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Liu Z, Wong H, Liu J. Why do Social Workers Leave? A Moderated Mediation of Professionalism, Job Satisfaction, and Managerialism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:230. [PMID: 36612550 PMCID: PMC9819938 DOI: 10.3390/ijerph20010230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Turnover has been a serious concern to social service organizations. A lack of committed social workers is a risk to organizational performance and service quality. Therefore, it is vital to better understand the leaving process of social work practitioners. The study constructed a moderated mediation model to examine the mediating role of job satisfaction between employees' professionalism and turnover intention and the moderating role of the perceived level of managerialism in the context of social work organizations. A total of 667 participants from Guangzhou, Shenzhen, and Shanghai in China were recruited to complete the survey. Results presented that job satisfaction plays a full mediation role in the relationship between professionalism and turnover intention. In addition, the positive relationship between professionalism and job satisfaction, as well as the negative relationship between professionalism and turnover intention were moderated by managerialism. The findings enrich knowledge about turnover among social workers in the context of China and inspire to foster professionalism among service workers to improve job satisfaction and alleviate turnover intention and actual turnover as well as to apply management techniques and structures properly to strengthen the effect of professionalism on promoting job satisfaction and on preventing turnover intention.
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Affiliation(s)
- Ziyu Liu
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, China
| | - Hung Wong
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, China
| | - Jifang Liu
- School of Finance, Jilin University of Finance and Economics, Changchun 130117, China
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Prenestini A, Sartirana M, Lega F. Involving clinicians in management: assessing views of doctors and nurses on hybrid professionalism in clinical directorates. BMC Health Serv Res 2021; 21:350. [PMID: 33858410 PMCID: PMC8047525 DOI: 10.1186/s12913-021-06352-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hybrid professionalism is one of the most effective ways to involve clinicians in management practices and responsibilities. With this study we investigated the perceptions of doctors and nurses on hybridization in clinical directorates (CDs) in hospitals. METHODS We investigated the attitudes of healthcare professionals (doctors and nurses) towards eight hospital CDs in the Local Health Authority (LHA) of Bologna (Emilia Romagna, Italy) 6 years after their implementation. We used a validated questionnaire by Braithwaite and Westbrook (2004). Drawing on Palmer et al. (2007), we added a section about the characteristics of department heads. In all, 123 healthcare professionals in managerial roles completed and returned the questionnaire. The return rate was 47.4% for doctors and 31.6% for nurses. RESULTS Doctors reported an increase in clinical governance, interdisciplinarity collaboration, and standardization of clinical work. Hybridization of practices was noted to have taken place. While doctors did not see these changes as a threat to professional values, they felt that hospital managers had taken greater control. There was a large overlap of attitudes between doctors and nurses: inter-professional integration in CDs fostered alignment of values and aims. The polarity index was higher for responses from the doctors than from the nurses. CONCLUSION The study findings have implications for policy makers and managers: mission and strategic mandate of CDs; governance of CDs, leadership issues; opportunities for engaging healthcare professionals; changes in managerial involvement during the COVID-19 pandemic. We also discuss the limitations of the present study and future areas for research into hybrid structures.
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Affiliation(s)
- Anna Prenestini
- Department of Economics, Management and Quantitative Methods (DEMM) and Center of Research and Advanced Education in Health Administration (CRC HEAD), Università degli Studi di Milano, Milan, Italy.
| | - Marco Sartirana
- Centre for Research on Healthcare and Social Management (CeRGAS) and SDA Bocconi Government, Health and Not for Profit division, Bocconi University, Milan, Italy
| | - Federico Lega
- Department of Biomedical Sciences for Health (SCIBIS) and Center of Research and Advanced Education in Health Administration (CRC HEAD), Università degli Studi di Milano, Milan, Italy.,Center for Applied Research in Health Economics, Organization and Management, IRCCS Galeazzi, Milan, Italy
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Mæhle PM, Small Hanto IK, Smeland S. Practicing Integrated Care Pathways in Norwegian Hospitals: Coordination through Industrialized Standardization, Value Chains, and Quality Management or an Organizational Equivalent to Improvised Jazz Standards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9199. [PMID: 33317088 PMCID: PMC7764546 DOI: 10.3390/ijerph17249199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/20/2020] [Accepted: 12/04/2020] [Indexed: 11/26/2022]
Abstract
The goal of coordinating pathways for cancer patients through their diagnostic and treatment journey is often approached by borrowing strategies from traditional industries, including standardization, process redesign, and variation reduction. However, the usefulness of these strategies is sometimes limited in the face of the complexity and uncertainty that characterize these processes over time and the situation at both patient and institutional levels. We found this to be the case when we did an in-depth qualitative study of coordination processes in patient pathways for three diagnoses in four Norwegian hospitals. What allows these hospitals to accomplish coordination is supplementing standardization with improvisation. This improvisation is embedded in four types of emerging semi-formal structures: collegial communities, networks, boundary spanners, and physical proximity. The hierarchical higher administrative levels appear to have a limited ability to manage and support coordination of these emerging structures when needed. We claim that this can be explained by viewing line management as representative of an economic-administrative institutional logic while these emerging structures represent a medical-professional logic that privileges proximity to the variation and complexity in the situations. The challenge is then to find a way for emergent and formal structures to coexist.
