Social capital and knowledge sharing: effects on patient safety

Association between cultural capital and health literacy during the COVID-19 pandemic among community residents in China: the mediating effect of social capital

Background

Health literacy is crucial for managing pandemics such as COVID-19 and maintaining the health of the population; our goal was to investigate the impact of cultural capital on health literacy during the COVID-19 pandemic among community residents and to further examine the mediating role of social capital in the relationship between cultural capital and health literacy.

Methods

A cross-sectional study was conducted among 1,600 community residents selected in Chongqing, China using a stratified random sampling method. Data were gathered through a questionnaire survey, including sociodemographic characteristics, cultural capital, social capital, and health literacy. Chi-square analysis, one-way ANOVA, t-test, and hierarchical linear regression were used to analyze the level of health literacy among community residents and the related elements; the structural equation model (SEM) was used to explore the influential mechanisms of health literacy and explore whether social capital acted as a mediator in the relationship between cultural capital and health literacy.

Results

Cultural capital, community participation, community trust, reciprocity, and cognitive social capital had a significant positive effect on health literacy. In addition, the results of SEM indicated that cultural capital not only directly influences health literacy (β = 0.383, 95% CI = 0.265-0.648), but also indirectly influences health literacy through three types of social capital (β = 0.175, 95% CI = 0.117-0.465; β = 0.191, 95% CI = 0.111-0.406; β = 0.028, 95% CI = 0.031-0.174); its mediating effect accounting for 50.7% of the overall effect.

Conclusions

Our results highlight the empirical link between cultural capital and health literacy, and suggest that social capital mediates this connection. These findings suggest that governments and communities should focus on the construction of community cultural capital and provide residents with better social capital to improve their health literacy to prepare for future pandemics.

Understanding Social Media Usage at Work from the Perspective of Social Capital Theory

With the pervasive use of social media (SM) in organizations, it is regarded as a relevant driver that can influence an employee’s job performance. This study fills in the gap that extends the job performance concept by discovering the role of SM in innovative performance in introducing new ideas beyond standard specifications to produce novel and valuable organizational outcomes. By adopting the social capital theory (SCT), the present study investigates the roles of social media use at work in predicting social capital (network ties, shared vision, and trust) that might promote work engagement and subsequently affect employees’ innovative job performance. The data was collected through an online survey, and 291 Malaysian employees participated. The partial least square structural equation modelling (PLS-SEM) technique was applied in data analysis for the measurement model and structural model used in this study. Findings show that SM use at work significantly predicts network ties, shared vision, and trust. Besides, network ties and trust positively promoted work engagement except for shared vision. Subsequently, work engagement was associated with innovative job performance. This study provides theoretical and practical implications for extending knowledge, as well as mitigating plans and efforts to resolve employees’ performance concerning the issues of SM use at work.

Governance for Patient Safety: A Framework of Strategy Domains for Risk Management

BACKGROUND

Adverse events in healthcare are primarily due to system failures rather than individuals. Risk reduction strategies should therefore focus on strengthening systems, bringing about improvements in governance, and targeting individual practices or products. The purpose of this study was to conduct a scoping review to develop a global framework of management strategies for sustaining a safety-oriented culture in healthcare organizations, focusing on patient safety and the adoption of good safety-related practices.

METHODS

We conducted a search on safety-related strategies in 2 steps. The first involved a search in the PubMed database to identify effective, broadly framed, cross-sector domains relevant to clinical risk management strategies in healthcare systems. In the second step, we then examined the strategies adopted by running a scoping review for each domain.

RESULTS

Our search identified 8 strategy domains relevant to patient safety: transformational leadership, patient engagement, human resources management quality, innovation technology, skills certification, education in patient safety, teamwork, and effective communication.

CONCLUSIONS

This scoping review explores management strategies key to healthcare systems' efforts to create safety-oriented organizations. Improvement efforts should focus particularly on the domains identified: combined together, they would nurture an overall safety-oriented culture and have an impact on preventable adverse events.

