Building social capital in healthcare organizations: thinking ecologically for safer care

Knowing your team in the intensive care unit: an ethnographic study on familiarity

Effective interprofessional team function is integral to high-quality care in the intensive care unit (ICU). However, little is known about how familiarity develops among teams, which may be an important antecedent to effective team function and quality care. To examine team familiarity and how it impacts ICU team function and care, we conducted an ethnographic study in four ICUs (two medical ICUs, one mixed medical-surgical ICU, and one surgical ICU) in two community hospitals and one academic medical center. We conducted 57.5 h of observation, 26 shadowing experiences, and 26 interviews across the four ICUs sequentially. We used thematic analysis to examine familiarity among the team. We found that ICU team members become familiar with their team through interpersonal, relational interactions, which involved communication, time working together, social interactions, trust, and respect. Our findings underscore the relational aspect of effective teams and demonstrate that time working together, social interactions, communication, developing trust, and respect are pathways to familiarity and optimal team function. Leveraging unique and creative ways to enhance the relational aspects of ICU teams could be an area for future research and lead to improved ICU outcomes.

Patient safety for people experiencing advanced dementia in hospital: A video reflexive ethnography

BACKGROUND

Patient safety for people experiencing dementia in acute hospitals is a global priority. Despite national strategies as well as safety and quality guidelines, how safety practices are enacted within the complexities of everyday work are poorly understood and articulated.

METHODS

Using video reflexive ethnography, this 18-month study was conducted within an inpatient geriatric evaluation and management unit for people experiencing dementia and/or delirium in Australia. Patients, family members, and staff members participated by: allowing researchers to document fieldwork notes and video-record their practices and/or accounts thereof; and/or interpreting video-recordings with researchers to co-analyse and make sense of the data.

RESULTS

Safe care for people experiencing advanced dementia involved: negotiating risk via leadership, teamwork, and transparency; practice-based learning through situated adaptation; managing personhood versus protocols by doing the 'right' thing; joyful and meaningful work; as well as incorporating patient and family voices to do safety together.

CONCLUSION

Patient safety for people experiencing dementia requires continuous responsiveness and prioritising in the context of multiple risks by a staff collective with a shared purpose. Ongoing research to better understand how the nuances of patient safety unfold in everyday complex clinical realities in diverse contexts and with key stakeholders is required.

Impact of a health services innovation university program in a major public hospital and health service: a mixed methods evaluation

Background

While health services and their clinicians might seek to be innovative, finite budgets, increased demands on health services, and ineffective implementation strategies create challenges to sustaining innovation. These challenges can be addressed by building staff capacity to design cost-effective, evidence-based innovations, and selecting appropriate implementation strategies. A bespoke university award qualification and associated program of activities was developed to build the capacity of staff at Australia’s largest health service to implement and evaluate evidence-based practice (EBP): a Graduate Certificate in Health Science majoring in Health Services Innovation. The aim of this study was to establish the health service’s pre-program capacity to implement EBP and to identify preliminary changes in capacity that have occurred as a result of the Health Services Innovation program.

Methods

A mixed methods design underpinned by the Consolidated Framework for Implementation Research informed the research design, data collection, and analysis. Data about EBP implementation capacity aligned to the framework constructs were sought through qualitative interviews of university and health service executives, focus groups with students, and a quantitative survey of managers and students. The outcomes measured were knowledge of, attitudes towards, and use of EBP within the health service, as well as changes to practice which students identified had resulted from their participation in the program.

Results

The Health Services Innovation program has contributed to short-term changes in health service capacity to implement EBP. Participating students have not only increased their individual skills and knowledge, but also changed their EPB culture and practice which has ignited and sustained health service innovations and improvements in the first 18 months of the program. Capacity changes observed across wider sections of the organization include an increase in connections and networks, use of a shared language, and use of robust implementation science methods such as stakeholder analyses.

Conclusion

This is a unique study that assessed data from all stakeholders: university and health service executives, students, and their managers. By assembling multiple perspectives, we identified that developing the social capital of the organization through delivering a full suite of capacity-building initiatives was critical to the preliminary success of the program.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43058-022-00293-3.

