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
Becker, Edmund R; Potter, Sharyn J
Drawing on stakeholder theory and Weber's distinction between formal and substantive rationality, we posit that: (1) for-profit organizations manage stakeholders in ways that result in the organization being more efficient and less socially responsible than organizations that are not as profit oriented, and (2) organizations with major corporate relationships that are not local manage stakeholders in a manner that results in the organization being more efficient and less socially responsible than organizations without such arrangements. We test these hypotheses with 1994 data on 4,705 of the nation's short-term general hospitals using two measures of hospital efficiency and four measures of social responsibility. Results confirm that for-profit hospitals and hospitals lacking local ties are managing stakeholder relationships in ways that increases the efficiency of these hospitals but decreases their social responsiveness. We conclude by speculating that organizational efficiency and social responsibility may be inversely related and then summarize some of the academic, managerial, and policy implications, with emphasis on the implications for stakeholder theory.
Bittar, O J
The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.
I introduce an organizational model describing the response of the hospital emergency department. The hybrid simulation/analytical model (called a "metamodel") can estimate a hospital's capacity and dynamic response in real time and incorporate the influence of damage to structural and nonstructural components on the organizational ones. The waiting time is the main parameter of response and is used to evaluate the disaster resilience of health care facilities. Waiting time behavior is described by using a double exponential function and its parameters are calibrated based on simulated data. The metamodel covers a large range of hospital configurations and takes into account hospital resources in terms of staff and infrastructures, operational efficiency, and the possible existence of an emergency plan; maximum capacity; and behavior both in saturated and overcapacitated conditions. The sensitivity of the model to different arrival rates, hospital configurations, and capacities and the technical and organizational policies applied during and before a disaster were investigated. This model becomes an important tool in the decision process either for the engineering profession or for policy makers.
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 culture influences employees’ job satisfaction, commitment and performance. A strong corporate culture enhances organizational performance. Objective: The aim of this study was to determine the type of organizational culture in Qazvin hospitals. Methods: A descriptive and cross-sectional study was conducted by a survey questionnaire in Qazvin (2013 that was distributed among 800 hospital employees and managers based on stratified random sampling. Findings: The mean of hospitals’ organizational culture was 2.95 out of 5 score. Hospitals' organizational cultures were evaluated as strong in attention to details and stability dimensions and moderate in creativity, risk taking, team working and power distance dimensions. Attention to details in public hospitals was higher than private and social security hospitals. Conclusion: Organizational culture of Qazvin hospitals was evaluated as moderate. Managers for improving hospitals' performance and enhancing employees' and patients' satisfaction should create a culture of higher creativity, innovation, team working and risk taking and lower power distance.
The 1979 nuclear accident at Three Mile Island (TMI) near Harrisburg, Pennsylvania, caused severe organizational problems for neighboring health care institutions. Dauphin County, just north of TMI, contained four hospitals ranging in distance from 9.5 to 13.5 miles from the stricken plant. Crash plans put into effect within 48 hours of the initial incident successfully reduced hospital census to below 50 per cent of capacity, but retained bedridden and critically ill patients within the risk-zone. No plans existed for area-wide evacuation of hospitalized patients. Future-oriented disaster planning should include resource files of host institution bed capacity and transportation capabilities for the crash evacuation of hospitalized patients during non-traditional disasters
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
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 effecti...
Extant literature suggested that positive organizational climate leads to higher levels of organizational commitment, which is an important concept in terms of employee attitudes, likewise, the concept of perceived organizational performance, which can be assumed as a mirror of the actual performance. For healthcare settings, these are important matters to consider due to the fact that the service is delivered thoroughly by healthcare workers to the patients. Therefore, attitudes and perceptions of the employees can influence how they deliver the service. The aim of this study was to evaluate healthcare employees' perceptions of organizational climate and test the hypothesized impact of organizational climate on organizational commitment and perceived organizational performance. The study adopted a quantitative approach, by collecting data from the healthcare workers currently employed in public hospitals in North Cyprus, utilizing a self-administered questionnaire. Collected data was analyzed with the help of Statistical Package for Social Sciences, and ANOVA and Linear Regression analyses were used to test the hypothesis. Results revealed that organizational climate is highly correlated with organizational commitment and perceived organizational performance. Simple linear regression outcomes indicated that organizational climate is significant in predicting organizational commitment and perceived organizational performance. There was a positive and linear relationship between organizational climate with organizational commitment and perceived organizational performance. Results from the regression analysis suggested that organizational climate has an impact on predicting organizational commitment and perceived organizational performance of the employees in public hospitals of North Cyprus. Organizational climate was found to be statistically significant in determining the organizational commitment of the employees. The results of the study provided some critical
Vegro, Thamiris Cavazzani; Rocha, Fernanda Ludmilla Rossi; Camelo, Silvia Helena Henriques; Garcia, Alessandra Bassalobre
Objective To assess the values and practices that characterize the organizational culture of a private hospital in the state of São Paulo in the perspective of nursing professionals. Methods Quantitative, descriptive, cross-sectional study. Data collection was conducted between January and March 2013 using the Brazilian Instrument for Assessing Organizational Culture. Twenty-one nurses and sixty-two nursing aides and technicians participated in the study. The responses of the participants were coded into numerical categories, generating an electronic database to be analyzed by means of the software Statistical Package for the Social Sciences. Results Scores of cooperative professionalism values (3.24); hierarchical strictness values (2.83); individual professionalism values (2.69); well-being values (2.71); external integration practices (3.73); reward and training practices (2.56); and relationship promotion practices (2.83). Conclusion In the perception of workers, despite the existence of hierarchical strictness there is cooperation at work and the institution pursues customer satisfaction and good interpersonal relationships.
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.
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 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 satisfaction with working time, handover shifts and schedules were also better in attractive hospitals (P Job satisfaction and commitment were higher in attractive hospitals, whereas burnout and intention to leave were lower (P retention. Nurses face difficulties in their work situations, but some hospitals are perceived as healthy organizations. The concept of attractive institutions could
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.
Jalali, Mohammad S; Kaiser, Jessica P
Cybersecurity incidents are a growing threat to the health care industry in general and hospitals in particular. The health care industry has lagged behind other industries in protecting its main stakeholder (ie, patients), and now hospitals must invest considerable capital and effort in protecting their systems. However, this is easier said than done because hospitals are extraordinarily technology-saturated, complex organizations with high end point complexity, internal politics, and regulatory pressures. The purpose of this study was to develop a systematic and organizational perspective for studying (1) the dynamics of cybersecurity capability development at hospitals and (2) how these internal organizational dynamics interact to form a system of hospital cybersecurity in the United States. We conducted interviews with hospital chief information officers, chief information security officers, and health care cybersecurity experts; analyzed the interview data; and developed a system dynamics model that unravels the mechanisms by which hospitals build cybersecurity capabilities. We then use simulation analysis to examine how changes to variables within the model affect the likelihood of cyberattacks across both individual hospitals and a system of hospitals. We discuss several key mechanisms that hospitals use to reduce the likelihood of cybercriminal activity. The variable that most influences the risk of cyberattack in a hospital is end point complexity, followed by internal stakeholder alignment. Although resource availability is important in fueling efforts to close cybersecurity capability gaps, low levels of resources could be compensated for by setting a high target level of cybersecurity. To enhance cybersecurity capabilities at hospitals, the main focus of chief information officers and chief information security officers should be on reducing end point complexity and improving internal stakeholder alignment. These strategies can solve cybersecurity
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.
Baird, Kevin M; Tung, Amy; Yu, Yanjie
There is widespread evidence of the purported benefits of employee organizational commitment (EOC) and its impact on both individual and organizational performance. This study contributes to this literature by providing a unique insight into this relationship, focusing on the interrelationship between EOC with hospital performance and the role of the provision of adequate facilities in eliciting EOC. The aim of this study was to introduce and empirically examine a new theoretical model in which it is argued that the performance of hospitals with regard to the provision of adequate facilities (medical facilities, support facilities, and staff resources) influences the level of EOC, which in turn influences hospital performance with regard to patient care and operational effectiveness. To examine the interrelationships between the provision of adequate facilities, EOC, and hospital performance, the study utilizes a survey of hospital managers. The findings support the theoretical model, with the provision of support facilities and staff resources positively indirectly associated with both patient care and operational effectiveness through their impact on EOC. The findings highlight the importance of providing adequate facilities and EOC within hospitals and suggest that CEOs and general managers should try to enhance the provision of such resources in an attempt to elicit EOC within their hospitals. The findings suggest that managers should try to enhance their provision of adequate facilities in order to elicit EOC and enhance hospital performance. With regard to medical facilities, they should consider and incorporate the latest technology and up-to-date equipment. They should also provide adequate staff resources, including appropriate numbers of beds, nurses, and doctors, to prevent "fatigue" (West, 2001, p. 41) and provide adequate support facilities.
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
Møller Larsen, Marcus; Pedersen, Torben
this, firms need a high degree of architectural knowledge, which is typically gained through learning by doing. We therefore argue that firms with more offshoring experience are more likely to include organizational objectives in their offshoring strategies. We develop and find support......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...... for this hypothesis using a mixed-method approach based on a qualitative case study and comprehensive data from the Offshoring Research Network. These findings contribute to research on the organizational design and architecture of offshoring and the dynamics of organizational architectures....
Khayat Moghadam S
Full Text Available Objectives: A new and unique tool for survival of organizations among their competitors is the use of organizational intelligence; Organizational intelligence means having a comprehensive knowledge of all the environmental factors that affect on the organization. This research is one of the few studies with the aim of determine the organizational intelligence level of hospitals and ranking of organizational intelligence components to enable administrators to provide more accurate identification of strengths and weaknesses and take more effective steps to improve service delivery. Materials and Methods: This is a descriptive-analytical and applicable study performed in the 2012 at 12 General Hospital related to Mashhad University of Medical Sciences. Data collection was performed by Albrecht organizational intelligence questionnaire. The data gathering tool was the questionnaire Albrecht Organizational Intelligence. The collected Data were analyzed using T-test and Smirnov test with SPSS-16 software. The significance level for all tests was considered 0.05. Results: All components of organizational intelligence were in the optimum status. Component of Shared fate gained the first rank and component of knowledge Deployment gained the last rank. Conclusion: Ranking of organizational intelligence components is different in hospitals of the province and the county; representing different features and conditions. Considering the importance of organizational intelligence role in the promotion of organization, hospital managers can take active steps to improve organizational intelligence based on done rankings.
Jacobs, Rowena; Mannion, Russell; Davies, Huw T O; Harrison, Stephen; Konteh, Fred; Walshe, Kieran
This paper examines the relationship between senior management team culture and organizational performance in English acute hospitals (NHS Trusts) over three time periods between 2001/2002 and 2007/2008. We use a validated culture rating instrument, the Competing Values Framework, to measure senior management team culture. Organizational performance is assessed using a wide range of routinely collected indicators. We examine the associations between organizational culture and performance using ordered probit and multinomial logit models. We find that organizational culture varies across hospitals and over time, and this variation is at least in part associated in consistent and predictable ways with a variety of organizational characteristics and routine measures of performance. Moreover, hospitals are moving towards more competitive culture archetypes which mirror the current policy context, though with a stronger blend of cultures. The study provides evidence for a relationship between culture and performance in hospital settings. Copyright © 2012 Elsevier Ltd. All rights reserved.
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
Shurberg, D.A.; Haber, S.B.
A large volume of literature hypothesizes a direct relationship between organizational culture and organizational effectiveness. Culture data have been collected by the authors and others at nuclear power plants (NPPs) and other organizations that demand high reliability. In this paper, the literature and data are used to explore a critical dimension of the accident response process in an NPP: the transition from an anticipatory strategy to an ad hoc strategy. In particular, the effect of organizational culture on the implementation of each of these strategies is examined
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.
Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiasvand, Hesam
A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders' satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals
Reducing operational inefficiencies represents one of the most promising sources of potential savings in hospitals today. Health Forum convened a panel of hospital executives and industry experts to discuss the daunting challenges and big opportunities that lie ahead.
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.
Shortell, S M; Getzen, T E
Based on organization theory and the work of Roemer and Friedman, seven dimensions of hospital medical staff organization structure are proposed and examined. The data are based on a 1973 nationwide survey of hospital medical staffs conducted by the American Hospital Association. Factor analysis yielded six relatively independent dimensions supporting a multidimensional view of medical staff organization structure. The six dimensions include 1) Resource Capability, 2) Generalist Physician Contractual Orientation, 3) Communication/Control, 4) Local Staff Orientation, 5) Participation in Decision Making, and 6) Hospital-Based Physician Contractual Orientation. It is suggested that these dimensions can be used to develop an empirical typology of hospital medical staff organization structure and to investigate the relationship between medical staff organization and public policy issues related to cost containment and quality assurance. PMID:511580
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.
Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…
Arnetz, Judith; Hamblin, Lydia E; Sudan, Sukhesh; Arnetz, Bengt
To identify organizational factors contributing to workplace violence in hospitals. A questionnaire survey was conducted in 2013 among employees in a Midwestern hospital system (n = 446 respondents). Questions concerned employees' experiences of violence at work in the previous year and perceptions of the organizational safety climate. Logistic regressions examined staff interaction and safety climate factors associated with verbal and physical violence, respectively. Interpersonal conflict was a risk factor for verbal violence (OR 1.49, 95% CI 1.04-2.12, p violence (OR .98, 0.97-0.99). A poor violence prevention climate was a risk factor for verbal (OR 0.48, 0.36-0.65, p violence. Interventions should aim at improving coworker relationships, work efficiency, and management promotion of the hospital violence prevention 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
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.
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.
Trybou, Jeroen; Gemmel, Paul; Van Vaerenbergh, Yves; Annemans, Lieven
Background: Belgian hospitals face a growing shortage of physicians and increasingly competitive market conditions. In this challenging environment hospitals are struggling to build effective hospital-physician relationships which are considered to be a critical determinant of organizational success. Methods: Employed physicians of a University hospital were surveyed. Organizational attributes were identified through the literature and two focus groups. Variables were measured using valida...
Noval de la Torre, A; Bulchand Gidumal, J; Melián González, S
Background. There are not too many studies that deal with the organizational commitment of emergency physicians. This commitment has been shown to impact organizational performance. The aim of this paper is to analyse the degree of commitment of the emergency physicians in Spanish public hospitals and the factors that may influence it. Method. Online survey using SurveyMonkey to emergency physicians in Spanish public hospitals. Results. Two hundred and five questionnaires were received, 162 from physicians and 43 from heads of the emergency service. Results show an intermediate level of commitment, with affective commitment showing the lowest level and continuance commitment showing the highest level. The capabilities of the physician have an influence on their affective commitment; specific training in emergency procedures and seniority has an influence on their continuance commitment; and the opinion they hold about the organization of their service influences affective commitment. Conclusions. Emergency physicians show an average involvement in the hospital in which they work (average 3.8 on a range of 1 to 5), feel an average affection for it (3.4), and have a high intention to keep working there (4.0). The resources the hospital has due to its level do not have an influence on this commitment, while the training and perceptions of the service do have an influence.
Waring, Justin; Marshall, Fiona; Bishop, Simon
Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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
SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.
Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972
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).
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.
Katja Skinder Savić
Full Text Available Introduction: Organizational culture is formed via communication, resolving conflicts, team work and interconnection. The aim of the study was to present the connections between organizational culture and job satisfaction indicators. Methods: A quantitative descriptive approach was used. The study included nursing employees and medical practitioners in six Slovenian hospitals. A 30 per cent quota sample was used, with a response rate of 35.2 % (n = 310. The Organization Culture Assessment Instrument (OCAI (α = 0,818 and Index of Work Satisfaction (α = 0,921 questionnaires were used. The data was processed with SPSS 20.0 statistical software by using the t-test, single variance analysis, correlation, factor and regression analysis. Results: The greatest total average value among employees of both job groups with regard to organizational culture was the market (x = 28.21 and hierarchy (x = 27.57. Job satisfaction indicators (collaboration, leadership, decision-making, autonomy can be explained in 20 % of cases with adhocracy organizational culture (β = 0.318, p < 0.001, market (β = 0.219, p < 0.001 and clan (β = 0.161, p = 0.006. Discussion and conclusion: In Slovenian hospitals, control over work, abiding by the rules and attaining, goals prevails. An overview of the literature reveals the influence of culture on satisfaction. Other factors affecting satisfaction, including stress and abuse of hierarchical power, should be studied.
Jahani, Mohammad Ali; Mahmoudjanloo, Shahrbanoo; Rostami, Fatemeh Hoseini; Nikbakht, Hosein Ali; Mahmoudi, Ghahraman
Studying the role of employees as the base of an organization on achieving organizational goals has increased in recent years . To have better organizational citizens, organizations should encourage their staff . As the most powerful form of organizational behavior, organizational citizenship is more influential than organizational cooperation . Studies have shown that cooperative behavior, such as the citizenship behavior results in easier organizational communication, promoting organizational planning, improving inter-personal cooperation and developing better organizational climate, directly influence staff satisfaction, work life quality, service-provision, job commitment and financial output . As the most fundamental organizational behavior, the organizational citizenship behavior (OCB) causes so-called organizational effectiveness. This study Focused on the comparing organizational citizenship behavior components including conscientiousness, courtesy, altruism, sportsmanship and civic virtue among hospitals based on ownership. Research population included all therapeutic and non-therapeutic employees working in the five selected hospital located in Golestan province, Iran in 2016. This study is approved by Ethical committee of Islamic Azad Sari Branch. Based on Cochran׳s sampling formula, 312 employees working in different hospital sections and units (nurses and administrative personnel) were proportionally selected as the research sample. They completed the Persian version of Podsakoff׳s standard scale measuring organizational citizenship behavior. The data were analyzed using SPSS 22 and applying inferential statistics approaches such as t-test, Tukey, and ANOVA in the confidence interval of 95%.
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.
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.
Toole, Cheryl A; DeGrazia, Michele; Connor, Jean Anne; Gauvreau, Kimberlee; Kuzdeba, Hillary Bishop; Hickey, Patricia A
Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States. Clinical nurse leaders in NICUs located in freestanding children's hospitals were invited to participate in an electronic cross-sectional survey. Descriptive analyses were used to summarize nursing and organizational characteristics. The response rate was 30% (13/43), with 69.2% of NICUs classified as level III/IV and 30.8% classified as level II/III. Licensed bed capacity varied significantly (range, 24-167), as did the proportion of full-time equivalent nurses (range, 71.78-252.3). Approximately three-quarters of staff nurses held baccalaureate degrees or higher. A quarter of nurses had 16 or more years (26.3%) of experience, and 36.9% of nurses had 11 or more years of nursing experience. Nearly one-third (29.2%) had 5 or less years of total nursing experience. Few nurses (10.6%) held neonatal specialty certification. All units had nurse educators, national and unit-based quality metrics, and procedural checklists. This study identified (1) variation in staffing models signaling an opportunity for collaboration, (2) the need to establish ongoing processes for sites to participate in future collaborative efforts, and (3) survey modifications necessary to ensure a more comprehensive understanding of nursing and organizational characteristics in freestanding children's hospital NICUs.
Conclusion: Considering the undesirable aspects of the research among nurses of Tehran University of Medical Sciences hospitals, It is recommended to improve the quality of work life, preventing burnout and creating an appropriate organizational atmosphere for nurses in the workplace. However, organizational justice, and other organizational variables should be assessed for improving of organizational citizenship behavior.
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.
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. PMID:25870494
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
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.
Littlepage, Ben; Clark, Teresa; Wilson, Randal; Stout, Logan
Community colleges in Tennessee, either directly or indirectly, experienced unprecedented change as a result of Tennessee Promise. The present study explored how student support service administrators at three community colleges responded to organizational change as a result of the Tennessee Promise legislation. Investigators selected community…
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.
Röthlin, Florian; Schmied, Hermann; Dietscher, Christina
In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Bratberg, Espen; Monstad, Karin
Sickness absence has risen over the past years in Norway. One explanation put forward is that a tougher labor market represents a health hazard, while a competing hypothesis predicts that loss of job security works as a disciplinary device. In this analysis we aim to trace a causal impact of organizational turmoil or job insecurity on sickness absence, applying a difference-in-difference approach. Utilizing a negative financial shock that hit specific employers and workplaces, we find that si...
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.; et al.,
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
Saeed Bahramzadeh; Hossein Ali Bahramzadeh; Gorji Mohammad Bagher
In the current research the relationship between the acceptance of IT and organizational agility of Bojnourd Social Security Hospital is analyzed. In this regard, Davis's technology acceptance model (TAM) and organizational agility, based on the model of London Institute study, has been examined. The statistical population is the entire hospital staff of 360. The sample size was determined 186 by using Krejcie and Morgan table. This research is practical in terms of purpose, and in terms of m...
Davis, Jullet A; Whitman, Marilyn V
Like several states in the Southeast, Alabama is in the nascent stages of an increase in the population of foreign-born individuals for whom English is a second language. These individuals are also culturally different from the traditional southern population. Given the impact of culture and language on a person's service utilization, the introduction of new cultures may pose significant challenges for Alabama's health care providers if they are not prepared. The purpose of this project is to examine the organizational characteristics associated with the provision of culturally and linguistically appropriate services by Alabama hospitals. The data for the project come from a survey of all medical/surgical hospitals (N = 101). Fifty-nine surveys were returned, giving us a 58% response rate. The data were analyzed using correlations, analysis of variance, and logistic regression. Approximately 47% of the sample hospitals reported having a staff interpreter. Furthermore, hospitals that had staff interpreters did seem to be more aware of their community, which was reflected in their mission statements. In addition, directors who viewed their role as fulfilling the strategic plan accepted the task of providing staff interpreters. Thus, several hospitals in Alabama seemed to be ready to meet the cultural and language needs of their markets.
