Companies can promote organizational learning by regulating mechanisms in its internal firm structure. An argument is put forward that firms can possess a learning strategy whose purpose is to optimize organizational mechanisms that promote organizational learning. This paper theoretically discusses how internal firm structures may be designed to optimize organizational learning.
Heerwagen, J.H.; Heubach, J.G.; Brown, B.W.; Sanchez, J.A.; Montgomery, J.C.; Weimer, W.C.
In response to a request from the Pacific Northwest Laboratory`s Analytical Chemistry Upgrades Program, a team was formed to (1) review work environment and productivity research, (2) report the research in a manner usable to organizational decision-makers, (3) identify Hanford Site facilities examples of the work environment principles and research, and (4) publish the review results in a referred journal. This report summarizes the work environment-organizational effectiveness research reviewed, provides the foundation for a publishable article, and outlines the integration of work environment research and organizational effectiveness in continuing improvement programs and strategic planning. The research cited in this review shows that the physical work environment offers a valuable tool that, used wisely, can contribute significantly to the performance of an organization, its bottom-line economics, and the well-being of all of its employees. This finding leads to one central recommendation: to derive the maximum benefit to the corporation, managers and designers must integrate organizational goals and programs with work environment design. While much of the research cited focuses on office environments, the results and design principles and practices are relevant to a full range of settings: laboratories, schools, hospitals, and factories. The major findings of the research reviewed are summarized below in four areas: (1) performance, (2) well-being, (3) image, and (4) turnover and recruitment.
Organizational culture refers to the beliefs and values that have existed in an organization for a long time, and to the beliefs of the staff and the foreseen value of their work that will influence their attitudes and behavior. It is therefore essential to understand the relationship between organizational cultures and organizational effectiveness. A cross-sectional study was undertaken that focused on hospital nurses in Taiwan. Data was collected using a structured questionnaire; 900 questionnaires were distributed and 473 valid questionnaires were returned. Organizational cultures were significantly (positively) correlated with organizational effectiveness (p<0.001). When the interaction between the leadership and employees is good, the latter will make a greater contribution to team communication and will also be encouraged to accomplish the mission and objectives assigned by the organization, thereby enhancing organizational effectiveness.
Jensen, Andreas Schmidt; Aldewereld, Huib; Dignum, Virginia
be supported to include organizational objectives and constraints into their reasoning processes by considering two alternatives: agent reasoning and middleware regulation. We show how agents can use an organizational specification to achieve organizational objectives by delegating and coordinating...... their activities with other agents in the society, using the GOAL agent programming language and the OperA organizational model....
Arnold, Jeffrey L; Levine, Brian Neil; Manmatha, R; Lee, Francis; Shenoy, Prashant; Tsai, Ming-Che; Ibrahim, Taha K; O'Brien, Daniel J; Walsh, Donald A
Numerous examples exist of the benefits of the timely access to information in emergencies and disasters. Information technology (IT) is playing an increasingly important role in information-sharing during emergencies and disasters. The effective use of IT in out-of-hospital (OOH) disaster response is accompanied by numerous challenges at the human, applications, communication, and security levels. Most reports of IT applications to emergencies or disasters to date, concern applications that are hospital-based or occur during non-response phases of events (i.e., mitigation, planning and preparedness, or recovery phases). Few reports address the application of IT to OOH disaster response. Wireless peer networks that involve ad hoc wireless routing networks and peer-to-peer application architectures offer a promising solution to the many challenges of information-sharing in OOH disaster response. These networks offer several services that are likely to improve information-sharing in OOH emergency response, including needs and capacity assessment databases, victim tracking, event logging, information retrieval, and overall incident management system support.
Full Text Available The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication and coordinated care increases in direct proportion to sophisticated technology and treatment strategies of complex disease processes. Safe patient care is facilitated by individual professional learning; inter-professional team learning and system based organizational learning, which encompass modified context specific learning by multiple teams and team members in a health care organization. Organizational learning in health care systems is central to managing the learning requirements in complex interconnected dynamic systems where all have to know common background knowledge along with shared meta-knowledge of roles and responsibilities to execute their assigned functions, communicate and transfer the flow of pertinent information and collectively provide safe patient care. Organizational learning in health care is not a onetime intervention, but a continuing organizational phenomenon that occurs through formal and informal learning which has reciprocal association with organizational change. As such, organizational changes elicit organizational learning and organizational learning implements new knowledge and practices to create organizational changes.
Jones, David A.; Willness, Chelsea R.; Glavas, Ante
Researchers, corporate leaders, and other stakeholders have shown increasing interest in Corporate Social Responsibility (CSR)—a company’s discretionary actions and policies that appear to advance societal well-being beyond its immediate financial interests and legal requirements. Spanning decades of research activity, the scholarly literature on CSR has been dominated by meso- and macro-level perspectives, such as studies within corporate strategy that examine relationships between firm-level indicators of social/environmental performance and corporate financial performance. In recent years, however, there has been an explosion of micro-oriented CSR research conducted at the individual level of analysis, especially with respect to studies on how and why job seekers and employees perceive and react to CSR practices. This micro-level focus is reflected in 12 articles published as a Research Topic collection in Frontiers in Psychology (Organizational Psychology Specialty Section) titled “CSR and organizational psychology: Quid pro quo.” In the present article, the authors summarize and integrate findings from these Research Topic articles. After describing some of the “new frontiers” these articles explore and create, the authors strive to fulfill a “quid pro quo” with some of the meso- and macro-oriented CSR literatures that paved the way for micro-CSR research. Specifically, the authors draw on insights from the Research Topic articles to inform a multilevel model that offers multiple illustrations of how micro-level processes among individual stakeholders can explain variability in meso (firm)-level relationships between CSR practices and corporate performance. The authors also explore an important implication of these multilevel processes for macro-level societal impact. PMID:28439247
Jones, David A; Willness, Chelsea R; Glavas, Ante
Researchers, corporate leaders, and other stakeholders have shown increasing interest in Corporate Social Responsibility (CSR)-a company's discretionary actions and policies that appear to advance societal well-being beyond its immediate financial interests and legal requirements. Spanning decades of research activity, the scholarly literature on CSR has been dominated by meso- and macro-level perspectives, such as studies within corporate strategy that examine relationships between firm-level indicators of social/environmental performance and corporate financial performance. In recent years, however, there has been an explosion of micro-oriented CSR research conducted at the individual level of analysis, especially with respect to studies on how and why job seekers and employees perceive and react to CSR practices. This micro-level focus is reflected in 12 articles published as a Research Topic collection in Frontiers in Psychology (Organizational Psychology Specialty Section) titled "CSR and organizational psychology: Quid pro quo." In the present article, the authors summarize and integrate findings from these Research Topic articles. After describing some of the "new frontiers" these articles explore and create, the authors strive to fulfill a "quid pro quo" with some of the meso- and macro-oriented CSR literatures that paved the way for micro-CSR research. Specifically, the authors draw on insights from the Research Topic articles to inform a multilevel model that offers multiple illustrations of how micro-level processes among individual stakeholders can explain variability in meso (firm)-level relationships between CSR practices and corporate performance. The authors also explore an important implication of these multilevel processes for macro-level societal impact.
Harris, Curtis; Bell, William; Rollor, Edward; Waltz, Tawny; Blackwell, Pam; Dallas, Cham
We designed and conducted a regional full-scale exercise in 2007 to test the ability of Atlanta-area hospitals and community partners to respond to a terrorist attack involving the coordinated release of 2 dangerous chemicals (toluene diisocyanate and parathion) that were being transported through the area by tanker truck. The exercise was designed to facilitate the activation of hospital emergency response plans and to test applicable triage, decontamination, and communications protocols. Plume modeling was conducted by using the Defense Threat Reduction Agency's (DTRA) Hazard Prediction and Assessment Capability (HPAC) V4 program. The scenario went through multiple iterations as exercise planners sought to reduce total injuries to a manageable, but stressful, level for Atlanta's health care infrastructure. Atlanta-area hospitals rapidly performed multiple casualty triage and were able to take in a surge of victims from the simulated attack. However, health care facilities were reticent to push the perceived manageable numbers of victims, and scenarios were modified significantly to lower the magnitude of the simulated attack. Additional coordination with community response partners and incident command training is recommended. Security at health care facilities and decontamination of arriving victims are two areas that will require continued review. Atlanta-area hospitals participated in an innovative regional exercise that pushed facilities beyond traditional scopes of practice and brought together numerous health care community response partners. Using lessons learned from this exercise coupled with subsequent real-world events and training exercises, participants have significantly enhanced preparedness levels and increased the metropolitan region's medical surge capacity in the case of a multiple casualty disaster.
Sumner, Jennifer; Liberman, Aaron; Rotarius, Timothy; Wan, Thomas T H; Eaglin, Ronald
Health care in the United States is a system that, organizationally speaking, is fragmented. Each hospital facility is independently operated and is responsible for the hiring of its own employees. Corrupt individuals can take advantage of this fragmentation and move from hospital to hospital, gaining employment while hiding previous employment history. However, the need to exchange pertinent information regarding employees will become necessary as hospitals seek to fill positions throughout their organizations. One way to promote this information exchange is to develop trusted information sharing networks among hospital units. This study examined the problems surrounding organizational information sharing and the cultural factors necessary to enhance the exchange of employee information. Surveys were disseminated to 2,603 hospital chief executive officers and chief information officers throughout the nation. A sample of 154 respondents provided data into their current hiring practices and on their willingness to engage in the sharing of employee information. Findings indicated that, although fear of defamation and privacy violations do hinder the exchange of information between hospitals during the hiring process, by increasing external trust, linking the sharing process with the organizational goals of the hospital, and developing a "sharing culture" among hospitals, the exchange of employee information could be enhanced.
Rennick, Janet E; Dougherty, Geoffrey; Chambers, Christine; Stremler, Robyn; Childerhose, Janet E; Stack, Dale M; Harrison, Denise; Campbell-Yeo, Marsha; Dryden-Palmer, Karen; Zhang, Xun; Hutchison, Jamie
Pediatric intensive care unit (PICU) hospitalization places children at increased risk of persistent psychological and behavioral difficulties following discharge. Despite tremendous advances in medical technology and treatment regimes, approximately 25% of children demonstrate negative psychological and behavioral outcomes within the first year post-discharge. It is imperative that a broader array of risk factors and outcome indicators be explored in examining long-term psychological morbidity to identify areas for future health promotion and clinical intervention. This study aims to examine psychological and behavioral responses in children aged 3 to 12 years over a three year period following PICU hospitalization, and compare them to children who have undergone ear, nose and/or throat (ENT) day surgery. This mixed-methods prospective cohort study will enrol 220 children aged 3 to 12 years during PICU hospitalization (study group, n = 110) and ENT day surgery hospitalization (comparison group, n = 110). Participants will be recruited from 3 Canadian pediatric hospitals, and followed for 3 years with data collection points at 6 weeks, 6 months, 1 year, 2 years and 3 years post-discharge. Psychological and behavioral characteristics of the child, and parent anxiety and parenting stress, will be assessed prior to hospital discharge, and again at each of the 5 subsequent time points, using standardized measures. Psychological and behavioral response scores for both groups will be compared at each follow-up time point. Multivariate regression analysis will be used to adjust for demographic and clinical variables at baseline. To explore baseline factors predictive of poor psychological and behavioral scores at 3 years among PICU patients, correlation analysis and multivariate linear regression will be used. A subgroup of 40 parents of study group children will be interviewed at years 1 and 3 post-discharge to explore their perceptions of the impact of PICU
José G. Vargas Hernández; Mohammad Reza Noruzi
Organizational economics makes important contributions to management theory. The focus of structural contingency theory is on the phenomena of the economy significant in organizational management theory and other new paradigms of organizational theories. However, the theory of organizational economics has hardly taken the multiple disciplines of organizational behaviour, strategy and theory, but is aligned with the management theories of psychology, sociology and policy dealing with human mot...
Swasti Sri Harjanti
Full Text Available Abstract. As a response to negative growth in the mobile legacy projection - which supports 50% of Telkom revenue, and a positive high growth projection in the ICT and digital business revenue, Telkom decides to shift the business to digital. To be a successful digital company, Telkom has created strategic initiatives, including organizational transformation adopting Customer Facing Unit (CFU concept that has been done for several months but there still no evaluation method for the success. This paper purpose is to evaluate the implementation of one human capital management strategic initiatives - CFU transformation implementation success, through Organizational Health Index and Organizational Agility Maturity model and formulate a recommendation for Telkom to create a more healthy and agile organization. This research using 11 synthetized dimension of Organization Health Index and Organizational Agility Maturity Model method as tools. Questionnaire consist of 53 practices that represented by 55 questions that asks about respondents extent to which they agree (satisfaction and whether it meet respondents expectation. Survey result shows that Telkom already in a healthy condition and agile as an organization. This result concluded that by methods used in this research, the transformation could be stated as a success. However, according to the result, maintain and improvement of current health and agility still needed, especially improvement regarding innovation and learning. Keywords:Organization, organizational agility, organizational health index, telecommunication, transformation
Walters, E Haydn; Dawson, David J
The major problem of access block to acute hospital admissions in Australia needs a more radical response than a focus on increasing inpatient beds, as suggested recently. Australia needs to take on board recent changes in United Kingdom hospital systems, which have revolutionised patient flow during acute admissions and dramatically improved efficiency, clinical quality and outcomes. Accident and emergency departments in the UK became recognised as part of acute hospital dysfunction. Now, increasingly, patients needing admission are directed as soon as possible to an acute medical assessment and admission unit (AMAAU), thus freeing accident and emergency staff for re-defined core priorities. AMAAUs require supervision by a new style of acute general physician, who drives timely management of acute medical patients, defines patient needs, estimates the likely date of discharge, and selects the most appropriate inpatient clinical stream. These reforms are staff-intensive and expensive, but cost-effective and patient-focused. They highlight the need for an adequate scale for acute clinical services and defined streams of care within individual hospitals, as well as explicit networking at a regional level to guarantee specialist acute services when needed.
