Social identification: linking high performance work systems, psychological empowerment and patient care

Content Validity of Assessment Instrument for High-Performance Work Systems in Health Care Industry

Background and Purpose: The main purpose of this article is to content validate and evaluate a measuring instrument of high-performance work systems (HPWS) in healthcare organizations that capture the nurses' perception of HPWS present in their working organization. Methods: A panel of six experts participated to validate the HPWS instrument through their feedback. Later, coding and recoding of expert feedback were performed to calculate the item content validity index (I-CVI), scale content validity index (S-CVI), and Kappa statistic coefficient (K*) to rate its content validity. Results: For 50 out of 52 items of the measuring instrument, I-CVI is well above the recommended minimum acceptable value of .78. The S-CVI value is observed as .94, and the K* value is above .74 for 50 items. Conclusion: The results indicated excellent content validity for all the domains indicating evidence that the HPWS scale and the items on it are content valid and can be used for nursing research in the healthcare industry.

High-performance work practices and employee wellbeing: organizational identification as a mediator

AIM

The aim of this study was to examine how high-performance work practices affect engagement and workplace bullying, two different aspects of employee wellbeing. Furthermore, the study sought to examine the potential mediating role of organizational identification in these relationships.

METHOD

A two-wave survey study (n = 213) was conducted among psychologists in Finland.

RESULTS

The results showed that high-performance work practices (HPWPs) were positively associated with engagement and negatively associated with the risk of workplace bullying. Moreover, organizational identification acted as mediator of the HPWPs-engagement relationship, though alongside the significant indirect effect via organizational identification there was also a significant direct effect of HPWPs on engagement.

DISCUSSION

The study adds knowledge to ongoing debates on whether HPWPs support or undermine employee wellbeing. In particular, it extends our understanding of the association between HPWPs and relationship wellbeing, a topic that has so far received scant attention. Furthermore, the study advances our understanding of explanatory mechanisms in the HPWPs-engagement relationship and points to the importance of organizational identification for explaining why HPWPs lead to higher engagement.

Work-related Communication Mediates the Relationship between Perceived Diversity Climate and Psychological Empowerment among Part-time Nurses: A Cross-sectional Study

AIM

This study investigates which work-related communication mediates the relationship between diversity climate and psychological empowerment among part-time nurses.

BACKGROUND

Part-time nurses' high psychological empowerment is desirable because it may lead to high quality nursing practice.

METHODS

Anonymous self-report questionnaires or web-based surveys were used to measure diversity climate (Climate for Inclusion Scale), psychological empowerment (Japanese version of the Psychological Empowerment Scale), and work-related communication (scale developed in this study). The respondents were part-time nurses from departments with shift work in six Japanese hospitals having over 200 beds. The surveys were conducted from September to October 2020. Multiple regression analyses and a significance test of indirect effects were then conducted.

RESULTS

Among the work-related communication components, "expressing thoughts about their work" fully mediated the relationship between diversity climate and psychological empowerment.

CONCLUSIONS

It is important for part-time nurses to be actively "expressing thoughts about their work" to enhance their psychological empowerment. Positive diversity climate is also important because it allows part-time nurses to express their thoughts regarding work.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers can enhance part-time nurses' psychological empowerment by encouraging them to express their work-related opinions based on the diversity climate.

Challenging experiences differentiation: a theoretical framework of its implications for work units

Purpose

Previous research has provided substantial attention to how individual-level challenging experiences lead to individual- and organization-related outcomes. This paper aims to expand existing challenging experiences theory and research by proposing a theoretical framework that addresses how challenging experiences differentiation relates to work unit effectiveness.

Design/methodology/approach

The authors integrate the literature on challenging experiences with that of work unit identification and citizenship behavior to shed light on the intervening mechanisms through which challenging experiences differentiation relates to work unit effectiveness.

Findings

The authors’ theoretical framework proposes that challenging experiences differentiation diminishes work unit effectiveness through the mediating roles of variation in work unit identification and variation in citizenship behavior among unit members.