Factors of feelings of happiness at work among staff in geriatric care facilities

Aim

To examine the factors influencing feelings of happiness at work among caregivers in geriatric care facilities.

Methods

Self‐reported questionnaires were distributed to caregivers (n = 1396) at 26 geriatric care facilities. The response rate was 68%. The questionnaire had items regarding feelings of happiness at work, professionalism in dementia care (i.e. intrinsic motivation), wage adequacy, and subscales of The Social Capital and Ethical Climate in the Workplace scale (extrinsic motivations), basic attributes, and work and organizational characteristics. Data pertaining to 632 staff members were used in the multivariable logistic regression for the group with high scores on feelings of happiness at work, by sex and occupation.

Results

Higher professionalism in dementia caregiving was more likely to occur in the high‐score groups among all staff (OR 1.21–1.55, P < 0.01). Female nurses and male professional caregivers with higher scores for social capital in the workplace (OR 3.11, P < 0.01; OR = 2.33, P < 0.05) and female professional caregivers with higher scores for ethical leadership (OR 1.78, P < 0.01) were more likely to be in the high‐score group for feelings of happiness at work, whereas male professional caregivers with perceived inadequacy of wages (OR 0.33, P < 0.05) were less likely to be in the high‐score group for feelings of happiness at work.

Conclusions

The findings underlined the important contributory factors of feelings of happiness at work, which could motivate stakeholders to enhance social capital, ethical leadership, and remuneration and other extrinsic rewards to improve staff well‐being. Geriatr Gerontol Int 2021; 21: 818–824.

Work-related burnout among personnel at a university hospital: identifying quantitative and qualitative differences using latent class analysis

BACKGROUND

Burnout among hospital personnel is frequent and has impacts on the quality of care. Monitoring is important, but there is a lack of specificity for individual patterns of burnout syndromes.

AIMS

This study aimed to identify specific burnout profiles in a hospital setting.

METHOD

Using job satisfaction data from a survey of 4793 hospital personnel, we performed a latent class analysis on the work-related items of the Copenhagen Burnout Inventory (CBI). Total burnout score, job satisfaction and work-related variables were compared across classes.

RESULTS

Five latent work-related burnout profiles were revealed, including a high-risk class (9.5% of participants) and two classes with similar total CBI scores: a high-fatigue class (6%), including young administrative personnel who reported less pleasure at work but a better work-life balance, and an emotional-exhaustion class (13.1%), including older healthcare personnel who were more satisfied at work and could use their skills appropriately. Finally, personnel in the high-risk class were younger healthcare professionals, reporting lower job satisfaction, poorer working conditions and less respect from their direct hierarchy.

CONCLUSIONS

The risk and type of burnout depended on personnel's characteristics and their social and work environments. Tailored interventions should be used to address these different profiles.

Prevention of occupational injuries and accidents: A social capital perspective

Prior research has consistently established the pragmatic nature of literature regarding occupational injuries and accidental happenings faced by nursing professionals. However, current realities require a subjective approach to identify preventative measures that could influence occupational health and safety in healthcare sectors. A qualitative design followed a descriptive approach to assess unbiased opinions towards occupational obstructions that lead to accidental happenings. This study used the social capital framework in particular as a support resource to eliminate its detrimental effects on nurse's capacity to serve their patients. The findings extended the fundamental understanding of social capital from social ties to workplace and personal ties as potential mechanisms of support. Healthcare organizations need to redefine their control policies to provide the ultimate support to their care agents. A social capital model offers nursing practitioners and nursing managers an approach for building evidence-based policies with implications for nurse's safety, education and training.

Social Capital: A Concept Analysis

The concept of social capital appears in the literature of multiple disciplines as a social determinant of health, an important aspect of human interaction, and a means to support population health capacity. Little is known about the use of social capital within the context of nursing. This article's aim provides insight into the concept of social capital and nursing. Avant and Walker methodology was used to analyze a sample of 78 articles. Along with a variety of articles and content themes, findings from this concept analysis include critical attributes, an operational definition, and reflections regarding future use.