An important issue in the design of secure supply chains is the understanding of the relation between supply chains and the organizational responsibility of specific parts of these supply chains. Organizational boundaries change over time by means of vertical and/or horizontal (des)-integration and
Johnson, Susan L.; Boutain, Doris M.; Tsai, Jenny H.-C.; de Castro, Arnold B.
OBJECTIVE To explore how workplace bullying is addressed by hospital nursing unit managers and organizational policies. BACKGROUND Although workplace bullying is costly to organizations, nurses report that managers do not consistently address the issue. METHODS This study used discourse analysis to analyze interview data and policy documents. RESULTS There were differences in the manner in which managers and the policy documents labeled bullying-type behaviors and discussed the roles and responsibilities of staff and managers. Policies did not clearly delineate how managers should respond to workplace bullying. CONCLUSIONS These differences can allow management variation, not sanctioned by policy. Unclear policy language can also offer insufficient guidance to managers, resulting in differential enforcement of policies. PMID:26301552
Goeschel, Christine A; Wachter, Robert M; Pronovost, Peter J
Concern about the quality and safety of health care persists, 10 years after the 1999 Institute of Medicine report To Err is Human. Despite growing awareness of quality and safety risks, and significant efforts to improve, progress is difficult to measure. Hospital leaders, including boards and medical staffs, are accountable to improve care, yet they often address this duty independently. Shared responsibility for quality and patient safety improvement presents unique challenges and unprecedented opportunities for boards and medical staffs. To capitalize on the pressure to improve, both groups may benefit from a better understanding of their synergistic potential. Boards should be educated about the quality of care provided in their institutions and about the challenges of valid measurement and accurate reporting. Boards strengthen their quality oversight capacity by recruiting physicians for vacant board seats. Medical staff members strengthen their role as hospital leaders when they understand the unique duties of the governing board. A quality improvement strategy rooted in synergistic efforts by the board and the medical staff may offer the greatest potential for safer care. Such a mutually advantageous approach requires a clear appreciation of roles and responsibilities and respect for differences. In this article, we review these responsibilities, describe opportunities for boards and medical staffs to collaborate as leaders, and offer recommendations for how boards and medical staff members can address the challenges of shared responsibility for quality of care.
Dilwali, Prashant K
The responsibility of hospitals is changing. Those activities that were once confined within the walls of the medical facility have largely shifted outside them, yet the requirements for hospitals have only grown in scope. With the passage of the Patient Protection and Affordable Care Act (ACA) and the development of accountable care organizations, financial incentives are focused on care coordination, and a hospital's responsibility now includes postdischarge outcomes. As a result, hospitals need to adjust their business model to accommodate their increased need to impact post-acute care settings. A home care service line can fulfill this role for hospitals, serving as an effective conduit to the postdischarge realm-serving as both a potential profit center and a risk mitigation offering. An alliance between home care agencies and hospitals can help improve clinical outcomes, provide the necessary care for communities, and establish a potentially profitable product line.
Livia Oliveira Borges
Full Text Available O presente estudo analisa o relacionamento entre os valores organizacionais e os níveis da síndrome de burnout, em três hospitais universitários do Rio Grande do Norte. Foi desenvolvido com uma amostra de 205 profissionais de saúde, através da aplicação de questionários estruturados. Os dados foram submetidos a análises quantitativas (por exemplo, análises das distribuições de freqüência, de variância e de regressão. Os resultados apontam convergência dos escores nos fatores dos valores ideais por organização participante e divergências no que se refere tanto aos escores dos fatores dos valores reais quanto às descompensações axiológicas (diferenças entre ideal e real. Os participantes diferem quanto ao avanço do processo de desenvolvimento da síndrome de burnout por organizações. Constatou-se o papel de mediação das organizações no relacionamento entre valores organizacionais e a síndrome de burnout, de modo que os pólos axiológicos efetivamente relacionados à referida síndrome e/ou aos seus fatores dependem da configuração geral da cultura organizacional de cada uma e dos conflitos que lhe são inerentes.The present study analyzes the relationship between the organizational values and the levels of the burnout syndrome in three universitarian hospitals. It was developed with the sample of 205 health professionals, though to an application of structured questionnaires. The data were submitted quantitative analysis (for example, analysis of frequency distributions, analyses of variance and regression analyses. The results show a convergence among scores of ideal values for organizations and divergences among the scores of real values and the differences from ideal and real values. The participants differ in the advance of the burnout syndrome process for organizations. The results evidences the mediation role of the organizations in the relationship between organizational values and the burnout syndrome
Crane, Glenis J; Kymes, Steven M; Hiller, Janet E; Casson, Robert; Martin, Adam; Karnon, Jonathan D
Decision-analytic models are routinely used as a framework for cost-effectiveness analyses of health care services and technologies; however, these models mostly ignore resource constraints. In this study, we use a discrete-event simulation model to inform a cost-effectiveness analysis of alternative options for the organization and delivery of clinical services in the ophthalmology department of a public hospital. The model is novel, given that it represents both disease outcomes and resource constraints in a routine clinical setting. A 5-year discrete-event simulation model representing glaucoma patient services at the Royal Adelaide Hospital (RAH) was implemented and calibrated to patient-level data. The data were sourced from routinely collected waiting and appointment lists, patient record data, and the published literature. Patient-level costs and quality-adjusted life years were estimated for a range of alternative scenarios, including combinations of alternate follow-up times, booking cycles, and treatment pathways. The model shows that a) extending booking cycle length from 4 to 6 months, b) extending follow-up visit times by 2 to 3 months, and c) using laser in preference to medication are more cost-effective than current practice at the RAH eye clinic. The current simulation model provides a useful tool for informing improvements in the organization and delivery of glaucoma services at a local level (e.g., within a hospital), on the basis of expected effects on costs and health outcomes while accounting for current capacity constraints. Our model may be adapted to represent glaucoma services at other hospitals, whereas the general modeling approach could be applied to many other clinical service areas.
Takahashi, Akira; Ishii, Noboru; Kawashima, Takahisa; Nakao, Hiroyuki
INTRODUCTION For the assessment on medical response capacity for disaster in local area (such as rescue capacity, transport capacity and treatment capacity), it is necessary to assess it in peace time, and understand how many sufferers from disaster the hospital can respond to. Here the estimated formula of Hospital Treatment Capacity (hereinafter shortened to HTC), the maximum receivable number of patients in hospital (hereinafter shortened to MRN) was showed, which derived from the assessment on emergency medical response in Kobe University Hospital as an example. MATERIALS AND METHODS We treated a total of 12,032 patients transferred and admitted to Kobe University Hospital from April 2003 to January 2005. We calculated the required number of medical personnel, equipment and length of treatment time in order to respond to 410 severe traumas, 35 burn injuries, and 28 patients with blood purification, which were considered to be main clinical conditions in disaster. Beside, the occupation of emergency room and the operation room per hour were also investigated in our hospital. RESULTS HTC (MRN) for each clinical condition within H hours is expressed by following formula: (1) HTC (MRN) for burn injuries = The maximum integer of ( or =H/1.85) (2) HTC (MRN) for patients with blood purification = The maximum integer of ( or =H/2.00) (3) HTC (MRN) for severe traumas =The maximum integer of ( or =H/2.82+b) CONCLUSION The treatment capacity within local area is able to be assessed by adopting the estimated formula of HTC (MRN).
Kogure, Tomohito; Jujo, Kentaro; Hamada, Kazuyuki; Saito, Katsumi; Hagiwara, Nobuhisa
Tolvaptan has been gradually spread to use as a potent diuretic for congestive heart failure in the limited country. However, the response to this aquaretic drug still is unpredictable. A total of 92 patients urgently hospitalized due to congestive heart failure and treated with tolvaptan in addition to standard treatment was retrospectively analyzed. Responder of tolvaptan treatment was defined as a patient with peak negative fluid balance greater than 500 mL/day, and clinical profiles were compared between 76 responders and 16 non-responders. Responders started to increase daily urine volume (UV) from Day 1 through Day 3. In contrast, non-responders showed no significant increase in daily UV from the baseline up to Day 5. Time between admission and tolvaptan administration was shorter in responders, even without statistical significance (3.3 vs. 4.6 days, p = 0.053). Multivariate analysis revealed that blood urea nitrogen (BUN) [cutoff: 34 mg/dL, odds ratio (OR) 9.0, 95% confidence interval (CI) 1.42-57.3, p tolvaptan responsiveness. It suggests that renal perfusion may affect tolvaptan-induced UV. Finally, durations of stay in intensive care unit and total hospitalization were significantly shorter in responders (median: 6.0 vs. 13.0 days, p = 0.022; 15.0 vs. 25.0 days, p = 0.016, respectively). Responders of tolvaptan have lower BUN and renin activity at baseline, and shorten hospitalization period. Trial Registration The study was registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) with the identifier UMIN000023594. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024988.
Lilian Aparecida Pasquini Miguel
Full Text Available Innovation is a source of competitive advantage and is based on the continuous creation of organizational knowledge, which is supported by the individual learning. The individual learning of traditional / comportamentalist and constructivist nature can be understood, by extension, as organizational learning. The knowledge can be innovative if, along with the enabling conditions that characterize it - intention, fluctuation or chaos, autonomy, redundancy and variety of requirements – the process of learning is based on a constructivist nature, the only one capable to generate new learning solutions. The organizational values are beliefs that guide the organizations behavior and constitute motivational goals. This work had as aim to identify the relationship between organizational values and the creation of knowledge. The descriptive exploratory research used the quantitative method. The organizational values appeared in this study mainly associated to the knowledge creation aspects in the internal sphere of the organizations. The orientation towards the external environment appeared less related to the organizational values.
Walrath, Jo M; Dang, Deborah; Nyberg, Dorothy
This study investigated registered nurses' (RNs) and physicians' (MD) experiences with disruptive behavior, triggers, responses, and impacts on clinicians, patients, and the organization. Using the Disruptive Clinician Behavior Survey for Hospital Settings, it was found that RNs experienced a significantly higher frequency of disruptive behaviors and triggers than MDs; MDs (45% of 295) and RNs (37% of 689) reported that their peer's disruptive behavior affected them most negatively. The most frequently occurring trigger was pressure from high census, volume, and patient flow; 189 incidences of harm to patients as a result of disruptive behavior were reported. Findings provide organizational leaders with evidence to customize interventions to strengthen the culture of safety.
Kuokkanen, Liisa; Suominen, Tarja; Rankinen, Sirkku; Kukkurainen, Marja-Leena; Savikko, Nina; Doran, Diane
This study describes the views of multidisciplinary teams on work-related empowerment in a transitional organization. The data were collected between September 2003 and January 2004 (n=115) and one year later (n=112) using a self-administered questionnaire consisting of verbal and behavioural items, empowerment outcomes, and factors promoting and impeding empowerment. The target population consisted of all members working in multidisciplinary teams at the Rheumatism Foundation Hospital in Finland. The response rate was 58% at both data collections. The data were analysed statistically using SPSS software. The multidisciplinary teams rated their work empowerment quite highly. The number of empowerment promoting factors was lowest for the category of future orientedness, consisting of continuity of work, opportunities for advancement, and access to information. The number of impeding factors was also highest for the same category of future orientedness, consisting here of organizational bureaucracy and hierarchy, authoritarian leadership, poor access to information, and short working periods. It is important not to underestimate the impacts of organizational changes: they have a direct effect on the work environment and may contribute to higher rates of dissatisfaction, burnout and absenteeism among health care workers.
Reeves, Ashleigh; Gregg, Chris; Lindell, Michael; Prater, Carla; Joyner, Timothy; Eggert, Sarah
This study describes response to and preparedness for eruption and unrest at Kīlauea and Mauna Loa volcanoes, respectively. The on-going 1983-present eruption of Kīlauea's East Rift Zone (ERZ) has generated a series of lava flow crises, the latest occurring in 2014 and 2015 when lava from a new vent flowed northeast and into the perimeter of developed areas in the lower Puna District, some 20km distant. It took ca. 2 months for the June 27 lava flow to advance a distance to which scientists reported it might be a concern to people downslope, but this prompted widespread formal and informal responses and culminated in improvements to infrastructure, voluntary evacuations of residents and businesses and closure of schools. Unlike Kīlauea, which has had frequent crises since the mid-20th century, the last eruption of nearby Mauna Loa occurred in 1984 and the last eruption and crisis on its Southwest Rift Zone (SWZ) was in 1950, so residents there are less familiar with eruptions than in Puna. In September 2015, the US Geological Survey, Hawaiian Volcano Observatory upgraded Mauna Loa's Alert Level from Normal to Advisory due to increases in unrest above known background levels. A crisis on Mauna Loa's SWZ would likely be much different than the recent 2014-15 crisis at Kīlauea as steep topography downslope of the SWZ and typical high discharge rates mean lava flows move fast, posing increased risk to areas downslope. Typically, volcanic eruptions have significant economic consequences out of proportion with their magnitudes. Furthermore, uncertainties regarding the physical and organizational communication of risk information amplify these economic losses. One significant impediment to risk communication is limited knowledge about the most effective ways to verbally, numerically and graphically communicate scientific uncertainty. This was a challenge in the recent lava flow crisis on Kīlauea. The public's demand for near-real time information updates, including
M. Abdi Talarposht
Full Text Available Background: Agility is an effective response to the changing and unpredictable environment and using these changes as opportunities for organizational improvement. Objective: The aim of the present study was to rank the factors affecting agile supply chain of hospitals of Iran. Methods: This applied study was conducted by cross sectional-descriptive method at some point of 2015 for one year. The research population included managers, administrators, faculty members and experts were selected hospitals. A total of 260 people were selected as sample from the health centers. The construct validity of the questionnaire was approved by confirmatory factor analysis test and its reliability was approved by Cronbach's alpha (α=0.97. All data were analyzed by Kolmogorov-Smirnov, Chi-square and Friedman tests. Findings: The development of staff skills, the use of information technology, the integration of processes, appropriate planning, and customer satisfaction and product quality had a significant impact on the agility of public hospitals of Iran (P<0.001. New product introductions had earned the highest ranking and the development of staff skills earned the lowest ranking. Conclusion: The new product introduction, market responsiveness and sensitivity, reduce costs, and the integration of organizational processes, ratings better to have acquired agility hospitals in Iran. Therefore, planners and officials of hospitals have to, through the promotion quality and variety of services customer-oriented, providing a basis for investing in the hospital and etc to apply for agility supply chain public hospitals of Iran.