Originality/value

By linking challenging experiences differentiation and work unit effectiveness, the authors’ framework highlights the importance of studying challenging experiences at the unit level of analysis.

Leadership empowering behaviour as a predictor of employees' psychological well-being: Evidence from a cross-sectional study among secondary school teachers in Kohat Division, Pakistan

In this technologically developed scenario, many organizations in developing countries including Pakistan have expanded the enthusiasm for understanding and creating an encouraging administrative and managerial environment. Numerous organizations are struggling for structural changes by deserting the old-fashioned organizational management style and implementing an empowering leadership where leaders give more authority to subordinates in decision making and responsibilities with the aim to increase organizational productivity. Therefore, the study examined the leadership empowering behaviour as a predictor of employees’ psychological well-being of the educational institutions at secondary level in Kohat Division, Pakistan. A total sample of 564 secondary school teachers (male n = 379; female n = 185) was carefully chosen through a stratified random sampling technique. In this study, a non-experimental predictive correlational design was adopted. In order to collect data from the participants, two different standardized research tools i.e., the Leader Empowering Behaviour Questionnaire and Ryff’s Psychological Well-being Scale were used. After the collection of data, it was analyzed on the basis of mean, standard deviation, Pearson’s product-moment correlation, and multiple linear regression model. In conclusion, the study confirmed a significant positive correlation between leadership empowering behaviour and employees’ psychological well-being. Leadership empowering behaviours predict employees’ psychological well-being positively. Therefore, it was recommended that empowering behaviour might be adopted by the school leaders to improve the employees’ psychological well-being for better organizational productivity.

Emotional intelligence: predictor of employees' wellbeing, quality of patient care, and psychological empowerment

BACKGROUND

The study explored the role of emotional intelligence (EI) on employees' perceived wellbeing and empowerment, as well as their performance, by measuring their quality of care.

METHODS

The baseline data for the present project was collected from 78 staff of a Victorian aged care organization in Australia. Self-administered surveys were used to assess participants' emotional intelligence, general well-being, psychological empowerment, quality of care, and demographic characteristics. The model fit was assessed using structural equation modelling by AMOS (v 24) software.

RESULTS

The evaluated model confirmed that emotional intelligence predicts the employees' psychological empowerment, wellbeing, and quality of care in a statistically significant way.

CONCLUSIONS

The current research indicates that employees with higher EI will more likely deliver a better quality of patient care. Present research extends the current knowledge of the psychological empowerment and wellbeing of employees with a particular focus on emotional intelligence as an antecedent in an under-investigated setting like aged care setting in Australia.

Empowerment and Employee Well-Being: A Mediation Analysis Study

This study examines the relationship between structural and psychological empowerment and its effects on employees’ psychological, physical, and social well-being. Despite the quantity of previously published works, empirical evidence about these relationships in the workplace is scarce. We developed a mediation model in which structural empowerment predicts employee well-being via psychological empowerment. We based our study on the EU-27 data from the 6th European Working Conditions Survey (EWCS). Data were collected from a questionnaire administered face-to-face to a random sample of employees and the self-employed representative of the working population in the European Union (number of valid responses in this study: 23,468). The effects of the relationships among the variables considered were evaluated using Partial Least Squares (PLS). Results indicate that structural empowerment was positively related to psychological empowerment, which was positively related to job satisfaction, work engagement, and social well-being. The expected relationships for work stress and physical well-being were not found.