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.
Law, Madelyn P; Orlando, Elaina; Baker, G Ross
Changes in resident duty hours in Europe and North America have had a major impact on the internal organizational dynamics of health care organizations. This paper examines, and assesses the impact of, organizational interventions that were a direct response to these duty hour reforms. The academic literature was searched through the SCOPUS database using the search terms "resident duty hours" and "European Working Time Directive," together with terms related to organizational factors. The search was limited to English-language literature published between January 2003 and January 2012. Studies were included if they reported an organizational intervention and measured an organizational outcome. Twenty-five articles were included from the United States (n=18), the United Kingdom (n=5), Hong Kong (n=1), and Australia (n=1). They all described single-site projects; the majority used post-intervention surveys (n=15) and audit techniques (n=4). The studies assessed organizational measures, including relationships among staff, work satisfaction, continuity of care, workflow, compliance, workload, and cost. Interventions included using new technologies to improve handovers and communications, changing staff mixes, and introducing new shift structures, all of which had varying effects on the organizational measures listed previously. Little research has assessed the organizational impact of duty hour reforms; however, the literature reviewed demonstrates that many organizations are using new technologies, new personnel, and revised and innovative shift structures to compensate for reduced resident coverage and to decrease the risk of limited continuity of care. Future research in this area should focus on both micro (e.g., use of technology, shift changes, staff mix) and macro (e.g., culture, leadership support) organizational aspects to aid in our understanding of how best to respond to these duty hour reforms.
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.
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
Vessey, Judith A
The data-based literature addressing children's psychological responses to hospitalization was reviewed using methods outlined by Cooper (1989). Using a developmental science perspective, early research was reviewed and a model of variables that contribute to children's responses was constructed. This model consists of three major foci, including maturational and cognitive variables (developmental level, experience, coping style), ecological variables (family and hospital milieu), and biological variables (inborn factors and pathophysiology). Coping serves as the overarching framework for examining these variables and their contributions to children's responses to hospitalization. A variety of theoretical perspectives from the social sciences have been used, with psychoanalytic and stress and adaptation theories predominating. The majority of the research used simple case study, descriptive, or pre- and post-test designs. Methodologic issues were common. Little qualitative work has been done. Future research directions call for studies to adopt new theoretical and empirical models that are methodologically rigorous and clinically relevant and that embrace the precepts of developmental science.
Background Belgian hospitals face a growing shortage of physicians and increasingly competitive market conditions. In this challenging environment hospitals are struggling to build effective hospital-physician relationships which are considered to be a critical determinant of organizational success. Methods Employed physicians of a University hospital were surveyed. Organizational attributes were identified through the literature and two focus groups. Variables were measured using validated questionnaires. Descriptive analyses and linear regression were used to test the model and relative importance analyses were performed. Results The selected attributes predict hospital attractiveness significantly (79.3%). The relative importance analysis revealed that hospital attractiveness is most strongly predicted by professional attributes (35.3%) and relational attributes (29.7%). In particular, professional development opportunities (18.8%), hospital prestige (16.5%), organizational support (17.2%) and leader support (9.3%) were found to be most important. Besides these non-economic aspects, the employed physicians indicated pay and financial benefits (7.4%) as a significant predictor of hospital attractiveness. Work-life balance and job security were not significantly related to hospital attractiveness. Conclusions This study shows that initiatives aimed at strengthening physicians’ positive perceptions of professional and relational aspects of practicing medicine in hospitals, while assuring satisfactory financial conditions, may offer useful avenues for increasing the level of perceived hospital attractiveness. Overall, hospitals are advised to use a differentiated approach to increase their attractiveness to physicians. PMID:24884491
Trybou, Jeroen; Gemmel, Paul; Van Vaerenbergh, Yves; Annemans, Lieven
Belgian hospitals face a growing shortage of physicians and increasingly competitive market conditions. In this challenging environment hospitals are struggling to build effective hospital-physician relationships which are considered to be a critical determinant of organizational success. Employed physicians of a University hospital were surveyed. Organizational attributes were identified through the literature and two focus groups. Variables were measured using validated questionnaires. Descriptive analyses and linear regression were used to test the model and relative importance analyses were performed. The selected attributes predict hospital attractiveness significantly (79.3%). The relative importance analysis revealed that hospital attractiveness is most strongly predicted by professional attributes (35.3%) and relational attributes (29.7%). In particular, professional development opportunities (18.8%), hospital prestige (16.5%), organizational support (17.2%) and leader support (9.3%) were found to be most important. Besides these non-economic aspects, the employed physicians indicated pay and financial benefits (7.4%) as a significant predictor of hospital attractiveness. Work-life balance and job security were not significantly related to hospital attractiveness. This study shows that initiatives aimed at strengthening physicians' positive perceptions of professional and relational aspects of practicing medicine in hospitals, while assuring satisfactory financial conditions, may offer useful avenues for increasing the level of perceived hospital attractiveness. Overall, hospitals are advised to use a differentiated approach to increase their attractiveness to physicians.
Full Text Available Introduction: High organizational justice and its factors are associated with reduced turnover intention. Therefore, in this study, we aimed to examine the relationship between organizational justice and turnover intention among hospital nurses. Materials and Methods: This descriptive, analytical study was conducted on 135 nurses working in Labafi Nejad Hospital in Tehran, Iran, 2015. The data were collected using Beugre's (1998 questionnaire of organizational justice questionnaire. To analyze the data, Pearson’s correlation and ANOVA tests were performed using SPSS, version 20. Results: Mean organizational justice and turnover intention scores were 68.85±7.67 and 47.8±12.47, respectively. Among the different types of organizational justice, the highest mean score was pertinent to interactional justice (75.24±16.68. A significant inverse correlation was observed between turnover intention and organizational justice (r=-0.36, interactional justice (r=-0.38, and procedural justice (r=-0.36, while no association was noted between turnover intention and systemic and distributive types of justice. Furthermore, there was no link between demographic variables, organizational justice, and turnover intention. Conclusion: Considering the prominent role of organizational justice in personnel’s intention to leave their job, and given high costs of recruiting and training new staff, managers should pay especial attention to promoting justice and employees’ satisfaction and enhancing stability in their organizations by reinforcing positive attitudes in the employees.
Schmidt-Wilcke, Heinrich Alyosius
The self-concept of hospitals today includes the role of service providers, and so they act accordingly. This attitude is chiefly held by hospital administrators. It means that at management level there is a shift of values toward business ethics. However, hospital management is responsible not only for the business aspects of the hospital but also for the provision of adequate medical care to patients. Therefore, hospitals as service providers must be governed by the principles of medical as well as of business ethics. These principles, although from different areas, can be made to largely coincide, but can also lead to divergent positions within a hospital. The result is what within the scope of medical ethics, too, is experienced as a conflict of principles, e.g., the principle of beneficence versus the principle of autonomy. A reconciliation of such divergent moral positions can often be effected by analyzing the actual conflict situation and thus reaching consensus. The conflict between the principles of medical ethics and business ethics takes place chiefly within the sphere of activity of those providing medical and nursing care. As a consequence, a necessary business decision taken by the management to improve the productivity of medical and nursing activities can lead to serious deficits on the staff side. In terms of business ethics, this is a lack of beneficence toward individual staff members that are perhaps overtaxed, and at the same time, in terms of medical ethics, a potential lack of beneficence toward hospital patients is implicitly accepted. In general, management has the responsibility for bringing about, in the day-to-day operation of a hospital, a plausible reconciliation of the ethical principles of two spheres of activity that are only apparently independent of each other.
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.
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.
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 vs. 77%, p vs. 69%, p vs. 64%, p vs. 7.9%, p organizational culture that supported coordination of care (p 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.
Uriell, Zannette A; Schultz, Rosemary A
...) Customer Assessment Survey. Because of the new administration mode, a non-response follow-up was administered after the field closed to determine if there were differences between those who responded and those who...
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
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.
Tourani, Sogand; Khosravizadeh, Omid; Omrani, Amir; Sokhanvar, Mobin; Kakemam, Edris; Najafi, Behnam
Background: Despite advances in science and technology, human resources are of the major capital for organizations. Workforce retention is required to improve organizational efficiencies. Objective: Therefore, in this study, the relationship between organizational justice (as one of the most influential factors) and turnover intention was investigated. Methods: This descriptive-analytic study was done in the Comprehensive Jame Women’s Hospital of Tehran in 2015. The statistical sample consisted of 135 nursing staff members. The data were collected using a questionnaire of Beugre’s organizational justice and analyzed by the use of Spearman’s and Anova statistical tests. Results: Averages of organizational justice was obtained to be 68.85 ± 7.67 . Among different sorts of organizational justice, the highest average score of 75.24 ± 16.68 was achieved relevant to interactional justice. A significant relationship was observed between organizational justice (r = -0.36), interactional justice (r = -0.38), and procedural justice (r = -0.36) and turnover intention, but no relation was found between turnover intention and systemic and distributive justice. Furthermore, there was no relationship between demographic variables, organizational justice, and turnover intention. Conclusion: Considering the prominent role of organizational justice in the personnel’s intention to stay or leave and due to the high costs of recruiting and training new staff, managers should pay especial attention to justice and provide their employees’ satisfaction and stability in their organizations by creating a positive mindset in them. PMID:27482163
Fard, Samaneh Bahrololumi
Strategically, every organization follows a specific systematic plan of action to control the service recovery procedures, namely organizational responses. Organizational responses vary due to different approaches and opinions; however, six responses are usually referenced in the literature: timeliness, redress, facilitation, credibility, attentiveness and apology. Therefore, Investigation of the impacts of organizational responses on hotel-casino customers‟ satisfaction and loyalty in Northe...
To determine if there is a relationship between the risk of postoperative complications and the nonclinical hospital characteristics of bed size, ownership structure, relative urbanicity, regional location, teaching status, and area income status. This study involved a secondary analysis of 2006 administrative hospital data from a number of U.S. states. This data, gathered annually by the Agency for Healthcare Research and Quality (AHRQ) via the National Inpatient Sample (NIS) Healthcare Utilization Project (HCUP), was analyzed using probit regressions to measure the effects of several nonclinical hospital categories on seven diagnostic groupings. The study model included postoperative complications as well as additional potentially confounding variables. The results showed mixed outcomes for each of the hospital characteristic groupings. Subdividing these groupings to correspond with the HCUP data analysis allowed a greater understanding of how hospital characteristics' may affect postoperative outcomes. Nonclinical hospital characteristics do affect the various postoperative complications, but they do so inconsistently.
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.
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.
Shurberg, D.A.; Haber, S.B.
The ability of an organization to effectively move from an anticipatory to an ad hoc strategy may well depend on the organization having the ability to balance these two apparently dichotomous cultural styles. The organization which is most capable of making the necessary transition in an optimal manner may well exhibit some aspects of both cultural styles during normal operations. Data collected at one NPP does exhibit this pattern of results, with the organization exhibiting a clear hierarchical chain of command and perceived conventional behavioral expectations as well as exhibiting a more decentralized and collegial approach to decisionmaking, a team work orientation, and informal communications. Thus, it is expected that this organization possesses the capabilities to make a successful transition from an anticipatory to an ad hoc strategy. Data collected at a second NPP more strongly exhibits the traditional style suggested as being important during the anticipatory strategy, with more formal communications and bureaucratically controlled decision-making. This organization may experience difficulty if faced with the need to make a transition from an anticipatory to an ad hoc strategy. These conclusions are further validated based on observation of Emergency Preparedness Exercise Inspections, which suggest that the more anticipatory types of behaviors actually inhibit successful performance during an ad hoc response. The final validation of these hypotheses needs to be demonstrated with cultural data collected during emergency simulations. The mechanism to obtain such data during these types of situations is an area for future research
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.
Fathabad, Heidar Sharifi; Yazdanpanah, Abbas; Hessam, Somayeh; Chimeh, Elham Ehsani; Aghlmand, Siamak
One of the most important reasons of turnover is perceptions of organizational justice. The purpose of this study was to investigate the effect of perceived organizational justice and its components on turnover intentions of nurses in hospitals of Urmia University of Medical Sciences. This cross-sectional study was among nurses. 310 samples were estimated according to Morgan Table. Two valid and reliable questionnaires of turnover and organizational justice were used. Data analysis was performed using the software SPSS20. Using the Kolmogorov-Smirnov test, the normality and relationship between variables with Pearson and Spearman correlation test were analyzed. Most people were married and aged between 26 and 35 years, BA and were hired with contraction. The mean score of organizational justice variable was 2.59. The highest average was the interactional justice variable (2.81) and then Procedural fairness variable (2.75) and distributive justices (2.03) were, respectively. The mean range of turnover variable was 3.10. The results showed weak and negative relationship between various dimensions of organizational justice and turnover in nurses. Organizational justice and turnover had inverse relationship with each other. Therefore how much organizational justice in the organization is more; employees tend to stay more. Finally, suggestions for improvement of justice proposed.
Hogan, Tory H; Lemak, Christy Harris; Hearld, Larry R; Sen, Bisakha P; Wheeler, Jack R C; Menachemi, Nir
Changes in payment models incentivize hospitals to vertically integrate into sub-acute care (SAC) services. Through vertical integration into SAC, hospitals have the potential to reduce the transaction costs associated with moving patients throughout the care continuum and reduce the likelihood that patients will be readmitted. The purpose of this study is to examine the correlates of hospital vertical integration into SAC. Using panel data of U.S. acute care hospitals (2008-2012), we conducted logit regression models to examine environmental and organizational factors associated with hospital vertical integration. Results are reported as average marginal effects. Among 3,775 unique hospitals (16,269 hospital-year observations), 25.7% vertically integrated into skilled nursing facilities during at least 1 year of the study period. One measure of complexity, the availability of skilled nursing facilities in a county (ME = -1.780, p integration into SAC. Measures of munificence, percentage of the county population eligible for Medicare (ME = 0.018, p integration into SAC. Dynamism, when measured as the change county population between 2008 and 2011 (ME = 1.19e-06, p integration into SAC. Organizational resources, when measured as swing beds (ME = 0.069, p integration into SAC. Organizational resources, when measured as investor owned (ME = -0.052, p integration into SAC. Hospital adaption to the changing health care landscape through vertical integration varies across market and organizational conditions. Current Centers for Medicare and Medicaid reimbursement programs do not take these factors into consideration. Vertical integration strategy into SAC may be more appropriate under certain market conditions. Hospital leaders may consider how to best align their organization's SAC strategy with their operating environment.
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.
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.
Sopoh, Ghislain Emmanuel; Kouckodila Nzingoula, Michael Florian; Sossa Jérôme, Charles; Hessou Ahahanzo-Glèlè, Yolaine; Damienne Agueh, Victoire; Tinoaga Ouédraogo, Laurent; Makoutodé, Michel
Organizational culture, a frequently ignored concept, affects job satisfaction and productivity in organizations. To determine the factors associated with the strength of organizational culture (OC) in Mono / Couffo regional hospital in Lokossa in Benin. This cross-sectional and analytical study involved 121 workers of Mono/Couffo hospital in March 2015. Data on the strength of OC was collected using a questionnaire based on the validated tool proposed by Cameron and Quinn (2006). Logistic regression was performed to explore the nature of the relationship between the independent variables and OC using Odds ratios. 62% of the surveyed subjects had a positive perception of organizational culture. This perception was statistically associated with managerial factors (moral support of workers and type of relationship with the executive staff). The risk of perceiving a low strength of OC was sixfold higher OR = 3.78, 95% CI (1.08 - 13.22) among subjects who felt they did not have moral support from executive staff than in those who perceived this moral support. The risk of perceiving a weak OC was higher among subjects who considered relations with the staff to be uncordial [OR = 14.32, 95% CI (4.35 - 47.11)] compared to those who considered these relations to be cordial. Human resource management factors were more closely associated with the strength of organizational culture. Hospital managers should pay more attention to these factors in their hospitals to promote better institutional performance.
Schreuder, Kay; van Bommel, A.C.M.; De Ligt, K.M.; Maduro, J.H.; Vrancken Peeters, M.T.F.D.; Mureau, M.A.M.; Siesling, S.
Background: Aims of the current study were to identify which hospital organizational factors determine the variation in the use of immediate breast reconstruction (IBR) after mastectomy for ductal carcinoma in situ (DCIS) or invasive breast cancer and to investigate whether these factors explain the
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.
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
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.
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.
Shamsuddin Alaraki, Mohammad
The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation. A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals. The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve "customer satisfaction" nor to achieve measurable improvements in "quality results" scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi
Saame, Iisi; Reino, Anne; Vadi, Maaja
The concept of organisational culture (also referred to later as OC) is one of the approaches in modern organisational analysis exploring the values, attitudes and beliefs behind human behaviour in the workplace. OC as a social phenomenon is considered to be important for the sustainability of every organisation. In the service sector, OC may affect the nature and quality of the services provided. The aim of this paper is twofold: on the one hand, to highlight the patterns of OC in a hospital; and, on the other hand, to outline relationships between OC and patient satisfaction. The study was conducted in Tartu University Hospital, one of the most influential health care organisations in Estonia. This paper has original value by presenting an insight into organisational culture in the Estonian health care sector, and the findings of the study will expand knowledge of OC in the health care sector in general. The OC instrument applied in a quantitative cross-sectional study was earlier developed according to the Competing Values Framework (CVF). Data from 456 medical and non-medical professionals were analysed using non-parametric tests of descriptive statistics. A factor analysis was performed to assess the instrument's compatibility for analysing the OC pattern in the health care sector. The dominant culture type in all the groups investigated was the Internal Processes type, mainly followed by the Rational Goal type, while different cultural patterns were observed in professional groups. The factor analysis yielded a three-subscale solution. Clinics with high patient satisfaction did not score more than clinics with low patient satisfaction in terms of the Human Relations type. In future studies a random sample design and a multidisciplinary approach to OC research should be followed in order to further explore OC patterns in hospitals and their consequences for different aspects of hospital performance.
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.
Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri; Aaviksoo, Ain
The aim of the present study was to examine Estonian nurses' thinking with regard to how they perceive their autonomy, control over practice, teamwork and organizational support in regional, central and general hospitals. BACKGROUND; Despite the well-documented fact that there is a need to improve nurses' working environments in hospitals to promote safe patient care, in Europe broader studies on this topic have not received priority thus far. A nationally representative stratified random sample of 478 acute care hospital nurses was surveyed using the Nursing Work Index-Revised (NWI-R) instrument in 2005/2006. Nurses perceived their autonomy, control over practice and organizational support remarkably lower than nurse-physician relationships. Age and tenure were highly related to the nurses' perceptions. The Estonian nurses' ambivalent perceptions of the organizational attributes reflected the effects ascribed to hospital reforms. There is an urgent need for nurse managers to be particularly alert and attentive with regard to nurses who have been practising the profession for more than a decade. Support for their practice should be provided with the long-term goal of assuring the retention of those experienced nurses. Continuous monitoring of nurses' perceptions should be used systematically as a tool for staffing decisions at the hospital level.
Bacon, Cynthia Thornton; Mark, Barbara
The purpose of this study was to examine the relationships between hospital context, nursing unit structure, and patient characteristics and patients' satisfaction with nursing care in hospitals. Although patient satisfaction has been widely researched, our understanding of the relationship between hospital context and nursing unit structure and their impact on patient satisfaction is limited. The data source for this study was the Outcomes Research in Nursing Administration Project, a multisite organizational study conducted to investigate relationships among nurse staffing, organizational context and structure, and patient outcomes. The sample for this study was 2,720 patients and 3,718 RNs in 286 medical-surgical units in 146 hospitals. Greater availability of nursing unit support services and higher levels of work engagement were associated with higher levels of patient satisfaction. Older age, better health status, and better symptom management were also associated with higher levels of patient satisfaction. Organizational factors in hospitals and nursing units, particularly support services on the nursing unit and mechanisms that foster nurses' work engagement and effective symptom management, are important influences on patient satisfaction.
Erik De Waard
Full Text Available 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 specifically designed to handle crises. By definition, crisis response organizations have to be prepared to react to unpredictable events. Moreover, the volatility of the crisis situation itself requires a high degree of flexibility to get or keep the situation under control. The study hypothesizes modular organizing and organizational sensing to be key drivers of organizational responsiveness. Empirically, we examine the effect these two variables have on the responsiveness of the Netherlands armed forces for crisis response deployment. Findings indicate that modular organizing and organizational sensing are drivers of responsiveness. In addition, our study uncovered the importance of an organization’s level of system decomposition to responsiveness. A high degree of system granularity can lead to a predominantly inward focus whereas organizational responsiveness calls for a strong external orientation.
Dias, Casimiro; Escoval, Ana
The main purpose of this article is to examine how the internal and external dimensions of organizational flexibility impact hospital performance. Results reveal that matching internal and external flexibilities contributes to the development of capabilities to adopt new strategic options. Such interactions have a significant impact in terms of hospital performance. A cluster of dynamic hospitals, which is characterised by high levels of both internal and external flexibilities, (instead of that have high levels of both internal and external flexibilities) was found to have the double level of performance compared with other clusters. The implications for research and managerial practice are discussed. Copyright © 2014 Longwoods Publishing.
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.
Machado, Valéria Bertonha; Kurcgant, Paulina
This study was carried out in a philanthropic medium-size hospital institution in Sao Paulo - Brazil, aiming to disclose the cultural features of the institution. The adopted methodology was the qualitative study, following the steps proposed by Thévenet: document analysis, interview and observation. The analysis showed that when a new professional group starts working in an institution, it considers that some values must be changed. This change means to restructure the management of the organization and the people involved in it, facing the conflict posed by changing or preserving the old system.