Sappington, Rodney W.
In research conducted at academic and community hospitals in the United States since 2001, this paper examines complex human and technological relationships employed to renegotiate behavior within hospital administrative and clinical cultures. In the planning and implementation of PACS in a four-facility hospital we will enter into what can be described as processes of "adoption" and "resistance", seemingly opposite approaches to system implementation, which I argue are in fact key responses to planning, design, and customization of imaging and information systems in a context of convergence. In a larger context of convergence known as NBIC tools (nanotechnology, biotechnology, information technology, and cognitive sciences) it has become increasingly clear to leaders in the field that it is essential to redesign organizational technologies. A novel system has little chance of being fully utilized by conventional organizational structures in an era of system convergence. The challenge of embracing a larger systems perspective lies in opening untapped potential within the healthcare enterprise by preparing the ground for reflection on new approaches to training, and bridging specialized knowledge across computer engineering, clinical decision making, and organizational perspectives for the benefit of patient care. Case studies will demonstrate how organizational and system design technologies are crucial in insuring that PACS implementation strategies can encourage the emergence of new levels of quality for patient care. The goal is to provide successful design-build models that are true to organizational specificity, persons, and clinical practices undergoing change and uncertainty.
2007 FINAL REPORT I JULY 2006 to JULY 2007 4. TITLE AND SUBTITLE Sm. CONTRACT NUMBER Effects of Emergency Preparedness and Disaster Response on...public release; distribution is unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Emergency preparedness and disaster response requires collaboration...training, personnel, equipment, supplies and large amounts of funding. Disaster response strains not only the emergency departments of hospitals, but also
Ekiz, Erdogan H.; Arasli, Huseyin; Farivarsadri, Guita; Bavik, Ali
The main aim of the study is to determine what kind of complaints students have, how universities react to these complaints, and how relevant reactions affect justice perceptions, complainant satisfaction, exit and negative word of mouth intensions of the students. In order to find out students' perceptions on university responses to their…
Gish, Liv; Ipsen, Christine; Poulsen, Signe
responsibilities were to continuously focus on the process and secure momentum. This was done by allocating the necessary resources, supporting the in-house facilitator by having regular meetings with them, continuously give feedback to the employees about the intervention, continuously evaluate the intervention...
Boissinot, L; Benamou, M; Léglise, P; Mancret, R-C; Huchon-Bécel, D
Concern about euthanasia and medically assisted suicide is currently growing around the world and particularly in France. Though not authorized at present in France, the role of hospital pharmacist in this issue needs to be discussed. This article aims to gather medical and legal literature of European Union member states on these issues and particularly in France. To propose a practical thinking on the possible role of hospital pharmacist. Among European Union, euthanasia and/or assisted suicide have already been introduced in some member states' laws. In France, Leonetti law currently sets the legal framework for the management of end of life. To address the society's demand on these issues, French President F. Hollande made two ethics committees responsible for working on it. Both were mainly against euthanasia and assisted suicide. Though a bit forgotten in this debate, hospital pharmacist needs to be associated in the thinking, as the main "drug-keeper". Indeed, guidelines are necessary to outline and ensure a safe drug use, complying with professional ethics, if lethal doses are voluntarily prescribed. Pharmaceutical work is in constant evolution and is addressing new issues still unanswered, including assisted suicide and euthanasia. French pharmaceutical authorities should seize upon them, in order to guarantee pharmaceutical ethics. These practices, if authorized by law, should remain exceptional, and law strictly enforced. The pharmacist could be one of these "lawkeepers". Copyright © 2014 Elsevier Masson SAS. All rights reserved.
M. Abdi Talarposht; GH. Mahmodi; MA. Jahani
Background: Agility is an effective response to the changing and unpredictable environment and using these changes as opportunities for organizational improvement. Objective: The aim of the present study was to rank the factors affecting agile supply chain of hospitals of Iran. Methods: This applied study was conducted by cross sectional-descriptive method at some point of 2015 for one year. The research population included managers, administrators, faculty members and experts were sele...
Applebaum, Ronald L.
Discusses fundamental problems in selecting an approach to organizational communications; the purpose of an organizational communication course; the structure and content of organizational communication coursework; and teaching strategies used in the basic course in organizational communication. (RS)
Review of: Organizational Behaviour in Construction / Anthony Walker (Wiley-Blackwell,2011 336 pp)......Review of: Organizational Behaviour in Construction / Anthony Walker (Wiley-Blackwell,2011 336 pp)...
José G. Vargas Hernández
Full Text Available Organizational economics makes important contributions to management theory. The focus of structural contingency theory is on the phenomena of the economy significant in organizational management theory and other new paradigms of organizational theories. However, the theory of organizational economics has hardly taken the multiple disciplines of organizational behaviour, strategy and theory, but is aligned with the management theories of psychology, sociology and policy dealing with human motivation, induction and enforcement as distinct from the theories of structures, strategies and planning to deal with designs appropriate for a computer on which the will of member compliance is not problematic (Donaldson, 1990. This paper aims at reviewing the organizational economics in detail, its definitions, implications and feature and Elements of organizational economics and also the prescriptive and descriptive organizational economics.
Oyetola, Elijah Olufemi; Adesina, Olufunlola Motunrayo; Oluwadaisi, Adeniyi; Adewale, Adedotun; Adewole, Opeyemi; Anizoba, E
The aims of this study are to determine the prevalence, pattern of presentation, and response to conservative (medical) interventions among patients who presented with temporomandibular joint (TMJ) pain in a Nigerian teaching hospital. Consecutive patients who presented in Oral Medicine and Periodontology Clinic of Obafemi Awolowo University Teaching Hospitals' Complex on account of TMJ pain from January 2015 to December 2015 were recruited for the study. They were all interviewed and examined. The severity of pain was recorded using visual analog scale (VAS). Patients were treated with medications and physiotherapy. They were reviewed at 2, 4, and 6 weeks. Those who could not make the appointment were contacted through phone. The findings were recorded and analyzed using STATA version 11. A total of 401 participants were seen, 55 presented on account of TMJ pain. The mean age of patients with TMJ pain was 54 ± 16.9 with 60% being female. Pain was present in all participants; other signs include clicking joint sound (85%), jaw deviation (64%), attrition (24%), and reduced mouth opening (23%). The left joint was more frequently affected (75%). Following 6 weeks of conservative treatments, none of the respondents had VAS score of more than 3. The prevalence of TMJ pain was 13%. TMJ was found to be more common in participants above 50 years with female predilection. Pain was most common symptom seen, and response to conservative treatments as assessed using VAS following 6-week of treatment showed complete remission of the pain.
Emad Mraweh Mustafa
Full Text Available For the last 30 years, the goal of improving the survival rate for patients post cardiopulmonary arrest has remained unattainable. This apparent failure to rescue opened the door to devise new strategies to improve patient outcomes at the onset of subtle deterioration, rather than at the point of cardiac arrest. Institute for Healthcare Improvement (IHI introduced the Rapid Response Team (RRT as one of the six preventative steps to save lives. Nurses’ perceptions of the RRT influenced by the content and process support provided. Nurses are responsible to detect the early signs of deterioration, and activate the RRT service. The aim of this cross sectional descriptive study was to examine nurses’ perceptions about the effect of the RRT and perceived content and process support in managing patient deterioration by using mental model maintenance and building at individual, group and hospital levels in a tertiary hospital in the Kingdom of Saudi Arabia. 300 nurses were recruited using a convenience sampling method. The study findings showed that the overall perceptions about the RRT were high. There was a significant positive correlation between the frequent utilization of the RRT and the perceived content support. The analysis of the open ended questions indicated that there were more advantages to have the RRT service than disadvantages. This study suggested that RRT service is influential in improving nurses’ perceptions about managing Patients’ deterioration. Training program about RRT utilization should include both content and process support, which may enhance building and maintaining mental model.
Al-Ahmadi, Talal A
The issue of patient safety has received an increasing attention worldwide. In Saudi Arabia, policy makers and health organizations continually strive to substantially reduce medical errors and improve quality of health care. The aim of this research was to explore the perceptions of Riyadh hospitals' staff on patient safety and error reporting and to identify factors that influence the levels of frequency of events reported. A cross-sectional survey, using Hospital Survey on Patient Safety Culture (HSPSC), was carried out in 2008. The questionnaire was distributed to all hospitals' staff in Riyadh, which included nine public hospitals and two private hospitals. A total of 1224 questionnaires were returned over a six-month period, giving a response rate of 47.4%. Organizational learning was the safety culture dimension with the highest positive response (75.9%), while the non-punitive response to error received the lowest positive response (21.1%). The key areas that need improvement in public hospitals include handoffs and transitions, communication openness, staffing, and non-punitive response to error. The private hospitals need an improvement in two aspects; staffing and non-punitive response to error. The results show that all types of mistakes were reported more frequency in private hospitals than in public hospitals. Most respondents reported "no events" in the twelve months preceding the survey, with the percentage of not reporting being higher in private sector compared to public hospitals. The high percent of "no event" reports may represent under-reporting in all hospitals. Regression analysis indicated that event reporting was influenced by feedback and communication about error, staff position, teamwork across units, non- punitive response to error, supervisor/managers expectations and actions promoting patients safety, and type of hospital. Areas needs improvement in Riyadh hospitals includes handoffs and transitions, communication openness, staffing
The aim was to investigate whether job satisfaction enhances organizational commitment among nursing personnel while exploring whether organizational support perception has a moderating effect on the relationship between their job satisfaction and organizational commitment. A cross-sectional survey was sent to 400 nurses; 386 valid questionnaires were collected, with a valid response rate of 96.5%. According to the research findings, nurses' job satisfaction has a positive and significant influence on organizational commitment. Results also indicated that the moderating effect of nurses' organizational support perception on the relationship between their job satisfaction and organizational commitment was stronger for high organizational support perception than it was for low organizational support perception. This study suggests that organizational support perception will develop a sense of belonging, and this will help improve nurses' job satisfaction and organizational commitment. This kind of relationship is rarely discussed in the research literature, and it can be applied for human resources management of nursing staff. © The Author(s) 2014.
Ethical Competencies and the Organizational Competency ‘Responsible University Social Innovation’: looking at new ways of understanding universities and the competency-based education model in the context of significant social changes in Latin America
Javier Villar Olaeta
Full Text Available Ethical competencies are included in all competency-based education models and are considered essential for the professional preparation of students, especially in terms of their professional conduct and workplace preparedness. As such, the Tuning Academy, along with incorporating ethical competencies in its group of generic competencies, also considers the organizational competency Responsible University Social Innovation (RUSI as part of its Tuning ALFA II Latin América project. This competency, in the area of organizational character, addresses innovation in the context of social responsibility, which it assumes each university should have, in terms of ethical responsibility toward the members of a community. This concept incorporates the equal relationship between the university’s internal community and civil society. By means of interviews with experts in the areas of service-learning, social responsibility, and ethical civil and professional education from the University of Deusto and the Zerbikas Foundation, this article discusses the connection and implementation of both generic ethical competencies and the RUSI organizational competency in higher education in order to respond to the new challenges to professional training in today’s world, all of which ultimately assumes a change in universities’ understandings of themselves as institutions and the role of higher education in general.
Adams, Samuel H.; Wiswell, Albert K.
Trust facilitates individual and organizational learning, and is often misunderstood by organizations although they must continuously learn in order to attain organizational goals and survive. Leaders of organizations often view trust defensively and their reactions may impede organizational learning This paper builds on prior research concerning…
McGonagle, Alyssa K; Essenmacher, Lynnette; Hamblin, Lydia; Luborsky, Mark; Upfal, Mark; Arnetz, Judith
Although many studies link teamwork in health care settings to patient safety, evidence linking teamwork to hospital worker safety is lacking. This study addresses this gap by providing evidence linking teamwork perceptions in hospital workers to worker injuries, and further, finds a linkage between manager commitment to safety and teamwork. Organizational records of worker injuries and survey responses regarding management commitment to safety and teamwork from 446 hospital workers within 42 work units in a multi-site hospital system were examined. Results underscored the particular importance of teamwork on worker injuries as well as the importance of management commitment to safety as relating to teamwork. To improve worker safety, organizational leaders and unit managers should work to maintain environments wherein teamwork can thrive.
Mijakoski, Dragan; Karadzinska-Bislimovska, Jovanka; Basarovska, Vera; Montgomery, Anthony; Panagopoulou, Efharis; Stoleski, Sasho; Minov, Jordan
Burnout results from a prolonged response to chronic emotional and interpersonal workplace stressors. The focus of research has been widened to job engagement. Purpose of the study was to examine associations between burnout, job engagement, work demands, and organisational culture (OC) and to demonstrate differences between physicians and nurses working in general hospital in Skopje, Republic of Macedonia. Maslach Burnout Inventory and Utrecht Work Engagement Scale were used for assessment of burnout and job engagement. Work demands and OC were measured with Hospital Experience Scale and Competing Values Framework, respectively. Higher scores of dedication, hierarchy OC, and organizational work demands were found in physicians. Nurses demonstrated higher scores of clan OC. Burnout negatively correlated with clan and market OC in physicians and nurses. Job engagement positively correlated with clan and market OC in nurses. Different work demands were related to different dimensions of burnout and/or job engagement. Our findings support job demands-resources (JD-R) model (Demerouti and Bakker). Data obtained can be used in implementation of specific organizational interventions in the hospital setting. Providing adequate JD-R interaction can lead to prevention of burnout in health professionals (HPs) and contribute positively to better job engagement in HPs and higher quality of patient care.