Developments in the HRM–Performance Research stream: The mediation studies

Testing Human Resource Management (HRM)’s effect on organisational performance has been a core part of HRM research over the past 25 years. Whereas pioneering studies in the field neglected the mechanisms explaining this relationship, treating it as a ‘black box’, in the last decade the focus has been on examining the mediators of this relationship. Most recently, a series of reviews has been more critical of the field, particularly highlighting its diversity and underplaying of employee involvement, a concern central to its inception. This paper assesses these mediation studies in the light of these concerns, which provide criteria by which I summarise them and assess the extent to which they have advanced the field. The analysis demonstrates that the main problems of the black-box studies remain: the misalignment of the use of additive indexes and the theory of synergistic relationships, confusion over analysis methods, inadequate justification of the selection of practices in the empirical investigations, and under-representation of employee involvement. The researchers continue to present the field as a unified one. However, since the majority of studies are centred on high-performance work systems, there is a clear schism across them between these studies and those centred on high-involvement management. The paper reinforces the importance of this distinction, on the basis that a high-performance work system is a technology, a set of sophisticated personnel practices, whereas high-involvement management is a managerial philosophy or orientation towards fostering employee involvement. The paper concludes by suggesting ways of overcoming the recurring problems in HRM–performance research, and how these vary between the two perspectives.

Hearing the Voices of Wingless Angels: A Critical Content Analysis of Nurses' COVID-19 Experiences

The world has been affected by an outbreak of the novel coronavirus (COVID-19). Health care workers are among those most at risk of contracting the virus. In the fight against the coronavirus, nurses play a critical role. Still, most social media platforms demonstrate that nurses fear that their health is not being prioritized. The purpose of this study is to investigate nurses' experiences through analyzing the main themes shared on Instagram by nurses during the COVID-19 pandemic. In contrast with highly structured research, the current paper highlights nurses' natural language use in describing their experiences during the first months of the outbreak in their workplace. Instagram captions were utilized as a data source. Leximancer was utilized for the content analysis of nurses' narratives towards their coronavirus experience. We sought to accomplish three research objectives: the first was to identify the main themes in the descriptions of nurses' experiences shared via their social media, specifically Instagram; then, to determine the relationships among concepts, and finally, to give useful implications based on the findings. The current study uses a qualitative (i.e., narratives) approach to analyze the main components of the nurses' experiences during the pandemic. The Leximancer software analysis revealed nine major textual themes and the relationships among these themes. In order of the relative importance, the themes were "patients", "coronavirus", "exhaustion", "family", "hospital", "personal protective equipment" (PPE), "shift", "fear", and "uncertainty". The results offer practical implications based on the social media information regarding nurses' overall experiences.

Link of Patient Care Outcome to Occupational Differences in Response to Human Resource Management: A Cross-Sectional Comparative Study on Hospital Doctors and Nurses in China

This study assessed the link of patient care outcome to occupational differences in response to human resource management. A cross-sectional survey was conducted in three large regional hospitals in China. A total of 700 questionnaires were distributed to doctors, nurses, allied health workers, and managers and 499 (71%) were completed. Data were analyzed using a final sample of 193 doctors and 180 nurses. Quality of patient care was rated by the participants using a modified version of the Victorian Patient Satisfaction Questionnaire. Human resource management was measured on seven aspects: job security, recruitment, training, transformational leadership, information sharing, job quality, and teams. The differences between doctors and nurses in response to the human resource management practices and their associations with quality of care were compared through independent samples t-tests, correlational analyses, and moderator regressions. Doctors gave a higher rating on quality of patient care than their nurse counterparts. ‘Training’, ‘transformational leadership’, and ‘information sharing’ were more likely to be associated with higher ratings on quality of patient care in nurses. By contrast, a greater association between ‘teams’ and quality of patient care was found in doctors. Although doctors and nurses in China are exposed to the same hospital management environment, professional differences may have led them to respond to management practices in different ways.

Employee organizational commitment and hospital performance

BACKGROUND

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.

PURPOSE

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.

METHODOLOGY/APPROACH

To examine the interrelationships between the provision of adequate facilities, EOC, and hospital performance, the study utilizes a survey of hospital managers.

RESULTS

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.

CONCLUSION

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.

PRACTICE IMPLICATIONS

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.

Using embeddedness theory to explain self-initiated expatriation intention of entry-level job applicants

Purpose

The purpose of this paper is to explain why entry-level job applicants intend to leave their home country to work abroad by adopting the framework of country embeddedness (i.e. career and community embeddedness).

Design/methodology/approach

Hypotheses are tested using survey data of a sample of prospective healthcare entry-level job applicants (i.e. last year medical students) using hierarchical regression analyses and bootstrapping procedures.