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.
Ramos, Silvina; Romero, Mariana; Ortiz, Zulma; Brizuela, Vanessa
In 2010, the Safe and Family-Centered Maternity Hospitals initiative was launched in order to transform large public maternity centers into settings where safe practices are implemented and the rights of women, newborn infants and families are warranted. As a result, the paradigm of perinatal care was modified. This article reports on the findings of organizational culture as a component for the implementation of the initiative. The sample was selected in a non-probabilistic way and was made up of 29 public hospitals located in the province of Buenos Aires that participated in the initiative. During 2011 and 2012, an anonymous, self-administered survey was completed by members of the Department of Neonatology and the Department of Obstetrics. The survey collected information on three dimensions of the organizational culture: organizational environment, safe practices, and facilitation of change. A total of 1828 surveys were collected; 51% of survey respondents stated that there is a need to improve communication by having more meetings, while 60% made a positive assessment of various aspects of leadership. Work overload was described as the main cause of conflicts by 60%. Approximately 25% agreed and showed commitment with the initiative of transforming maternity centers. Adherence to practices was dissimilar depending on the practice, but half of survey respondents reported that there were genuine reasons for change. The assessment of the organizational culture showed that commitment to the Safe and Family-Centered Maternity Hospitals initiative is yet to be consolidated, and the evaluation of leadership is not comprehensive. Work overload and communication failures are the main reasons for conflict.
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
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.
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
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.
Borg, M A; Waisfisz, B; Frank, U
It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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
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
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.
Whitcombe, Anne; Cooper, Kay; Palmer, Emma
The objective of this mixed methods systematic review is to examine the relationship between organizational culture and the health and wellbeing of hospital nurses, and to develop an aggregated synthesis of quantitative and qualitative systematic reviews to derive recommendations for policy and practice.Organizational culture comprises factors such as leadership, management and support, a health and safety oriented workplace climate and job characteristics.The quantitative component of this review will explore the relationship between organizational culture and the following outcomes in hospital nurses which may be indicators of health and wellbeing: work-related injury such as needlestick or sharp injuries, musculoskeletal injuries and conditions such as low back pain, burnout and general wellbeing.The qualitative component of this review will explore the perceptions of hospital nurses in relation to the impact of organizational culture on their own health and wellbeing and those of their nursing colleagues.
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.
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.
CONTEXT/PURPOSE: With the growing momentum toward hospital quality measurement and reporting by public and private health care payers, hospitals face increasing pressures to improve their medical record documentation and administrative data coding accuracy. This study explores the relationship between the organizational knowledge-sharing structure related to quality and hospital coding accuracy for quality measurement. Simultaneously, this study seeks to identify other leadership/management characteristics associated with coding for quality measurement. Drawing upon complexity theory, the literature on "professional complex systems" has put forth various strategies for managing change and turnaround in professional organizations. In so doing, it has emphasized the importance of knowledge creation and organizational learning through interdisciplinary networks. This study integrates complexity, network structure, and "subgoals" theories to develop a framework for knowledge-sharing network effectiveness in professional complex systems. This framework is used to design an exploratory and comparative research study. The sample consists of 4 hospitals, 2 showing "good coding" accuracy for quality measurement and 2 showing "poor coding" accuracy. Interviews and surveys are conducted with administrators and staff in the quality, medical staff, and coding subgroups in each facility. Findings of this study indicate that good coding performance is systematically associated with a knowledge-sharing network structure rich in brokerage and hierarchy (with leaders connecting different professional subgroups to each other and to the external environment), rather than in density (where everyone is directly connected to everyone else). It also implies that for the hospital organization to adapt to the changing environment of quality transparency, senior leaders must undertake proactive and unceasing efforts to coordinate knowledge exchange across physician and coding subgroups and
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
Schreuder, K.; van Bommel, A.C.M.; de Ligt, K. M.; Maduro, John H.; Vrancken Peeters, M.T.F.D.; Mureau, Marc A.M.; Siesling, S.
Objectives Significant hospital variation in the use of immediate breast reconstruction (IBR) after mastectomy exists in the Netherlands. Aims of this study were to identify hospital organizational factors affecting the use of IBR after mastectomy for ductal carcinoma in situ (DCIS) or invasive
Haron, Yafa; Segal, Zvi; Barhoum, Masad
Quality improvement in health care organizations requires structural reorganization and system reform and the development of an appropriate organizational "culture." In 2007, the Division of Quality and Excellence in Civil Service in Israel developed a concept to improve quality management in governmental institutions throughout the country. To put this strategy into practice, Western Galilee Hospital, a governmental hospital, in northern Israel, developed a plan to advance the quality management system where each department and unit is autonomously responsible for its own quality and excellence. Since the hospital has been certificated by ISO 9001 for more than 10 years (the only hospital in Israel to have this certificate), the main challenge now is to improve the quality and excellence system in every department. The aim of this article is to describe the implementation of a comprehensive program designed to raise the ability of managers and workers in Western Galilee Hospital in addressing all of the government's requirements for quality and excellence in service in Israel.
Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra
Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions.
Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas
Several public policy initiatives, particularly those involving managed care, aim to enhance cooperation between partners in the health care sector because it is expected that such cooperation will reduce costs and generate additional revenue. However, empirical evidence regarding the effects of cooperation on hospital performance is scarce, particularly with respect to creating a comprehensive measure of cooperation behavior. The aim of this study is to investigate the impact of hospital cooperation behavior on organizational performance. We differentiate between horizontal and vertical cooperation using two alternative measures-cooperation depth and cooperation breadth-and include the interaction effects between both cooperation directions. Data are derived from a survey of German hospitals and combined with objective performance information from annual financial statements. Generalized linear regression models are used. The study findings provide insight into the nature of hospitals' cooperation behavior. In particular, we show that there are negative synergies between horizontal administrative cooperation behavior and vertical cooperation behavior. Whereas the depth and breadth of horizontal administrative cooperation positively affect financial performance (when there is no vertical cooperation), vertical cooperation positively affects financial performance (when there is no horizontal administrative cooperation) only when cooperation is broad (rather than deep). Horizontal cooperation is generally more effective than vertical cooperation at improving financial performance. Hospital managers should consider the negative interaction effect when making decisions about whether to recommend a cooperative relationship in a horizontal or vertical direction. In addition, managers should be aware of the limited financial benefit of cooperation behavior.
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.
Vera Maria Avaldi
Full Text Available Primary health care is essential for an appropriate management of heart failure (HF, a disease which is a major clinical and public health issue and a leading cause of hospitalization. The aim of this study was to evaluate the impact of different organizational factors on readmissions of patients with HF.The study population included elderly resident in the Local Health Authority of Bologna (Northern Italy and discharged with a diagnosis of HF from January to December 2010. Unplanned hospital readmissions were measured in four timeframes: 30 (short-term, 90 (medium-term, 180 (mid-long-term, and 365 days (long-term. Using multivariable multilevel Poisson regression analyses, we investigated the association between readmissions and organizational factors (discharge from a cardiology department, general practitioners' monodisciplinary organizational arrangement, and implementation of a specific HF care pathway.The 1873 study patients had a median age of 83 years (interquartile range 77-87 and 55.5% were females; 52.0% were readmitted to the hospital for any reason after a year, while 20.1% were readmitted for HF. The presence of a HF care pathway was the only factor significantly associated with a lower risk of readmission for HF in the short-, medium-, mid-long- and long-term period (short-term: IRR [incidence rate ratio]=0.57, 95%CI [confidence interval]=0.35-0.92; medium-term: IRR=0.70, 95%CI=0.51-0.96; mid-long-term: IRR=0.79, 95%CI=0.64-0.98; long-term: IRR=0.82, 95%CI=0.67-0.99, and with a lower risk of all-cause readmission in the short-term period (IRR=0.73, 95%CI=0.57-0.94.Our study shows that the HF care specific pathway implemented at the primary care level was associated with lower readmission rate for HF in each timeframe, and also with lower readmission rate for all causes in the short-term period. Our results suggest that the engagement of primary care professionals starting from the early post-discharge period may be relevant in the
Zenaida Solís Chuquiyaur; Luisa Zamudio Eslava; Juan Matzumura Kasano; Hugo Gutiérrez Crespo
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 clima...
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 (Pwork experience with SE and OC. This research showed that SE and OC ?are moderate. SE and OC have strong correlation with turnover, critical thinking, job satisfaction, and individual and organizational improvement. Therefore, applying appropriate human resource policies is crucial to reinforce these measures.
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 pay, promotion and supervision factors which encourage personnel to be satisfied and demonstrate their OCB as their reciprocal reaction.
Chu, Cheng-I; Lee, Ming-Shinn; Hsu, Hsiang-Ming; Chen, I-Chi
Organizational citizenship behaviors (OCB) are deemed indispensable due to their importance in promoting positive relationships among employees and involving employees in the organization's activities. OCB is believed to facilitate attainment of a hospital's goals and enhance a hospital's performance. The aim of this study is to extend the work of previous studies by providing an integrated model of OCB and demonstrate its applicability in a non-Western culture. Questionnaires were completed by 314 non-supervisory hospital nurses, each of whom was given a supervisor rating for their OCB. Exploratory factor analysis was used to assess the convergent and discriminant validity of the variables in the model. Multiple regression analysis was used because it provided estimates of net effects and explanatory power. The results showed that job satisfaction, supervisor support, job involvement, and procedural justices had significant effects on the nurses' citizenship behaviors. Since the study used a non-Western site in one of Taiwan's health care institutions, its overall findings should contribute to further understanding of the cross-cultural aspects of OCB.
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.
Hsieh, Hui-Min; Clement, Dolores G; Bazzoli, Gloria J
Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.
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.
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.
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
Mehmet Arcan TUZCU
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 factor...
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.
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 organizational commitment and organizational citizenship behaviors (Δχ2 = 26.397, p organizational commitment and organizational citizenship behaviors.
Førde, Reidun; Hansen, Thor Willy Ruud
The structure of ethics work in a hospital is complex. Professional ethics, research ethics and clinical ethics committees (CECs) are important parts of this structure, in addition to laws and national and institutional codes of ethics. In Norway all hospital trusts have a CEC, most of these discuss cases by means of a method which seeks to include relevant guidelines and laws into the discussion. In recent years many committees have received more cases which have concerned questions of principle. According to Ellen Fox and co-authors the traditional CEC model suffers from a number of weaknesses. Therefore, in their organization a separate body deals with organizational matters. In this paper, we discuss what is gained and what is lost by creating two separate bodies doing ethics consultation. We do this through an analysis of detailed minutes of CEC discussions in one CEC during a 6-year period. 30 % of all referrals concerned matters of principle. Some of these discussions originated in a dilemma related to a particular patient. Most of the discussions had some consequences within the hospital organization, for clinical practice, for adjustment of guidelines, or may have influenced national policy. We conclude that a multiprofessional CEC with law and ethics competency and patient representation may be well suited also for discussion of general ethical principles. A CEC is a forum which can help bridge the gap between clinicians and management by increasing understanding for each others' perspectives.
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.
Dhakal, Yogit; Bhuiyan, Moshiur; Prasad, Pwc; Krishna, Aneesh
The purpose of this article is to identify and assess service delivery issues within a hospital emergency department and propose an improved model to address them. Possible solutions and options to these issues are explored to determine the one that best fits the context. In this article, we have analysed the emergency department's organizational models through i* strategic dependency and rational modelling technique before proposing updated models that could potentially drive business process efficiencies. The results produced by the models, framework and improved patient journey in the emergency department were evaluated against the statistical data revealed from a reputed government organization related to health, to ensure that the key elements of the issues such as wait time, stay time/throughput, workload and human resource are resolved. The result of the evaluation was taken as a basis to determine the success of the project. Based on these results, the article recommends implementing the concept on actual scenario, where a positive result is achievable.
Robin, Stryker; Heidi, Reynolds-Stenson; Krista, Frederico
Because the US addresses work-family concerns mostly through voluntary employer-provided benefits combined with anti-discrimination legislation, organizational mediation of law shapes the content and impact of employ-ers’ response to employees’ work- family issues. Centrality of organiza-tional mediation means centrality of HR professional discourse. Given skyrocketing lawsuits claiming family responsibilities discrimination (FRD), we examine FRD-related discourse, 1980-2012, in the two high...
Bartlett, Kenneth; Kang, Dae-seok
This study examines the relationship between employee attitudes towards training and organizational commitment among a sample of nurses in New Zealand and the United States. Results show that perceived access to training, training frequency, motivation to learn from training, benefits of training, and supervisory support for training were…
the environmental and social aspects in day-to-day business ... responsibility of the host, in which the host not only takes care of the actual guest, but does so in a more ..... implementation of this into hospitality service skills will provide.
Maria U. Kottwitz; Volker Schade; Christian Burger; Lorenz Radlinger; Achim Elfering
Background: Although work absenteeism is in the focus of occupational health, longitudinal studies on organizational absenteeism records in hospital work are lacking. This longitudinal study tests time pressure and lack of time autonomy to be related to higher sickness absenteeism. Methods: Data was collected for 180 employees (45% nurses) of a Swiss hospital at baseline and at follow-up after 1 year. Absent times (hours per month) were received from the human resources department of the hosp...
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
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
Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas
Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.
McMillan, Kathy; Taylor, Elizabeth Johnston
Most Americans pray; many pray about their health. When they are hospitalized, however, do patients want an offer of prayer from a healthcare provider? This project allowed for the measurement of hospitalized patient's responses to massage therapists' offers of a colloquial prayer after a massage. After the intervention, 78 patients completed questionnaires that elicited quantitative data that were analyzed using uni- and bivariate statistical analyses. In this sample, 88% accepted the offer of prayer, 85% found it helpful, and 51% wanted prayer daily. Patients may welcome prayer, as long as the clinician shows "genuine kindness and respect."
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.
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. 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 me...
Kowalski, Christoph; Nitzsche, Anika; Scheibler, Fueloep; Steffen, Petra; Albert, Ute-Susann; Pfaff, Holger
To examine whether patients' perception of a hospital's organizational climate has an impact on their trust in physicians after accounting for physicians' communication behaviors as perceived by the patients and patient characteristics. Patients undergoing treatment in breast centers in the German state of North Rhein-Westphalia in 2006 were asked to complete a standardized postal questionnaire. Disease characteristics were then added by the medical personnel. Multiple linear regressions were performed. 80.5% of the patients responded to the survey. 37% of the variance in patients' trust in physicians can be explained by the variables included in our final model (N=2226; R(2) adj.=0.372; porganizational climate. The impact of their perception of physicians' communication behaviors persists after introducing hospital organizational characteristics. Perceived physician accessibility shows the strongest association with trust. A trusting physician-patient relationship among breast cancer patients is associated with both the perceived quality of the hospital organizational climate and perceived physicians' communication behaviors. With regard to clinical organization, efforts should be put into improving the organizational climate and making physicians more accessible to patients.
Full Text Available Background: Understanding the factors affecting the performance of the staff in organizations will lead to increased their efficiency. The purpose of this study was to investigate the impact of organizational citizenship behavior (OCB on job performance in Dr. Kermanshahi hospital in Kermanshah. OCB is a voluntary behavior that goes beyond formal job descriptions of the staff and improves organizational performance . Methods: This descriptive-analytical study, which was based on structural equation modeling, was conducted in 2012.The study population included 311 staff at doctor Muhammad Kermanshahi hospital that were selected by simple random sampling. To evaluate the concepts of organizational citizenship behavior, job performance and personality attributes, Podsakoff, Patterson and NEO questionnaires were used, respectively. Data were analyzed by SPSS and AMOS software (version 21. Results: The results of the study revealed that 57% of respondents were women, 37.8% were in the age group 25 to 35 years, 40.7% had bachelor's degree and 30.2% had less than 5 years of experience. Also, personality characteristics of the staff affected their job performance. There was a significant relationship between organizational citizenship behaviour and job performance. Conclusions: This study confirmed the effects of OCB on promoting the performance of the staff. So, we can reinforce OCB in the hospital by taking advantage of the benefits of meta-functional behaviors in organization and consequently promoting the performance of the staff to.
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.
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 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
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
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.
Fisher, Anita; Baumann, Andrea; Blythe, Jennifer
Social and economic changes in industrial societies during the past quarter-century encouraged organizations to develop greater flexibility in their employment systems in order to adapt to organizational restructuring and labour market shifts (Kallenberg 2003). During the 1990s this trend became evident in healthcare organizations. Before healthcare restructuring, employment in the acute hospital sector was more stable, with higher levels of full-time staff. However, in the downsizing era, employers favoured more flexible, contingent workforces (Zeytinoglu 1999). As healthcare systems evolved, staffing patterns became more chaotic and predicting staffing requirements more complex. Increased use of casual and part-time staff, overtime and agency nurses, as well as alterations in skills mix, masked vacancy counts and thus rendered this measurement of nursing demand increasingly difficult. This study explores flexible nurse staffing practices and demonstrates how data such as nurse vacancy statistics, considered in isolation from nurse utilization information, are inaccurate indicators of nursing demand and nurse shortage. It develops an algorithm that provides a standard methodology for improved monitoring and management of nurse utilization data and better quantification of vacancy statistics. Use of standard methodology promotes more accurate measurement of nurse utilization and shortage. Furthermore, it provides a solid base for improved nursing workforce planning, production and management.
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.
Hanlon, N T
An era of managerialism in health care delivery systems is now well ensconced throughout the nations of the OECD. This development has occurred, in large part, as a response to funding pressures in institutionally based health care delivery imposed by principal third party insurers. In the case of publicly funded hospitals, the more traditional concerns for stewardship and appeasement of professional groups is being replaced by a greater emphasis on cost consciousness and corporate-style leadership as these organizations seek to reposition themselves in new funding and regulatory environments. While institutional theory and strategic management perspectives help illuminate these issues, this paper argues that a place-based perspective is also needed to understand the changes currently underway in health care delivery and publicly funded human services more generally. This is illustrated with reference to developments in the strategic management of public hospitals in the province of Ontario. Evidence from a survey of senior administrators of public hospitals, distributed at the height of these policy reform initiatives, is examined to shed light on local level management responses to changing policy and fiscal pressures. The data suggest that the latest policy directions in the province of Ontario will 'encourage' hospital executives in particular community settings to steer their organizations in very unfamiliar directions. The findings suggest a need for greater attention to context and setting in health services research and policy.
Gamze Bayın; Gözde Terekli Yeşilaydın
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 b...
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.
Grossi, D.; Royakkers, L.M.M.; Dignum, F.P.M.
Aim of the present paper is to provide a formal characterization of various different notions of responsibility within groups of agents (Who did that? Who gets the blame? Who is accountable for that? etc.). To pursue this aim, the papers proposes an organic analysis of organized collective agency by
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.
We studyworkers’ incentives of reporting problems within an OLG organization consisting of a subordinate and a manager. The subordinate is responsible for reporting a problem, and the manager is responsible for solving the reported problem. The subordinate has an incentive to conceal a detected problem since if he reports it but the manager is too lazy to solve the problem, the responsibility is transferred to the subordinate since he becomes a manager in the next period. We show that conceal...
Full Text Available The article is theoretically based on management culture as part of the formal organizational culture, separately reviewing some of its elements. Expert evaluation organization, process and results of the instrument shaped by the authors and meant for qualitative research are briefly presented. The structure of the instrument is detailed by presenting its component parts and explanations. The research was carried out by interviewing the top managers of two big manufacturing company groups consisting of six enterprises. 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 corporate social responsibility. It should be emphasized that the companies of both groups are preparing to become socially responsible and this results in the timeliness and importance of the research. Structured interviewing method was applied for the research, and the substantive content of the interview included strategy, organizational structure, rules and regulations, technologies, processes, information systems, control and incentive issues. The results of the research show that in both groups of the manufacturing companies management culture and corporate social responsibility, analysing them in terms of formal organizational culture, are perceived in very narrow aspects and their development is not part of the organizations’ strategic goals. The results of the study suggest that the ideas of corporate social responsibility cannot be implemented in a consistent way unless they are integrated into the formal part of organisational culture which plays an instrumental role.
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
Maignan, I.S.J.; MacAlister, D.
This article investigates socially responsible buying (SRB), a subject that has received little attention in past marketing literature on buyer-seller relationships. On the basis of a brief review of the literature on corporate social responsibility, the article proposes a conceptualization of SRB
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 ...
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.
Wei, Ching-Yao; Chiou, Shu-Ti; Chien, Li-Yin; Huang, Nicole
To determine the prevalence of workplace violence and explore the role of hospital organizational characteristics and health promotion efforts in reducing hospital violence among nurses in Taiwan. Cross-sectional survey. One hundred hospitals across Taiwan. The final sample in our study comprised responses from 26,979 nurses. The data were obtained from a nationwide hospital survey, Physical and Mental Health and Safety Needs in Full-Time Health Care Staff, which was developed and conducted by the Bureau of Health Promotion, Taiwan, in 2011. The main dependent variable was whether nurses had experienced violence within the past year. Physical violence, threatened or intimidated personal safety, verbal violence or sexual harassment were all included. Of the 26,979 nurses, 13,392 nurses (49.6%) had experienced at least one episode of any type of violence in the past year; 5150 nurses (19.1%) had been exposed to physical violence, and 12,491 nurses (46.3%) had been exposed to non-physical violence. The prevalence of having experienced any violence varied widely and ranged from the highest (55.5%) in an emergency room or intensive care unit to the lowest (28.3%) among those aged 55-65 years. After adjusting for other characteristics, younger nurses were significantly more likely to be exposed to any violent threat. Nurses working in public hospitals had a significantly higher risk of workplace violence than those working in private hospitals. Significant variations were also observed among work units. Although nurses working in a certified health promoting hospital (HPH) did not have a lower risk of workplace violence, those working in an outstanding HPH had a significantly lower risk of workplace violence. A similar pattern was observed for non-physical violence. Workplace violence is a major challenge to workplace safety for nurses in hospitals. This large scale nurse survey identified individual, work and hospital characteristics associated with workplace violence
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.