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Affiliation(s)
- Per Magnus Mæhle
- Institute of Health and Society, Faculty of Medicine, University of Oslo, 0314 Oslo, Norway
- Comprehensive Cancer Centre, Division of Cancer Medicine, Oslo University Hospital, 0450 Oslo, Norway; (I.K.S.H.); (S.S.)
| | - Ingrid Kristine Small Hanto
- Comprehensive Cancer Centre, Division of Cancer Medicine, Oslo University Hospital, 0450 Oslo, Norway; (I.K.S.H.); (S.S.)
| | - Sigbjørn Smeland
- Comprehensive Cancer Centre, Division of Cancer Medicine, Oslo University Hospital, 0450 Oslo, Norway; (I.K.S.H.); (S.S.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
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Fragmented fields: Professionalisms and work settings in Italian management consultancy. JOURNAL OF PROFESSIONS AND ORGANIZATION 2019. [DOI: 10.1093/jpo/joz011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Management consultancy has long been a contested terrain in the sociology of the professions. Although the professionalism of management consultants has always been emphasized by practitioners themselves, the lack of a strong community of peers has been an impediment to their professionalization. In this article, I argue that professionalism is not the outcome of a process of regulation and institutionalization but that it has to be conceived a discourse comprising norms, worldviews, and values that define what is appropriate for an individual to be considered a competent and recognized member of this community. Given the diversity characterizing the field, there are multiple discourses surrounding professionalism of management consultants, and these discourses are shaped by work settings. Work settings are a combination of the type of organization professional partnership or professional service firm and the employment status (employee or self-employed). Drawing on the empirical evidence from various work settings (professional service firms, professional partnership, and self-employment), I investigate four clusters of practitioners identified in 55 biographical and semi-structured interviews conducted with management consultants in Italy. Four types of professionalism emerge from the clusters. Organizing professionalism is the sole professionalism that appears in all work settings. Other discourses (corporate, commercialized, and hybrid professionalism) are context-dependent and more likely to be found in specific work settings.
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van de Riet MCP, Berghout MA, Buljac-Samardžić M, van Exel J, Hilders CGJM. What makes an ideal hospital-based medical leader? Three views of healthcare professionals and managers: A case study. PLoS One 2019; 14:e0218095. [PMID: 31185051 PMCID: PMC6559653 DOI: 10.1371/journal.pone.0218095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/24/2019] [Indexed: 11/29/2022] Open
Abstract
Medical leadership is an increasingly important aspect of hospital management. By engaging physicians in leadership roles, hospitals aim to improve their clinical and financial performances. Research has revealed numerous factors that are regarded as necessary for ‘medical leaders’ to master, however we lack insights into their relative importance. This study investigates the views of healthcare professionals and managers on what they consider the most important factors for medical leadership. Physicians (n = 11), nurses (n = 10), laboratory technicians (n = 4) and managers (n = 14) were interviewed using Q methodology. Participants ranked 34 statements on factors elicited from the scientific literature, including personal features, context-specific features, activities and roles. By-person factor analysis revealed three distinct views of medical leadership. The first view represents a strategic leader who prioritizes the interests of the hospital by participating in hospital strategy and decision making. The second view describes a social leader with strong collaboration and communication skills. The third view reflects an accepted leader among peers that is guided by a clear job description. Despite these differences, all respondents agreed upon the importance of personal skills in collaboration and communication, and having integrity and a clear vision. We find no differences in views related to particular healthcare professionals, managers, or departments as all views were defined by a mixture of departments and participants. The findings contribute to increased calls from both practice and literature to increase conceptual clarity by eliciting the relative importance of medical leadership-related factors. Hospitals that wish to increase the engagement of physicians in improving clinical and financial performances through medical leadership should focus on selecting and developing leaders who are strong strategists, socially skilled and accepted by clinical peers.
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Affiliation(s)
- Merlijn C. P. van de Riet
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- * E-mail:
| | - Mathilde A. Berghout
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Martina Buljac-Samardžić
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Carina G. J. M. Hilders
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Greenfield D, Eljiz K, Butler-Henderson K. It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare Comment on "(Re) Making the Procrustean Bed Standardization and Customization as Competing Logics in Healthcare". Int J Health Policy Manag 2018. [PMID: 29524942 PMCID: PMC5819378 DOI: 10.15171/ijhpm.2017.77] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, 'standardization' and 'customization,' and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being 'competing' logics in healthcare, standardization and customization are long standing 'colluding' logics. Mannion and Exworthy's call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions.
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Affiliation(s)
- David Greenfield
- Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia
| | - Kathy Eljiz
- Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia
| | - Kerryn Butler-Henderson
- Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia
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Mannion R, Exworthy M. (Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare. Int J Health Policy Manag 2017; 6:301-304. [PMID: 28812821 PMCID: PMC5458790 DOI: 10.15171/ijhpm.2017.35] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 03/13/2017] [Indexed: 12/12/2022] Open
Abstract
Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by 'standardization' and 'customization' in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics - the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery.
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Affiliation(s)
- Russell Mannion
- Health Services Management Centre, University of Birmingham, Birmingham, UK
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Olakivi A. Unmasking the enterprising nurse: migrant care workers and the discursive mobilisation of productive professionals. SOCIOLOGY OF HEALTH & ILLNESS 2017; 39:428-442. [PMID: 27611112 DOI: 10.1111/1467-9566.12493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Public care work organisations in Northern Europe often seek to increase their economic efficiency in ways that care workers criticise for reducing both their professional autonomy and the quality of care. Recently, the ideal of 'enterprising nursing' has emerged as a political belief according to which economic efficiency, care workers' autonomy and the quality of care can be improved in tandem by cultivating care workers' agential abilities. This article examines the reception of this belief among migrant care workers in Finland. Drawing on research interviews, the analysis demonstrates how migrant care workers may have difficulties in aligning themselves with the enterprising ideals but also in protesting them. Ethnicity, and the status of a migrant, can offer resources for both constructing enterprising subjectivities and reframing care workers' agency, and their organisational environment, in more critical terms.
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Affiliation(s)
- Antero Olakivi
- Department of social research, University of Helsinki, Finland
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