Hocevar, Susan Page; Jansen, Erik; Thomas, Gail Fann
9/11 and Hurrican Katrina exposed the United States' vunerabilities within and across organizational and jurisdictional boundaries. A number of breakdowns in collaboration were evident: a lack of information sharing among agencies, confused inter-organizational relationshiips, competing roles and responsibilities, and shortcomings in leadership. In response to these inadequacies in collaboration, scholars have engaged in theoretical and empirical work in hopes of preventing another 9/11 and...
Park, Junhee; Yun, Eunkyung; Han, Sangsook
This study was conducted to identify the factors that influence nurses' organizational citizenship behavior. A cross-sectional design was used, with a convenience sample of 547 nurses from four university hospitals in Seoul and Gyeonggi province. The data were collected through a questionnaire survey done from September 22 to October 10, 2008. The tools used for this study were scales on organizational citizenship behavior (14 items), self-leadership (14 items), empowerment (10 items), organizational commitment (7 items), job satisfaction (8 items) and transformational.transactional leadership (14 items). Cronbach's alpha and factor analysis were examined to test reliability and construct validity of the scale. The data collected were processed using SPSS Window 15.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and means, standard deviations, correlation coefficients and multiple regression analysis. The factors influencing nurses' organizational citizenship behavior were identified as self-leadership(beta=.247), empowerment (beta=.233), job satisfaction (beta=.209), organizational commitment (beta=.158), and transactional leadership (beta=.142). Five factors explained 42.0% of nurses' organizational citizenship behavior. The results of this study can be used to develop further management strategies for enhancement of nurses' organizational citizenship behavior.
Full Text Available Osteopontin is an endogenous molecular marker for tumor hypoxia, and hypoxia is one of the factors that determine the aggressiveness of the disease. The purpose of this study is to determine the correlation between osteopontin levels and radiation response in malignant glioma. A retrospective cohort study was conducted on 15 malignant glioma patients who underwent radiation therapy from July 2004 to May 2015 at the RSUPN Dr. Cipto Mangunkusumo Hospital. Osteopontin levels were measured from paraffin-embedded tissue using a commercial ELISA kit. Tumor volume was calculated using computed tomography (CT scan and magnetic resonance imaging (MRI images, based on three-dimensional volume measurements. Tumor response was evaluated by comparing pre- and post-radiation tumor volumes using CT scan and MRI images. The mean osteopontin level was 0.49 ± 0.45 ng/mL and the mean percentage change in tumor volume was 8.59 ± 54.22%, with a 60% enlargement in tumor volume. A progressive disease was found in 26.7% of patients. There was a weak but insignificant negative correlation (r = -0.39, p = 0.146 between the level of osteopontin and radiation response. In contrast, there was a strong but insignificant positive correlation (r = +0.68, p = 0.219 between the level of osteopontin and radiation response in the patient group that used the chemosensitizer temozolamide.
Braaten, Jane Saucedo
The goal of rapid response team (RRT) activation in acute care facilities is to decrease mortality from preventable complications, but such efforts have been only moderately successful. Although recent research has shown decreased mortality when RRTs are activated more often, many hospitals have low activation rates. This has been linked to various hospital, team, and nursing factors. Yet there is a dearth of research examining how hospital systems shape nurses' behavior with regard to RRT activation. Making systemic constraints visible and modifying them may be the key to improving RRT activation rates and saving more lives. The purpose of this study was to use cognitive work analysis to describe factors within the hospital system that shape medical-surgical nurses' RRT activation behavior. Cognitive work analysis offers a framework for the study of complex sociotechnical systems. This framework was used as the organizing element of the study. Qualitative descriptive design was used to obtain data to fill the framework's five domains: resources, tasks, strategies, social systems, and worker competency. Data were obtained from interviews with 12 medical-surgical nurses and document review. Directed content analysis was used to place the obtained data into the framework's predefined domains. Many system factors affected participants' decisions to activate or not activate an RRT. Systemic constraints, especially in cases of subtle or gradual clinical changes, included a lack of adequate information, the availability of multiple strategies, the need to justify RRT activation, a scarcity of human resources, and informal hierarchical norms in the hospital culture. The most profound constraint was the need to justify the call. Justification was based on the objective or subjective nature of clinical changes, whether the nurse expected to be able to "handle" these changes, the presence or absence of a physician, and whether there was an expectation of support from the RRT
King, Emmanuel; Horvath, Rebecca; Shulkin, David J
Rapid response teams and medical emergency teams have been utilized to rapidly manage seriously ill patients at risk of cardiopulmonary arrest and other high-risk conditions but have not been extensively described in the American medical literature. To describe a full year's experience of implementing a rapid response team (RRT) in an academic medical center. Retrospective analysis of our hospital's RRT database and description of the implementation process from July 2004 to July 2005. Urban, academic medical center. The RRT system was activated for 307 potentially unstable patients. The most common reasons for an RRT activation were cardiac, respiratory, and neurological conditions. At least 37% of RRT calls were for off-unit inpatients and to outpatient/common areas frequented by outpatients and visitors, whereas at least 42% occurred in inpatient units. Most RRT calls, 82.9%, occurred during daytime hours. In the opinion of RRT leaders 98% of the evaluated calls were appropriate and 85% of the RRT responses resulted in the prevention of further clinical deterioration. An RRT was introduced into an academic medical center, and the results suggested it is capable of preventing clinical deterioration in unstable patients and may have the potential to decrease the frequency of cardiac arrests. The RRT also may fill a gap in patient safety by enabling rapid triage and expedited treatment of off-unit inpatients, outpatients, and visitors. The keys to the early success of our implementation of an RRT were multidisciplinary input and improvements made in real time. (c) 2006 Society of Hospital Medicine.
Regan, Susan; Reyen, Michele; Lockhart, Abigail C; Richards, Ann E; Rigotti, Nancy A
Hospitalized smokers benefit from tobacco counseling received in hospital only if it continues after discharge. Interactive voice response (IVR) technology may be useful in delivering this care. We conducted a randomized controlled trial testing two intensities of follow-up contact using an IVR system; 738 cigarette smokers who received inpatient counseling at an academic medical center were enrolled. Participants were randomized to receive four IVR calls during the first month postdischarge that included the offer of a call back (CB) from a smoking counselor (IVR + CB, N = 368) or 1 IVR call at 2 weeks postdischarge that assessed smoking outcomes without offering any counseling support (IVR, N = 370). All were assessed by human telephone call at 12 weeks. Postdischarge counseling and medication utilization rates and self-reported smoking cessation were assessed at 2 and 12 weeks postdischarge. Of those randomized to IVR + CB, 59% received a CB offer and 34% of those receiving offers accepted. Cessation rates did not differ between IVR + CB and IVR at 2 weeks (39% vs. 39%, rate ratio: 1.02, 95% CI: 0.85-1.22) or 12 weeks (29% vs. 26%, rate ratio: 1.11, 95% CI: 0.90-1.41). Medication use did not differ by group but was higher among those accepting versus declining CB offers (69% vs. 52%, p offers, although offers were not associated with increased smoking cessation.
Benin, Andrea L; Borgstrom, Christopher P; Jenq, Grace Y; Roumanis, Sarah A; Horwitz, Leora I
The objective of this study was to qualitatively describe the impact of a Rapid Response Team (RRT) at a 944-bed, university-affiliated hospital. We analysed 49 open-ended interviews with administrators, primary team attending physicians, trainees, RRT attending hospitalists, staff nurses, nurses and respiratory technicians. Themes elicited were categorised into the domains of (1) morale and teamwork, (2) education, (3) workload, (4) patient care, and (5) hospital administration. Positive implications beyond improved care for acutely ill patients were: increased morale and empowerment among nurses, real-time redistribution of workload for nurses (reducing neglect of non-acutely ill patients during emergencies), and immediate access to expert help. Negative implications were: increased tensions between nurses and physician teams, a burden on hospitalist RRT members, and reduced autonomy for trainees. The RRT provides advantages that extend well beyond a reduction in rates of transfers to intensive care units or codes but are balanced by certain disadvantages. The potential impact from these multiple sources should be evaluated to understand the utility of any RRT programme.
Benin, Andrea L; Borgstrom, Christopher P; Jenq, Grace Y; Roumanis, Sarah A; Horwitz, Leora I
The objective of this study was to qualitatively describe the impact of a Rapid Response Team (RRT) at a 944-bed, university-affiliated hospital. We analysed 49 open-ended interviews with administrators, primary team attending physicians, trainees, RRT attending hospitalists, staff nurses, nurses and respiratory technicians. Themes elicited were categorised into the domains of (1) morale and teamwork, (2) education, (3) workload, (4) patient care, and (5) hospital administration. Positive implications beyond improved care for acutely ill patients were: increased morale and empowerment among nurses, real-time redistribution of workload for nurses (reducing neglect of non-acutely ill patients during emergencies), and immediate access to expert help. Negative implications were: increased tensions between nurses and physician teams, a burden on hospitalist RRT members, and reduced autonomy for trainees. The RRT provides advantages that extend well beyond a reduction in rates of transfers to intensive care units or codes but are balanced by certain disadvantages. The potential impact from these multiple sources should be evaluated to understand the utility of any RRT programme.
Saad Al Qahtani
Full Text Available Saad Al Qahtani1,21Intensive Care Department, Critical Care Response Team, King Abdulaziz Medical City (KAMC, National Guard Health Affairs, 2King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi ArabiaIntroduction: Patient care and safety is the main goal and mission of any health care provider. We surveyed nurses in the wards and obtained their feedback about the quality of care delivered by the Critical Care Response Team (CCRT.Methods: Our hospital has 900 beds. A self-administered survey was given onsite to all ward nurses. Survey items were identified, discussed, reviewed, piloted, and finalized over a 3-month period in a focus group discussion format during three CCRT core group meetings. Responses were anonymous and collected by the nurses onsite.Results: The total number of returned and analyzed surveys was 274 (98.6%. Ninety-seven percent agreed that CCRT staff arrived in a timely manner. Ninety-four percent reported that CCRT staff helped in managing sick patients and ~70% reported that it strengthened team dynamics. Only 50% of the nurses felt CCRT staff improved competence at the bedside. The overall satisfaction was 100%; none of the nurses were dissatisfied with the team.Conclusion: The CCRT helped manage sick patients in the wards. However, CRRT staff should remember to involve and communicate with the team initiator and the patient’s physician to optimize patient health care.Keywords: rapid response team, medical emergency team, critical care response team, satisfaction
Chiok Foong Loke, J
Research in the west has shown that job satisfaction, productivity and organizational commitment are affected by leadership behaviours. The purpose of this study is to determine the effect of leadership behaviours on employee outcomes in Singapore. Very little research related to this subject has been done in health care settings in this country. The comparison of the results of the different types of settings and samples will allow a better understanding of the relationship between leadership behaviours and employee outcomes and thus help to determine if leadership is worth the extra effort. The study explored the relationships between five leadership behaviours identified by Kouzes and Posner and the employee outcomes of registered nurses practising in the general wards, intensive care units and the coronary care unit in an acute hospital. Survey questionnaires were used to elicit responses from 100 registered nurses and 20 managers belonging to the organization. Data collected included demographic characteristics and the degree to which the five types of leadership behaviours were used as perceived by the nurse managers and the registered nurses. In addition, the level of nurse job satisfaction, the degree of productivity and the extent of organizational commitment are described. The findings show a similar trend to the original studies in the United States of America. Use of leadership behaviours and employee outcomes were significantly correlated. The regression results indicate that 29% of job satisfaction, 22% of organizational commitment and 9% of productivity were explained by the use of leadership behaviours. Recommendations are made in the light of these findings.
Full Text Available The purpose of this study is to determine the reasons of organizational silence for nurses who constitute avast majority among health professionals and responsible from patient care in the first degree. In this context, it was demonstrated the differentiation the silence reasons of nurses according to the defining features of nurses and determine the relationships among dimensions for the silence reasons. The survey sample is 237 nurses working at a university hospital.As a result, it is found that nurses most show silent behaviour because of"managerial and organizational reasons".Age, year of study in organizations and positions variables constitute a significant difference on silence average. In addition, between the factor of managerial and organizational reasons and factors of fear of job size and fear of damaging relations were found to be a strong correlation.Based on the research findings, it is suggested to the manathat creating a transparent environment in which employees articulate their ideas,concerns and views minimize the reasons pushing employees to remain silent. .
Amestoy, Simone Coelho; Trindade, Letícia de Lima; Waterkemper, Roberta; Heidman, Ivonete Teresinha Schülter; Boehs, Astrid Egged; Backes, Vânia Marli Schubert
The aim of this study is make a theorical-reflection about the importance of using dialogical leadership in hospital institutions through Freirean referencial. The dialogical leadership pattern differs from the coercive and autocratic methods, for being reasoned on the establishment of an efficient communicational process, able to stimulate autonomy, co-responsibility and appreciation of each member from nurse team. The dialogical leadership, unlike the directive one, is a management instrument, that pursuits to minimize the conflicts and stimulate the formation of healthy interpersonal relationships, which can contribute to the improvement of organizational atmosphere and quality care provided to health services users.
Manuel Morales Allende; Cristina Ruiz-Martin; Adolfo Lopez-Paredes; Jose Manuel Perez Ríos
.... The cause may be the spread of research among different fields. In this paper, we focus on the study of organizational resilience with the aim of improving the level of resilience in organizations...
Isabella Francisca Freitas Gouveia de Vasconcelos
The concept of radical innovation in technology, products, services and organizational forms inherently brings the idea of disruption and adaptation of the organization to a new level of complexity...
Carver, Lara; Candela, Lori; Gutierrez, Antonio P
To describe organizational commitment and generational differences in nursing faculty. The study provides new knowledge on generational differences in organizational commitment among nursing faculty with regard to work values, perceived organizational support, perceived person-organization fit, developmental experiences, and global job satisfaction. A cross-sectional, descriptive design was used with random stratified sampling procedures. Surveys measuring organizational commitment and related constructs were sent electronically to 4886 faculty, yielding a 30% response rate. Significant differences were noted between generations of faculty regarding organizational commitment and related measures. Include specific strategies for fostering commitment from each generation. Copyright © 2011 Elsevier Inc. All rights reserved.