Mohammad Hossein Yarmohammadian
Full Text Available Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS. Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational, barriers (internal and external of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.
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.
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
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
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...... government. The findings show that Alitalia and the Italian government adopted a crisis communication strategy not completely suitable for Alitalia's crisis scenario. They, in fact, focused more on providing information and corrective action strategies rather than applying an authentic adaptive strategy...
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.
Andersen, Torben Juul
for durable advantages. Sustainable performance arguably derives from interactive decision-making processes that deal with opportunities as they emerge informed by updated environmental analytics. The combination of experiential insights from decentralized responses and forward-looking reasoning at the center...
Full Text Available Corporate social responsibility (CSR has become a major part of the foodservice industry due to external forces which encourage enterprises’ responsiveness. In reality, consumers’ social concern influences their attitudes towards foodservice firms’ socially responsible practices and purchase decisions, thereby influencing senior management to react. Considering this issue, this study examines the impact of senior management’s ethical leadership in evaluating operational, commercial, and economic performances along with the mediating role of CSR in the foodservice industry. A conceptual model was formulated and empirically tested based on responses from 196 foodservice franchise firms in South Korea. The results indicated ethical leadership significantly influenced CSR and operational performance, while CSR also had a positive effect on operational and commercial performances. Additionally, operational performance had a significantly positive influence on commercial performance, which subsequently enhanced economic performance. Overall, the findings highlight the role that ethical leadership exhibited by senior management of foodservice franchises influenced initiation of CSR activities, which provide implications for research and industry practice and is outlined.
Eva Pasek De Pinto
Full Text Available The controversial and even hostile climate of coexistence of many schools formed a culture where prevailing values contrary to the stated vision and mission. Therefore, the objective of the study was to describe the responsibility and social solidarity as values of organizational culture in Venezuelan schools. Methodologically, it was a descriptive research with field design. The population was 200 subjects and sample of 74 members of staff managerial, teaching, administrative and environmental support of three schools. To gather information about the variables responsibility and social solidarity a valid and reliable questionnaire was applied (79.7%, alpha of Cronbach. As result it was found empirical evidence that 69% of the staff is responsible and 40% is solidarity. In conclusion, the practice of organizational values is not ideal or generalized because only some of its aspects are practiced in addition that not all the staff practice them. Low solidarity makes it difficult the coexistence, for the success and excellence of institutions.
Casal, Jose C; Bogui, Frederic B
It has been proposed that employees aware of organizational wrongdoing face two decisions: whether or not to blow the whistle and whether or not to leave their organizations. Of these only the decision to blow the whistle has received attention, leaving a gap in knowledge; thus, a survey of 330 management accountants was analyzed to examine potential predictors of intended responses to organizational wrongdoing. Analysis of ratings indicated that intent to leave increased with seriousness of wrongdoing and expected retaliation for whistleblowing and decreased with expected effectiveness of whistleblowing. Intent to stay and blow the whistle increased with expected effectiveness of whistleblowing and role responsibility for reporting and decreased with expected retaliation for whistleblowing; intent to leave and blow the whistle increased with expected effectiveness of whistleblowing and role responsibility for reporting.
Mahmood Reza Esmaeili
Conclusion: The results showed that organizational agility can be considered as an important factor in organizational forgetting management and enhancement of staff empowerment which is a necessary requirement for managers to adapt to today's dynamic environment.
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.
Gray, Carolyn Steele; Berta, Whitney; Deber, Raisa; Lum, Janet
In health care, accountability is being championed as a promising approach to meeting the dual imperatives of improving care quality while managing constrained budgets. Few studies focus on public sector organizations' responsiveness to government imperatives for accountability. We applied and adapted a theory of organizational responsiveness to community care agencies operating in Ontario, Canada, asking the question: What is the array of realized organizational responses to government-imposed accountability requirements among community agencies that receive public funds to provide home and community care? A sequential complementary mixed methods approach was used. It gathered data through a survey of 114 home and community care organizations in Ontario and interviews with 20 key informants representing 13 home and community care agencies and four government agencies. It generated findings using a parallel mixed analysis technique. In addition to responses predicted by the theory, we found that organizations engage in active, as well as passive, forms of compliance; we refer to this response as internal modification in which internal policies, practices, and/or procedures are changed to meet accountability requirements. We also found that environmental factors, such as the presence of an association representing organizational interests, can influence bargaining tactics. Our study helps us to better understand the range of likely responses to accountability requirements and is a first step toward encouraging the development of accountability frameworks that favor positive outcomes for organizations and those holding them to account. Tailoring agreements to organizational environments, aligning perceived compliance with behaviors that encourage improved performance, and allowing for flexibility in accountability arrangements are suggested strategies to support beneficial outcomes.
Full Text Available Most human activities are the product ofcoordinated actions performed by individualsworking as a team rather than individuals workingalone. Thus, the processes through which theyaccomplish their tasks, change, decide andrelate to each other inside an organization isessential. This paper is about the importanceof Organizational Diagnosis in management ofchange. Organizational Diagnosis is an essentialstep in every initiative of change, and with everchanging environment in which flexibility andcreativity are proving to be key values, mostmanagers are interested in questions regardingthe nature of organizational process and structure,human relations, and nature of change. The paperpresents such a case of using organizationaldiagnosis as a management tool in a changeprocess inside a health care organization. Usingthis tool has helped the management team identifythe existing gaps between “what is” and “whatshould be” and has increased the chances of asuccessful change process.
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…
Kjeldsen, Anne Mette; Jonasson, Charlotte; Ovesen, Maria
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....../non-routine, various goals, and organizational planning affect a simultaneous widening or restriction of the local DL. In return, such local DL also leads to ongoing changes in the form of novel work routines for improved collaboration. Moreover, the findings show that restrictions of DL are in some cases considered...
Glisson, Charles; Hemmelgarn, Anthony; Green, Philip; Williams, Nathaniel J.
Objectives: The primary objective of the study was to assess whether the Availability, Responsiveness and Continuity (ARC) organizational intervention improved youth outcomes in community based mental health programs. The second objective was to assess whether programs with more improved organizational social contexts following the 18-month ARC…
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.
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.
Chatot-Henry, Didier; Chatot-Henry, Carole; Courcier, Dominique
The financial difficulties encountered by Martinique hospitals has led to restructuring of the territory's medical project with the merger of three healthcare facilities. These new constraints impacting the work environment with organizational consequences in services. A management experiment was attempted in a geriatric day care hospital based on the use of health promotion concepts. After an overview of the unit's activity based on the perceptions of staff, patients and private physicians, a one-day research-action structural seminar was organized. Group dynamics, unit functioning, shared values, success factors, and improvement strategies were discussed. This seminar resulted in the development of a business model based on five values (respect, professionalism, cohesion, empathy, communication). Three operational working groups were established to implement the conclusions of the seminar in the unit. This experiment focused on an alternative approach to the management of small health care services by the use of health promotion.
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
Orhan Adıgüzel; Kenan Kayadibi
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 u...
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.
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.
Reiter, Kristin L; Nahra, Tammie A; Alexander, Jeffrey A; Wheeler, John R C
Not-for-profit hospitals are complex organizations and, therefore, may face unique challenges in responding to financial incentives for quality. In this research, we explore the types of behavioural changes made by not-for-profit Michigan hospitals in response to a pay-for-performance system for quality. We also identify factors that motivate or facilitate changes in effort. We apply a conceptual framework based on agency theory to motivate our research questions. Using data derived from structured interviews and surveys administered to 86 hospitals participating in a pay-for-performance system, we compare hospitals reporting and not reporting behavioural changes. Separate analyses are performed for hospitals reporting structure-related changes and hospitals reporting process-related changes. Our findings confirm that hospitals respond to incentive payments; however, our findings also reveal that hospital responses are not universal. Rather, involvement by boards of trustees, willingness to exert leverage with physicians, and financial and competitive motivations are all associated with hospitals' behavioural responses to incentives. Results of this research will help inform payers and hospital managers considering the use of incentives about the nature of hospitals' responses.
Justenlund, Anders; Rebelo, Sofia
the researchers with structures to set up an interview guide for future qualitative interviews. This research recognises the individual's motives for understanding and excercising CSR in the hospitality industry. The authors aim to construct an analytical framework taking as a starting point the understanding...... of implemented CSR-principles within an international hotel chain, recognised for its best practice. In the long term the intention is to learn how future hospitality professionals (present hospitality students) perceive CSR. The paper also includes refelctions on how different welfare state structures affect...
Niska, Richard W; Burt, Catharine W
This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.
Full Text Available It is very important to investigate what factors influence a high level of the service customer orientation of hotels employees under the conditions of the transition and a high rate of the unemployment. One of the conclusions of the research is that management of the hotels in Serbia don’t fully recognize the potentials of the knowledge of employees as a possible competitive advantage during organizational changes in a high competitive global environment. Since job satisfaction is one the most important factor which influences readiness for organizational changes of employees we investigate in the study the relationships between job satisfaction, perceptions of organizational customer climate, cultural dimensions and employees customer orientation among front-line employees in the hotel industry in a non-Western country in the transition. Data for the current study were collected through the use of a survey instruments completed by front-line employees in several hotels in the north province of Serbia –Vojvodina. This part of Serbia is one of the most developed part of Serbia and tourism industry is one of the important factors of the economic development of the region.
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.
Andrés Jiménez Figueroa
Full Text Available The study of family responsibility has become more relevant in Chile. Research suggests that from the public and private sectors various initiatives towards the implementation of public policies that favor this inclusion are required. The global labor scene has changed considerably in the social, economic and family areas, exposing the need to reorganize the distribution of work responsibilities between men and women. As a contribution to the discussion, we analyze here the main background, and the need to review public policies, to implement the measures in the organizational field and to investigate further appropriate measures to Chile as a means to improve the quality of workinglife in the country
Everhart, Damian; Schumacher, Jessica R; Duncan, R Paul; Hall, Allyson G; Neff, Donna F; Shorr, Ronald I
Patient falls in acute care hospitals represent a significant patient safety concern. Although cross-sectional studies have shown that fall rates vary widely between acute care hospitals, it is not clear whether hospital fall rates remain consistent over time. The aim of this study was to determine whether hospitals can be categorized into fall rate trajectory groups over time and to identify nurse staffing and hospital characteristics associated with hospital fall rate trajectory groups. We conducted a 54-month (July 2006-December 2010) longitudinal study of U.S. acute care general hospitals participating in the National Database for Nursing Quality Indicators (2007). We used latent class growth modeling to categorize hospitals into groups based on their long-term fall rates. Nurse staffing and hospital characteristics associated with membership in the highest hospital fall rate group were identified using logistic regression. A sample of 1,529 hospitals (mean fall rate of 3.65 per 1,000 patient days) contributed data to the analysis. Latent class growth modeling findings classified hospital into three groups based on fall rate trajectories: consistently high (mean fall rate of 4.96 per 1,000 patient days), consistently medium (mean fall rate of 3.63 per 1,000 patient days), and consistently low (mean fall rate of 2.50 per 1,000 patient days). Hospitals with higher total nurse staffing (odds ratio [OR] = 0.92, 95% confidence interval [CI] [0.85, 0.99]), Magnet status (OR = 0.49, 95% CI [0.35, 0.70]), and bed size greater than 300 beds (OR = 0.70, 95% CI [0.51, 0.94]) were significantly less likely to be categorized in the "consistently high" fall rate group. Over this 54-month period, hospitals were categorized into three groups based on long-term fall rates. Hospital-level factors differed among these three groups. This suggests that there may be hospitals in which "best practices" for fall prevention might be identified. In addition, administrators may be able
Full Text Available Introduction: Realm of health care that organizations have faced in recent years has been described with high level of dynamism and development. To survive in such conditions, performance evaluation can have an effective role in satisfying proper quality for services. This study aimed to evaluate the performance of Shahid Sadoghi Yazd hospital through EFQM approach. Methods: This was a descriptive cross-sectional study. Data collection instrument was EFQM organization Excellence Model questionnaire which was completed by all the managers. The research data was gathered from a sample of 302 patients, staff, personnel and medical staff working in different parts of the hospital. Random stratified samples were selected and descriptive statistics were utilized in order to analyze the data. Results: The results revealed that Shahid Sadoughi hospital acquired 185.41 points out of the total 500 points considered in the model EFQM. In other words, the rating reflects the fact that regarding the defined desired position, the hospital has not achieved the desired rating. Conclusion: Since the hospital performance is posited in a low-middle class, much more attention is required in regard to therapeutic management in this hospital. Therefore, codifying an efficient and effective program to improve the hospital performance is necessary. Furthermore, it seems that EFQM model can be considered as a comprehensive model for performance evaluation in hospitals.
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.
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.
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
Shwartz, Michael; Cramer, Irene E; Holmes, Sally K; Cohen, Alan B; Restuccia, Joseph D; VanDeusen Lukas, Carol; Sullivan, Jennifer L; Charns, Martin P
The goal of the Pursuing Perfection (P2) program was to encourage organizations to push quality improvement to new levels of excellence. As part of an evaluation of P2, we surveyed employees at the 7 participating P2 organizations to (1) assess their perceptions of patient care quality and improvement progress and (2) examine perceived performance on organizational and workgroup characteristics associated with quality. Many survey questions were drawn from existing conceptual models and survey instruments. We used factor analysis to create new scales from questions that were not part of established scales. We used correlation coefficients and multivariable models to examine relationships among variables. Variables most strongly associated with perceived quality included standardized and simplified care processes resulting in coordinated care and smooth handoffs, a clear sense of organizational direction and clear action plans, and communication with staff about reasons for change and improvement progress made. Of those variables with a strong relationship to quality, ones with relatively low mean ratings included workgroup coordination; sufficient resources and support for improvement; training; and efficient use of people, time, and energy. These are important areas on which management should focus to improve employee ratings of quality.
and reliability (P = 0.05; r = 0.34. Also a significant positive relationship was found between the continuance commitment and reliability (P = 0.04; r = 0.30. Conclusion: Considering the correlation of normative and continuance commitments with some dimentions of the quality of hospital services it seems that planning and action twards improvement of these commitments may lead to high-quality services.
Kim, Han-Sung; Kim, Young-Hoon; Woo, Jung-Sik; Hyun, Sook-Jung
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.
N. O. Vetiutneva
Full Text Available The aim of the work is the content analysis and methodological justification of the professional functions of the Responsible persons for quality assurance of medicines in pharmaceutical and hospital institutions. Materials and methods. The following research methods were used: system and comparative analysis, generalization, systematization, graphic modeling, observation. Research materials: normative legal acts, normative documents, recommendations of international organizations, information of wholesale and retail pharmaceutical companies, pharmaceutical and hospital institutions, professional non-governmental organizations, placed on official web-sites and collected in the process of direct observation. Results. The personnel and qualification aspects of professional activity of Responsible persons of pharmaceutical and hospital institutions were discussed. On the basis of analysis of the modern legal and regulatory framework, a general list of professional functions of the Responsible persons of health care institutions had been formed. The content analysis and comparison of the number of the functions of Responsible persons performed in health care institutions of different types is carried out. The new functions of the Responsible persons of health care institutions are considered. The managerial nature of the professional functions of the Responsible persons and the expediency of their complementing with the leadership functions are substantiated. On the basis of international management standards, requirements of GPP and GPEP, systematization of the functions of the Responsible persons of health care institutions in the groups and subgroups was performed. Conclusions. The generalization and systematization of the professional functions of the Responsible persons of health care institutions had been carried out for five classification groups of functions, namely: leadership, planning, organizational, control and information, of which the
Full Text Available The paper presents the results of the impact of certain dimensions of organizational culture (Future Orientation, Power Distance, Human Orientation and Performance Orientation on organizational commitment in companies in Serbia. Through a survey, responses were obtained from a total of N = 400 middle managers from 129 companies. The results show a statistically significant correlation between the observed dimensions of organizational culture and organizational commitment dimensions. Also, there is a statistically significant predictive effect of certain dimensions of organizational culture on the dimensions of organizational commitment. The biggest influences on the dimensions of organizational commitment have dimensions Future Orientation - FO and Performance Orientation - PO. On the other hand, under the most affected dimension of organizational culture is the dimension of organizational commitment Organizational identification - OCM1.
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.
The study of safety in complex systems has focused on different issues over the past decades. This focus was often linked to the conclusions of previous accidents'/incidents' analyses. When accidents were attributed to technical causes, safety research focused on technical developments. When they were later attributed to 'human errors', safety research focused on this 'component'. And when, since the mid-eighties accidents have been attributed to 'organizational factors', safety research has focused on these very same 'organizational factors'. The present thesis argues for a 'practice view' over safety to be taken. This view is mainly drawn from the field of research on High Reliability Organizations (HRO). HRO theorists' point of view on safety is that we can operate complex systems safely despite the fact that we have made them so complex that they are prone to 'normal accidents'. Humans involved in the operation of our systems actually create safety. Safety is formed through the adaptation of work practice to local conditions, and this adaptation is part of safe operation. Safety is not only a substantial quality of our socio-technical systems: the discursive dimension of safety actually seems to be a central component of safety creation. However, the adaptive ability of HRO can sometimes become their downfall. Adaptation, which is the backbone of safety, can sometimes be a drawback as well. Consequently, the practice view of safety, proposed in the present work, argues that we need to further comprehend how work practice evolves over time, and more specifically what are the inherent characteristics of work practice that create this evolution. Empirical studies from health-care and nuclear power generation highlight different details about organizational reliability. For instance, one study of planning at a nuclear power plant draws our attention to the different roles of planning in the organization. Another study, within heath-care, underlines the evolution of
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.
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
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.
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…
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.
Yeo, Young Hyun; Lee, Keon-Hyung; Kim, Hye Jeong
Just as living organisms have a creation-maintenance-extinction life cycle, organizations also have a life cycle. Private organizations will not survive if they fail to acquire necessary resources through market competition. Public organizations, however, continue to survive because the government has provided financial support in order to enhance public interest. Only a few public organizations in Korea have closed. With the introduction of new public management since the economic crisis in 1997, however, public organizations have had to compete with private organizations. Public hospitals are not free to open or close their business. They are also controlled by the government in terms of their prices, management, budgets, and operations. As they pursue public interest by fulfilling the government's order such as providing free or lower-priced care to the vulnerable population, they tend to provide a lower quality of care and suffer a financial burden. Employing a case study analysis, this study attempts to understand the external environment that local public hospitals face. The fundamental problem of local public hospitals in Korea is the value conflict between public interest and profitability. Local public hospitals are required to pursue public interest by assignment of a public mission including building a medical safety net for low-income patients and managing nonprofitable medical facilities and emergent health care situations. At the same time, they are required to pursue profitability by achieving high-quality care through competition and the operation of an independent, self-supporting system according to private business logic. Under such paradoxical situations, a political decision may cause an unexpected result.
Kenis, P.N.; Raab, J.; Kraaij – Dirkzwager, Marleen; Timen, A.
The paper will report results of a research project on the organizational network response to prevent or contain an outbreak of an infectious disease in the Netherlands. The paper is one of the first to present an attempt to conduct an ex ante evaluation of a response network in a likely future
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.
Wray, J L; Sadowski, S M
The authors present an overview of current graduate medical education (GME) issues, particularly the financial challenges to teaching hospitals resulting from the Balanced Budget and Tax Payer Relief Acts of 1997 and other recent market-driven factors. They describe in detail the nature of Medicare GME payments before and after the 1997 legislation, with specific examples, and explain the negative financial impact of the legislation and aspects of the legislation that are designed to alleviate that impact. Other factors influencing GME program size and composition are also discussed, including oversupplies or shortages of physicians, the concern that teaching hospitals are using public funds to train international medical graduates, changing training requirements, etc. The authors also describe a recent consulting assignment during which they assisted a major teaching hospital to develop a GME strategy that was responsive to the organization's mission and patients and that took into account future GME financing challenges. Detailed explanations are given of how the consultants analyzed the hospital's GME programs and finances, developed and ranked key institution-specific program criteria (strategic, organizational and operational, and financial), and, in consultation with all key stakeholders, formulated a GME strategy specific to the institution's needs. The authors conclude by cautioning that each institution's GME strategy will be different, but that it is important for institutions to develop such strategies to better face future challenges.
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 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.
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
Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Philip, Irène; Biron, Pierre; Perrier, Lionel
Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the organizational performances of acute care hospital surgical units throughout France. This retrospective study was based on data derived from three national databases for year the 2012: IPAQSS (Indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. National data and methodological support were provided by the French Ministry of Health (DGOS) and the French National Authority for Health (HAS). Multivariate linear models were used to assess four organizational performance indicators: the occupancy rate of surgical inpatient beds, operating room utilization, the activity per surgeon, and the activity per both nurse anesthetist and anesthesiologist which were dependent variables. Several independent variables were taken into account, including the degree of EHR use. The models revealed a significant positive impact of EHR use on operating room utilization and bed occupancy rates for surgical inpatient units. No significant association was found between the activity per surgeon or the activity per nurse anesthetist and anesthesiologist with EHR use. All four organizational performance indicators were impacted by the type of hospital, the geographical region, and the severity of the pathologies. We were able to verify the purported potential benefits of EHR use on the organizational performances of surgical
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 relationship between POS and II (adjusted R(2) = 0.032, t = 2.26; p = 0.026) and ER (adjusted R(2) = 0.22, t = 5.81; p relationship was present between DJ (p = 0.54) or POS (p = 0.57) and SD. Organizational identification positively moderates the relationship between POS and ER (p = 0.045) and between DJ and ER (p = 0.056). The relationships between POS and II (p = 0.54) and between DJ and II (p = 0.99) were not moderated by OI. Professional identification did not moderate the studied relationships. Our results demonstrate that both perceptions of economic and noneconomic exchange are important to self-employed physicians' customer-oriented behaviours. Fostering organizational identification could enhance this reciprocity dynamic.
