The Role of Organizational Culture and Climate in Innovation and Effectiveness

The postgraduate medical educational climate assessed by the Danish Residency Educational Climate Test (DK-RECT): a validation and cross-sectional observational study

BACKGROUND

A good educational climate is essential for delivering high-quality training for medical trainees, professional development, and patient care. The aim of this study was to (1) validate the Dutch Residency Educational Climate Test (D-RECT) in a Danish setting and (2) describe and evaluate the educational climate among medical trainees.

METHODS

D-RECT was adopted in a three-step process: translation of D-RECT into Danish (DK-RECT), psychometric validation, and evaluation of educational climate. Trainees from 31 medical specialties at Copenhagen University Hospital - Rigshospitalet, Denmark were asked to complete an online survey in a cross-sectional study.

RESULTS

We performed a forward-backward translation from Dutch to Danish. Confirmatory factor analysis showed that DK-RECT was robust and valid. The reliability analysis showed that only seven trainees from one specialty were needed for a reliable result. With 304 trainees completing DK-RECT, the response rate was 68%. The subsequent analysis indicated a positive overall educational climate, with a median score of 4.0 (interquartile range (IQR): 3.0-5.0) on a five-point Likert scale. Analysis of the subscales showed that the subscale Feedback received the lowest ratings, while Supervision and Peer collaboration were evaluated highest.

CONCLUSIONS

Psychometric validation of D-RECT in a Danish context demonstrated valid results on the educational climate in specialist training. DK-RECT can be used to evaluate the effectiveness of interventions in the future and can facilitate the conversation on the educational climate.

Planning for Implementation Science in Clinical Practice Research: An Augmentative and Alternative Communication Example

PURPOSE

Most evidence-based clinical research findings in communication sciences and disorders never achieve full implementation by practicing clinicians. To address this almost universal problem, this tutorial focuses on the initial planning steps of including implementation methodologies as part of clinical practice research programs. Integrating the principles and methodologies of implementation science can shift the current reality, leading to better uptake of evidence-based interventions.

METHOD

A step-by-step approach to integrating implementation science into new or existing research projects is provided, including the construction of a logic model, the selection of an implementation framework, and the selection of research methodologies. A detailed example of an augmentative and alternative communication research program is provided to illustrate the process.

CONCLUSIONS

Readily available online tools can help researchers start the process of integrating implementation science into clinical practice research, and existing frameworks can assist with developing and guiding research programs to ensure maximal impact. If the ultimate goal is to improve the daily lives of individuals with communication disorders through the use of evidence-based practices, clinical practice researchers must integrate these approaches into their research programs.

Advancing a cultural change agenda in higher education: issues and values related to reimagining academic leadership

Traditional models of academic leadership are based largely on managerial and transactional approaches. Such efforts frequently support status quo individual success rather than values-based leadership based on collective institutional or sustainability-centered pursuits. Evolved reward systems and leaderships modes that support collective and institution-level effort and innovations prioritizing community and sustainability require new leadership models. Innovative leadership models that transcend traditional gatekeeping are needed and four leadership modes to support innovation and collective efforts are discussed, including shared leadership that draws on distributed contributions of multiple individuals; creative or innovative leadership that requires risk-taking, experimentation, and experiential learning; qualitative leadership that is data-driven and includes evidence-based innovation; and, dynamic leadership based on demonstrated agility and ability to traverse different spaces using diverse modes of doing and thinking. Progressive leaders can move in and out of these modes in response to ecosystem needs, demands, and changes through the use of design thinking and initiatives to support innovation and sustainability in higher education. Success in evolved leadership approaches, including centering sustainability goals that impact institutions themselves and communities in which they exist, require aligning reformed leadership goals and practices with funding models and reward systems, as well as policies and institutional change strategies.

Twelve-month organizational study examining the associations among behavioral healthcare worker's perceptions of autonomy, decision-making power, organizational commitment, and burnout: Reconceptualizing the role of commitment in shaping staff member experiences of the work environment

Previous research has demonstrated that behavioral healthcare workers' experiences of autonomy and decision-making power in the workplace are positively associated with their commitment to the organization and negatively associated with occupational burnout. Models examining the relationships between workplace climate and staff member well-being generally conceptualize workplace climates as predictors of individual commitment and burnout. However, the relationships among these constructs have primarily been explored in cross-sectional study designs. The current study adds to the existing literature by examining the relationships among perceived autonomy and decision-making power in the organizational climate, and individual levels of organizational commitment and burnout over a 12-month period (N = 43). The study was done in a public hospital's behavioral healthcare department in the Western New York region. Cross-lagged panel analyses were conducted to assess if time-one scores on perceived autonomy and decision-making power predicted time-two scores of organizational commitment and burnout. Findings indicate that, contrary to popular conceptualization, individual staff member's commitment to the organization predicted future states of perceived autonomy and decision-making power. Individual commitment to the organization may be a driving factor in how staff members experience and perceive the service environment.