Ashraf AZ Zaghloul
Full Text Available Ashraf AZ Zaghloul, Nagwa Y Abou El EneinDepartment of Health Administration and Behavioural Sciences, High Institute of Public Health, University of Alexandria, Alexandria, EgyptObjective: The objective of the study was to explore the difference in stress levels among nurses working at two different health care organizations and the determinants of nurse stress within each organization. Job stress is defined as the harmful emotional and physical reactions resulting from the interactions between the worker and her/his work environment where the demands of the job exceed the worker’s capabilities and resources.Methodology: A convenient sample of nurses in two hospitals in Alexandria; Shark Al Madina (n = 120 and Karmouz (n = 170 hospitals. All nurses present at the time of the study were approached to be included in the study. The response rate for Shark Al Madina hospital was 94% and for Karmouz hospital, 71%. Data collection took place using a nurse stress questionnaire previously developed and tested for validity and reliability to measure stress in clinical nursing practice. The 5% level of significance was used throughout the statistical analysis for all relevant tests.Results: The highest mean stress scores were the same for both hospitals. The dimension of coping with new situations was 2.7 ± 0.6 at Shark Al Madina hospital and was 2.5 ± 0.7 at Karmouz hospital while the dimension of job security was 2.7 ± 0.6 and 2.5 ± 0.7 at Shark Al Madina and Karmouz hospitals, respectively. Stepwise multiple regression for Shark Al Madina hospital model revealed workload (β = 1.38, security (β = 5.04, and shortage of support staff (β = 3.39. For the Karmouz hospital model, stepwise multiple regression revealed security (β = 4.78 and shortage of resources (β = 3.66.Conclusion: Stressors among nurses appear to be the same despite the differences in organizational or hierarchical structure where they work or the type of consumer they serve. It
Altuntas, Serap; Baykal, Ulku
This research used a descriptive and explorative design to determine the levels of nurses' organizational trust and organizational citizenship and to investigate relationships between the levels of organizational trust and organizational citizenship behaviors. Nurses who had completed their orientation from a total of 11 hospitals with bed capacities of 100 and located in the European district of Istanbul were included in the sample for this study. Formal, written applications and approval of the ethical committee were obtained from concerned institutions before proceeding with the data collection step. The Organizational Trust Inventory and the Organizational Citizenship Level Scale, a questionnaire form including five questions regarding nurses' personal characteristics, were used in data collection. Data collection tools were distributed to 900 nurses in total, and usable data were obtained from 482 nurses. Number and percentage calculations and Pearson correlation analysis were used to assess research data. The results of the present research showed that nurses had a higher than average level of trust in their managers and coworkers and they trusted more in their managers and coworkers than their institutions. The Organizational Citizenship Level Scale indicated that the behavior most frequently demonstrated by the nurses was conscientiousness, followed by courtesy and civic virtue, whereas sportsmanship was displayed to an average extent. An analysis of relationships between nurses' level of organizational trust and their organizational citizenship behaviors revealed that nurses who trust in their managers, institutions, and coworkers demonstrated the organizational citizenship behaviors of conscientiousness, civic virtue, courtesy, and altruism more frequently. The findings attained in this study indicated that the organizational trust the staff had in their institutions, managers, and coworkers influenced the organizational citizenship behaviors of
Responsabilidad social interna: entre la diferencia y el discurso en el escenario organizacional/Internal social responsibility: between the difference and the discourse in the organizational scenario/Responsabilidade social interna: entre a diferença e o discurso no cenário organizacional
Nancy Piedad Diaz Ortiz; Mariana Lima Bandeira
... contradictions inherent to these discourses. From a bibliographic review oversocial responsibility, discourse, social identity theory and self-concept theory, the individual, social and organizational mechanisms of elaboration and overcome of...
Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik
Background: Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival after out-of-hospital cardiac arrest, but it is unknown to what degree bystander CPR remains positively associated with survival with increasing time to potential defibrillation. The main objective...... was to examine the association of bystander CPR with survival as time to advanced treatment increases. Methods: We studied 7623 out-of-hospital cardiac arrest patients between 2005 and 2011, identified through the nationwide Danish Cardiac Arrest Registry. Multiple logistic regression analysis was used...... out-of-hospital cardiac arrest statistics, an additional 233 patients could potentially be saved annually if response time was reduced from 10 to 5 minutes and 119 patients if response time was reduced from 7 (the median response time in this study) to 5 minutes. Conclusions: The absolute survival...
United States foreign policy is tied extensively to health initiatives, many related to the use of military assets. Despite substantial resource investment by the US Department of Defense (DoD) in hospital ship humanitarian assistance and disaster response missions, the impact of this investment is unclear. A systematic literature review of both peer-reviewed and grey literature using eight databases representing the international community and multiple sectors was conducted. Data on the characteristics of missions directly related to US Navy hospital ship humanitarian assistance and disaster response from 2004-2012 were extracted and documented. Of the 1445 sources reviewed, a total of 43 publications met criteria for review. Six (13.9%) met empirical documentation criteria and 37 (86.0%) were considered nonempirical expert opinions and anecdotal accounts that were primarily descriptive in nature. Overall, disaster response accounted for 67.4% (29/43) and humanitarian assistance 25.6% (11/43). Public and private sector participants produced 79.0% (34/43) and 20.9% (9/43) of the publications respectively. Of private sector publications, 88.9% (8/9) focused on disaster response compared to 61.8% (21/34) from the public sector. Of all publications meeting inclusion criteria, 81.4% (35/43) focused on medical care, 9.3% (4/43) discussed partnerships, 4.7% (2/43) training, and 4.7% (2/43) medical ethics and strategic utilization. No primary author publications from the diplomatic, development, or participating host nations were identified. One (2.3%) of the 43 publications was from a partner nation participant. Discussion Without rigorous research methods yielding valid and reliable data-based information pertaining to Navy hospital ship mission impact, policy makers are left with anecdotal reports to influence their decision-making processes. This is inadequate considering the frequency of hospital ship deployments used as a foreign policy tool and the considerable
Background Fall prevention programs for hospitalized patients have had limited success, and the effect of programs on decreasing total falls and fall-related injuries is still inconclusive. This exploratory multi-hospital study examined the unique contribution of call light response time to predicting total fall rates and injurious fall rates in inpatient acute care settings. The conceptual model was based on Donabedian's framework of structure, process, and health-care outcomes. The covariates included the hospital, unit type, total nursing hours per patient-day (HPPDs), percentage of the total nursing HPPDs supplied by registered nurses, percentage of patients aged 65 years or older, average case mix index, percentage of patients with altered mental status, percentage of patients with hearing problems, and call light use rate per patient-day. Methods We analyzed data from 28 units from 4 Michigan hospitals, using archived data and chart reviews from January 2004 to May 2009. The patient care unit-month, defined as data aggregated by month for each patient care unit, was the unit of analysis (N = 1063). Hierarchical multiple regression analyses were used. Results Faster call light response time was associated with lower total fall and injurious fall rates. Units with a higher call light use rate had lower total fall and injurious fall rates. A higher percentage of productive nursing hours provided by registered nurses was associated with lower total fall and injurious fall rates. A higher percentage of patients with altered mental status was associated with a higher total fall rate but not a higher injurious fall rate. Units with a higher percentage of patients aged 65 years or older had lower injurious fall rates. Conclusions Faster call light response time appeared to contribute to lower total fall and injurious fall rates, after controlling for the covariates. For practical relevance, hospital and nursing executives should consider strategizing fall and
Full Text Available Abstract Background Fall prevention programs for hospitalized patients have had limited success, and the effect of programs on decreasing total falls and fall-related injuries is still inconclusive. This exploratory multi-hospital study examined the unique contribution of call light response time to predicting total fall rates and injurious fall rates in inpatient acute care settings. The conceptual model was based on Donabedian's framework of structure, process, and health-care outcomes. The covariates included the hospital, unit type, total nursing hours per patient-day (HPPDs, percentage of the total nursing HPPDs supplied by registered nurses, percentage of patients aged 65 years or older, average case mix index, percentage of patients with altered mental status, percentage of patients with hearing problems, and call light use rate per patient-day. Methods We analyzed data from 28 units from 4 Michigan hospitals, using archived data and chart reviews from January 2004 to May 2009. The patient care unit-month, defined as data aggregated by month for each patient care unit, was the unit of analysis (N = 1063. Hierarchical multiple regression analyses were used. Results Faster call light response time was associated with lower total fall and injurious fall rates. Units with a higher call light use rate had lower total fall and injurious fall rates. A higher percentage of productive nursing hours provided by registered nurses was associated with lower total fall and injurious fall rates. A higher percentage of patients with altered mental status was associated with a higher total fall rate but not a higher injurious fall rate. Units with a higher percentage of patients aged 65 years or older had lower injurious fall rates. Conclusions Faster call light response time appeared to contribute to lower total fall and injurious fall rates, after controlling for the covariates. For practical relevance, hospital and nursing executives should consider
Bastug, Gülsüm; Pala, Adem; Kumartasli, Mehmet; Günel, Ilker; Duyan, Mehdi
Organizational trust and organizational commitment are considered as the most important entraining factors for organizational success. The most important factor in the formation of organizational commitment is trust that employees have in their organizations. In this study, the relationship between organizational trust and organizational…
This study aims to describe organizational culture and commitment and to predict organizational commitment from organizational culture in Turkish primary schools. Organizational Culture Scale (Ipek "1999") and Organizational Commitment Scale (Balay "2000") were used in the data gathering process. The data were collected from…
Oriol Meneses Echemendia
Full Text Available Infectious mononucleosis (IM is a polyclonal lymphoproliferative disease, with an excellent prognosis caused by a virus of the herpes family of viruses known as Epstein-Barr virus. A descriptive study was conducted in order to describe the behavior of inmunoviral and haematological response in patients with infectious mononucleosis, at the José Martí Pérez Provincial Paediatric Hospital of Sancti Spiritus, in the period from May 1 of 2008 to June 30 of 2009. The study sample was 79 patients who fulfilled the inclusion criteria. The variables used included: age, permanence of heterophile antibodies in blood, in response to the agglutination test for heterophil antibodies, haemoglobin, leukocyte global counts, absolute and relative lymphocyte counts. The predominant age group was that of 5-9 years (40.5%. 22.8% had anemia, 83.5% had leukocytosis, 93.7% had absolute lymphocytosis and 89.8% had relative lymphocitosis. The agglutination test for heterophil antibodies (Paul Bunnell was placed in the range of (1:112. The disease predominated in school age, and leukocytosis, absolute and relative lymphocytosis were present in most patients. Paul Bunnell test was placed in positive range.
Borhani, Fariba; Jalali, Tayebe; Abbaszadeh, Abbas; Haghdoost, Aliakbar
The high turnover of nurses has become a universal issue. The manner in which nurses view their organization's ethical climate has direct bearing on their organizational commitment. The aim of this study was to determine the correlation between nurses' perception of ethical climate and organizational commitment in teaching hospitals in the southeastern region of Iran. A descriptive analytical design was used in this study. The sample consisted of 275 nurses working in four teaching hospitals in the southeastern region of Iran. The instruments used in this study included a demographic questionnaire, Ethical Climate Questionnaire, and Organizational Commitment Questionnaire. Data analysis was carried out using Pearson's correlation, t-test, and descriptive statistic through Statistical Package for Social Science, version 16. The result of this research indicated a positive correlation among professionalism, caring, rules, independence climate, and organizational commitment. Therefore, findings of this study are a guideline for researchers and managers alike who endeavor to improve organizational commitment.
Alammar, Kamila; Alamrani, Mashael; Alqahtani, Sara; Ahmad, Muayyad
To predict nurses' job involvement on the basis of their organizational commitment and personal characteristics at a large tertiary hospital in Saudi Arabia. Data were collected in 2015 from a convenience sample of 558 nurses working at a large tertiary hospital in Riyadh, Saudi Arabia. A cross-sectional correlational design was used in this study. Data were collected using a structured questionnaire. All commitment scales had significant relationships. Multiple linear regression analysis revealed that the model predicted a sizeable proportion of variance in nurses' job involvement (p organizational commitment enhances job involvement, which may lead to more organizational stability and effectiveness.
Hald, Kim Sundtoft
Company performance is increasingly affected by a range of external factors embeddedin a complex network of action controlled by other companies' in its environment. A wellmanaged company, it's argued, is one that is aware of these external factors, and one whoin response seeks to implement tactics...... orweakened by partner- comfortability and dependability. Then we show how partnersperceived attraction towards an industrial company can be managed using a combinationof structural- and behavioral adjustments.Key words: Inter-organizational relationships; Relationship Management; Relationship...
Bahrami, Mohammad Amin; Montazeralfaraj, Razieh; Gazar, Saeed Hashemi; Tafti, Arefeh Dehghani
Background: Organizational citizenship behavior just referred to a set of discretionary workplace behaviors that exceed one’s job requirements. The main objective of this study was to determine the relationship between organizational perceived justice and organizational citizenship behavior. Methods: This cross-sectional study was done in Shahid Sadoughi Hospital in Yazd, Iran in 2013. A total of 100 hospital employees contributed in the study. The required data was gathered using 2 valid questionnaires, including the Moorman & Niehoff organizational perceived justice questionnaire and the McKinsey organizational citizenship behavior questionnaire. Data were analyzed using SPSS version 16. Descriptive statistics, Chi square, and Pearson’s correlation coefficient were used for data analysis. Results: There was a significant positive relationship between organizational perceived justice and organizational citizenship behavior among the studied hospital’s employees (P ≤ 0.05, R = 0.33). Conclusion: This study confirmed that any policy that leads to better organizational justice perception will contribute in better organizational citizenship behavior which will increase the hospital’s productivity. PMID:25763156
Krause Hansen, Hans
, and societal levels, as well as how corruption is and can be responded to through public scandals and more elaborate communicative strategies of corruption control, or anti-corruption. A focus on corruption and corruption control provides organizational communication scholars with entry points to explore...... the powerful communicative dynamics playing out between the local organizational meanings of particular practices and externally imposed definitions of what constitutes appropriate organizational behavior....