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.
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.
Meschi, Tiziana; Ticinesi, Andrea; Prati, Beatrice; Montali, Arianna; Ventura, Antonio; Nouvenne, Antonio; Borghi, Loris
Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients. The unit is partitioned into smaller wards, each with a specific intensity level of care, including a rapid-turnover ward (mean length of stay model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view.
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.
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
Seyed Mohammad Reza Salehi; Naser Mirsepasi; Ali Akbar Farhangi
The primary objective of this paper is to study the present status of organizational adaptability in Iranian broadcasting system against environmental changes and present possible suggestions to empower the organization to cope with future changes. The study uses the method developed by Denison (1990) [Denison, D. R. (1990). Corporate culture and organizational effectiveness. John Wiley & Sons.] to study the organizational changes. Using a sample of 354 randomly selected employees who worked ...
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.
Langlais, Philip J; Bent, Blake J
The development of effective means to enhance research integrity by universities requires baseline measures of individual, programmatic, and institutional factors known to contribute to ethical decision making and behavior. In the present study, master's thesis and Ph.D. students in the fields of biological, health and social sciences at a research extensive university completed a field appropriate measure of research ethical decision making and rated the seriousness of the research issue and importance for implementing the selection response. In addition they were asked to rate their perceptions of the institutional and departmental research climate and to complete a measure of utilitarian and formalistic predisposition. Female students were found to be more ethical in their decision making compared to male students. The research ethical decision measure was found to be related to participants' ethical predisposition and overall perception of organizational and departmental research climate; however, formalism was the only individual predictor to reach statistical significance and none of the individual subscales of the research climate measure were significantly correlated to ethicality. Participants' ratings of the seriousness of the issue were correlated with their ratings of the importance of carrying out their selected response but neither was significantly predictive of the ethicality of their responses. The implications of these findings for the development of more effective training programs and environments for graduate students in research ethics and integrity are discussed.
McCombie, C.; Issler, H.; Kowalski, E.
The organizational structures and the division of responsibilities within the Swiss radioactive waste management program are based strongly on the principle that waste producers must assume full responsibility for choosing and implementing appropriate methods for treatment and disposal of residues while independent oversight and control by government safety authorities must be guaranteed. The structures within the governmental bodies ensure that proper regulatory and control functions are as free as possible from any conflicts of interest and that appropriate technical expertise is available. The more detailed organization within Nagra, which is necessary to over the wide range of tasks--in technical projects as well as in legal matters and in the area of communication--is also described. Important boundary conditions which determine the allocation of roles and responsibilities, and which are rather specific to Switzerland, include the small absolute size of the country and its nuclear program, the absence of a major centralized national geological survey, the high level of technical expertise in engineering organizations and in the university system, and the modest size of all bodies involved
TariVerdi, Mersedeh; Miller-Hooks, Elise; Kirsch, Thomas
Mass casualty incidents are a concern in many urban areas. A community's ability to cope with such events depends on the capacities and capabilities of its hospitals for handling a sudden surge in demand of patients with resource-intensive and specialized medical needs. This paper uses a whole-hospital simulation model to replicate medical staff, resources, and space for the purpose of investigating hospital responsiveness to mass casualty incidents. It provides details of probable demand patterns of different mass casualty incident types in terms of patient categories and arrival patterns, and accounts for related transient system behavior over the response period. Using the layout of a typical urban hospital, it investigates a hospital's capacity and capability to handle mass casualty incidents of various sizes with various characteristics, and assesses the effectiveness of designed demand management and capacity-expansion strategies. Average performance improvements gained through capacity-expansion strategies are quantified and best response actions are identified. Capacity-expansion strategies were found to have superadditive benefits when combined. In fact, an acceptable service level could be achieved by implementing only 2 to 3 of the 9 studied enhancement strategies. (Disaster Med Public Health Preparedness. 2018;page 1 of 13).
Laner, Stephen; And Others
Following an explanation of the Level of Responsibility/Equitable Pay Function, its applicability is demonstrated to the analysis and to the design and redesign of organizational hierarchies. It is shown how certain common dysfuntional anomalies can be avoided by structuring an organization along the principles outlined. A technique is then…
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
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.
The diagnosis of infectious diseases and the role of the microbiology laboratory are currently undergoing a process of change. The need for overall efficiency in providing results is now given the same importance as accuracy. This means that laboratories must be able to produce quality results in less time with the capacity to interpret the results clinically. To improve the clinical impact of microbiology results, the new challenge facing the microbiologist has become one of process management instead of pure analysis. A proper project management process designed to improve workflow, reduce analytical time, and provide the same high quality results without losing valuable time treating the patient, has become essential. Our objective was to study the impact of introducing automation and computerization into the microbiology laboratory, and the reorganization of the laboratory workflow, i.e. scheduling personnel to work shifts covering both the entire day and the entire week. In our laboratory, the introduction of automation and computerization, as well as the reorganization of personnel, thus the workflow itself, has resulted in an improvement in response time and greater efficiency in diagnostic procedures.
Langberg, Joshua M; Becker, Stephen P; Epstein, Jeffery N; Vaughn, Aaron J; Girio-Herrera, Erin
The purpose of the study was to evaluate predictors of response and mechanisms of change for the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD). Twenty-three middle school students with ADHD (grades 6-8) received the HOPS intervention implemented by school mental health providers and made significant improvements in parent-rated materials organization and planning skills, impairment due to organizational skills problems, and homework problems. Predictors of response examined included demographic and child characteristics, such as gender, ethnicity, intelligence, ADHD and ODD symptom severity, and ADHD medication use. Mechanisms of change examined included the therapeutic alliance and adoption of the organization and planning skills taught during the HOPS intervention. Participant implementation of the HOPS binder materials organization system and the therapeutic alliance as rated by the student significantly predicted post-intervention outcomes after controlling for pre-intervention severity. Adoption of the binder materials organization system predicted parent-rated improvements in organization, planning, and homework problems above and beyond the impact of the therapeutic alliance. These findings demonstrate the importance of teaching students with ADHD to use a structured binder organization system for organizing and filing homework and classwork materials and for transferring work to and from school.
Astua Chaverri, Erika; Jimenez Cordero, Martin; Jimenez Quesada, Ulises; Montero Cordero, Rosa Ma.
The search for new ways to protect occupationally exposed population, external users and the environment has been the need to optimize all aspects of radiation protection, to prevent incidents or accidents, by the use of ionizing radiation. Proposal consists in carrying out field work to be involving staff who work with ionizing radiation in the areas of diagnostic radiology, radiotherapy and nuclear medicine in hospitals Rafael Angel Calderon Guardia, Hospital Mexico and Hospital San Juan de Dios. The collected data were coded and analyzed for a situational diagnosis of radiation protection. The results have led to the proposal of the Design of an Organizational Model for Radiological Protection Service to the hospitals included in the investigation. (author) [es
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 ...
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
Full Text Available The phenomenon of job stress is an inevitable part of professional life and in the activities and efficiency is reflected in the organization. This study aimed to identify and predict the relationship between psychological capital and job deviation behavior through job stress regarding the moderating role of perceived organizational support. This study is correlation by using descriptive methods for applied goals. Standard questionnaire was used to collect data. 180 participants was estimated and stratified random sampling. The results showed the significance of the relationship between the variables except the relationship between deviant behaviors with psychological capital. Also, the interactive role of job stress and perceived organizational support on psychological capital and job deviation behavior was confirmed. This means that for the hospital's nurses and staffs with job stress, increasing perceived organizational support associated with enhancing psychological capital and decreasing job deviation behavior. These results emphasize necessity of recognizing interactive role of job stress and perceived organizational support in psychological capital and job deviation behavior
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.
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.
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.
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.
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…
Oliveira, Joana Nicolau
A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics This research investigated Portuguese Hospitals’ Corporate Social Responsibility reporting practices, by analyzing Hospitals’ Annual Reports and websites. The main hospital stakeholders were presented and activities pertaining to each group included. Overall, it appears that there is a lack of strategic CSR reporting on both private and publ...
Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry
This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals. We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008. We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI. Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.
Al-bdour; A. Ali.; Ellisha Nasruddin.; Soh Keng Lin
This study attempts to investigate the relationship between internal CSR practices and organizational commitment based on the social exchange theory (SET). Specifically, we examine the impact of five dimensions of internal CSR practices on organizational commitment: health and safety, human rights, training and education, work life balance and workplace diversity. The proposed model was tested on a sample of 336 frontline employees within the banking sector in Jordan. Res...
Jennifer H. Gao
Previous research suggested that Corporate Social Responsibility (CSR) is positively related to organization's attractiveness to potential employees. This paper tries to explore the effective dimensions of CSR on employee engagement and the mediating factors that lay between the two constructs. The author proposes that CSR has a direct impact on employee engagement, and that perceived organizational support (POS) and Chinese values mediate this relationship, so CSR may also contribute indirec...
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.
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.
Leineweber, C; Chungkham, H S; Westerlund, H; Tishelman, C; Lindqvist, R
The present shortage of registered nurses (RNs) in many European countries is expected to continue and worsen, which poses a substantial threat to the maintenance of healthcare in this region. Work-family conflict is a known risk factor for turnover and sickness absence. This paper empirically examines whether the nurse practice environment is associated with experienced work-family conflict. A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analyzed here is based on a national sample of 8356 female and 592 male RNs from 369 hospital departments. We found that 6% of the variability in work-family conflict experienced by RNs was at the department level. Organizational level factors significantly accounted for most of the variability at this level with two of the work practice environment factors examined, staffing adequacy and nurse involvement in hospital affairs, significantly related to work-family conflict. Due to the design of the study, factors on ward and work group levels could not be analyzed, but are likely to account for additional variance which in the present analysis appears to be on the individual level, with private life factors likely explaining another major part. These results suggest that higher level organizational factors in health care have a significant impact on the risk of work-family conflict among RNs through their impact on the nurse practice environment. Lower level organizational factors should be investigated in future studies using hierarchical multilevel sampling. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
Andressa Hennig Silva
Full Text Available Among the complexities of today's globalized world, CSR appears as an emerging and dynamic subject that enjoys increasing attention in the organizational context as it becomes a must for companies that want to stay competitive in the market. Faced with this context, the central objective of this study is to examine the ways in which companies bring corporate social responsibility into their organizational structures. As for the methodological procedures, this study appears as quantitative, descriptive and as a survey. The data collection instrument used was a questionnaire adapted from Aldama; Love; Trostianki (2009 in a sample of 15 companies which have won the RS Quality Award in the years 2011-2013 in the categories Diamond, Silver and Gold. As a result it was found that companies adopt different ways of incorporating CSR function into the organizational structure, much of which is still in the design phase, since the activities and responsibilities in this sector are not discharged within a specific division, but rather linked to other sectors, such as quality management, which has boosted the adoption of CSR by companies.
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.
Yang, Lianping; Liu, Chaojie; Ferrier, J Adamm; Zhang, Xinping
This study identifies potential organizational barriers associated with the implementation of the Chinese National Essential Medicines Policy (NEMP) in rural primary health care institutions. We used a multistage sampling strategy to select 90 township hospitals from six provinces, two from each of eastern, middle, and western China. Data relating to eight core NEMP indicators and institutional characteristics were collected from January to September 2011, using a questionnaire. Prescription-associated indicators were calculated from 9000 outpatient prescriptions selected at random. We categorized the eight NEMP indicators using an exploratory factor analysis, and performed linear regressions to determine the association between the factor scores and institution-level characteristics. The results identified three main factors. Overall, low levels of expenditure of medicines (F1) and poor performance in rational use of medicines (F2) were evident. The availability of medicines (F3) varied significantly across both hospitals and regions. Factor scores had no significant relationship with hospital size (in terms of number of beds and health workers); however, they were associated with revenue and structure of the hospital, patient service load, and support for health workers. Regression analyses showed that public finance per health worker was negatively associated with the availability of medicines (p finance from local governments may reduce medicine stock lines of township hospitals and lead them to seek alternative sources of income, jeopardizing their capacity to meet the needs of local consumers. Copyright © 2015 Elsevier Ltd. All rights reserved.
Chen, Wen-Ching; Hwu, Hai-Gwo; Wang, Jung-Der
We surveyed 222 nurses, nursing assistants, and clerks at a psychiatric hospital in Taiwan on responses to workplace violence, treatment of violent patients, and reporting behavior. Staff reported 78 incidents of physical violence (PV), 113 of verbal abuse (VA), 35 of bullying/ mobbing (BM), 21 of sexual harassment (SH), and 10 of racial harassment (RH) over the course of one year. Among affected staff, only 31% of those experiencing PV and consequences, especially for BM, and shame for SH. Reliable systems for responding to and reporting patient violence should be developed.
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
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...
Janati, Ali; Sadeghi-Bazargani, Homayoun; Hasanpoor, Edris; Sokhanvar, Mobin; HaghGoshyie, Elaheh; Salehi, Abdollah
Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed. The hospital emergency response checklist was used to collect data. Tool components included command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery. Data entry and analysis were carried out using SPSS software (version 20). The results showed that the emergency response rate of hospitals was 54.26% in Tabriz. The lowest response rates were for Shafaa hospital (18.89%) and the highest response rates were for Razi Hospital (91.67%). The components of hospital emergency response were assessed to be between 48.07% (surge capacity) and 58.95% (communication). On the basis of the World Health Organization checklist, the emergency response rate for hospitals in Tabriz was only 54.26%. Therefore, hospital emergency responses against disasters have to be improved and must be made to reach 100%. It is essential to design a comprehensive framework for hospital emergency response. (Disaster Med Public Health Preparedness. 2018;12:166-171).
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...
Hook, Joshua N; Boan, David; Davis, Don E; Aten, Jamie D; Ruiz, John M; Maryon, Thomas
Hospital safety culture is an integral part of providing high quality care for patients, as well as promoting a safe and healthy environment for healthcare workers. In this article, we explore the extent to which cultural humility, which involves openness to cultural diverse individuals and groups, is related to hospital safety culture. A sample of 2011 hospital employees from four hospitals completed measures of organizational cultural humility and hospital safety culture. Higher perceptions of organizational cultural humility were associated with higher levels of general perceptions of hospital safety, as well as more positive ratings on non-punitive response to error (i.e., mistakes of staff are not held against them), handoffs and transitions, and organizational learning. The cultural humility of one's organization may be an important factor to help improve hospital safety culture. We conclude by discussing potential directions for future research.
Andrzej Baniak; Jacek Cukrowski
This paper examines the effects of changes in information-processing technology on the efficient organizational forms of data-processing in decision-making systems. Data-processing is modelled in the framework of the dynamic parallel processing model of associative computation with an endogenous set-up costs of the processors. In such a model, the conditions for efficient organization of information-processing are defined and the architecture of the efficient structures is considered. It is s...
Alexander, J A; Burns, L R; Morrisey, M A; Johnson, V
Physician-organization integration (POI) has emerged as a key issue for hospitals and health systems seeking to improve the quality and cost-effectiveness of care. Although competition and managed care are often cited as primary market drivers of the adoption of POI strategies, prior research has shown only weak associations between these market attributes and POI. This article argues that the role of key organizational decision makers has not been adequately accounted for in explaining strategic change. The study examines the role of hospital CEO perceptions of competition in predicting the adoption of five different approaches to POI. CEO perceptions of general market competition are explained by a combination of market and organizational attributes. Furthermore, when controlling for objective characteristics of the environment and organization, CEO perceptions of competition have consistent, statistically significant associations with four of five measures of POI examined.
I exploit a plausibly exogenous change in hospital financial incentives to examine whether the behavior of private not-for-profit hospitals varies with the share of nearby hospitals organized as for-profit firms. My results show that not-for-profit hospitals in for-profit intensive areas are significantly more responsive to an increased incentive to treat low-income patients insured by the Medicaid program than are other not-for-profit providers. The heterogeneity in behavior is not due to di...
Aas, I H Monrad
At present, most hospitals have a department of radiology where images are captured and interpreted. Decentralization is the opposite of centralization and means 'away from the centre'. With a Picture Archiving and Communication System (PACS) and broadband communications, transmitting radiology images between sites will be far easier than before. Qualitative interviews of 26 resource persons were performed in Norway. There was a response rate of 90%. Decentralization of radiology interpretations seems less relevant than centralization, but several forms of decentralization have a role to play. The respondents mentioned several advantages, including exploitation of capacity and competence. They also mentioned several disadvantages, including splitting professional communities and reduced contact between radiologists and clinicians. With the new technology decentralization and centralization of image interpretation are important possibilities in organizational change. This will be important for the future of teleradiology.
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.
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.
Estiri, Mehrdad; Seyyed Amiri, Nader; Khajeheian, Datis
The relationship between leaders and followers regarding their gender is an important research issue in recent decades. Also the importance of effective leadership in hospitality organizations has been stressed widely in literature. This issue has drawn the attention of researchers towards...
Organizatins Health maintenance organizations have usually been distinguished from traditional health care indemnity plans that permit covered individuals to...Capitation and reform- Challenges and choice for hospital leadership . Haeitals, 67 (7), 23-26. Freund, D. A., Rossiter, L. F., Fox, P. D. Meyer, J. A
Papazu, Irina Maria Clara Hansen; Nelund, Mette
Organization studies have shown limited interest in the part that scaling plays in organizational responses to climate change and sustainability. Moreover, while scales are viewed as central to the diagnosis of the organizational challenges posed by climate change and sustainability, the role...... turn something as immense as the climate into a small and manageable problem, thus making abstract concepts part of concrete, organizational practice....
In the debate over the tax status of voluntary hospitals, most hospital executives and trustees do not seem to comprehend--or want to comprehend--the underlying issues. First, the terror of being associated with a tax hike has led many politicians to seek other "revenue enhancements" that are more ingenious than they are honest. On the other hand, many of these governments have legitimate financial problems and are seeking new sources of revenue. A second, related issue is uncertainty over what should be done about the uninsured and Medicaid populations. In the absence of an acceptable solution, we will continue to provide direct public support to public hospitals and indirect public support to private providers--including charitable tax exemptions. The third underlying issue is hospitals' curiously narrow view of their private-sector status. Most of the functions hospitals provide are not only publicly funded; they are, in fact, public functions. Finally, hospitals believe they are inherently moral organizations because they provide an inherently moral service. But hospitals grew to their present role in society almost by accident; their services are neither unique nor ethically superior. It is in how hospitals provide care that their morality can be measured, not in the fact that they provide some kind of care to somebody. An honest appraisal of these issues will help each hospital answer the basic question: As an ethical and moral matter, should this organization be paying taxes? But is this fight really about taxes? I believe society and government are using taxation as a metaphor for trust in hospitals.
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
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...... the organizational forms discussed in the paper. It is asserted that the underlying organizational phenomena are not changing but that the manifestations and representations are shifting due to technological developments....
Smyth, T; Sheehan, M; Siskind, V
The study investigates the knowledge, intentions, and driving behavior of persons prescribed medications that display a warning about driving. It also examines their confidence that they can self-assess possible impairment, as is required by the Australian labeling system. We surveyed 358 outpatients in an Australian public hospital pharmacy, representing a well-advised group taking a range of medications including those displaying a warning label about driving. A brief telephone follow-up survey was conducted with a subgroup of the participants. The sample had a median age of 53.2 years and was 53 percent male. Nearly three quarters (73.2%) had taken a potentially impairing class of medication and more than half (56.1%) had taken more than one such medication in the past 12 months. Knowledge of the potentially impairing effects of medication was relatively high for most items; however, participants underestimated the possibility of increased impairment from exceeding the prescribed dose and at commencing treatment. Participants' responses to the safety implications of taking drugs with the highest level of warning varied. Around two thirds (62.8%) indicated that they would consult a health practitioner for advice and around half would modify their driving in some way. However, one fifth (20.9%) would drive when the traffic was thought to be less heavy and over a third (37.7%) would modify their medication regime so that they could drive. The findings from the follow-up survey of a subsample taking target drugs at the time of the first interview were also of concern. Only just over half (51%) recalled seeing the warning label on their medications and, of this group, three quarters (78%) reported following the warning label advice. These findings indicated that there remains a large proportion of people who either did not notice or did not consider the warning when deciding whether to drive. There was a very high level of confidence in this group that they could
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; Yap Poh LIAN; Lau Wee YEAP; Rusnah MUHAMAD
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 moderatin...
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...... of organizational conflict where members of an organization are seen as politicized actors engaged in power struggles that continually ebb and flow....
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...
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)
The primary goal of this dissertation is to develop and provide preliminary validation for a new measure of culturally responsive practice. This instrument, which is called the Culturally Responsive Practice Scale (CRPS), includes items that reflect ways that teachers teach multicultural students in their classrooms. To accomplish the goal, three…
Solitander, Nikodemus; Fougere, Martin; Sobczak, Andre; Herlin, Heidi
As the number of institutions adopting the United Nations' Principles for Responsible Management Education (PRME) initiative grows, there is an overhanging risk that many of them will merely add "responsibility" as a topic to the existing curriculum. The authors contend that a serious reading of PRME should instead entail thinking in…
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
Full Text Available This paper presents some reflections on strategic response models, in particular the models proposed by Pache, Santos and Oliver, and it evaluates their complementarity and differences, especially regarding the interactions between decision making and the possible strategic responses to institutional demands. It is argued that the theoretical contributions of Pache and Santos can be categorized under the dimension of utility, because they can enhance the potential to operationalize and test the model. However, the reflections made in this paper not only highlight the need to take into account other external and internal factors for the study of strategic responses, but also the integration of different linkages of the decision process with strategic responses to institutional demands.