Measuring social capital of healthcare organizations reported by employees for creating positive workplaces - validation of the SOCAPO-E instrument

Background

In highly segmented and complex healthcare organizations social capital is assumed to be of high relevance for the coordination of tasks in healthcare. So far, comprehensively validated instruments on social capital in healthcare organizations are lacking. The aim of this work is to validate an instrument measuring social capital in healthcare organizations.

Methods

This validation study is based on a cross-sectional survey of 1050 hospital employees from 49 German hospitals which specialize in breast cancer care. Social capital was assessed by a six-item scale. Reliability analyses and confirmatory factor analyses were conducted to determine the content validity of items within the theory-driven one-dimensional scale structure. The scale’s associations with measures of the social aspects of the work environment (identification, social support, open communication climate) were estimated to test convergent validity. Criterion-related validity was evaluated by conducting structural equation modelling to examine the predictive validity of the scale with measures of work engagement, well-being and burnout.

Results

A one-dimensional structure of the instrument could be identified (CFI = .99; RMSEA = .06). Convergent validity was shown by hypothesis-consistent correlations with social support offered by supervisors and colleagues, a climate of open communication, and employee commitment to the organization. Criterion-related validity of the social capital scale was proved by its prediction of employee work engagement (R² = .10–.13 for the three subscales), well-being (R² = .13), and burnout (R² = .06–.11 for the three subscales).

Conclusions

The confirmed associations between social capital and work engagement, burnout as well as well-being stress the importance of social capital as a vital resource for employee health and performance in healthcare organizations. In healthcare organizations this short instrument can be used as an efficient instrument to measure the organizations’ social capital.

A contemporary understanding of nurses' workplace social capital: A response to the rapid changes in the nursing workforce

AIM

To provide an updated definition of the concept of nurses' workplace social capital that addresses changes in the contemporary nursing workforce.

BACKGROUND

Social capital explains the components of a constructive work environment. Advancements in psychology of workplace and changes in the demographic structure of nursing workforce call for a revised version of nurses' workplace social capital.

METHOD

Walker and Avant's approach was implemented. Data were compiled from 'Medline' and 'CINAHL', 'Google' search engine, book chapters and expertise of nursing academicians.

RESULTS

Nurses' workplace social capital is a relational network that is configured by interactions among healthcare professionals. Although, various attributes influence these interactions, Relational Network, Trust, Shared Understanding, Reciprocity and Social Cohesion are considered as the major attributes. A healthy relational network creates a healthy workplace which can be further fortified by effective communication, active group engagements and a supportive leadership.

CONCLUSIONS

Results of our concept analysis should establish a theoretical groundwork for nurse leaders to better build and more effectively lead the contemporary nursing workforce.

IMPLICATION FOR NURSING MANAGEMENT

Leaders' dedication to workplace social capital is the tenet of a constructive workplace, which in return can support nurses to flourish in their clinical and the other professional responsibilities.

Positive aspects of authentic leadership in nursing work: integrative review

ABSTRACT Objective: To identify and analyze the existing scientific production on the positive aspects of authentic leadership in the nurse’s work process. Method: This is an integrative literature review. The databases used were Scientific Electronic Library Online; Latin American and Caribbean Literature on Health Sciences; and National Library of Medicine - National Institutes of Health. Results: In this study, 17 articles were selected for analysis; 1 study (6%) was published in a national journal, and 16 (94%) were international studies. Of the 17 (100%) articles studied, 11 (65%) were developed in Canada. The hospital environment was present in the 17 (100%) articles. Final considerations: Authentic leadership has several positive aspects that significantly influence the nurse’s work process, such as engagement and job satisfaction, retention of new nurses, organizational commitment, among others.

Investigation into the metric properties of the workplace social capital questionnaire and its association with self-rated health and psychological distress amongst Greek-Cypriot registered nurses: cross-sectional descriptive study

Background

Social capital can been described as an individual or a collective attribute, with structural and cognitive components, and a bonding, bridging and linking typology. While extensively studied in the community, studies in occupational settings are sparse by comparison. Furthermore, there is no uniformity in its measurement. This study investigated the construct validity of a Workplace Social Capital questionnaire (WSC), originally developed in the Finnish Public Sector occupational cohort, in a different socio-cultural setting (Cyprus), language (Greek) and occupational group (Registered Nurses). It also explored its criterion concurrent validity according to observed association with self-rated health and psychological distress.