Flemington, Tara; Fowler, Cathrine; Tran, Quang Nhat; Fraser, Jennifer
Ongoing fiscal stability has enabled the National Assembly in Vietnam to turn its attention to improving the health and well-being of women and children. Training pediatric health care professionals in the recognition and response to child abuse presentations in the emergency setting has the potential to improve outcomes for the disproportionate number of vulnerable children presenting to the emergency setting with nonaccidental injuries. This study explored the training needs and expectations of the staff preparing to undertake such a clinical training program. This qualitative study is based on semistructured interviews with 16 clinicians from the emergency setting of a leading pediatric hospital in Vietnam. Interview questions focused on current practice in recognizing and responding to child abuse and neglect presentations, the level of training and experience of participants, and subjective reports of confidence in recognizing abuse. Interviews were conducted in English and Vietnamese, with check-translation of transcripts performed by an independent translator. A culture of collegiality and innovative workplace practices was revealed. Analysis revealed two overarching themes that were related to the need for evidence, forensic analysis, respecting families, and consultation. Despite participant confidence in recognizing and reporting child abuse and neglect presentations, knowledge deficits were found. This article presents a critical analysis of the context within which the first evidence-based clinical training program of its kind in Vietnam was developed and implemented in a pediatric children's hospital. Clinicians felt a strong moral obligation to protect children from further harm, however encountered a number of barriers inhibiting this process. Findings significantly shaped the Safe Children Vietnam training program and will also contribute to the development of protocols and improvement of community support services at the study site.
California State Dept. of Education, Sacramento. Bureau of Homemaking Education.
This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…
Swain, Sarada Prasanna; Behura, Sushree Sangita; Dash, Manoj Kumar
Literatures regarding clinical symptomatology and treatment response of catatonia are very few. To assess onset, clinical profile, diagnostic break up, treatment response and outcome in patients diagnosed as Catatonia, reported to a tertiary care hospital. The present study was a cross-sectional descriptive study conducted in indoor of Mental Health Institute (Centre of Excellence), S.C.B. Medical College, between March 2015 to March 2016. A total of 34 patients were included in the study who reported at outdoor department of Mental Health Institute with catatonic symptoms. All patients admitted in inpatient department were routinely assessed through a detailed semi-structured interview. The diagnosis of catatonia was made if the patients present with three or more symptoms out of twelve symptoms fulfilling the criteria of DSM-5. All the patients were assessed through Bush-Francis Catatonia Rating Scale. They were initially given parental lorazepam at the doses ranging from 4-12 mg per day as per requirement. Patients who did not respond to lorazepam trial were given ECT. The patients were predominantly presented with retarded symptoms of catatonia such as staring, mutism, withdrawal, posturing and negativism. Schizophrenia and other psychotic spectrum disorders were more commonly presented as catatonia as compared to mood disorders. Younger age group patients were mainly responded to lorazepam only, whereas older age group patients responded to both ECT and lorazepam. This study has came out with very important insights in the age of incidence, phenomenology, clinical profile, source of referral, diagnostic break up and treatment response with lorazepam and ECT in catatonic patients following mental disorder.
Bonafide, Christopher P; Localio, A Russell; Holmes, John H; Nadkarni, Vinay M; Stemler, Shannon; MacMurchy, Matthew; Zander, Miriam; Roberts, Kathryn E; Lin, Richard; Keren, Ron
Bedside monitor alarms alert nurses to life-threatening physiologic changes among patients, but the response times of nurses are slow. To identify factors associated with physiologic monitor alarm response time. This prospective cohort study used 551 hours of video-recorded care administered by 38 nurses to 100 children in a children's hospital medical unit between July 22, 2014, and November 11, 2015. Patient, nurse, and alarm-level factors hypothesized to predict response time. We used multivariable accelerated failure-time models stratified by each nurse and adjusted for clustering within patients to evaluate associations between exposures and response time to alarms that occurred while the nurse was outside the room. The study participants included 38 nurses, 100% (n = 38) of whom were white and 92% (n = 35) of whom were female, and 100 children, 51% (n = 51) of whom were male. The race/ethnicity of the child participants was 45% (n = 45) black or African American, 33% (n = 33) white, 4% (n = 4) Asian, and 18% (n = 18) other. Of 11 745 alarms among 100 children, 50 (0.5%) were actionable. The adjusted median response time among nurses was 10.4 minutes (95% CI, 5.0-15.8) and varied based on the following variables: if the patient was on complex care service (5.3 minutes [95% CI, 1.4-9.3] vs 11.1 minutes [95% CI, 5.6-16.6] among general pediatrics patients), whether family members were absent from the patient's bedside (6.3 minutes [95% CI, 2.2-10.4] vs 11.7 minutes [95% CI, 5.9-17.4] when family present), whether a nurse had less than 1 year of experience (4.4 minutes [95% CI, 3.4-5.5] vs 8.8 minutes [95% CI, 7.2-10.5] for nurses with 1 or more years of experience), if there was a 1 to 1 nursing assignment (3.5 minutes [95% CI, 1.3-5.7] vs 10.6 minutes [95% CI, 5.3-16.0] for nurses caring for 2 or more patients), if there were prior alarms requiring intervention (5.5 minutes [95% CI, 1.5-9.5] vs 10.7 minutes [5.2-16.2] for patients
Szabla, David B.
In this survey research study, the researcher employed a causal-comparative, or ex post facto, design to explore the relationship between how union employees of a U.S. county government perceived implementation of a new electronic performance appraisal process and how they responded to the planned organizational change along cognitive, emotional,…
Valeria Maria Gataz Sguario
Full Text Available Diante da utilização de portais como importantes veículos de comunicação e informação, este artigo relata o desenvolvimento do portal corporativo interno de um hospital universitário, mediante a analogia com os processos de análise, síntese e representação da informação, bem como os benefícios alcançados e as perspectivas para o fomento da gestão da informação e da aprendizagem organizacional. O artigo se divide em três tópicos. A primeira parte discute os processos de gestão da informação e da aprendizagem organizacional, enfatizando a influência e as contribuições da tecnologia da informação. A segunda descreve o processo de análise - com a coleta das informações; de síntese - com a definição dos objetivos e do planejamento; e da representação das informações - que resultou no desenvolvimento do portal. E, por último, são apresentados os benefícios e as perspectivas de evolução desse portal, bem como a força da cultura organizacional e do indivíduo nesse contexto.
Ukawa, Naoto; Tanaka, Masayuki; Morishima, Toshitaka; Imanaka, Yuichi
The objective of this work was to elucidate aspects of organizational culture associated with hospital performance in perioperative antibiotic prophylaxis using quantitative data in a multicenter and multidimensional study. Cross-sectional retrospective study using a survey data and administrative data. Eighty-three acute hospitals in Japan. A total of 4856 respondents in the organizational culture study, and 23 172 patients for the quality indicator analysis. Multilevel models of various cultural dimensions were used to analyze the association between hospital organizational culture and guideline adherence. The dependent variable was adherence or non-adherence to Japanese and CDC guidelines at the patient level and main independent variable was hospital groups categorized according to organizational culture score. Other control variables included hospital characteristics such as ownership, bed capacity, region and urbanization level of location. The multilevel analysis showed that hospitals with a high score in organizational culture were more likely to adhere to the Japanese and CDC guidelines when compared with lower scoring hospitals. In particular, the hospital group with high scores in the 'collaboration' and 'professional growth' dimensions had three times the odds for Japanese guideline adherence in comparison with low-scoring hospitals. Our study revealed that various aspects of organizational culture were associated with adherence to guidelines for perioperative antibiotic use. Hospital managers aiming to improve quality of care may benefit from improving hospital organizational culture. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Moran, Kenneth A
Recent changes in the United States (US) economy have radically disrupted revenue generation among many institutions within higher education within the US. Chief among these disruptions has been fallout associated with the financial crisis of 2008-2009, which triggered a change in the US higher education environment from a period of relative munificence to a prolonged period of scarcity. The hardest hit by this disruption have been smaller, less wealthy institutions which tend to lack the necessary reserves to financially weather the economic storm. Interestingly, a review of institutional effectiveness among these institutions revealed that while many are struggling, some institutions have found ways to not only successfully cope with the impact of declining revenue, but have been able to capitalize on the disruption and thrive. Organizational response is an important factor in successfully coping with conditions of organizational decline. The study examined the impacts of organizational response on institutional effectiveness among higher education institutions experiencing organizational decline. The study's research question asked why some US higher educational institutions are more resilient at coping with organizational decline than other institutions operating within the same segment of the higher education sector. More specifically, what role does organizational resilience have in helping smaller, private non-profit institutions cope and remain effective during organizational decline? A total of 141 US smaller, private non-profit higher educational institutions participated in the study; specifically, the study included responses from participant institutions' key administrators. 60-item survey evaluated administrator responses corresponding to organizational response and institutional effectiveness. Factor analysis was used to specify the underlying structures of rigidity response, resilience response, and institutional effectiveness. Multiple regression
Sterns, Jay B
Physicians and their practice patterns are the largest single determinant of the level of aggregate national health care expenditures. Integrated delivery systems (organizations linking a multispecialty physician groups and acute care hospitals) appear to be more efficient than other organizational structures while providing better clinical outcomes. To determine whether a subset of hospitals was more or less efficient than the national average, we relied on data from the Dartmouth Atlas Project, which included data from 4,346 hospitals. The analysis was restricted to patients who had one or more of 12 chronic illnesses associated with a high probability of death, and the number of hospitals identified as our control group was 14, represented by 13 organizations. Based on the preliminary data, physicians operating in a multispecialty group appear to use less physician resources to care for their patients and admit less often to a hospital, thereby reducing health care expenditures. As the federal government seeks to foster more efficient health care delivery and better outcomes, it may look to the physician-led integrated delivery network as an example of an efficient and high quality model.
Manuel Morales Allende
Full Text Available Developing resilient individuals, organizations and communities is a hot topic in the research agenda in Management, Ecology, Psychology or Engineering. Despite the number of works that focus on resilience is increasing, there is not completely agreed definition of resilience, neither an entirely formal and accepted framework. The cause may be the spread of research among different fields. In this paper, we focus on the study of organizational resilience with the aim of improving the level of resilience in organizations. We review the relation between viable and resilient organizations and their common properties. Based on these common properties, we defend the application of the Viable System Model (VSM to design resilient organizations. We also identify the organizational pathologies defined applying the VSM through resilience indicators. We conclude that an organization with any organizational pathology is not likely to be resilient because it does not fulfill the requirements of viable organizations.
Yi, Sangyoon; Becker, Markus; Knudsen, Thorbjørn
Routines have been perceived as a source of inertia in the process of organizational change. In this study, we suggest an overlooked, but prevalent, mechanism by which the inertial nature of routines helps, rather than hinders, organizational adaptation. Routine-level inertia plays a hidden role...
Purpose: Despite the growth in research on conditions for successful learning by organizations and the introduction of expanding practices and approaches, a progressive and shared understanding of the link between organizational learning and governance is currently missing. This paper aims to take a closer look at organizational learning from a…
Richard Beckhard defined Organizational Development as ’a planned effort, organization-wide, and managed from the top to increase organization...some of theories, models, and tools of Organizational Development (OD) and serves as a guide for the author. It represents the current state in the
P. Sreeramana Aithal
An overview of Organizational Behaviour – History of Organisational Behaviour and its emergence as a disciple-emerging perspective Organizational Behaviour. Individual process in organisation – Learning, perception and attribution- Individual differences - Basic concepts of motivation - Advanced concepts of motivation. Group process in Organisation – Group dynamics, leadership theories - Power, politics and conflict - inter- personal communication. Enhancing individu...
Watwood, Britt; And Others
Based on studies comparing leadership in two rural community colleges undergoing change and examining the management of change at Maryland's Allegany College, this paper presents a conceptual framework and model for managing organizational change. First, a framework for understanding the community college chair's role in organizational change is…
Carlos E. Quintero Castellanos
Full Text Available The objective of this essay is to propose a way to link the theoretical body that has been weaved around governance and organizational theory. For this, a critical exposition is done about what is the theoretical core of governance, the opportunity areas are identified for the link of this theory with organizational theory. The essay concludes with a proposal for the organizational analysis of administrations in governance. The essay addresses with five sections. The first one is the introduction. In the second one, I present a synthesis of the governance in its current use. In the next one are presented the work lines of the good governance. In the fourth part, I show the organizational and managerial limits in the governance theory. The last part develops the harmonization proposal for the governance and organizational theories.
Schlagwein, Daniel; Bjørn-Andersen, Niels
Extant organizational learning theory conceptualizes organizational learning as an internal, member-based process, sometimes supported by, yet often independent of, IT. Recently, however, several organizations have begun to involve non-members systematically in their learning by using crowdsourcing......, a form of open innovation enabled by state-of-the-art IT. We examine the phenomenon of IT-enabled organizational learning with crowdsourcing in a longitudinal revelatory case study of one such organization, LEGO (2010-14). We studied the LEGO Cuusoo crowdsourcing platform’s secret test in Japan, its...... widely recognized global launch, and its success in generating top-selling LEGO models. Based on an analysis of how crowdsourcing contributes to the organizational learning at LEGO, we propose the “ambient organizational learning” framework. The framework accommodates both traditional, member...
Blanca S. GRAMA
Full Text Available The dynamic features of the labor market outline the perfect background in which organization are constantly dealing with the necessity to implement change in strategy, structure, processes or culture. On this background the factors that can damage the process of organizational change receive more and more attention. Cynicism in organizational change is a possible source of resistance which starts to capture researchers interests. Organizational cynicism research represents a new subject in the specialized literature of Romania. Research on this topic show that organizational cynicism is the result of attitudes made out of beliefs, affects and behavior toward organization. On the basis of the reviews and conceptualization we propose a research agenda of cynicism on organizational change.