The Effect of Innovative Organizational Climate on Employee Job Satisfaction

Innovation has critical importance in making a difference in the competitive environment of organizations and countries. Organizations that produce similar products or services in the same market need to be innovative to make a difference to their competitors. For increasing innovation in organizations, first of all, the management approach should be in a way that supports innovation. Organizations that determine their organizational policies by considering the demands of the employees within an organizational structure suitable for the modern age and employee expectations are more advantageous in this regard. It is not easy to achieve sustainable success in organizations where employees' ideas are not given importance, and only certain people make decisions and implement them. In this respect, the suggestions put forward by all employees should be considered in solving problems and improving product and service quality. Organizations also need to allocate supporting resources so that employees can improve existing processes or introduce new initiatives. In organizations with an innovative climate, employees are involved in critical processes. Their ideas are considered essential, and financial support is provided for their suggestions and ideas in product development and problem-solving. Although some research on the effects of an innovative climate on organizational performance has been carried out, few studies examined the effects of the innovative climate on employees' attitudes towards work. In this regard, this study it is aimed to examine the impact of innovative climate perception of white-collar employees working at middle and upper levels on job satisfaction. Quantitative research was designed to achieve this aim. A total of 222 employees from the food, textile, and automotive sectors participated in the research. A questionnaire form including scales whose psychometric properties were tested previously and a personal information form was created. The questionnaire form was delivered to the participants online. Within the scope of the research, frequency, internal consistency, factor, independent samples T-test, and correlation analysis were applied. The findings showed a positive and strong correlation between the innovative organizational climate perception of the employees (including the sub-dimensions) and their job satisfaction. The innovative climate perception of the employees did not differ according to the variables such as the position in the organization (middle and lower level) and whether they have a managerial role. The obtained results were discussed, and some research suggestions were made.

Development of an Early Activation Hip Fracture Care Bundle and Implementation Strategy to Improve Adherence to the National Hip Fracture Clinical Care Standard

Objective

To develop and implement a multidisciplinary early activation mechanism and bundle of care (eHIP) to improve adherence to ACSQHC standards in a regional trauma centre.

Methods

Barriers to implementation were categorised using the Theoretical Domains Framework, then linked to specific strategies guided by the Behaviour Change Wheel and Behaviour Change Technique Taxonomy (BCTT). The resulting implementation strategies were assessed using Affordable, Practical, Effective, Acceptable, had Side-effects (APEASE) criteria.

Results

Eighty-three barriers to implementation of the hip fracture care bundle were identified. The behaviour change wheel process resulted in the identification of 41 techniques to address these barriers. The predominant mechanisms to achieve this were development and implementation of 1) formal policy that outlines eHIP roles; 2) video promotion; 3) pager group; 4) fascia iliaca block enabling; 5) eMR modifications; 6) face-to-face reinforcement and modelling; 7) communication and prompts; 8) environmental restructuring.

Conclusion

We applied behaviour change theory through a pragmatic evidence-based process. This resulted in a codesigned strategy to overcome staff and organisational barriers to the implementation of a multidisciplinary early activation mechanism and bundle of care (eHIP). Future work will include evaluation of the uptake and clinical impact of the care bundle.

Research on Knowledge Gap Identification Method in Innovative Organizations under the “Internet+” Environment

Under the “Internet+” environment, the R&D intensity of products and services has increased; hence, organizations need to improve their ability to integrate knowledge and technology resources. Knowledge gaps will arise when an organization’s knowledge reserves fail to meet the needs of innovation activities. This research established a network of complete knowledge topics under the “Internet+” environment based on the Word2Vec model. The word vectors and word frequencies of organizational reserve knowledge texts were analyzed to establish an organizational reserve knowledge topic network. The Term Frequency-Inverse Document Frequency algorithm was used to identify the demanded knowledge topic. The satisfaction capability of demanded knowledge in the reserve knowledge topic network was calculated via the eigenvector centrality and the fuzzy evaluation method. The corresponding strategies were then put forward to make up the knowledge gap. Finally, a case study was conducted and compared with SWOT (Strengths, Weaknesses, Opportunities, and Threats) and Venn diagram analysis on the economic and management college of a university in Beijing to verify the effectiveness of this method.