A conceptual model of nurses' workplace social capital: a theory synthesis

BACKGROUND

Research has confirmed the importance of workplace social capital in the nursing workforce. Integration of the empirical evidence about nurses' workplace social capital into a scientific collection can provide a comprehensive presentation of this concept. This scientific collection can be a conduit for further research and advancement of nursing management and leadership. The purpose of this paper, therefore, is to discuss the process of developing a conceptual model of nurses' workplace social capital, an effective and concise approach to illustrate a scientific phenomenon.

METHODS

The model of nurses' workplace social capital was developed following Walker and Avant's strategy of theory synthesis. Empirical evidence relevant to nurses' workplace social capital was synthesized by systematically examining the existing literature. PubMed, CINAHL, Web of Science and Google Scholar were searched periodically from October 2017 to July 2020.

RESULTS

Our proposed conceptual model lays out the determinants and outcomes of nurses' workplace social capital and specifies the relational statements among these concepts. Nurses' workplace social capital is influenced by the organizational and individual determinants shaped by multiple layers of sub-concepts. The development and implementation of nurses' workplace social capital has three themes of consequences: 1) nurses' outcomes; 2) patients' outcomes; and 3) organizational outcomes. All the concepts and statements have been organized and aligned with the principles of "inventory of determinants or results" and "theoretical blocks".

CONCLUSION

Our theoretical synthesis offers a comprehensive picture of the current knowledge of nurses' workplace social capital. Efforts should be dedicated to evaluating, revising, and revamping this newly developed model based on future empirical evidence. Our synthesized conceptual model is the segue to more comprehensive studies about nurses' workplace social capital. Interventional programs for the development of social capital can be structured based on the identified determinants.

The impact of work-place social capital in hospitals on patient-reported quality of care: a cohort study of 5205 employees and 23,872 patients in Denmark

BACKGROUND

Decision-makers increasingly consider patient-reported outcomes as important measures of care quality. Studies on the importance of work-place social capital-a collective work-place resource-for the experience of care quality are lacking. We determined the association between the level of work-place social capital and patient-reported quality of care in 148 hospital sections in the Capital Region of Denmark.

METHODS

This cross-sectional study combined section-level social capital from 5205 health care professionals and 23,872 patient responses about care quality. Work-place social capital encompassed three dimensions: trust, justice and collaboration. Patient-reported quality of care was measured as: overall satisfaction, patient involvement, and medical errors. Linear regression analysis and generalized linear models assessed the mean differences in patient reported experience outcomes and the risk of belonging to the lowest tertile of care quality.

RESULTS

A higher level of work-place social capital (corresponding to the interquartile range) was associated with higher patient-reported satisfaction and inpatient and acute care patient involvement. The risk of a section belonging to the lowest tertile of patient involvement was lower in sections with higher social capital providing inpatient (RR = 0.39, 0.19-0.81 per IQR increase) and acute care (RR = 0.53, 0.31-0.89). Patient-reported errors were fewer in acute care sections with higher social capital (RR = 0.65, 0.43 to 0.99). The risk of being in the lowest tertile of patient-reported satisfaction was supported for acute care sections (RR = 0.47, 0.28-0.79).

CONCLUSIONS

Although we found small absolute differences in the association between patient-reported experience measures and social capital, even a small upward shift in the distribution of social capital in the hospital sector would, at the population level, have a large positive impact on patients' care experience.

The effects of the relational dimension of social capital on tacit and explicit knowledge sharing: a mixed-methods approach

Purpose

Knowledge sharing among individuals from different teams is rare. Agile methods encourage only the exchange of tacit knowledge within teams. This study aims to analyse the influence of trust, norms of cooperation and reciprocity on tacit and explicit knowledge sharing among individuals from different software development teams.

Design/methodology/approach

Data were collected using a cross-sectional survey involving 205 individuals working in software development teams. The authors adopted a mixed-methods approach involving partial least squares structural equation modelling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA).