Zhu, Junya; Li, Liping; Zhou, Zehui; Lou, Qingqing; Wu, Albert W
Patient safety climate is associated with patient outcomes in hospitals around the world. A better understanding of how safety climate varies within and across hospitals will help identify improvement opportunities. We examined variations in safety climate by work area and job category in Chinese hospitals. We administered the Chinese Hospital Survey on Patient Safety Climate in 2011 to workers in 6 hospitals in China, with completed surveys from 1464 (86% response). We calculated the percent positive response for survey items and dimensions among hospitals and compared this across work areas and job categories using general linear models. Overall, 68% of responses suggested the presence of a positive safety climate. The percent positive responses were highest for organizational learning (86.1%) and unit management support for safety (84.5%) and lowest for staffing (30.6%) and error reporting (44.5%). Workers in surgical units, intensive care units, operating rooms, and emergency departments were slightly more negative regarding overall safety climate than those in medical and ancillary units. Physicians reported worse perceptions than nurses or other hospital workers on all dimensions except for unit management support for safety and communication and peer support. The perceived problem with staffing in Chinese hospitals was consistent with other studies. The lack of positive responses for error reporting may indicate a lack of awareness of the importance of learning from and reporting minor events and near misses. Variations within and across hospitals in safety climate suggest that improvement interventions should be tailored to individual units and professional groups.
Smith, Carol E; Rebeck, Shelby; Schaag, Helen; Kleinbeck, Susie; Moore, Janice M; Bleich, Michael R
Hospitals have restructured job duties and responsibilities in response to market pressures and in an effort to improve quality. This study presents a model for evaluating patient satisfaction outcomes following a work redesign that included the realignment of responsibility for discharge education from clinical nurse specialists to cross-trained, multidisciplinary workers. The outcomes data cannot be generalized, as they relate to a particular redesign and one institution. However, this analysis provides a framework for a systematic, multidisciplinary approach to evaluating organizational change.
Bro-Jeppesen, John; Kjaergaard, Jesper; Wanscher, Michael
OBJECTIVES: Whole-body ischemia during out-of-hospital cardiac arrest triggers immediate activation of inflammatory systems leading to a sepsis-like syndrome. The aim was to investigate the association between level of systemic inflammation and mortality in survivors after out-of-hospital cardiac...
The business management of most successful companies is a result of the processes, organizational structure and coordinated operation of supporting systems and employees, which appear in organizational capabilities of the company. Within the business processes, this includes development and continuous improvement of key internal rules and regulations, sharing impact and responsibility, operation of expectations and basic checkpoints for organizational units, creation of most important technic...
Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael
Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.
Alexiev, A.S.; Volberda, H.W.; van den Bosch, F.A.J.
In firm decisions to engage in interorganizational collaboration in the context of innovation, conceptions of the organizational environment play an essential role. In this paper, we develop a multidimensional model of how managers use interorganizational collaboration as an organizational response
Leary, Marion; Schweickert, William; Neefe, Stacie; Tsypenyuk, Boris; Falk, Scott Austin; Holena, Daniel N
How nontechnical factors such as inadequate role definition and overcrowding affect outcomes of in-hospital cardiac arrest (IHCA) is unknown. Using a bundled intervention, we sought to improve providers' role definitions and decrease overcrowding during IHCA events. To determine if a bundled intervention consisting of a nurse/physician leadership dyad, visual cues for provider roles, and a "role check" would lead to reductions in crowding and improve perceptions of communication and team leadership. Baseline data on the number and type of IHCA providers were collected. Providers were asked to complete a postevent survey rating communication and leadership. A bundled intervention was then introduced. Data were then obtained for the subsequent IHCA events. Twenty ICHA events were captured before and 34 after the intervention. The number of physicians present at pulse checks 2 (median [interquartile range]: 6 [5-8] before vs 5 [3-6] after, P = .02) and 3 (7 [5-9] vs 4 [4-5], P = .004) decreased significantly after the intervention. The overall number of providers at the third pulse check (18 [14-22] before vs 14 [12-16] after, P = .04) also decreased after the intervention. On a 10-point Likert scale, ratings of communication (8 [7-8]) and physician leadership (8 [7-9]) did not differ significantly from before to after the intervention. Both the physician leads (90%) and patients' primary nurses (97%) were able to identify clear nurse leaders. A bundled intervention targeted at improving IHCA response led to a decrease in overcrowding at ICHA events without substantial changes in the perceptions of communication or physician leadership. ©2016 American Association of Critical-Care Nurses.
Schneider, Benjamin; Ehrhart, Mark G; Macey, William H
Organizational climate and organizational culture theory and research are reviewed. The article is first framed with definitions of the constructs, and preliminary thoughts on their interrelationships are noted. Organizational climate is briefly defined as the meanings people attach to interrelated bundles of experiences they have at work. Organizational culture is briefly defined as the basic assumptions about the world and the values that guide life in organizations. A brief history of climate research is presented, followed by the major accomplishments in research on the topic with regard to levels issues, the foci of climate research, and studies of climate strength. A brief overview of the more recent study of organizational culture is then introduced, followed by samples of important thinking and research on the roles of leadership and national culture in understanding organizational culture and performance and culture as a moderator variable in research in organizational behavior. The final section of the article proposes an integration of climate and culture thinking and research and concludes with practical implications for the management of effective contemporary organizations. Throughout, recommendations are made for additional thinking and research.
Full Text Available BACKGROUND: Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. OBJECTIVES: We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. METHODS: We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. RESULTS: The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4 and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27. Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029. CONCLUSION: The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of
Hammer, Antje; Arah, Onyebuchi A.; DerSarkissian, Maral; Thompson, Caroline A.; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger
Background Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. Objectives We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. Methods We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. Results The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). Conclusion The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could
Little, Charles M; McStay, Christopher; Oeth, Justin; Koehler, April; Bookman, Kelly
The use of after-action reviews (AARs) following major emergency events, such as a disaster, is common and mandated for hospitals and similar organizations. There is a recurrent challenge of identified problems not being resolved and repeated in subsequent events. A process improvement technique called a rapid improvement event (RIE) was used to conduct an AAR following a complete information technology (IT) outage at a large urban hospital. Using RIE methodology to conduct the AAR allowed for the rapid development and implementation of major process improvements to prepare for future IT downtime events. Thus, process improvement methodology, particularly the RIE, is suited for conducting AARs following disasters and holds promise for improving outcomes in emergency management. Little CM , McStay C , Oeth J , Koehler A , Bookman K . Using rapid improvement events for disaster after-action reviews: experience in a hospital information technology outage and response. Prehosp Disaster Med. 2018;33(1):98-100.
Kringelum, Louise Tina Brøns
This thesis explores how processes of business model innovation can unfold in a port authority by transcending organizational boundaries through inter-organizational collaboration. The findings contribute to two fields of academic inquiry: the study of business model innovation and the study of how...... by applying the engaged scholarship approach, thereby providing a methodological contribution to both port and business model research. Emphasizing the interplay of intra- and inter-organizational business model innovation, the thesis adds insight into the roles of port authorities, business model trends...
This essay attempts to explore the relationship between leaders, organizational culture, and national culture. Leaders cre⁃ate“climate of the organization”with six mechanisms. Furthermore, leaders style of management is considerably influenced by their national culture based on Hofstede’s organizational culture theory. Varieties of examples and cases are analyzed to illustrate that leadership beliefs and practices have direct relationship with organizational culture and shape their individualistic communica⁃tion styles and goals that influence to a significant degree in establishing shared values, beliefs and practices among employees within an organization.
Foss, Nicolai Juul; Klein, Peter G.
We briefly survey Hayek’s work and argue for its increasing relevance for organizational scholars. Hayek’s work inspired aspects of the transaction cost approach to the firm as well as knowledge management and knowledge-based view of the firm. But Hayek is usually seen within organizational...... scholarship as a narrow, technical economist. We hope to change that perception here by pointing to his work on rules, evolution, entrepreneurship and other aspects of his wide-ranging oeuvre with substantive implications for organizational theory....
Williams, M; Cardona-Morrell, M; Stevens, P; Bey, J; Smith Glasgow, M E
Research indicates up to one-third of rapid response team calls relate to end-of-life symptoms. The CriSTAL criteria were developed as a screening tool to identify high risk of death within three months. The primary purpose of this pilot study was to investigate the timing of palliative care referrals in patients receiving rapid response team services, and patients' CriSTAL criteria score on admission. The potential feasibility of using the CriSTAL tool to stimulate earlier Palliative Care Team (PCT) referral served as an underlying goal, and investigation of a relationship between specific CriSTAL criteria and the prediction of in-hospital death was a secondary objective. A retrospective chart review of rapid response calls made in 2015 was used to identify patient risk of death on admission based on the CriSTAL criteria. The presence and timing of PCT referral as well as patient survival status to hospital discharge were documented for comparison. A sample of 183 charts from 584 inpatients involved in over 600 RRT events recorded in 2015. The study was undertaken in a 676-bed teaching hospital in the Midwestern U.S. Ninety-one patients died during the hospital stay while 92 patients from the 493 individuals who survived were randomly selected for full analysis. Applying CriSTAL criteria to the 141 individuals aged 50 years or older indicated that frailty (OR=1.43, 95%CI 1.08-1.89, p=0.012), being a male (OR=3.14; 95%CI 1.40-7.05, p=0.006), and the presence of two or more comorbidities (OR=3.71, 95%CI 1.67-8.24, p=0.001) were the most significant predictors of in-hospital death after adjusting for age. A CriSTAL score of 6 was the optimal cut-off for high-risk of in-hospital death. Palliative care consultations within the high-risk population occurred for 45.2% of the deceased and 40.4% of the survivors. Consultation often occurred within two days of the RRT event and many patients (46.8%) died within one day of the consultation. A positive relationship was found
Chowdhury, Dhiman Deb
This article extends literature of Organizational Citizenship Behavior (OCB) in the context of corporate sustainability. The author presents the concept of Organizational Citizenship Behavior towards Sustainability (OCBS) as a variant, contending it's appropriateness for today's much needed behavioral competence to implement sustainability measure at organizational level. The formulation of OCBS espouses Organizational Citizenship Behavior (OCB) with a twist. The viewpoint defended that a for...
Conclusion: The present study showed that the current status of functional safety in Isfahan private hospitals is not completely satisfactory and the provincial health managers, especially Isfahan University of Medical Sciences, are expected to regularly monitor planning and decision-making about the risks threatening these hospitals, especially in the areas of contingency plans of medical operations and access to medicines as well as equipment and supplies needed in an emergency situation.
Liu, Cai Yun; Xu, Lei; Zang, Yu Li
To investigate the circadian pattern of cortisol secretion and other stress indictors in association with audiovisual stimuli in adolescents having otorhinolaryngological surgery in hospital. Hospitalization for surgery is a major stressful life event for adolescents causing negative consequences, including anxiety. Recent studies suggest that entertaining and educational interventions might be effective at reducing such adversities, but little is known about the pattern of these responses and effects. Randomized controlled trial. Adolescents with otorhinolaryngological surgery in hospital without any contraindictions for salivary cortisol enzyme immunoassays will be recruited and randomly allocated to experimental, placebo and control. Stress indicators will be collected regularly for 5 days. Standard audiovisual interventions will be displayed for experimental and placebo groups including a simultaneous video-recording of facial and behavioural changes on the second afternoon postadmission and stress indicators will be collected pre- and three times with 20-minute interval postintervention. Follow-up will be conducted to evaluate the longer term effects at 2 weeks, 1-month and 3 months postadmission, respectively. Descriptive and comparative analyses of stress indicators will be performed to examine group differences. Competitive funding was obtained from the Independent Innovation Foundation of Shandong University for interdisciplinary research in 2012. This study will help identify timeslots for interventions for integrating strength-building into stress response reduction in adolescents hospitalized for surgery. © 2013 John Wiley & Sons Ltd.
Carlos Hernan Isaza Velez; Hernan Isaza
This article aims to delve the reader in the study of a widespread phenomenon among researchers in Human Resources, allowing engagement with the concept of organizational culture as a field that...
Dobusch, Leonhard; Schoeneborn, Dennis
that the organizationality of a social collective is accomplished through “identity claims”—i.e., speech acts that concern what the social collective is or does—and negotiations on whether or not these claims have been made on the collective's behalf. We empirically examine the case of the hacker collective Anonymous......This paper examines how fluid social collectives, where membership is latent, contested, or unclear, achieve “organizationality”, that is, how they achieve organizational identity and actorhood. Drawing on the “communicative constitution of organizations” perspective, we argue...... and analyze relevant identity claims to investigate two critical episodes in which the organizationality of Anonymous was contested. Our study contributes to organization studies by showing that fluid social collective are able to temporarily reinstate organizational actorhood through the performance...
Schein, Edgar H
"Regarded as one of the most influential management books of all time, this fourth edition of Leadership and Organizational Culture transforms the abstract concept of culture into a tool that can be...
... Relationship of process to strategic measurements Summary 37 36Contents 19/10/2000 1:23 pm Page vi vi THE ORGANIZATIONAL MEASUREMENT MANUAL 4 PART 2 ESTABLISHING A PROCESS MEASUREMENT PROGRAMME...
Scheuer, John Damm
This paper takes it point of departure in actor-network-theory (ANT). It responds to the Next Management Theory tracks call for papers that address and further develops our understanding of organizational change as translation processes. It moreover addresses a critique of ANT researchers...... in organizational studies for making descriptions of studied empirical phenomena rather than developing theories and giving normative advice about how organizations or organizational change processes may be theorized, analyzed, managed and/or organized better. A new ANT-inspired theory about the characteristics...... of organizations, organizational change and change agents is therefore developed combining ANT with other theories. The relevance of this view is demonstrated in an analysis of a case where a nurse and the leader of a clinic for orthopedic surgery try to translate and thus implement a risk-management and deviation...
TKnowing the change process in order domination, if possible, it represents a characteristic of an efficient management organization that can ensure competitiveness. An organization is even more efficient, more competitive, as has the ability to continuously develop on multiple levels. This explains the fact that literature is increasingly approaching the concept of organizational development. Organizational Change is a process that, regardless of the applied field, will require scrolling, in...