The mediating role of procedural justice on the relationship between job analysis and employee performance in Jordan Industrial Estates

Job analysis and employees' perception of justice have a significant influence on employee performance within an organization. This study examined the relationships between job analysis, job performance, and procedural justice among local employees in Jordan Industrial Estates. The literature demonstrated gaps in knowledge regarding the relationships between these variables in developing countries, which are intended to be filled by this study. The study drew from the pay model and equity theory. Data were collected with a survey questionnaire from 690 Jordanian employees working in three industrial estates. The data were analyzed through structural equation modelling (SEM) using SPSS and AMOS software tools. The results indicated to a significant positive relationship between job analysis and job performance, job analysis and procedural justice, and a positive relationship between procedural justice and job performance. Also, it is found that procedural justice mediates the relationship between job analysis and job performance. It is expected that the results of this study would have an impact on employee's performance through the fair implementation of one of the human resources practices, namely, job analysis, and thus organizational performance. Also, it contributes to the body of knowledge and supports the mediating role of procedural justice in decisions taken within the organization.

A contemporary understanding of organizational climate in healthcare setting: A concept analysis

AIM

The overarching objective of this report is to provide an updated definition of the concept of organizational climate and to strengthen its operational application.

BACKGROUND

Organizational climate is one of the major contributing factors to the exodus of the nursing workforce from the profession. Extensive research has addressed the impact of "organizational climate" on the nursing workforce; yet variations in the interpretation of the concept calls for an updated definition.

DESIGN

Walker and Avant's strategy was implemented.

DATA SOURCE

Data were compiled from Medline and CINAHL, Google search engine, and book chapters.

REVIEW METHOD

A comprehensive and detailed review of the literature was performed. Nineteen historic publications (1939-2012) and 39 healthcare-related publications (2013-2018) were included in the final review.

RESULTS

The climate of an organization reflects a set of core values and behaviors that can be used to implement evidence-based leadership and management within the context of the 21st century. We have revised the definition of organizational climate to capture this context.

CONCLUSION

The perception of a supportive and constructive climate in an organization propels the workforce, independent of ethnic or personal background, to a higher level of productivity and encourages loyalty and workforce stability.

Aligning workplace wellness with global change: an integrated model

Purpose

The purpose of this study is to present evidence for a new model of change management designed to create a continuous integrated alignment between ongoing external organizational change and the proven internal environmental factors related to employee emotional wellness and workplace engagement that in turn directly impact organizational performance relationships within society and the human condition.

Design/methodology/approach

This research uses a quantitative approach based on both primary and secondary data. The secondary data includes an analysis of the 2018 Public Service Employee Survey of Canada (N = 163,121) conducted by the Government of Canada while the primary data involves a 2018 employee survey conducted by the author of both civilian and sworn police officer employees with the British Columbia division of the Royal Canadian Mounted Police (N = 2,129) as well as a 2019 survey by the author of Corrections Officers at the Kent Maximum Security Institution in Agassiz, British Columbia (N = 174).

Findings

The key findings presented in this paper provide new evidence that correlations between key organizational workplace factors and employee wellness and performance are directly linked to the ability to address rapidly evolving external environmental factors; that traditional change management approaches are often insufficient to create a positive nexus between the results of environmental scanning and internal workplace environments; and that a new holistic model described in this paper can serve as a powerful diagnostic tool for change managers to identify how internal organizational structures, systems and climates can harmonize with external climates including societal expectations, economic and technological change and public policy.

Research limitations/implications

The research findings pertain to about 100,000 employees of the Canadian public service and their readiness to manage well-established external environmental factors based on their rating of key internal environmental factors rated to workplace wellness and employee emotional health. Further research on the topic of external/internal organizational change adaptability is required specific to private sector organizations.

Practical implications

The practical implications of the change management matrix diagnostic model have been proven in earlier beta testing with a group of organizational executives. The presentation of the data in the matrix format resulted in quick and clear identification of major areas of required change. Those changes resulted in improved service delivery, public safety and public trust. A second test was conducted by MBA students successfully applying the matrix model to identify key areas requiring change in various case studies.

Social implications

Society at present has many new expectations of organizational behavior and citizenship as rapid changes in external environments occur including changes to technology, corporate governance, communications, economic conditions, social values, demographics and public policy. A failure by organizations to ensure that their internal environments of corporate culture, structure, systems and the workplace climate are in sync with external change presents major threats to employee and social well-being and organizational success.

Originality/value

A unique model of organizational change management is presented that allows for successfully adapting internal organizational environments to the challenges of meeting rapidly advancing integrated external environmental forces. The result becomes an integrated ecosystem of external and internal environmental forces that offer adaptability to complex and evolving challenges ranging from social, economic, technological and climate change.