Findings

PLS-SEM shows: the antecedents have different influence in tacit knowledge sharing (TKS) and in explicit knowledge sharing (EKS); trust influences directly TKS, and it only influences EKS indirectly, while reciprocity influences TKS directly and EKS both directly and indirectly; norms of cooperation directly influence TKS, and they only influence EKS indirectly. Overall, the fsQCA findings support PLS-SEM results: TKS contributes to EKS; reciprocity or trust is a sufficient condition for TKS and EKS; norms of cooperation are a sufficient condition for TKS; larger firms without high levels of reciprocity and trust cannot expect TKS and EKS. The quantitative and qualitative results are aligned.

Research limitations/implications

The results cannot be generalisable because snowball sampling was used, and most of the respondents were Brazilians.

Practical implications

This study should help managers and scholars: to appreciate the relevancy of TKS among individuals using agile methods to nurture EKS and to understand the different effects of reciprocity, trust and norms of cooperation on both TKS and EKS.

Originality/value

Considering three constructs, this study uses a mixed-methods approach to investigate the potential of the relational dimension of social capital theory to leverage TKS and EKS, to overcome the limitations of agile methods. The originality of this study regards that it shows the constructs of relational social capital influencing TKS and EKS differently.

The quality of nursing care as perceived by nursing personnel: Critical incident technique

AIMS

To identify the determinants of the quality of nursing care from the perceptions of nursing personnel.

BACKGROUND

The quality of nursing care is often measured with standards, expectations, satisfaction and outcomes, but in developing countries, it relies mostly on negative indicators.

METHODS

A descriptive qualitative study was used. Semi-structured interviews based on the critical incident technique were conducted with a convenience sample of 136 nursing personnel who told 225 stories.

RESULTS

Seven quality determinants of nursing care were identified as follows: standard of care, triage and assessment, emergency care, communication with the patient or family, communication with colleagues, multidisciplinary teamwork and helping colleagues. The most important one was the standard of care.

CONCLUSION

Quality nursing care is based on the degree of excellence nursing personnel show with regard to their competences in technical care, communication and teamwork. A key attribute of quality nursing care is defined by the related standards, and the focus is mostly on the nursing care process.

IMPLICATIONS FOR NURSING MANAGEMENT

These findings can increase awareness of the determinants of nursing quality and the qualities of the nursing personnel involved and can help managers to evaluate nursing practice, select new employees and organise teams.

The role of workplace social capital on the relationship between perceived stress and professional identity among clinical nurses during the COVID-19 outbreak

AIM

Workplace social capital refers to relationship networks formed by individuals in an organization through long-term mutually beneficial interactions and cooperation with members. These relationship networks can create value and resources for organizations and individuals. This current study aimed to explore the potential impact of workplace social capital on the association between perceived stress and professional identity in clinical nurses during the COVID-19 outbreak.

METHODS

In this cross-sectional study, 308 Chinese clinical nurses filled out the Chinese Workplace Social Capital Scale, the Chinese Perceived Stress Scale, and the Chinese Nurse's Professional Identity Scale. Descriptive analysis, independent samples t test, analysis of variance, Pearson correlation analyses, and bootstrap method were performed to analyze the data.

RESULTS

Perceived stress was negatively correlated with professional identity (r = -0.455, p < .001). Workplace social capital was not found to moderate the relationship between perceived stress and professional identity (95% CI -0.03 to- 0.06, p = .47 > .05). Instead, it mediated that relationship (95% CI -0.61 to -0.19, p < .05), and its mediating effect was -0.37.

CONCLUSIONS

In the early stages of the COVID-19 outbreak, workplace social capital among the investigated clinical nurses failed to buffer the negative impact of perceived stress on professional identity, but it did play a part in mediating perceived stress and professional identity. A healthy workplace should be provided to clinical nurses to improve their professional identity, while lowering perceived stress.

Can a participatory organizational intervention improve social capital and organizational readiness to change? Cluster randomized controlled trial at five Danish hospitals

AIM

This study investigates the effect of a participatory organizational intervention on social capital and organizational readiness for change.

DESIGN

Cluster randomized controlled trial.