Findings

Results show that, first, home country career and community embeddedness are negatively associated with self-initiated expatriation intention (SIE-intention). Second, developmental feedback reduces SIE-intention. This relationship is at least partly due to increased home country career embeddedness. Third, national identity reduces SIE-intention. The relationship is at least partly due to increased home country community embeddedness.

Originality/value

This paper advances the understanding of SIE by focusing on home country factors associated with the decision to work abroad, whereas the majority of current research mainly considers host country variables.

Decision-making participation eulogizes probability of behavioral output; job satisfaction, and employee performance (evidence from professionals having low and high levels of perceived organizational support)

Purpose

The purpose of this paper is to test social exchange in the presence of perception about organizational support theory.

Design/methodology/approach

Data have been collected through a questionnaire survey at a primary level and were analyzed primarily by smartPLS.

Findings

Results show that all relationships among study variables are highly responsive to the perception about organizational support. Nonmonetary rewards create reciprocity of employee performance (EP), but their magnitudes get affected where practioners need to pay specific attention on employee perception about organizational discretionary arrangements.

Research limitations/implications

The sample size for this study was taken only 10 percent from the top ten banking organizations and these organizations were selected from three big cities only including two provincial capitals. Purposive/judgmental sampling technique is being used for the data collection purpose. As moving out from these cities earning opportunities, langue and behaviors are different; so, the results cannot be generalized to the entire country and other industries.

Practical implications

All managers who are intended and assigned for the increase in overall firms’ performances can achieve their targets and goals by focusing on decision-making participation (DMP) through job satisfaction. Further to this, in order to increase the strength of exchange relationship where firms can introduce DMP to increase employees’ performance, perception about organizational support (if it is to be focused) to its workers well-being can yield and induce employees to perform more.

Originality/value

This study ensures researchers not to forget to check the impact of perceived organizational support during a discussion on social exchange and more specifically nonmonetary part of the exchange. This study suggests the way to increase employee outcomes is by focusing on the employee perception about the organizational care about them and involving them in DMP which does not involve any monetary benefits and ultimately managers and organizations can concentrate on these points to have the overall increase in EP, while keeping themselves in limited or available budgets/resources.

A path analysis study of factors influencing hospital staff perceptions of quality of care factors associated with patient satisfaction and patient experience

Background

Hospital staff are interested in information on patient satisfaction and patient experience that can help them improve quality of care. Staff perceptions of quality of care have been identified as useful proxies when patient data are not available. This study explores the organizational factors and staff attitudes that influence staff perceptions of the quality of the care they provide in relation to patient satisfaction and patient experience.

Methods

Cross sectional survey completed by 258 staff of a large multi-campus, integrated metropolitan hospital in Australia. Structured equation modelling was used to analyse the data.

Results

Our data suggest that different perceived organizational factors and staff attitudes contribute to different pathways for patient satisfaction and patient experience indicators. Hospital staff in our sample were more likely to indicate they provided the care that would result in higher patient satisfaction if they felt empowered within a psychologically safe environment. Conversely their views on patient experience were related to their commitment towards their hospital. There was no relationship between the staff perceptions of patient satisfaction and the staff response to the friends and family test.

Conclusions

This study provides empirical evidence that staff perceptions of the quality of care they provide that is seen to be related to patient satisfaction and patient experience are enacted through different pathways that reflect differing perceptions of organizational factors and workplace psychological attitudes.

Electronic supplementary material

The online version of this article (10.1186/s12913-017-2718-x) contains supplementary material, which is available to authorized users.