Methods

Participants were 10% of all registered nurses (N = 362) who responded to the 8-item WSC scale during a nationwide educational programme. A unidimensional model was compared with the postulated two-factor (structural vs cognitive) and three-factor model (bonding, bridging, linking) in Confirmatory Factor Analyses. The association with self-rated health (0–100 Visual Analogue Scale) and mental distress (GHQ-12 ≥ 4) was assessed in linear and logistic regression models.

Results

A bonding (Cronbach’s a = 0.76), bridging (a = 0.78) and linking (a = 0.89) structure explained 77.6% of the variance and was a better fit as indicated by goodness of fit indices. Elevated odds of mental distress and poorer self-rated health were observed among participants with the lowest levels of perceived workplace social capital. In adjusted models, associations appeared stronger with bonding social capital (adjOR of mental distress = 2.71 95% CI = 1.08, 6.79) while those with the highest scores rated their health higher by 8.0 points on average (95% CI = 2.1, 13.8). Low linking social capital was also associated with poorer health but no consistent associations were observed with bridging.

Conclusion

While associations appeared stronger with bonding and linking, this may reflect a weakness of the measure to fully capture bridging social capital. Even though, this aspect might need strengthening, the WSC showed good metric properties in a different setting, language and occupational group. Cross-national and cognitive validation studies are needed.

The value of continuing professional development: A realistic evaluation of a multi-disciplinary workshop for health visitors dealing with children with complex needs

BACKGROUND

Continuing Professional Development is important for maintaining and developing knowledge and skills. Evidence regarding direct impact on practice is limited. Existing literature often lacks sufficient detail regarding the initiative or its evaluation, making transferability problematic.

OBJECTIVE

To explore the impact and perceived value of multi-disciplinary Continuing Professional Development workshops for Health Visitors who support families with children with complex health needs.

DESIGN

Realistic Evaluation principles guided the research. Workshop attendees were invited to participate (n.21), 81% (n.17) agreed. Data collection included a questionnaire and semi-structured interviews. Data analysis included descriptive statistics and qualitative thematic analysis.

SETTING

One North of England Health Service Trust.

FINDINGS

Interrelated temporal themes emerged. Before the workshop expectations included, uncertainty regarding content and ambiguity regarding attendance. During workshops comments focused on networking opportunities, the detail, content and facilitation of the learning experience. 'Emotional safety' enabled interaction, sharing and absorption of information, and potentially increased trust, confidence and social capital. Participants viewed the workshop as informative, enhancing insight regarding roles, services and processes. Post-workshop participants reported examples of practice enhancements attributed to workshop attendance including: confidence building; improved team working; facilitation of early referral and accessing additional support for families.

CONCLUSIONS

Findings suggest initiative developers aiming CPD at new or existing teams need to consider nurturing social capital and to pay attention to the context and mechanisms, which can prompt attendance, engagement and subsequent practice application.

The impact of social capital on clinical risk management in nursing: a survey in Iranian public educational hospitals

AIM

This study aimed to explore the social capital impact on clinical risk management from nurses' viewpoints.

DESIGN

This was a cross-sectional and analytical study conduct in six public educational hospitals affiliated to Tehran University of Medical Sciences (TUMS).

METHOD

Questionnaires were used as the data collection tool. Data were analysed using descriptive statistics, parametric and non-parametric tests by SPSS 16 at a significance level of 0.05.

RESULTS

Risk management, social capital and all its three dimensions evaluated in moderate level. It is confirmed that the social capital is one of the factors associated with the improvement of clinical risk management. There was a significant relationship between clinical risk management and social capital. In this respect, hospital managers and decision-makers could enhance clinical risk management by identifying and increasing different dimensions of social capital which consequently led to have a better patient safety culture in hospitals.