Predictors of shared decision making with people who have a serious mental illness and who are under justice supervision in the community

Shared decision making (SDM) can be an effective method for promoting service involvement among persons with serious mental illness (SMI). This survey study sought to identify predictors of positive attitudes toward the use of SDM with people with SMI who are living under probation and parole supervision. Supervising officers' (n = 291) perceptions of the capabilities of supervisees with SMI to contribute to their supervision plans, and their familiarity with recovery-oriented mental health services, were positively associated with attitudes toward using SDM. Training officers in common human goals and mental health recovery may advance SDM with supervisees with SMI.

Predicting Turnover: The Moderating Effect of Functional Climates on Emotional Exhaustion and Work Attitudes

High levels of emotional exhaustion are frequently reported among clinicians working in community mental health settings. This study draws on social exchange theory and examines the relationships between emotional exhaustion and mental health provider work attitudes and turnover, and the moderating effect of functional psychological climates. Data were analyzed using multilevel structural equation modeling in a sample of 311 mental health providers from 49 community mental health programs. Results revealed that emotional exhaustion was negatively related to work attitudes, and the relationship was moderated by functional climates characterized by high levels of cooperation, growth and advancement opportunities, and role clarity. Specifically, the relationship between emotional exhaustion and work attitudes was attenuated for providers working in programs with a more functional psychological climate. Lower work attitudes significantly predicted higher clinician turnover. Results are discussed as they relate to improving climates and enhancing mental health provider and organizational well-being.

Innovation capability in medical sciences universities: A qualitative study of Iran

BACKGROUND

Innovation is a competitive advantage, with its preservation and continuity dependent on the organizational innovation capability. This study was conducted with the aim of determining the innovation capability dimensions and components in medical sciences universities of Iran.

METHODS

The present study is a qualitative study with content analysis approach, undertaken in 2016-2017. The data processing included 10 deep interviews with the experts of the health innovation domain in top management of the three types of the medicine sciences universities of Iran with >5 years of experience. Targeted data sampling was performed using snowball method and continued until the saturation of the data. Data analysis was performed using conventional content analysis method using Maxqda 12 software.

RESULTS

Data analysis resulted in the extraction of 28 categories and 8 main themes including communications and interactions, innovation climate, university setting, policy factors (policy-making, rules and regulations), organizational culture, organizational resources, management and leadership, and organizational learning in two university internal and external dimensions.

CONCLUSION

To accelerate innovation in medical sciences universities, recognizing the potential of innovation capability is essential.

Organizational Culture at a Tertiary Care Center in Saudi Arabia: A Mixed Approach Study

Objective

To explore the prevailing culture among leaders at the King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia, as well as to evaluate the impact of organizational culture from the perspective of employees.

Subjects and methods

Utilizing a convenient sampling method, data were collected at the KFMC, Saudi Arabia, using two research approaches (focus group and cross-sectional). A total of 446 employees participated in this questionnaire-based study, and all questionnaires were analyzed to obtain the final data.

Results

About 51% of the participants were males and 49% were non-Saudi nationals. On a scale of 5 points, the overall score of the KFMC culture assessment was 3.6 (72%). The strongest recognized factor was the enjoyment (3.9/5; 78%). On the other hand, the factor with the lowest score was innovation (3.3/5; 66%).

Conclusion

The culture within an organization is very important. Communicating organizational strategic plans of change to employees and assuring their acknowledgment of the vision can inspire the behavior and attitude of employees at the workplace. This study strikes a note of challenge in some dimensions and items. Top management leaders are recommended to adjust their leadership behavior to focus on these challenges.

The relationship between consumer, clinician, and organizational characteristics and use of evidence-based and non-evidence-based therapy strategies in a public mental health system

We investigated the relationship between consumer, clinician, and organizational factors and clinician use of therapy strategies within a system-wide effort to increase the use of cognitive-behavioral therapy. Data from 247 clinicians in 28 child-serving organizations were collected. Clinicians participating in evidence-based practice training initiatives were more likely to report using cognitive-behavioral therapy when they endorsed more clinical experience, being salaried clinicians, and more openness to evidence-based practice. Clinicians participating in evidence-based practice initiatives were more likely to use psychodynamic techniques when they had older clients, less knowledge about evidence-based practice, more divergent attitudes toward EBP, higher financial strain, and worked in larger organizations. In clinicians not participating in evidence-based training initiatives; depersonalization was associated with higher use of cognitive-behavioral; whereas clinicians with less knowledge of evidence-based practices were more likely to use psychodynamic techniques. This study suggests that clinician characteristics are important when implementing evidence-based practices; and that consumer, clinician, and organizational characteristics are important when de-implementing non evidence-based practices. This work posits potential characteristics at multiple levels to target with implementation and deimplementation strategies.