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.
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.
Moreland, Jennifer J; Apker, Julie
Nurses function as central figures of health teams, coordinating direct care and communication between team members, patients, and their families. The importance of nurses to health care cannot be understated, but neither can the environmental struggles nurses routinely encounter in their jobs. Organizational communication and nursing scholarship show conflict and stress as two visible and ongoing challenges. This case study aims to (a) explore the ways conflict communication and communicative stress are experienced and endure in nursing and (b) understand how nurses discursively (mis)manage conflict and stress. Open-ended survey comments from nurses (N = 135) employed at a large teaching and research hospital were qualitatively analyzed. Weick's model of organizing, specifically his notion of communication cycles, emerged as a conceptual lens helpful for understanding cyclical conflict and stress. Results show that exclusionary communication, specifically nonparticipatory and unsupportive messages, contribute to nurse conflict and stress. Nurses tend to (mis)manage conflict and stress using respectful and disrespectful discourse. These communication patterns can facilitate or prohibit positive change. Metaphorically, nurse communicative conflict and stress can be depicted as fire. Relationships can go up in flames due to out-of-control fires in the form of destructive conflict. However, conflict and stress, like fire, can be harnessed for positive ends such as organizational decision making and innovation. Findings suggest conveying respect may help nurses manage and even avoid flames of conflict and stress. Solutions are offered to mitigate the effects of conflict and stress while developing respectful organizational cultures.
Telion, C.; Carli, P.
Anticipating exceptional risks and training to deal with serious and violent events which are given massive media coverage is a very real challenge for hospital staff, and one that AP-HP decided to face. The R*53 exercise involved dealing with radiation contaminated victims requiring organisation of a specific, protected care circuit within the hospital. It was designed as a pedagogical exercise as part of a collective learning process with the aim of providing data which could be used as the basis for subsequent training. (authors)
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...
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.
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.
Hildebrandt, Thomas; Mukkamala, Raghava Rao; Slaats, Tijs
We conservatively extend the declarative Dynamic Condition Response (DCR) Graph process model, introduced in the PhD thesis of the second author, to allow for discrete time deadlines. We prove that safety and liveness properties can be verified by mapping finite timed DCR Graphs to finite state...
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
Wu, Jason H.
This study was designed to examine the construct of academic optimism and its relationship with collective responsibility in a sample of Taiwan elementary schools. The construct of academic optimism was tested using confirmatory factor analysis, and the whole structural model was tested with a structural equation modeling analysis. The data were…
Davis, MC; Coan, P
This chapter examines how organizational change principles may be applied to promote organizational greening and employee pro-environmental behaviour. Four key areas of change management are focused upon: organizational culture; leadership and change agents; employee engagement; and the differing forms that change may take. The role of each factor in supporting environmental change is discussed, together with relevant research evidence drawn from the corporate sustainability; WPEB; management...
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. Based on an empirical investigation of the organizational bloggers using situational analysis and thematic network...... and resources, barriers and opportunities, which employees experience when acting as bloggers, as well as when acting on other transparent Web 2.0 mediated communications platforms for corporate purposes....
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 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.
Wijaya, Aditya Suryadinata
The application of CSR in service oriented industries like tourism, restaurant and hotel are considered important because of their direct relation with the environment or their high energy consumption. Through this thesis, author wants to encourage managers in hospitality industries to adopt CSR in its business, by giving an explanation and clearance of how company can received many benefits by applying CSR into its business. The goal of this thesis is determine a real connection between impl...
Full Text Available This paper considers the importance of the Treaty of Waitangi (1840 to Higher Education in New Zealand and how this influences the educational experience of hospitality, tourism and event management students. The paper reviews the literature on cultural diversity, internationalization and curriculum development, the role of culture in educating domestic and international students, and how the acculturation Higher Education students experience as part of their studies might lead to a deeper understanding of culture and identity in the hospitality workplace. The gap in the literature concerns how a higher education curriculum can assist in the development of cultural awareness and an understanding of historical commitments. The paper therefore identifies a number of key principles which are regarded as essential to the identity of those living in New Zealand/Aotearoa. The paper then goes on to illustrate how these principles could be applied to Higher Education. It suggests that these principles enshrined in the Treaty of Waitangi are also worth considering when creating an inclusive curriculum which supports all hospitality, tourism and events management students, irrespective of ethnic background, culture or upbringing. Finally, this paper proposes a matrix of ‘hooks’ - tools which academics can use to ensure their lectures address the needs of all learners. This matrix is developed from a study of the educational goals of the Principles of the Treaty of Waitangi (ToW, the founding document of this country. This research adds value by creating an awareness of the diverse environment in which academics and students operate, thereby enabling students to develop a cultural sensitivity to the international hospitality industry they will be employed in on graduation.
Pees, Richard C; Shoop, Glenda Hostetter; Ziegenfuss, James T
The purpose of this paper is to develop a conceptual understanding of organizational consciousness that expands the discussion of organizational analysis, and use a case study to apply it in the analysis of a merger between an academic health center and a regional medical center. The paper draws on the experiences and insights of scholars who have been exploring complex organizational issues in relationship with consciousness. Organizational consciousness is the organization's capacity for reflection; a centering point for the organization to "think" and find the degree of unity across systems; and a link to the organization's identity and self-referencing attributes. It operates at three stages: reflective, social, and collective consciousness. Translating abstract concepts such as consciousness to an organizational model is complex and interpretive. For now, the idea of organizational consciousness remains mostly a theoretical concept. Empirical evidence is needed to support the theory. Faced with complicated and compelling issues for patient care, health care organizations must look beyond the analysis of structure and function, and be vigilant in their decisions on where important issues sit on the ladder of competing priorities. Organizational consciousness keeps the organization's attention focused on purpose and unifies the collective will to succeed. If the paper can come to understand how consciousness operates in organizations, and learn how to apply it in organizational decisions, the pay-off could be big in terms of leading initiatives for change. The final goal is to use what is learned to improve organizational outcomes.
Arlina Nurbaity Lubis
Full Text Available Contemporary society demands that every organization operate with a sense of social responsibility. Many organizations now include corporate social responsibility (CSR activities in their work programs. In the health sector, however, the role of CSR has not been studied as intensively as in private corporations because the services provided by the health sector are already valued as directly serving humanity. This research aims to evaluate the impact of CSR on the health sector, specifically on government hospitals. This model was developed by analyzing the influence of CSR on hospital reputation, customer loyalty, and hospital values. By answering questionnaires, a total of 200 hospital patients from four government hospitals participated in the study. The proposed model was evaluated using path analysis with AMOS tools. The results of this study provide empirical evidence that overall, CSR positively affects the reputation of the hospital, patient loyalty, and hospital value. Although there is a direct negative effect of CSR on hospital value, the larger influence of indirect effect that occurs through the mediating role of reputation and patient loyalty variables shows that CSR is able to increase the hospital value. Practically, these results imply that CSR should be applied as a strategic tool in improving the value of the hospital.
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.
Harriet R. Kagoya
Conclusion and recommendations: Awareness of, responsiveness to and practice of patients’ rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses intrinsic patient, HW and health system factors to strengthen patients’ rights issues at the hospital.
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...
Mahmoudi, Ghahraman; Rostami, Fahimeh Hoseinian; Mahmoudjanloo, Shaharbanoo; Jahani, Mohammad Ali
Introduction: Motivational deficiencies and the low quality of working life significantly reduce employees’ work performance and consequently their efficacy (effectiveness and proper performance in doing a task or specific tasks). Aim: The aim of this study was to determine the relationship between achievement motivation and quality of working life with self-efficacy among staff working in Mazandaran hospitals, by taking organizational ownership as a mediator variable. Materials and Methods: This study was an applied descriptive-correlation. Research population consisted of all staff working in selected hospitals of Mazandaran Province, Iran. 341 employees were selected with randomly-stratified sampling as the statistical sample. Three valid questionnaires were used for data collection. Data were analysis based on structured equations and path analysis with SPSS19 and AMOS. Results: In private hospitals, there was a significant relationship between the quality of working life and self-efficacy (pmotivation and self-efficacy, there was no significant differences between university hospitals and social security hospitals, but relationship between the quality of working life and self-efficacy was significant (p motivation and self-efficacy in private hospitals and university hospitals, a significant differences was observed (pmotivation and quality of working life with self-efficacy. Staff’s empowerment courses for university hospitals and improvement in the overall space of job, increase in job security, reducing salary differences is suggested for private hospitals. PMID:29284991
This article presents the findings of a report by the HHS Office of Inspector General (OIG) on the performance of 172 Medicare-certified hospitals in the New York Metropolitan Area before, during, and after Sandy. It makes recommendations on how to close gaps that were found in emergency planning and execution for a disaster of this magnitude. To download the complete 40-page report and a Podcast based on it, go to http://oig.hhs.gov/oei/ reports/oei-06-13-00260. asp.
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…
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…
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...
Balotsky, Edward R
The 1983 Tax Equity and Fiscal Responsibility Act (TEFRA) transformed acute care from a benevolent to malevolent environment. A dual-paradigm of resource dependency and institutional theories that balances isomorphic with economic variables has emerged to better explain hospital strategic response to the resultant constraint on resources than a traditional single paradigm approach. Using the population of non-rural, non-federal acute-care hospitals, strategic response from 1982 to 2001 is studied; distinct cost and service changes occur. Cost strategy is linked primarily to Medicare utilization, a resource dependence response. Service strategy favors high technology regardless of prospective payment diffusion, an institutional theory perspective. Strategic implications are discussed.
Full Text Available In this study, the effects of organization-public relations and crisis communication strategies on audience perception and attitudes during a crisis have been investigated experimentally. In the context of the research, a university in Turkey was selected as the organization and students were selected as stakeholders and Coombs' situational crisis communication theories have been tested on 97 students in an experimental manner. Students were divided into 8 groups according to different corporate reputation and relational satisfaction perceptions; a crisis situation was created and a different crisis communication strategy was applied to each group. According to the research results, no matter what the thoughts were before the crisis, crisis communication strategy doesn’t reduce the responsibility of the organization in crisis and it doesn’t affect the minds of the audience, but the perception of corporate reputation and sense of relational satisfaction affect the credibility and confidence of the organization's words and actions. Regardless of the corporate reputation and relational satisfaction, the strategy of denying the crisis gave the highest accusation score and the messages given to reduce the negative consequences of the crisis were found effective within each participant group. The reason for this is that participants weren’t concerned about the cause of the crisis; they were concerned only with the messages to reduce the harmful effects of the crisis. According to the research results, organizations should make an effort to minimize the negative effects of the crisis and attach importance to their corporate reputation and relational satisfaction in order to increase the credibility of these efforts.
Romeo B. Lee
Full Text Available 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
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.
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.
Minnick, Ann F; Mion, Lorraine C; Johnson, Mary E; Catrambone, Cathy
To describe (1) the extent to which acute and intensive care units use the elements of nursing models (team, functional, primary, total patient care, patient-focused care, case management) and (2) the deployment of non-unit-based personnel resources. The lack of current data-based behavioral descriptions of the extent to which elements of nursing models are implemented makes it difficult to determine how work models may influence outcomes. Nurse managers of 56 intensive care units and 80 acute care adult units from 40 randomly selected US hospitals participated in a structured interview regarding (1) day-shift use of patient assignment behaviors associated with nursing models and (2) the availability and consistency of assignment of non-unit-based support personnel. No model was implemented fully. Almost all intensive care units reported similar assignment behaviors except in the consistency of patient assignment. Non-intensive care units demonstrated wide variation in assignment patterns. Patterns differed intra-institutionally. There were large differences in the availability and deployment of non-unit-based supportive resources. Administrators must recognize the differences in work models within their institutions as a part of any quality improvement effort. Attempts to test new work models must be rigorous in the measurement of their implementation.
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.
Keyvanara, Mahmoud; Sajadi, Haniye Sadat
Background: 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. Methods: 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. Results: 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. Conclusion: 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. PMID:26340391
Hatam, Nahid; Jalali, Marzie Tajik; Askarian, Mehrdad; Kharazmi, Erfan
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 p...
The Relationship between Organizational Justice and Organizational Citizenship Behavior among Nurses (Examining the Mediating Role of Organizational Commitment, Organizational Trust, and Job Satisfaction
Full Text Available Introduction: Justice has been recognized as the pivot of different organizational research, that the designation of the causal pattern involving the most important variables associated with it was the main objective of the present study. Materials and Methods: This was a descriptive-survey study. The statistical population consisted of all nurses of Imam Khomeini hospital in Urmia (n= 420, of which 201 nurses were selected by using Morgan’s table and by random sampling method. The instruments included questionnaires of organizational justice, organizational commitment, organizational trust, job satisfaction, and Organizational Citizenship Behavior whose reliability and validity were confirmed. The structural equations model method was used to analyze the data. Results:The results showed there was a positive and significant relationship between justice perception with organizational commitment, organizational trust, and job satisfaction. In addition, the mediating role of organizational commitment and trust was acknowledged in the relationship between justice and citizenship behavior in the model; however, the mediating role of satisfaction was not fitted in the relationship between justice and citizenship. Conclusion: According the research results that there was a positive and significant relationship between perception of justice with organizational commitment, organizational trust, and job satisfaction, paying attention to organizational justice for improving the staff’s organizational citizenship behavior is critical and indicates the distinct position of this variable in improving all attitudinal and behavioral variables and consequently in the hospital employees’ performance.
Murdani; Jakfar; Ekawati, D.; Nadira, R.; Darmadi
Hospital wastewater is a source of potential environmental contamination. Therefore, the waste water needs to be treated before it is discharged into the landfill. Various research methods have been used to treat hospital wastewater. However, some methods that have been implemented have not achieved the effluent standards for hospitals that have been set by the government. The experiment was conducted by an electrochemical method is electrolysis using aluminum electrodes with independent variable is the voltage, contact time and concentration of electrolytes. The response optimization using response surface with optimum conditions obtained by the contact time of 34.26 min, voltage 12 V, concentration electrolyte 0.38 M can decrease of COD 65.039%. The model recommended by the response surface for the three variables, namely quadratic response.
drag Drag-and-Drop Exercise Interactive Media Element This interactive exercise gets the learner to identify various strengths and weaknesses of the functional, divisional, matrix, horizontal, modular, and hybrid organizational structures.
Organizational goals differentiate organizations from other social collectives such as ... The way an organization transforms its resources into results through work ..... Maintenance (health/safety issues, gender issues, quality of working life).
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…
Mine TA rker
Global competition highlights the importance of innovation, flexibility, responsiveness, and cooperativeness for long-term organizational success. Innovative and spontaneous behaviours’ vitality is revealed in protecting organization in an ever-chancing environment. As a necessity, organizations will become more dependent on employees who are willing to contribute effective organizational functioning, regardless of their formal role requirements. Employee behaviours like citizenship behaviour...
Schein, Edgar H.
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 sec...
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....
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.
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...
The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...
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.
, 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
Bastug, Gulsum; Pala, Adem; Yilmaz, Taner; Duyan, Mehdi; Gunel, Ilker
Organizational silence can be defined as a way of behaviour belonging to men and women employees in the organization exhibited without reflecting their feelings, ideas, concerns and suggestions related with their workplaces, works for which they are responsible or other activities of the organization. In the period of organizational silence,…
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.
Sefrin, Peter; Kuhnigk, Herbert
Mass casualty events make demands on emergency services and disaster control. However, optimized in- hospital response defines the quality of definitive care. Therefore, German federal law governs the role of hospitals in mass casualty incidents. In hospital casualty surge is depending on resources that have to be expanded with a practicable alarm plan. Thus, in-hospital mass casualty management planning is recommended to be organized by specialized persons. To minimise inhospital patient overflow casualty surge principles have to be implemented in both, pre-hospital and in-hospital disaster planning. World soccer championship 2006 facilitated the initiation of surge and damage control principles in in-hospital disaster planning strategies for German hospitals. The presented concept of strict control of in-hospital patient flow using surge principles minimises the risk of in-hospital breakdown and increases definitive hospital treatment capacity in mass casualty incidents.
Investigating organizational quality improvement systems, patient empowerment, organizational culture, professional involvement and the quality of care in European hospitals: the 'Deepening our Understanding of Quality Improvement in Europe (DUQuE)' project
Groene, O.; Klazinga, N.; Wagner, C.; Arah, O.A.; Thompson, A.; Bruneau, C.; Suñol, R.
Hospitals in European countries apply a wide range of quality improvement strategies. Knowledge of the effectiveness of these strategies, implemented as part of an overall hospital quality improvement system, is limited. We propose to study the relationships among organisational quality improvement
Ouchi, William G.; Maguire, Mary Ann
Distinguishes between two modes of organizational control, personal surveillance (behavior control) and the measurement of outputs (output control). Output control occurs in response to a manager's need to provide legitimate evidence of performance, while behavior control is exerted when means-ends relations are known and appropriate instruction…
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.
Albu, Oana Brindusa; Flyverbom, Mikkel
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......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...... 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.
The aim of this research is to identify the primary school teachers perceptions of organizational dissent. The working group of the present study is formed by (n:171) primary school teachers working in the central province of Bolu in 2012-2013 academic year. In the study, the data were collected through organizational dissent scale developed by Özdemir (2010). The data were analyzed with the SPSS. Arithmetic means and standard deviations of the answers that teachers gave to the items were cal...
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.
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).
Mahmoudi, Ghahraman; Rostami, Fahimeh Hoseinian; Mahmoudjanloo, Shaharbanoo; Jahani, Mohammad Ali
Motivational deficiencies and the low quality of working life significantly reduce employees' work performance and consequently their efficacy (effectiveness and proper performance in doing a task or specific tasks). The aim of this study was to determine the relationship between achievement motivation and quality of working life with self-efficacy among staff working in Mazandaran hospitals, by taking organizational ownership as a mediator variable. This study was an applied descriptive-correlation. Research population consisted of all staff working in selected hospitals of Mazandaran Province, Iran. 341 employees were selected with randomly-stratified sampling as the statistical sample. Three valid questionnaires were used for data collection. Data were analysis based on structured equations and path analysis with SPSS19 and AMOS. In private hospitals, there was a significant relationship between the quality of working life and self-efficacy (pquality of working life and self-efficacy was significant (p quality of working life with self-efficacy. Staff's empowerment courses for university hospitals and improvement in the overall space of job, increase in job security, reducing salary differences is suggested for private hospitals.
Pawlak, Edward J.
The bureaucratic structures in which many clinicians work are often obstacles to effective services. The author suggests that the clinician would benefit the organization and its clients--as well as his own position--if he would learn certain tactics for tinkering with organizational structures, rules, and policies. (Author)
The following organizational factors are considered with respect to the human factor and operating safety of nuclear power plants: external influences; objectives and strategy; positions and ways of management; allocation of resources; working with human resources; operators' training; coordination of work; knowledge of organization and management; proceduralization of the topic; labour organizing culture; self-improvement system; and communication. (P.A.)
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...
Cristina Mihaela Lazar
Full Text Available The sustainable development of organizations within knowledge-based economy, in which knowledge represents the main priority, should focus on finding solutions for the intelligent management of the limited resources, especially through organizational change and its constant assessment as a long-term impact solution. The transition of organizations to the principles of knowledge-based economy involves a major change in organizational culture. The dynamism and complexity of the new type of society, which implies a higher and more diverse level of training, together with a continuous superior training of the workforce, increasing investment in research and development and, not least, a growing volume and a diversification of information, all these represent, chained together, an element of well-being for the future generations. The introductory section summarizes the concept of sustainability and places the development of companies and economies they aggregate, in a contemporary context of organizational change pressures, on the principles of the knowledge-based economy as the only resource, virtually inexhaustible in the long-term, and which leads to a sustainable development. There follows a methodological section, consisting in the instrumental description of the method of work and in reference to the database, thus providing the theoretical and practical foundation for the confrontation between the sustainable development index (SDI in Romania and in the European Union (EU. The results and discussion section of the paper includes a confrontation between the sustainable development of Romania and that of the European Union, drawing on the SDI for each case. This statistical tool was calculated starting from the values of several statistical indicators (available in EUROSTAT statistics, issued from four information subsystems (an economic one, a social one and an environment one as major subsystems of sustainable development, to which was added
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.
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.
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
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.
113. PROGRAM ELMNT. PROCJ CT, TASK ISSIS11Graduate School of Business Dr. L. L. Ctinings AC tW0XNTMNSA Uiversity of Wicosn r.R B DnamNR10-9 OtMadison...working life . Organization Studies, edited by David Hickson, is broader in scope and focuses upon multidisciplinary studies of organizations, the...Attitudes as schema for interpreting events in organizational life and as a basis for the construction of personal and shared causal maps has also
Gomart, Samantha B; Allerton, Fergus J W; Gommeren, Kris
To evaluate the accuracy and associated induced stress response of axillary, auricular, and rectal thermometry in hospitalized dogs. Prospective observational study from October 2011 to February 2012. University veterinary teaching hospital. Two hundred fifty hospitalized dogs. All hospitalized dogs were considered eligible unless their condition precluded measurement at one of the designated sites. A veterinary auricular infrared device for auricular temperature (OT) and an electronic predictive thermometer for rectal temperature (RT) and axillary temperature (AT) were used for temperature measurements. All recordings were obtained by the same investigator in a randomized fashion. Heart rate was noted before and immediately after each measurement. Stress behaviors (eg, vocalization, lip licking, shaking, panting, defensive behavior) were also recorded and graded from 0 (lowest) to 4 (highest). Signalment, analgesic therapy, and length of hospitalization were recorded. RT measurements were associated with greatest increase in heart rate (P 0.05). AT and to a lesser extent OT are reliable, less stressful alternatives to estimate RT in dogs. Further studies are needed to evaluate these techniques in hyperthermic dogs, and to evaluate the use of AT and OT as monitoring tools in intensive care patients. © Veterinary Emergency and Critical Care Society 2014.