The Influence of Supportive and Ethical Work Environments on Work-Related Accidents, Injuries, and Serious Psychological Distress among Hospital Nurses

The healthcare industry in Japan has experienced many cases of work-related injuries, accidents, and workers' compensation claims because of mental illness. This study examined the influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses. Self-reported questionnaires were distributed to nurses (n = 1114) from 11 hospitals. Valid responses (n = 822, 93% women, mean age = 38.49 ± 10.09 years) were used for analyses. The questionnaire included items addressing basic attributes, work and organizational characteristics, social capital and ethical climate at the workplace, psychological distress, and experience of work-related accidents or injuries in the last half year. The final model of a multivariate logistic regression analysis revealed that those who work less than 4 h of overtime per week (OR = 0.313), those who work on days off more than once per month (OR = 0.424), and an exclusive workplace climate (OR = 1.314) were significantly associated with work-related accidents or injuries. Additionally, an exclusive workplace climate (OR = 1.696) elevated the risk of serious psychological distress. To prevent work-related compensation cases, which are caused by these variables, strengthening hospitals' occupational health and safety is necessary.

A qualitative study on the attributes of nurses' workplace social capital in Japan

AIM

To identify attributes of nurses' workplace social capital in Japan.

BACKGROUND

Much attention has been paid to nurses' workplace social capital to improve the quality of the work environment; however, few studies are available on the attributes of nurses' workplace social capital.

METHODS

Semi-structured interviews were conducted with 32 nurses at seven hospitals. Nurses reported on the attributes of workplace social capital, such as characteristics facilitating individual positive action in an organisation, which were qualitatively analysed using the Kawakita Jiro method.

RESULTS

The attributes of nurses' workplace social capital were organised into six groups: affirmation; exchange of appreciation; unrestricted information sharing; ability to trust; access to the strength; and altruistic reciprocity.

CONCLUSION

The attributes of nurses' workplace social capital included a social structure that allowed nurses to make full use of their abilities both vertically and horizontally and were supported by a sense of security. In particular, newly emerged exchange of appreciation and altruistic reciprocity were important for nurses in Japan in building cooperative relationships with others.

IMPLICATIONS FOR NURSING MANAGEMENT

Managing human relationships, such as exchange of appreciation and altruistic reciprocity, in clinical settings based on nurses' workplace social capital may promote positive emotions in the organisation, positive ideas among staff and cooperative teamwork, which may lead to high-quality patient care.

Contributions of the sandwich doctoral program to methodological approaches: an experience report

Objective To share our experience on theoretical and methodological insights we have gained as researchers working together during the Sandwich Doctoral Program. Method This is a descriptive experience report. Results We have incorporated restoration thinking into a study on patient safety culture and will enhance knowledge translation by applying principles of deliberative dialogue to increase the uptake and implementation of research results. Conclusion Incorporating new approaches in Brazilian nursing research plays a key role in achieving international participation and visibility in different areas of nursing knowledge.

Building social capital through breastfeeding peer support: insights from an evaluation of a voluntary breastfeeding peer support service in North-West England

Background

Peer support is reported to be a key method to help build social capital in communities. To date there are no studies that describe how this can be achieved through a breastfeeding peer support service. In this paper we present findings from an evaluation of a voluntary model of breastfeeding peer support in North-West England to describe how the service was operationalized and embedded into the community. This study was undertaken from May, 2012 to May, 2013.

Methods

Interviews (group or individual) were held with 87 participants: 24 breastfeeding women, 13 peer supporters and 50 health and community professionals. The data contained within 23 monthly monitoring reports (January, 2011 to February 2013) compiled by the voluntary peer support service were also extracted and analysed.

Results

Thematic analysis was undertaken using social capital concepts as a theoretical lens. Key findings were identified to resonate with’bonding’, ‘bridging’ and ‘linking’ forms of social capital. These insights illuminate how the peer support service facilitates ‘bonds’ with its members, and within and between women who access the service; how the service ‘bridges’ with individuals from different interests and backgrounds, and how ‘links’ were forged with those in authority to gain access and reach to women and to promote a breastfeeding culture. Some of the tensions highlighted within the social capital literature were also identified.

Conclusions

Horizontal and vertical relationships forged between the peer support service and community members enabled peer support to be embedded into care pathways, helped to promote positive attitudes to breastfeeding and to disseminate knowledge and maximise reach for breastfeeding support across the community. Further effort to engage with those of different ethnic backgrounds and to resolve tensions between peer supporters and health professionals is warranted.