Kato, Ken; Yamauchi, Kazunobu; Miyaji, Makoto; Fujiwara, Nakako; Katsuyama, Kimiko; Amano, Hiroshi; Kobayashi, Santaro; Naito, Michio; Maki, Yasunori; Kawahara, Hirohisa; Maseki, Mitsuaki; Senoo, Yoshio
This study seeks to investigate doctors' desire to change the hospital where they work to sustain higher quality care. Self-administered questionnaires were sent to doctors in Aichi Prefecture, Japan. Data were analyzed using univariate and logistic regression analysis and recursive partitioning. Factors related to doctors' desire to change hospitals, according to logistic regression, were interaction between working hours and satisfaction with the hospital, evaluation, local government hospitals versus private ones, small vs large hospitals, ophthalmology versus internal medicine, desire to continue working as a hospital doctor and age. Additionally, working hours were also found to be related, based on recursive partitioning. The response rate was low and sampling bias was observed--therefore results need careful interpretation. Also, because this was a cross-sectional study, causal relationships could not be identified. Desire to change hospitals, but not actual behavior, was measured. Efforts to prevent doctors from changing hospitals should include considering job satisfaction and workload, doctor evaluation methods, support for career progression and organizational management. As the hospital doctor shortage in rural areas becomes more serious, exploring doctors' desire to leave their current hospital is meaningful for Japanese hospital managers and hospitals worldwide aiming to provide sustainable and higher quality care.
Sadiq, Abdul-Akeem; Graham, John D
There is an extensive body of research on the determinants of disaster preparedness at the individual and household levels. The same cannot be said for the organizational level. Hence, the purpose of this study is to shed light on the predictors of organizational preparedness for natural disasters. Since leaders of organizations have an incentive to overstate their level of preparedness and because surveys of organizational leaders suffer from selection bias and low response rates, we take the novel approach of interviewing employees about the organizations that employ them. Using an online survey, we collected information from a national sample of 2,008 U.S. employees and estimated the predictors of preparedness at the organizational level. We find, among other results, that organization size (facility level) is a consistent predictor of preparedness at the organizational level. We conclude with policy recommendations and outline an agenda for future research on organizational preparedness for natural disasters. © 2015 Society for Risk Analysis.
... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Organizational structure. 485.627 Section 485.627 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... participation: Organizational structure. (a) Standard: Governing body or responsible individual. The CAH has a...
Bar-On, Elhanan; Abargel, Avi; Peleg, Kobi; Kreiss, Yitshak
To propose strategies and recommendations for future planning and deployment of field hospitals after earthquakes by comparing the experience of 4 field hospitals deployed by The Israel Defense Forces (IDF) Medical Corps in Armenia, Turkey, India and Haiti. Quantitative data regarding the earthquakes were collected from published sources; data regarding hospital activity were collected from IDF records; and qualitative information was obtained from structured interviews with key figures involved in the missions. The hospitals started operating between 89 and 262 hours after the earthquakes. Their sizes ranged from 25 to 72 beds, and their personnel numbered between 34 and 100. The number of patients treated varied from 1111 to 2400. The proportion of earthquake-related diagnoses ranged from 28% to 67% (P earthquakes, patient caseload and treatment requirements varied widely. The variables affecting the patient profile most significantly were time until deployment, total number of injured, availability of adjacent medical facilities, and possibility of evacuation from the disaster area. When deploying a field hospital in the early phase after an earthquake, a wide variability in patient caseload should be anticipated. Customization is difficult due to the paucity of information. Therefore, early deployment necessitates full logistic self-sufficiency and operational versatility. Also, collaboration with local and international medical teams can greatly enhance treatment capabilities.
Ninan, David; Zhu, Janet; Kore, Amanda; Wasson, Elizabeth; Fullerton, Tricia; Ninan, Barbara
This analysis looks at the application of a robust process improvement methodology to achieve a sustained organizational change. The implementation took place in a safety net hospital's operating suites that had a problem with relatively long, nonproductive turnover times between surgical procedures. Organizational leadership empowered stakeholders to use Lean and Six-Sigma tools to develop more efficient organizational processes. These processes were then implemented in a phased approach with careful attention to the organization's culture. The result was a significant reduction in turnover times leading to greater operational efficiency.
Peyrat-Guillard, Dominique; Glińska-Neweś, Aldona
The analyses presented in this paper are based on the first step of the research project concerning the links between Positive Organizational Potential (POP), Organizational Commitment (OC) and Organizational Citizenship Behaviour (OCB). The survey was conducted in two samples and covered French and Polish firms. The results support a model adopted in the analysis and thus the importance of influence of POP, organizational culture and climate on employees’ behaviours and Organizational Develo...
Lau, Wing Keung Jason
Employee empowerment has long been associated with organizational outcomes such as innovation, greater effectiveness, and better performance. Non-academic professional employees in higher education are responsible for the important day-to-day operations of a university; therefore, organizational strategies such as employee empowerment that…
White, K; Scott, I A; Bernard, A; McCulloch, K; Vaux, A; Joyce, C; Sullivan, C M
The characteristics of mature contemporary rapid response systems are unclear. To determine the patient characteristics, processes and outcomes, both in-hospital and post-discharge, of a well-established rapid response system in a tertiary adult hospital. This is a prospective study of consecutive rapid response team (RRT) activations between 1 July and 25 November 2015. Variables included patient characteristics, timing, location and triggers of RRT activations, interventions undertaken, mortality and readmission status at 28 days post-discharge. A total of 1151 RRT activations was analysed (69.1 per 1000 admissions), involving 800 patients, of whom 81.5% were emergency admissions. A total of 351 (30.5%) activations comprised repeat activations for the same patient. Most activations (723; 62.8%) occurred out of hours, and 495 (43%) occurred within 48 h of admission. Hypotension, decreased level of consciousness and oxygen desaturation were the most common triggers. Advanced life support was undertaken in less than 7%; 198 (17.2%) responses led to transfer to higher-level care units. Acute resuscitation plans were noted for only 29.1% of RRT activations, with 80.3% stipulating supportive care only. A total of 103 (12.6%) patients died in hospital, equalling 14 deaths per 100 RRT activations. At 28 days, 150 (18.8%) patients had died, significantly more among those with multiple versus single RRT activations (24.9 vs 16.6%; odds ratio 1.66, 95% confidence interval 1.31-2.44; P = 0.013). Relatively few RRT activations are associated with acute resuscitation plans, and most interventions during RRT responses are low level. The high rate of post-RRT deaths and transfers to higher-level care units calls for the prospective identification of such patients in targeting appropriate care. © 2016 Royal Australasian College of Physicians.
Van Cleve, William C; Hagan, Pat; Lozano, Paula; Mangione-Smith, Rita
On November 4, 2009, the 250-bed Seattle Children's Hospital (SCH) identified a surge in its census--245 inpatients, well above the average midnight census of 207. In response, SCH activated its pandemic influenza surge plan in an effort to decrease the inpatient census. Within 16 hours, 51 patients (20.4% of total bed capacity) had been discharged, and inpatient census at SCH decreased to 222 patients. As part of a quality improvement project, SCH's response to the surge was investigated, with data drawn from interviews, a review of records created in the course of the surge plan implementation, an e-mail survey of attending physicians responsible for patient discharges, and models examining predictors of hospital discharges. Analysis of three years of hospital data (2007-2009) indicated that the high census on November 4 was an uncommon but not unprecedented occurrence. In addition, there was a clear positive association between an evening's census and the number of discharges during the following 24 hours. SCH discharged essentially the same number of patients on November 4 as on previous high-census days when the surge plan was not activated, suggesting that the surge plan did not succeed in creating excess discharges. Increasingly, evidence indicates that care quality depends on the degree to which hospital resources are sufficient to meet demand. Reverse triage, at least as implemented by SCH on November 4, 2009, is unlikely to represent an effective solution to surge outside of a disaster setting because of its requirement for centralized decision making. SCH has incorporated the results of this review into the way that it collects and analyzes data, manages flow, and responds to inpatient surges.
Lowery, Christopher M; Beadles, N A; Krilowicz, Thomas J
Previous research which has established a relationship between organizational citizenship behavior and job satisfaction has involved primarily white collar workers. This study extends the prior research to a different sample--blue collar workers--and investigates the relations of organizational citizenship behavior to the various facets of job satisfaction as measured by the Job Descriptive Index. We also examine the relative effects of organizational commitment and job satisfaction on citizenship behaviors. Analysis of responses from a sample of 91 machine operators employed by a clothing manufacturer in the southeastern United States indicates that citizenship behaviors of blue collar workers are related to satisfaction with coworkers, satisfaction with supervision, and satisfaction with pay, but not satisfaction with opportunities for advancement, satisfaction with the work itself, or organizational commitment.
Lee, Nick; Chamberlain, Laura
Although organizational research has made tremendous strides in the last century, recent advances in neuroscience and the imaging of functional brain activity remain underused. In fact, even the use of well-established psychophysiological measurement tools is comparatively rare. Following the lead of social cognitive neuroscience, in this review, we conceptualize organizational cognitive neuroscience as a field dedicated to exploring the processes within the brain that underlie or influence human decisions, behaviors, and interactions either (a) within organizations or (b) in response to organizational manifestations or institutions. We discuss organizational cognitive neuroscience, bringing together work that may previously have been characterized rather atomistically, and provide a brief overview of individual methods that may be of use. Subsequently, we discuss the possible convergence and integration of the different neuroimaging and psychophysiological measurement modalities. A brief review of prior work in the field shows a significant need for a more coherent and theory-driven approach to organizational cognitive neuroscience. In response, we discuss a recent example of such work, along with three hypothetical case studies that exemplify the link between organizational and psychological theory and neuroscientific methods.
... elective (nonemergency) diagnosis or treatment. (iii) A hospital is required by the conditions of... emergency medical condition, observations of signs or symptoms, preliminary diagnosis, results of diagnostic... stabilizing treatment, as defined in paragraph (d) of this section, or an appropriate transfer as defined in...
Edrees, Hanan H; Wu, Albert W
Second victims are health care providers who are emotionally traumatized after experiencing an unanticipated patient's adverse event. To support second victims, organizations can provide a dedicated support program for their workers. The aim of this study was to assess the extent of the second victim problem in acute care hospitals in the state of Maryland, the availability of emotional support services, and the need for organizational support programs. In-depth, semistructured interviews were conducted with 43 patient safety representatives from 38 acute hospitals in Maryland. Data were analyzed using QSR NVivo10 software and a mixed-methods approach to generate codes and extract themes from the interviews. Descriptive statistics were generated for hospital and participant characteristics. The response rate was 83% of hospitals. All participants reported that they and their executives were aware of the second victim problem. Although participants varied in their perceptions of whether a dedicated second victim support program would be helpful for their hospital, all thought that hospitals should offer organizational support programs. Several organizations are attempting to promote a "just culture" in responding to events, and there continues to be stigma associated with speaking up during a root cause analysis, and with accessing support if it were offered. The second victim problem is recognized in all hospitals in Maryland. However, even when support is available, health care providers face stigma and other barriers in accessing it. Future efforts should assess the need for second victim programs from the perspectives of second victims themselves to identify barriers and improve uptake of needed support.
Shahi, Mehraban; Sadoughi, Farahnaz; Ahmadi, Maryam
IT governance is a set of organizational structures ensuring decision-making rights and responsibilities with regard to the organization's IT assets. This qualitative study was carried out to identify the IT governance domains in teaching hospitals affiliated to Iran University of Medical Sciences. There were 10 heads of IT departments and 10 hospital directors. Semi structured interviews used for data collection. To analyze the data content analysis was applied. All the interviewees (100%) believed that decisions upon hospital software needs could be made in a decentralized fashion by the IT department of the university. Most of the interviewees (90%) believed that there were policies for logistics and maintenance of networks, purchase and maintenance, standards and general policies in the direction of the policies of the ministry of health and medical education. About 80% of the interviewees believed that the current emphasis of the hospital's IT unit and the hospital management for outsourcing of services were in the format of specialized contracts and under supervision of the university Statistic and IT department. A hospital strategic committee is an official organizational group consisting of hospital executives, heads of IT and multiple functional areas and business units in a hospital. In this committee, "the head of hospital" acts as the director of IT activities and ensures that IT strategies are alignment with the hospital business strategies.
Gupta, Vishal; Agarwal, Upasna A; Khatri, Naresh
This study examines the factors that mediate and moderate the relationships of perceived organizational support with work engagement and organization citizenship behaviour. Specifically, affective commitment is posited to mediate and psychological contract breach to moderate the above relationships. Nurses play a critical role in delivering exemplary health care. For nurses to perform at their best, they need to experience high engagement, which can be achieved by providing them necessary organizational support and proper working environment. Data were collected via a self-reported survey instrument. A questionnaire was administered to a random sample of 750 nurses in nine large hospitals in India during 2013-2014. Four hundred and seventy-five nurses (63%) responded to the survey. Hierarchical multiple regression was used for statistical analysis of the moderated-mediation model. Affective commitment was found to mediate the positive relationships between perceived organizational support and work outcomes (work engagement, organizational citizenship behaviour). The perception of unfulfilled expectations (psychological contract breach) was found to moderate the perceived organizational support-work outcome relationships adversely. The results of this study indicate that perceived organizational support exerts its influence on work-related outcomes and highlight the importance of taking organizational context, such as perceptions of psychological contract breach, into consideration when making sense of the influence of perceived organizational support on affective commitment, work engagement and citizenship behaviours of nurses. © 2016 John Wiley & Sons Ltd.
Prince, T R
Health care executives and health professionals often compare financial outcomes among not-for-profit community hospitals, such as operating margins and excess of revenue over expenses. Some performance measures used in these comparisons tend to be uniform yardsticks across community hospitals; other measures may vary significantly by legal, organizational, and reporting-practice differences among hospitals. A unique database of certified financial statements now permits an examination of these reporting-practice differences in the context of a three-year study of financial outcomes for 1,297 hospitals. Six panels are used in the study for partitioning hospitals in response to differences in reporting practices. Revenue over expenses expressed to net patient revenue and to total unrestricted assets are partially explained by 15 factors. The