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
Djalali, Ahmadreza; Khankeh, Hamidreza; Öhlén, Gunnar; Castrén, Maaret; Kurland, Lisa
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. 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. 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. 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.
The reorientation of hospital services in the state of New York to accommodate women's constitutional right to elective abortion was investigated. Market and resource constraints, the social orientations of the organization, and the values of physicians were examined in the effort to evaluate hospital response between 1971 and 1973. Analysis indicates that program innovation in obstetrical and gynecological services to include elective abortion was inhibited by economic factors that generally determined the feasibility of diverting finite resources to a new service and social orientations and values that determined the compatibility of elective abortions with the dominant values underlying hospital operations. The reform of New York abortion statutes and the subsequent ruling by the Supreme Court reiterating the right of women to terminate pregnancy failed to standardize the delivery of health care so that individual rights to service could be obtained everywhere in the state. The social changes ultimately realized through legislative and judicial action were essentially conditional upon the responsiveness of local health care providers. Legal action that failed to specifically address the administrative role of hospitals in social change qualified local access and could not be completely effective in legitimizing the redefinition of abortion in society.
Mok, Esther; Au-Yeung, Betty
The authors explore the relationship between organizational climate and empowerment among the nursing staff of a regional hospital in Hong Kong. The main purpose of the study was to apply the modified Spreitzer measure of empowerment in a hospital and to examine the relationship of organizational climate to perceptions of empowerment. From 658 questionnaires sent out, 331 nurses participated in the study with a response rate of 50.3%. Survey measures administered included the modified Litwin and Stringer Organizational Climate Questionnaire (LSOCQ) and the modified Spreitzer empowerment instrument. The relationships between organizational climate and empowerment were examined in a series of bivariate correlational analyses. The final section of the questionnaire asked the respondents to list three elements in the organizational climate that they perceived would further increase their feelings of empowerment. Exploratory factor analysis of the modified LSOCQ resulted in six factors: leadership, working harmony, challenge, recognition, teamwork and decision making. There was a positive correlation between organizational climate and psychological empowerment. Using multiple regression analysis, all the six derived climate factors significantly accounted for 44% of the variance. Among the six predicting factors, leadership and teamwork showed the most positive relationship with psychological empowerment. Responses from the open questions on perception of organizational climate that further enhance nurses' feelings of empowerment were categorized into eight areas. They include leadership, communication, working relationship, recognition, structure, training, teamwork and stress management. The study echoes previous studies in finding that organizational climate and, in particular, supportive leadership and teamwork are related to empowerment. The findings also suggest that the nurses in the study did not put much emphasis on the importance of participative decision
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.
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
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.
Murphy, James Peter
The safe service of alcohol is of vital importance to those in the food and beverage industry - failure to act responsibly can result in fines, loss of license and the potential closure of the business. Responsible sale and service of alcohol (RSA) is important for all levels of the hospitality, tourism and retail service industries to minimise the risk of alcohol-related problems associated with the use and abuse of alcohol by any person. Management and all staff who sell or supply alcohol m...
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
This research project is about the analysis of construction project organizations. The work is based on organizational theory and is a development of Linear Responsibility Analysis (LRA). The aim is to assess the extent to which project success is affected by organizational structure. The analysis of four public sector case studies raises several issues. First is the need for a systematic model of describing and analysing construction project environments. A framework has been developed that ...
Catalia Rafsiah Sari Sari
relationship Perceived Organizational Support on Organizational Citizenship Behavior through Organizational Commitment. Keywords: Perceived Organizational Support, Organizational Citizenship Behavior,Organizational Commitment
align with social work values such as “client-centeredness” and working with the individual welfare recipient face-to-face. The article finds that fitting social work into organizational schemas changes the work practices of social workers and also the way members of this profession define meaningful...... work and expertise. In addition, the article also finds that scoring schemas cause conflicts among social workers regarding the char-acter of expertise when values of social work (to meet a welfare recipient’s need) must be aligned with NPM-inspired values of organizations (to meet managers’ de...
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...... and investigate the kinds of imitations that might be produced from structures of not-knowing (i.e. structures intended to divide, obscure and protect knowledge). This point is illustrated through ethnographic studies and interviews within five HFT firms. The data show how a black-box structure of ignorance...
Kao, Hui-Yun; Ko, Hai-Yun; Guo, Peng; Chen, Chang-Hsun; Chou, Su-Mei
The Communicable Disease Control Medical Network (CDCMN), established in 2003 after the SARS outbreak in Taiwan, has undergone several phases of modification in structure and activation. The main organizing principles of the CDCMN are centralized isolation of patients with severe highly infectious diseases and centralization of medical resources, as well as a network of designated regional hospitals like those in other countries. The CDCMN is made up of a command system, responding hospitals, and supporting hospitals. It was tested and activated in response to the H1N1 influenza pandemic in 2009-10 and the Ebola outbreak in West Africa in 2014-2016, and it demonstrated high-level functioning and robust capacity. In this article, the history, structure, and operation of the CDCMN is introduced globally for the first time, and the advantages and challenges of this system are discussed. The Taiwanese experience shows an example of a collaboration between the public health system and the medical system that may help other public health authorities plan management and hospital preparedness for highly infectious diseases.
Young, Eric; Stickrath, Chad; McNulty, Monica C; Calderon, Aaron J; Chapman, Elizabeth; Gonzalo, Jed D; Kuperman, Ethan F; Lopez, Max; Smith, Christopher J; Sweigart, Joseph R; Theobald, Cecelia N; Burke, Robert E
Medical residents are routinely entrusted with transitions of care, yet little is known about the duration or content of their perceived responsibility for patients they discharge from the hospital. To examine the duration and content of internal medicine residents' perceived responsibility for patients they discharge from the hospital. The secondary objective was to determine whether specific individual experiences and characteristics correlate with perceived responsibility. Multi-site, cross-sectional 24-question survey delivered via email or paper-based form. Internal medicine residents (post-graduate years 1-3) at nine university and community-based internal medicine training programs in the United States. Perceived responsibility for patients after discharge as measured by a previously developed single-item tool for duration of responsibility and novel domain-specific questions assessing attitudes towards specific transition of care behaviors. Of 817 residents surveyed, 469 responded (57.4 %). One quarter of residents (26.1 %) indicated that their responsibility for patients ended at discharge, while 19.3 % reported perceived responsibility extending beyond 2 weeks. Perceived duration of responsibility did not correlate with level of training (P = 0.57), program type (P = 0.28), career path (P = 0.12), or presence of burnout (P = 0.59). The majority of residents indicated they were responsible for six of eight transitional care tasks (85.1-99.3 % strongly agree or agree). Approximately half of residents (57 %) indicated that it was their responsibility to directly contact patients' primary care providers at discharge. and 21.6 % indicated that it was their responsibility to ensure that patients attended their follow-up appointments. Internal medicine residents demonstrate variability in perceived duration of responsibility for recently discharged patients. Neither the duration nor the content of residents' perceived responsibility was
Full Text Available Background: Measuring patients’ satisfaction shows the efficacy of care providers to meet patients' expectations and supplies the valuable data for health policy makers. This study was conducted to assess patients’ satisfaction from hospital services and its relationship with responsiveness. Methods: This cross-sectional study was carried out at Zanjan University of Medical Sciences in 2013 -2014. A total of 486 were selected and World Health Survey (WHS questionnaire data was used. Results: most of the inpatients (76. 4 % and more than half of outpatient (54.2 % rated overall hospitals services at level of average and high satisfaction. The most favorable dimension in terms of patients' satisfaction was quality of care from both group patients point of view. There was statistically significant relationship between responsiveness domains and patients' satisfaction (p < 0.01. The findings of this study showed that the majority of inpatients and half of outpatients were overall satisfied with hospitals services. Conclusion: Both inpatients and outpatients were satisfied with quality of delivered care, but there was low satisfaction from participation in decision- making for inpatients and access to services in outpatients.
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.
Guy, M E
Most people think that conflict among the professional staff is inevitable and results from each profession's unique set of values. Each profession then defends itself by claiming its own turf. This article demonstrates that organizational complexity, not professional territorialism, influences the amount of intraorganizational conflict. In a comparison of two psychiatric hospitals, this study shows that there is not necessarily greater conflict across professions than within professions. However, there is a significantly greater amount of conflict among staff at a structurally more complex hospital than at a less-complex hospital, regardless of profession. Implications for management are discussed.
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.
Jacobsen, Christian Bøtcher; Jakobsen, Mads Leth
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...... 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...... 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....
Érica Aparecida Araújo
Full Text Available Hospitais são fundamentais para a sociedade devido à sua função socioeconômica e, principalmente, por promover a saúde em todos os sentidos. Mas possuem várias carências de gestão administrativa e qualidade com maior valor agregado, entre outras. Um dos temas que tem se sobressaído na dinâmica da gestão empresarial e que busca agregar valor e vantagens competitivas sustentáveis é a logística, porém esta é uma área relativamente inexplorada. Nesse contexto, o objetivo do estudo é identificar o estágio da logística e seu arranjo organizacional em uma organização hospitalar. Para tanto, utilizou-se uma abordagem qualitativa-exploratória, seguida de revisão de literatura, que visa a estruturação do conhecimento da logística, e estudo de caso. A coleta de dados foi realizada por pesquisa documental e entrevistas semiestruturadas. Os resultados permitiram apurar modificações na estrutura organizacional do hospital, contemplando a logística, e identificar que a instituição encontra-se no estágio 2, além de ressaltar as barreiras e os facilitadores do processo de adaptação.Hospitals are fundamental to society due to their socioeconomic function, especially, for promoting health in all senses. However, they face a shortage of administrative management, aggregated values with quality, and so on. One of the issues that stands out in the business management dynamics, that seeks to add sustainable competitive advantages and values, is the logistics, despite being a relatively unexplored area. In this context, the objective of this study was to identify the stage of logistics and its organizational arrangement in a hospital organization. To this end, an exploratory-qualitative approach followed by a bibliographical one and a case study were used, aiming at structuring the knowledge of logistics. Data collection was performed through documentary research and semi-structured interviews. The results enabled to determine
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
Kagoya, Harriet Rachel; Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C
The realisation of patients' rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health care-seeking behaviour and health outcomes. Although the Uganda Patients' Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. The study aimed to assess level of awareness of, responsiveness to and practice of patients' rights amongst patients and health workers (HWs) at Uganda's national referral hospital, Mulago Hospital in Kampala. A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May-June 2012, 2.5 years after the launch of the Uganda Patients' Charter. At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients' Charter. Awareness of patients' rights was significantly higher amongst HWs (70%) than patients (40%) ( p bribe HWs with money to access care, and political, socio-economic and tribal status. Awareness of, responsiveness to and practice of patients' rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses intrinsic patient, HW and health system factors to strengthen patients' rights issues at the hospital.
Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C.
Abstract Background The realisation of patients’ rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health care-seeking behaviour and health outcomes. Although the Uganda Patients’ Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. Aim The study aimed to assess level of awareness of, responsiveness to and practice of patients’ rights amongst patients and health workers (HWs) at Uganda's national referral hospital, Mulago Hospital in Kampala. Methods A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May–June 2012, 2.5 years after the launch of the Uganda Patients’ Charter. Results At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients’ Charter. Awareness of patients’ rights was significantly higher amongst HWs (70%) than patients (40%) (p bribe HWs with money to access care, and political, socio-economic and tribal status. Conclusion and recommendations Awareness of, responsiveness to and practice of patients’ rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel, multichannel, patient-centred approach that incorporates social services and addresses intrinsic patient, HW and health system factors to strengthen patients’ rights issues at the hospital. PMID:24563777
Biørn, Erik; Hagen, Terje P; Iversen, Tor; Magnussen, Jon
For policy-makers the heterogeneity of hospital response to reforms is of crucial concern. Even though a reform may entail a positive effect on average efficiency, policy-makers will consider the reform as less attractive if the variation in hospital efficiency increases. The reason is that increased variance of efficiency across hospitals is likely to increase the impact of geography on access to hospital services. This paper examines the heterogeneity with respect to the impact of a financial reform-Activity Based Financing (ABF)-on hospital efficiency in Norway. From a theoretical model we find an ambiguous effect of hospital heterogeneity on the effect of ABF on efficiency. The data set is from a contiguous 10-year panel of 47 hospitals covering both pre-ABF years and years after its imposition. Substantial heterogeneity in the responses, as measured by both estimated and predicted coefficients, is found. We did not find any significant correlation between pre-ABF measures of efficiency and the effect of ABF on efficiency. We did however find a strongly significant correlation between the effect of ABF and post-ABF efficiency. Thus, the analysis confirms the impression that, whereas pre-ABF efficiency did not play any role in how hospitals responded to ABF, those responding generally ended up as better-performing hospitals. Hence, for the type of reform studied in this article we find that policy-makers do not need to worry about the impact of location on patients' access to hospital services.
Sørensen, Hans Eibe; Stieglitz, Nils
Market orientation has evolved into a key construct in the marketing and strategy literature. While much progress has been made in empirical research, the concept lacks a coherent theoretical foundation. Essentially, much prior research has pointed to the role of market-sensing capabilities...... to explain performance differentials among firms (Day, 1994). We open up the black box of market-sensing capabilities by treating the issue of choosing marketing attributes of products as a problem of organizational search. Despite much robust research on organizational search in the strategy......, with their effectiveness depending on organizational and environmental factors. We provide an elaborate outline of the multidimensional aspect of firms' responsive and proactive search processes. First, we highlight the role of organizational aspiration-levels for market orientation. We then investigate the mechanisms...
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.
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.
organizational knowledge and ways of organizing, which have consequences for how subject positions are (re)configured in everyday corporate lives. Such identity work is rarely studied in local discursive practices of today’s modern and emergent corporations. The aspiration in the present article is to scrutinize...... local practices in a dialogue based leadership development forum in university settings. This provides insights into the lived lives and identity work in Aalborg University representing a temporary, polyphonic and cross-disciplinary research project in a modern corporation. The project was an example...... of a loose-coupled and temporary arrangement/organization that invited a diverse group of participants to engage in the co-production of knowledge in/on leadership communicative practices. The participants were professional leaders from diverse organizations in the North of Jutland together with researchers...
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
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…
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.
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.
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
Investigating the Status of Training Quality of Ophthalmologic Residents in Khatam-Ol-Anbia Hospital in Mashhad, Based on the Standards of EFQM Organizational Excellence Model in the Academic Year 2012-2013
Full Text Available Background and Purpose: As the leaders of educational organizations, universities use various models and approaches in evaluating their activities. However, excellence model for evaluation of educational services can demonstrate the distinction of this evaluation procedure. The aim of this study is to investigate the status of training quality of ophthalmologic residents in Khatam-Ol-Anbia Hospital in Mashhad based on the standards of organizational excellence model EFQM in the educational year of 2012-2013.Methods: This descriptive cross-sectional study has been conducted in the second half of 2013 in the educational, research, and therapeutic hospital of Khatam-Ol-Anbia, among the hospitals affiliated with Mashhad University of Medical Sciences. All students in the stage of residency in Ophthalmology entered this study. In this research, 18 men and 6 women participated. Moreover, in the statistical population of this research, 14 of the residents were non-native and 10 were native. Using standardized questionnaire of organizational excellence model in higher education sector and the degree of achievement of the educational services outcomes presented to learners was investigated. This questionnaire was first adapted from the main booklet published by Sheffield University, England. Following the extraction of the preliminary questionnaire, normalization of the instrument for validity was done by expert judgment, to examine the internal consistency of the various sections of the instrument and the reliability, Cronbach’s alpha coefficient of 0.96 was obtained. The questionnaire consists of 4 main sections, each of which questions contain certain indices of educational services. Using SPSS 16 and congruent with the background and research questions, the results were obtained.Results: The mean value of general status of the training quality of Ophthalmology residents has been obtained as 6.66 (of a max of 10. The mean value for the indices of
Harrison, Teresa M.; Debs, Mary Beth
Uses a systems approach to organizational theory to argue that technical communicators function as "boundary spanners," who make sense of and disseminate information required for coordination between organizational groups, and for effective responses to the environment. (JAD)
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.
Kato, Soichiro; Yamaguchi, Yoshihiro
In Japan, experience from an earthquake has always provided an opportunity to reconsider measures of disaster preparedness. To facilitate decision-making and its enforcement in a large-scale disaster response, a cross-agency organization and tough infrastructure are required as a foundation of crisis management. In the Fukushima nuclear power plant accident, the Fukushima Nuclear Disaster Management Center could not perform their mission due to the collapse of various infrastructure caused by the earthquake. The archipelago structure of Japan is easy terrain that provides approach from the shore to any place in the country; this makes it possible to plan effective relief operations. Therefore, in preparing for the next large-scale disaster, the use of a hospital ship has been discussed as one of the strong bases to combat collapse of infrastructure. For effective utilization of the ship, we will discuss the main points collated from experience of past disaster responses and training.
Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P
Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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.
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.
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.
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.
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....
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
Prætorius, Thim; Hasle, Peter; Nielsen, Anders Paarup
departments across four hospitals facing fast to slow response task requirements was carried out using interviews and observations. The selected cases were revealing as the departments had designed and formalized their daily hospital operations differently to solve collaboration and performance issues...... and hospital managers can consider designing bundles of organizational design features to proactively develop and ensure collaboration capable of solving collective tasks and bridging departmental and occupational silos to improve health care delivery. Originality/value: This research article addresses...
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.
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
Attention has increasingly been given to "greening" the environment, that is, to engaging in environmentally responsible behavior. Applied to hospitals, greening is collective interdisciplinary organizational behavior that reduces environmental hazards and overconsumption. An environmental crisis in hospitals is described. A number of individual and group psychological phenomena are detailed to explain the current absence of widespread greening in hospitals. Social and environmental psychology concepts for behavior change are combined to provide a model consisting of hospital administration and staff interventions to green this setting. Successful examples of these interventions are provided.
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
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.
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
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…
Paturas, James L; Smith, Deborah; Smith, Stewart; Albanese, Joseph
Healthcare organisations are a critical part of a community's resilience and play a prominent role as the backbone of medical response to natural and manmade disasters. The importance of healthcare organisations, in particular hospitals, to remain operational extends beyond the necessity to sustain uninterrupted medical services for the community, in the aftermath of a large-scale disaster. Hospitals are viewed as safe havens where affected individuals go for shelter, food, water and psychosocial assistance, as well as to obtain information about missing family members or learn of impending dangers related to the incident. The ability of hospitals to respond effectively to high-consequence incidents producing a massive arrival of patients that disrupt daily operations requires surge capacity and capability. The activation of hospital emergency support functions provides an approach by which hospitals manage a short-term shortfall of hospital personnel through the reallocation of hospital employees, thereby obviating the reliance on external qualified volunteers for surge capacity and capability. Recent revisions to the Joint Commission's hospital emergency preparedness standard have impelled healthcare facilities to participate actively in community-wide planning, rather than confining planning exclusively to a single healthcare facility, in order to harmonise disaster management strategies and effectively coordinate the allocation of community resources and expertise across all local response agencies.
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
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.
Burns, Lawton R; David, Guy; Helmchen, Lorens A
Radical innovation and disruptive technologies are frequently heralded as a solution to delivering higher quality, lower cost health care. According to the literature on disruption, local hospitals and physicians (incumbent providers) may be unable to competitively respond to such "creative destruction" and alter their business models for a host of reasons, thus threatening their future survival. However, strategic management theory and research suggest that, under certain conditions, incumbent providers may be able to weather the discontinuities posed by the disrupters. This article analyzes 3 disruptive innovations in service delivery: single-specialty hospitals, ambulatory surgical centers, and retail clinics. We first discuss the features of these innovations to assess how disruptive they are. We then draw on the literature on strategic adaptation to suggest how incumbents develop competitive responses to these disruptive innovations that assure their continued survival. These arguments are then evaluated in a field study of several urban markets based on interviews with both incumbents and entrants. The interviews indicate that entrants have failed to disrupt incumbent providers primarily as a result of strategies pursued by the incumbents. The findings cast doubt on the prospects for these disruptive innovations to transform health care.
Sterrett, Emily C; Myer, Charles M; Oehler, Jennifer; Das, Bobby; Kerrey, Benjamin T
Objective Study the performance of a pediatric critical airway response team. Study Design Case series with chart review. Setting Freestanding academic children's hospital. Subjects and Methods A structured review of the electronic medical record was conducted for all activations of the critical airway team. Characteristics of the activations and patients are reported using descriptive statistics. Activation of the critical airway team occurred 196 times in 46 months (March 2012 to December 2015); complete data were available for 162 activations (83%). For 49 activations (30%), patients had diagnoses associated with difficult intubation; 45 (28%) had a history of difficult laryngoscopy. Results Activation occurred at least 4 times per month on average (vs 3 per month for hospital-wide codes). The most common reasons for team activation were anticipated difficult intubation (45%) or failed intubation attempt (20%). For 79% of activations, the team performed an airway procedure, most commonly direct laryngoscopy and tracheal intubation. Bronchoscopy was performed in 47% of activations. Surgical airway rescue was attempted 4 times. Cardiopulmonary resuscitation occurred in 41 activations (25%). Twenty-nine patients died during or following team activation (18%), including 10 deaths associated with the critical airway event. Conclusion Critical airway team activation occurred at least once per week on average. Direct laryngoscopy, tracheal intubation, and bronchoscopic procedures were performed frequently; surgical airway rescue was rare. Most patients had existing risk factors for difficult intubation. Given our rate of serious morbidity and mortality, primary prevention of critical airway events will be a focus of future efforts.