Workplace social capital in nursing: an evolutionary concept analysis

AIM

To report an analysis of the concept of nurses' workplace social capital.

BACKGROUND

Workplace social capital is an emerging concept in nursing with potential to illuminate the value of social relationships at work. A common definition is needed.

DESIGN

Concept analysis.

DATA SOURCES

The Cumulative Index to Nursing and Allied Health Literature, PubMed, PsychINFO and ProQuest Nursing.

REVIEW METHODS

Databases were systematically searched using the keywords: workplace social capital, employee social capital, work environment, social capital and nursing. Sources published between January 1937-November 2012 in English that described or studied social capital of nurses at work were included. A total of 668 resources were found. After removing 241 duplicates, literature was screened in two phases: (1) titles and abstracts were reviewed (n = 427); and (2) remaining data sources were retrieved and read (n = 70). Eight sources were included in the final analysis.

RESULTS

Attributes of nurses' workplace social capital included networks of social relationships at work, shared assets and shared ways of knowing and being. Antecedents were communication, trust and positive leadership practices. Nurses' workplace social capital was associated with positive consequences for nurses, their patients and healthcare organizations.

CONCLUSION

Nurses' workplace social capital is defined as nurses' shared assets and ways of being and knowing that are evident in, and available through, nurses' networks of social relationships at work. Future studies should examine and test relationships between antecedents and consequences of nurses' workplace social capital to understand this important aspect of healthy professional practice environments better.

[The social representations of the process of choosing leaders in the perspective of the nursing team]

This exploratory-descriptive, qualitative study was performed with the objective to analyze the social representation of the process of choosing leaders among nursing workers of a university hospital. The information was obtained through free word association and open interviews. For the purposes of this study, thematic content analysis was performed, guided by the Social Representations Theory. Through this focus the following category emerged: division of the nursing team - the input and output of the process of choosing leaders. The category consists of a crystallization of the social representation of the subject, anchored in elements related to leadership, impartiality, change, knowledge, trust and humanization. The idea of leadership is highlighted as inducing a movement in the division of the team as it is associated with the process of choosing leaders for an environment of communication, suitable for integrating the team and recognizing potential leaders.

A Contingency Approach to the Strategic Management of Intangible Resources

Not with standing the increasing awareness of the importance of intangible resources for the success of organisations, there is a paucity of research investigating the impact of contingent factors on the strategic management of such resources. This research therefore aims to address this issue by investigating the contingencies which come into play in hospital organisations. It does so by using a case study approach to examine the impact of industry-specific and organisation-specific factors on management activities. It was found that factors such as task complexity and staff profile play a significant role in regulated management contexts making the adjustment of existing approaches an indispensable task for general managers who aim to achieve sustainable competitive advantage. The paper contributes to various disciplines. For example, it contributes to the literature on resource management, by proposing a framework for the effective management of intangible resources in the light of the impact of contingent factors.

A face oculta de um processo participativo para escolha de chefias de enfermagem

O estudo discute a articulação das equipes de enfermagem no desenvolvimento de um processo consultivo de escolha de chefias num hospital universitário. Trata-se de pesquisa qualitativa, do tipo exploratória e descritiva. A coleta de dados deu-se por meio de entrevistas com profissionais de enfermagem. Os dados foram analisados utilizando-se a técnica de análise de conteúdo do tipo temática. Através das manifestações dos profissionais, visualizaram-se duas vertentes que representam movimentos de integração e movimentos de separação na trajetória de cada equipe. Em algumas unidades o processo ocorre de forma integrada, norteado pela participação e relações democráticas. Já em outras, o funcionamento grupal é caracterizado pela divisão interna e por um conflito subjacente. Um olhar sobre a totalidade dos setores aponta que as equipes de enfermagem estão em diferentes estágios de evolução nos modos de participação e envolvimento na dinâmica da vida política institucional.