Understanding the perspectives of health service staff on the Friends and Family Test

Objectives The present study was designed to determine what staff consider when asked to respond to the Friends and Family Test question. Methods Over 300 health service staff responded to an online questionnaire exploring whether they would recommend treatment at their organisation to friends and family (Friends and Family Test). Results Staff identified staff attitudes and behaviours, the busyness of the health service and quality of care as themes that affected their recommendation. A considerable number of staff also identified factors largely outside the control of the health service as influencing their response. Conclusions Majority of respondents based their perceptions on personal expectations, with smaller numbers citing personal experience and hearsay. Staff would need to see changes both in the quality of care and management practice to amend their recommendation on the Friends and Family Test. What is known about the topic? The Friends and Family Test is seen as a useful tool to gather the opinions of patients and staff on the patient experience, yet there has been little validation of this question. What does this paper add? The present study suggests that, as currently worded, the question does not reliably report staff perceptions regarding patient experience. The study illustrates that the relationship with the organisation and perceptions of effective management are linked to staff responses. What are the implications for practitioners? The Family and Friends Test question may need to be more clearly focused to gather the desired information. Improvement on this indicator is only likely to be seen when management teams are meeting the expectations of staff for good management practice.

Empirical exploration of brilliance in health care: perceptions of health professionals

Objective The aim of the present study was to develop a positive organisational scholarship in health care approach to health management, informed by health managers and health professionals' experiences of brilliance in health care delivery. Methods A sample of postgraduate students with professional and/or management experience within a health service was invited to share their experiences of brilliant health services via online discussions and a survey running on the SurveyMonkey platform. A lexical analysis of student contributions was conducted using the individual as the unit of analysis. Results Using lexical analysis, the examination of themes in the concept map, the relationships between themes and the relationships between concepts identified 'care' as the most important concept in recognising brilliance in health care, followed by the concepts of 'staff' and 'patient'. Conclusions The research presents empirical material to support the emergence of an evidence-based health professional perspective of brilliance in health management. The findings support other studies that have drawn on both quantitative and qualitative materials to explore brilliance in health care. Pockets of brilliance have been previously identified as catalysts for changing health care systems. Both quality, seen as driven from the outside, and excellence, driven from within individuals, are necessary to produce brilliance. What is known about the topic? The quest for brilliance in health care is not easy but essential to reinvigorating and energising health professionals to pursue the highest possible standards of health care delivery. What does this paper add? Using an innovative methodology, the present study identified the key drivers that health care professionals believe are vital to moving in the direction of identifying brilliant performance. What are the implications for practitioners? This work presents evidence on the perceptions of leadership and management practices associated with brilliant health management. Lessons learned from exceptionally well-delivered services contain different templates for change than those dealing with failures, errors, misconduct and the resulting negativity.

Leadership empowering behaviour, psychological empowerment, organisational citizenship behaviours and turnover intention in a manufacturing division

Orientation: Employees’ perceptions of their leaders’ behaviour play a role in creating empowering environments where employees are willing to do more than what is expected, with retention of employees as a result.Research purpose: The aim of this study was to theoretically conceptualise and empirically determine the relationships between employees’ perception of their leaders’ empowering behaviour, psychological empowerment, organisational citizenship behaviours and intention to leave within a manufacturing division of an organisation.Motivation for the study: In the ever-changing work environment, organisations must capitalise on their human capital in order to maintain competitiveness. It is therefore important to identify the role of employees’ perception of leadership in contributing to the establishment of an environment where employees feel empowered, are willing to do more than what is expected and want to stay in the organisation.Research design, approach and method: A non-experimental, cross-sectional survey design was used. The total population (N = 300) employed at the manufacturing division was targeted. Two hundred completed questionnaires were obtained. The Leader Empowering Behaviour Questionnaire, Measuring Empowerment Questionnaire, Organisational Citizenship Behaviour Questionnaire and Intention to Leave Scale were administered.Main findings: Employees’ perception of their leaders’ empowering behaviour (keeping employees accountable, self-directed decision-making and people development), psychological empowerment (attitude and influence) and organisational citizenship behaviours (loyalty, deviant behaviour and participation) predict intention to leave the organisation.Practical/managerial implications: Organisations should foster the elements of a positive organisation, in this case leader empowering behaviours, if they want to retain their employees.Contribution/value-add: The results of this research contribute to scientific knowledge about the positive effects of employees experiencing their leaders as empowering.