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.
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.
Aydan, Seda; Kaya, Sidika
Objectives: To reveal the effect of perception of ethical climate by nurses and secretaries and their level of organizational trust on their whistleblowing intention. Methods: Nurses and secretaries working in a University Hospital in Ankara, Turkey, were enrolled in the study conducted in 2016. Responses were received from 369 nurses and secretaries working at Clinics and Polyclinics. Path analysis, investigation of structural equation models used while multi-regression analysis was also applied. Results: According to the regression model, ethical climate dimensions, profession, gender, and work place had significant impact on the whistleblowing intention. According to Path analysis, ethical climate had direct impact of 69% on whistleblowing intention. It was seen that organizational trust had an indirect impact of 27% on the whistleblowing score when ethical climate had a moderator role. Conclusion: In order to promote whistleblowing in organizations, it is important to keep the ethical climate perception of employees and the level of their organizational trust at high levels. PMID:29805421
Aydan, Seda; Kaya, Sidika
To reveal the effect of perception of ethical climate by nurses and secretaries and their level of organizational trust on their whistleblowing intention. Nurses and secretaries working in a University Hospital in Ankara, Turkey, were enrolled in the study conducted in 2016. Responses were received from 369 nurses and secretaries working at Clinics and Polyclinics. Path analysis, investigation of structural equation models used while multi-regression analysis was also applied. According to the regression model, ethical climate dimensions, profession, gender, and work place had significant impact on the whistleblowing intention. According to Path analysis, ethical climate had direct impact of 69% on whistleblowing intention. It was seen that organizational trust had an indirect impact of 27% on the whistleblowing score when ethical climate had a moderator role. In order to promote whistleblowing in organizations, it is important to keep the ethical climate perception of employees and the level of their organizational trust at high levels.
Full Text Available Yuanlin Song,1,* Yicheng Yang,2,* Wendong Chen,3,4 Wei Liu,2 Kai Wang,2 Xuehai Li,5 Ke Wang,2 Manny Papadimitropoulos,3,6 William Montgomery7 1Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, 2Lilly Suzhou Pharmaceutical Co, Ltd, Shanghai Branch, Shanghai, People's Republic of China; 3Division of Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, 4Normin Health, Toronto, ON, Canada; 5VitalStrategic Research Institute, Shanghai, People's Republic of China; 6Global Health Outcomes Research, Eli Lilly, Indianapolis, IN, USA; 7Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia *These authors contributed equally to this work Aims: To evaluate clinical outcomes and allocation of hospital costs associated with empirical use of vancomycin or linezolid for hospital-acquired pneumonia (HAP in the People's Republic of China. Methods: Hospital episodes including HAP treated by vancomycin or linezolid between 2008 and 2012 in a Chinese tertiary care hospital were retrospectively identified from hospital administrative databases. Propensity score methods created best-matched pairs for the antibiotics. The matched pairs were used for adjusted comparisons on clinical response and allocation of hospital costs. Multiple regression analyses adjusting residual imbalance after matching were performed to confirm adjusted comparisons. Results: Sixty matched pairs were created. Adjusted comparisons between vancomycin and linezolid showed similar clinical response rates (clinical cure: 30.0% versus 31.7%, respectively; P=0.847; treatment failure: 55.0% versus 45.0%, respectively; P=0.289 but a significantly lower in-hospital mortality rate for vancomycin (3.3% versus 18.3%, respectively; P=0.013. After further adjusting for the imbalanced variables between matched treatment groups, the risks of treatment failure associated with the two antibiotics were comparable (odds ratio: 1.139; P=0.308 and there was
AIKEN, MICHAEL; HAGE, JERALD
IN A STUDY OF ORGANIZATIONAL INTERDEPENDENCE, INTERVIEW RESPONSE DATA WERE OBTAINED IN A LARGE MIDWEST CITY FROM 520 STAFF MEMBERS OF TEN PRIVATE AND SIX PUBLIC SOCIAL WELFARE AND HEALTH ORGANIZATIONS PROVIDING SPECIAL SERVICES FOR THE MENTALLY RETARDED. INFORMATION OBTAINED FROM RESPONDENTS WAS POOLED TO REFLECT PROPERTIES OF THE 16…
Lim, Chang Seon
Contrast medium is a very useful tool for X-ray examinations. But contrast medium has some unavoidable adverse reactions. For those patients who have never received contrast medium before, it is impossible to predict whether they will suffer from certain kinds of adverse reactions. Thus, radiologists should use strategies to minimize adverse events and be prepared to promptly recognize and manage any reactions to the contrast media. If a radiologist commits medical malpractice, he will face civil responsibility. Medical malpractice means a tort or breach of contrast that occurs in a medical setting. Medical malpractices happen, despite the efforts of hospital staff. Many courts have applied the traditional doctrine of respondeat superior in actions against organizations for injuries caused by their employees. It is a legal doctrine, which states that an employer is responsible for employee actions performed within the course of the employment. A hospital is an organization for health purposes. An organization may be convicted of an offense committed by an employee of the organization acting in its behalf and within the scope of this office or employment. Organizational liability involves a wide variety of legal issues, including tort liability, wrongful employment practices, personal injury, breach of fiduciary duty, and so on. Many executive directors of organizations are aware of their personal and organizational risks of exposure to legal liabilities. The employer must have the right to control the physical conduct of the employee and must consent to receive the employee's services, while expecting some benefits from the services offered. Therefore, legal liability can be imposed for improper selection, assignment, training, and supervision of employees. In conclusion, the hospital itself has organizational liability for adverse reactions to the contrast medium
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.
Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.
Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous
Mark, Lynette J; Herzer, Kurt R; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I; Berkow, Lauren C; Haut, Elliott R; Hillel, Alexander T; Miller, Christina R; Feller-Kopman, David J; Schiavi, Adam J; Xie, Yanjun J; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W; Mirski, Marek A
Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. We developed a quality improvement program-the Difficult Airway Response Team (DART)-to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had 3 core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a Web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index >40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty
Gish, Liv; Ipsen, Christine; Poulsen, Signe
Researchers advocate that interventions should apply a participatory approach i.e. employee participation. It is also widely recognized that top management’s support is an important part of a successful intervention implementation. Lately there has been a request for multi-level intervention...... momentum and increase chances of successful implementation. Four SMEs participated in the study. The typical intervention construct was that top management initiated the intervention and first line managers had to manage the intervention on a daily basis together with two selected employees who acted as in...... between top management and first line management. The top manager’s most important responsibilities were to ensure that the first line manager understood the purpose of the intervention, and to support the first line manager’s dispositions through the intervention. The first line manager’s most important...
M. Somosi Veres
The business management of most successful companies is a result of the coordinated operation of the processes, organizational structure, supporting systems and employees which make up the organizational capabilities of the company. Within the business processes, this includes development and continuous improvement of key internal rules and regulations, the division of spheres of power and responsibility, the requirements and the operation of fundamental checkpoints for organizational units, ...
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.
Faridi, Adnan; Baloch, Akhtar; Wajidi, Abuzar
This paper examines the impact of modern and traditional training and development programs on the employees of banking sectors' organizational commitment and overall performance within Karachi, Pakistan. Furthermore, the paper explores the causal-effect relationship between organizational commitment's distinctive attributes and T&D program through mediating role of job satisfaction, by particularly looking at the contractual and permanent employees. By combining the strata, convenience, and p...
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
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
Azarmnejad, Elham; Sarhangi, Forogh; Javadi, Mahrooz; Rejeh, Nahid; Amirsalari, Susan; Tadrisi, Seyed Davood
Hospitalized neonates usually undergo different painful procedures. This study sought to test the effects of a familiar auditory stimulus on the physiologic responses to pain of venipuncture among neonates in intensive care unit. The study design is quasi-experimental. The randomized clinical trial study was done on 60 full-term neonates admitted to the neonatal intensive care unit between March 20 to June 20, 2014. The neonates were conveniently selected and randomly allocated to the control and the experimental groups. Recorded maternal voice was played for the neonates in the experimental group from 10 minutes before to 10 minutes after venipuncture while the neonates in the control group received no sound therapy intervention. The participants' physiologic parameters were assessed 10 minutes before, during, and after venipuncture. At baseline, the study groups did not differ significantly regarding the intended physiologic parameters (P > .05). During venipuncture, maternal voice was effective in reducing the neonates' heart rate, respiratory rate, and diastolic blood pressure (P familiar sounds to effectively manage neonates' physiologic responses to procedural pain of venipuncture. © 2017 John Wiley & Sons Australia, Ltd.
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.
Yuseon An, MS, RN; Jiyeon Kang, PhD, RN
Purpose: To identify the relationship between organizational culture and experience of workplace bullying among Korean nurses. Methods: Participants were 298 hospital nurses in Busan, South Korea. We assessed nursing organizational culture and workplace bullying among nurses using structured questionnaires from July 1 through August 15, 2014. Results: Most participants considered their organizational culture as hierarchy-oriented (45.5%), followed by relation-oriented (36.0%), innovatio...
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.
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)...
Valentina Mihaela GHINEA; Constantin BRĂTIANU
The purpose of this paper is to present a conceptual analysis of organizational culture modeling in the framework of system dynamics. Tom Peters and Robert Waterman demonstrated through their seminal research that organizational culture constitutes one of the most important key success factors in any company trying to achieve excellence in its business. Organizational culture is a strong nonlinear integrator of the organizational intellectual capital acting especially on the emotional knowled...
Cook, N.; Yanow, D.
Traditionally, theories of organizational learning have taken one of two approaches that share a common characterization of learning but differ in focus. One approach focuses on learning by individuals in organizational contexts; the other, on individual learning as a model for organizational
Full Text Available Organizational credibility, the extent of which an organization as the source of messages is perceived as trustworthy and reliable, is one important aspect to determine organization’s survival. The perceived credibility of the messages will either strengthen or worsen an organization reputation. The primary objective of this paper is to revisit the concept of organizational credibility and its interaction with organizational outcomes such as organizational reputation. Based on the situational crisis communication theory (SCCT, this paper focuses on the impact of organizational credibility on organizational reputation following a crisis. Even though the SCCT has been widely used in crisis communication research, the theory still has its own limitations in explaining factors that could potentially affect the reputation of an organization. This study proposes a model by integrating organizational credibility in the SCCT theoretical framework. Derived from the theoretical framework, three propositions are advanced to determine the relationships between organizational credibility with crisis responsibility and perceived organizational reputation. This paper contributes to further establishing the SCCT and posits key attributes in the organizational reputation processes..
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.
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.
Robinson, J C
As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership.
Musacchio Adorisio, Anna Linda
This article focuses on organizational remembering in banking. To provide an alternative to the repository image of memory in organization, organizational remembering is conceptualized as narrative, where narrative represents a way to organize the selection and interpretation of the past....... The narrative perspective deals with both the experiential and contextual nature of remembering by addressing concerns raised by critiques of organizational memory studies, namely, the subjective experience of remembering and the social and historical context in which remembering takes place. Antenarrative...... the narrative perspective reveals ruptures and ambiguities that characterize organizational remembering that would remain hidden in the organizational memory studies approach....
Syahril, Syahril; Andini, Isnani Yuli
Internal accountants has critical leverage to encourage hospitals to be involved in activities such as social or corporate social responsibility.This study aims to examines the role of internal accountants in the implementating of corporate social responsibility at RSUD Moh. Anwar Sumenep District. Research uses descriptive (qualitative) approach to interpret and describe data that obtained from observation, interview and documentation. This research concludes that RSUD Moh. Anwar Sumenep Dis...
Crisafulli, Ernesto; Guerrero, Mónica; Menéndez, Rosario; Huerta, Arturo; Martinez, Raquel; Gimeno, Alexandra; Soler, Néstor; Torres, Antoni
Inhaled corticosteroids are anti-inflammatory medications that can down-regulate the immunologic response in patients with COPD; however, their role at onset of COPD exacerbation is still not understood. The aim of this study was to assess the early inflammatory response and clinical presentation of patients with COPD exacerbation mediated by inhaled corticosteroids. Prospective data were collected on 123 hospitalized subjects with COPD exacerbation over a 30-month period at 2 Spanish university hospitals. Based on domiciliary use, comparative analyses were performed between subjects who did not use inhaled corticosteroids (n = 58) and subjects who did (n = 65). Measurements of serum biomarkers were recorded on admission to the hospital (day 1) and on day 3; clinical, physiological, microbiological, and severity data and mortality/readmission rates were also recorded. At days 1 and 3, both groups showed a similar inflammatory response; fluticasone produced lower levels of interleukin-8 compared with budesonide (P clinical features considered were similar in the 2 groups; multivariate analysis predicting clinical complications on hospitalization showed air-flow obstruction severity as the only predictive factor (odds ratio 3.13, 95% CI 1.13-8.63, P = .02). Our study demonstrates a lack of inhaled corticosteroid influence in the early systemic inflammatory response to and clinical presentation of COPD exacerbation. Copyright © 2014 by Daedalus Enterprises.
Full Text Available Abstract Background Little is known about the effects of geographic variation on outcomes of out-of-hospital cardiac arrest (OHCA. The present study investigated the relationship between population density, time between emergency call and ambulance arrival, and survival of OHCA, using the All-Japan Utstein-style registry database, coupled with geographic information system (GIS data. Methods We examined data from 101,287 bystander-witnessed OHCA patients who received emergency medical services (EMS through 4,729 ambulatory centers in Japan between 2005 and 2007. Latitudes and longitudes of each center were determined with address-match geocoding, and linked with the Population Census data using GIS. The endpoints were 1-month survival and neurologically favorable 1-month survival defined as Glasgow-Pittsburgh cerebral performance categories 1 or 2. Results Overall 1-month survival was 7.8%. Neurologically favorable 1-month survival was 3.6%. In very low-density (2 and very high-density (≥10,000/km2 areas, the mean call-response intervals were 9.3 and 6.2 minutes, 1-month survival rates were 5.4% and 9.1%, and neurologically favorable 1-month survival rates were 2.7% and 4.3%, respectively. After adjustment for age, sex, cause of arrest, first aid by bystander and the proportion of neighborhood elderly people ≥65 yrs, patients in very high-density areas had a significantly higher survival rate (odds ratio (OR, 1.64; 95% confidence interval (CI, 1.44 - 1.87; p Conclusion Living in a low-density area was associated with an independent risk of delay in ambulance response, and a low survival rate in cases of OHCA. Distribution of EMS centers according to population size may lead to inequality in health outcomes between urban and rural areas.
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
Bjerregaard, Toke; Jonasson, Charlotte
to the stabilization and maintenance of its institutional opposite. The reported findings are based on an ethnographic field study of the institutional change processes that occurred in a South Korean credit card company in the aftermath of the Asian economic crisis in 1997 during the IMF intervention. The development...... of contradictory logics in the Korean field gave, in some companies, rise to social struggles for defining the direction and aim of the institutional changes....
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…
Hauge, Amalie Martinus
—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 frst allows an analytical expansion to include...
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.
Sujan, Mark A; Chessum, Peter; Rudd, Michelle; Fitton, Laurence; Inada-Kim, Matthew; Cooke, Matthew W; Spurgeon, Peter
Handover across care boundaries poses additional challenges due to the different professional, organizational and cultural backgrounds of the participants involved. This paper provides a qualitative account of how practitioners in emergency care attempt to align their different individual and organizational priorities and backgrounds when handing over patients across care boundaries (ambulance service to emergency department (ED), and ED to acute medicine). A total of 270 clinical handovers were observed in three emergency care pathways involving five participating NHS organizations (two ambulance services and three hospitals). Half-day process mapping sessions were conducted for each pathway. Semi-structured interviews were carried out with 39 participants and analysed thematically. The management of patient flow and the fulfilment of time-related performance targets can create conflicting priorities for practitioners during handover. Practitioners involved in handover manage such competing organizational priorities through additional coordination effort and dynamic trade-offs. Practitioners perceive greater collaboration across departments and organizations, and mutual awareness of each other's goals and constraints as possible ways towards more sustainable improvement. Sustainable improvement in handover across boundaries in emergency care might require commitment by leaders from all parts of the local health economy to work as partners to establish a culture of integrated, patient-centred care. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Weech-Maldonado, Robert; Elliott, Marc N; Pradhan, Rohit; Schiller, Cameron; Dreachslin, Janice; Hays, Ron D
Cultural competency has been proposed as an organizational strategy to address racial/ethnic disparities in the healthcare system; disparities are a long-standing policy challenge whose relevance is only increasing with the increasing population diversity of the US and across the world. Using an integrative conceptual framework based on the resource dependency and institutional theories, we examine the relationship between organizational and market factors and hospitals' degree of cultural competency. Our sample consists of 119 hospitals located in the state of California (US) and is constructed using the following datasets for the year 2006: Cultural Competency Assessment Tool of Hospitals (CCATH) Survey, California's Office of Statewide Health Planning & Development's Hospital Inpatient Discharges and Annual Hospital Financial Data, American Hospital Association's Annual Survey, and the Area Resource File. The dependent variable consists of the degree of hospital cultural competency, as assessed by the CCATH overall score. Organizational variables include ownership status, teaching hospital, payer mix, size, system membership, financial performance, and the proportion of inpatient racial/ethnic minorities. Market characteristics included hospital competition, the proportion of racial/ethnic minorities in the area, metropolitan area, and per capita income. Regression analyses were conducted to assess the relationship between the CCATH overall score and organizational and market variables. Our results show that hospitals which are not-for-profit, serve a more diverse inpatient population, and are located in more competitive and affluent markets exhibit a higher degree of cultural competency. Our results underscore the importance of both institutional and competitive market pressures in guiding hospital behavior. For instance, while not-for-profit may adopt innovative/progressive policies like cultural competency simply as a function of their organizational goals
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
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.
Chapman, Derek S.; Reeves, Paige; Chapin, Michelle
A comprehensive measure of organizational culture was developed using a lexical approach, a method typically employed within the study of personality. 1761 adjectives were narrowed down and factor analyzed, which resulted in the identification of a nine factor solution to organizational culture, including the dimensions of: Innovative, Dominant, Pace, Friendly, Prestigious, Trendy, Corporate Social Responsibility, Traditional, and Diverse. Comprised of 135 adjectives most frequently used in describing organizational culture by current employees of several hundred organizations, the Lexical Organizational Culture Scale (LOCS) was found to predict employee commitment, job satisfaction, job search behaviors, and subjective fit better than earlier scales of organizational culture. PMID:29922200
Ballard, Elizabeth D; Horowitz, Lisa M; Jobes, David A; Wagner, Barry M; Pao, Maryland; Teach, Stephen J
Although validated suicide screening tools exist for use among children and adolescents presenting to emergency departments (EDs), the associations between screening positive for suicide risk and immediate psychiatric hospital admission or subsequent ED use, stratified by age, have not been examined. This is a retrospective cohort study of a consecutive case series of patients aged 8 to 18 years presenting with psychiatric chief complaints during a 9-month period to a single urban tertiary care pediatric ED. Eligible patients were administered a subset of questions from the Risk of Suicide Questionnaire. Outcomes included the odds of psychiatric hospitalization at the index visit and repeated ED visits for psychiatric complaints within the following year, stratified by age. Of the 568 patients presenting during the study period, responses to suicide screening questions were available for 442 patients (78%). A total of 159 (36%) of 442 were hospitalized and 130 (29%) of 442 had 1 or more ED visits within the following year. The proportion of patients providing positive responses to 1 or more suicide screening questions did not differ between patients aged 8 to 12 years and those aged 13 to 18 years (77/154 [50%] vs 137/288 [48%], P = 0.63). A positive response to 1 or more of the questions was significantly associated with increased odds of psychiatric hospitalization in the older age group [adjusted odds ratio, 3.82; 95% confidence interval, 2.24-6.54) and with repeated visits to the ED in the younger age group (adjusted odds ratio, 3.55 95% confidence interval, 1.68-7.50). Positive responses to suicide screening questions were associated with acute psychiatric hospitalization and repeated ED visits. Suicide screening in a pediatric ED may identify children and adolescents with increased need of psychiatric resources.
Ells, Carolyn; MacDonald, Chris
Organizational ethics is an emerging field concerned with the study and practice of the ethical behaviour of organizations. For effective application to healthcare settings, we argue that organizational ethics requires attention to organizations' special characteristics combined with tools borrowed from the fields of business ethics and bioethics. We identify and discuss several implications of this burgeoning field to healthcare organizations, showing how organizational ethics can facilitate policy making, accountability, self-evaluation, and patient and business perspectives. In our conclusion, we suggest an action plan for healthcare organizations to help them respond appropriately to their ethical responsibilities.
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.
Barzekar, Hosein; Karami, Mahtab
to examine the organizational factors affecting the application of information technology in hospitals. Since the organizational factors are one of the most important determinants of successful projects, by understanding their impact and identifying them it can help planning a systematic IT implementation. In this cross-sectional descriptive study 110 middle managers were chosen from teaching hospitals. Structured questionnaire was used for the data collection. There was a significant relationship between organization resource, organizational knowledge, process, management structure and values and goals with implementation of information technology. Findings showed that organizational factors had a considerable impact on implementation of information technology. Top managers must consider the important aspects of effective organizational factors.
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…