Generating social capital through public health leadership training: a six-year assessment

Social capital, or a sense of partnership leading to shared goals, provides a means for addressing today's public health workforce challenges. This concept is particularly important in underserved rural areas, though efforts to intentionally generate social capital have been limited. Within the rural state of Kansas, the Kansas Public Health Leadership Institute (KPHLI) has implemented a social capital pre/post assessment to quantify the impact of KPHLI training on social capital within the state's decentralized public health system. This paper discusses 38 assessment items related to bonding, bridging and linking social capital. The assessment was completed pre and post training by 130 of 148 scholars (87.8%) in six KPHLI training cycles. Data were analyzed using Wilcoxon paired t-tests in SPSS. Thirty-five of 38 items demonstrated statistically significant increases at post-test, across all 10 sub-domains. Leadership training by the KPHLI fosters quantifiable increases in characteristics of social capital, which are essential for public health systems to cope with increased workforce demands and prepare for accreditation. This study represents a key first step in examining the deliberate generation of social capital within a decentralized rural environment.

New tools for learning: a case of organizational problem analysis derived from debriefing records in a medical center

Purpose

This article aims to present a unique systematic and validated method for creating a linkage between past experiences and management of future occurrences in an organization.

Design/methodology/approach

The study is based on actual data accumulated in a series of projects performed in a major medical center. Qualitative and quantitative content analyses were performed on 158 debriefing documents that were generated during two years. The analyses yielded a dataset which was utilized for cluster analysis to construct an organizational hierarchical risk tree.

Findings

Three major project phases were found to be the most influential: planning, executing, and controlling. The major risk areas identified were found to be those related to the initial work plan, professional responsibility definition, quality control, and communication management.

Research limitations/implications

The study focuses on the aspects of organizational learning and suggests a new interpretation method for debriefing documents and a utilization method to mitigate potential risks. The most important outcome of the synergy was a new ability enabling staff members to improve their qualifications on a continuous basis. However, further research is required to examine the medical center debriefing and risk management from a long‐term perspective.

Originality/value

The current study was conceived during a discussion on the subject of safety improvement, where the impact of human behavior on risk events occurrence was debated. Hence, the paper was dedicated to analyzing the effects of the expanding limits of the prognosis “to err is human”. The method enables organizations to develop a tailored risk mitigation plan based on its accumulated processes and projects lessons‐learned. Although the paper describes a process conducted in a medical center, the method and findings are applicable to many other organizations.

Social capital and risk management in nursing

The purpose of the study was to examine the relationship between social capital and clinical risk management in hospitals from nurses' perspective. The results of our investigation suggest that higher values of social capital are associated with better ratings in clinical risk management behavior. An established atmosphere of trust and a feeling of common values and convictions can help nurses integrate clinical risk management into their daily work.

The relationship between social capital in hospitals and physician job satisfaction

BACKGROUND

Job satisfaction in the hospital is an important predictor for many significant management ratios. Acceptance in professional life or high workload are known as important predictors for job satisfaction. The influence of social capital in hospitals on job satisfaction within the health care system, however, remains to be determined. Thus, this article aimed at analysing the relationship between overall job satisfaction of physicians and social capital in hospitals.

METHODS

The results of this study are based upon questionnaires sent by mail to 454 physicians working in the field of patient care in 4 different German hospitals in 2002. 277 clinicians responded to the poll, for a response rate of 61%. Analysis was performed using three linear regression models with physician overall job satisfaction as the dependent variable and age, gender, professional experience, workload, and social capital as independent variables.

RESULTS

The first regression model explained nearly 9% of the variance of job satisfaction. Whereas job satisfaction increased slightly with age, gender and professional experience were not identified as significant factors to explain the variance. Setting up a second model with the addition of subjectively-perceived workload to the analysis, the explained variance increased to 18% and job satisfaction decreased significantly with increasing workload. The third model including social capital in hospital explained 36% of the variance with social capital, professional experience and workload as significant factors.

CONCLUSION

This analysis demonstrated that the social capital of an organisation, in addition to professional experience and workload, represents a significant predictor of overall job satisfaction of physicians working in the field of patient care. Trust, mutual understanding, shared aims, and ethical values are qualities of social capital that unify members of social networks and communities and enable them to act cooperatively.