METHODS

In 2016, 27 departments from five hospitals in Denmark were randomly allocated at the department level to 1 year of participatory intervention (14 clusters, 316 healthcare workers) or a control group (13 clusters, 309 healthcare workers). The participatory intervention consisted of 2 × 2 hr workshops, where managers, 2-5 healthcare workers from each department, and the hospital's health and safety staff, developed action plans for implementing solutions for improving the use of assistive devices at the department throughout the 1-year intervention period. Workplace social capital: (a) within teams (bonding); (b) between teams and nearest leaders (linking A); and (c) between teams and distant leaders (linking B) and organizational readiness for change were measured using questionnaires at baseline, 6, and 12 months.

RESULTS

No group-by-time interaction occurred for any of the outcome measures. However, explorative post hoc analysis showed within-group improvements in bonding and linking B social capital and organizational readiness for change following the participatory intervention.

CONCLUSION

Participatory organizational interventions may improve social capital within teams and between teams and distant leaders and organizational readiness for change.

IMPACT

Implementing participatory interventions at the workplace may be a cost-effective strategy as they provide additional benefits, e.g., increased social capital and improved organizational readiness for change, that exceed the primary outcome of the intervention.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT02708550) March 2016.

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.

Developing and Evaluating an Educational Program for Respiratory Infection Prevention among Rural Elderly Residents in South Korea

Based on social cognitive theory (SCT), an educational program was developed to prevent rural elderly residents from respiratory infections in South Korea. The effectiveness of the program was investigated in terms of knowledge, attitudes, and practices about respiratory infection prevention, as well as social capital. A pretest–posttest nonequivalent control group quasi-experimental design was used to test the short-term effect of this program. In addition, 1- and 6-month follow-up surveys were administered to evaluate the long-term effects. A total of 69 subjects (37 in the experimental group and 32 in the control group) participated in the experiment. The results showed that knowledge about respiratory infection prevention, respiratory infection prevention practices, and social capital were enhanced among the elderly residents who participated in the educational program. The educational effects differed significantly across time periods (pretest, posttest, 1- and 6-month follow up) in all the above variables. In particular, the program remained effective 1 month after the intervention, but a reinforcement session extended the program’s effects up to 6 months later. This educational program would be used as an effective intervention to help rural elderly residents prevent respiratory infections.

Do Work Engagement and Transformational Leadership Facilitate Knowledge Sharing? A Perspective of Conservation of Resources Theory

Based on the perspective of conservation of resources (COR) theory, this study adopts a multilevel approach to examine the influences of employees’ personal resources (i.e., work engagement and intrinsic motivation) and external resources (i.e., transformational leadership) on knowledge sharing. This study conducts a survey to explore the interrelationships among transformational leadership, work engagement, intrinsic motivation, and knowledge sharing. The sample includes 33 healthcare work groups consisting of 214 group members. The results show that an individual’s personal and external resources are positive and benefit the promotion of knowledge sharing. As for personal resources, work engagement has a positive impact on knowledge sharing by increasing intrinsic motivation. Regarding external resources, transformational leadership acts as a facilitator for knowledge sharing. Specifically, the conditional indirect effects of work engagement on knowledge sharing through intrinsic motivation are more positive under high levels of transformational leadership, rather than low levels of transformational leadership. Based on the COR theory, this is the first study to argue that knowledge sharing could be considered as an active activity and that individuals could be eager to perform knowledge sharing when they possess significant personal and external resources. The results of this study provide new insights into knowledge sharing.

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.

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.

Do extrinsic motivation and organisational culture additively strengthen intrinsic motivation in online knowledge sharing?

Purpose

This study aims to examine the relationship between intrinsic motivation and online knowledge sharing intentions (KSIs) and the moderating effect of extrinsic motivation and organisational culture on this relationship. The influence of online KSI on two dimensions of online knowledge sharing behaviour, knowledge donating and knowledge collecting, was also investigated.

Design/methodology/approach

Based on the extensive literature review, a questionnaire was designed. In total, 290 questionnaires from employees in Vietnamese companies in the banking and insurance industry were collected and tested using structural equation modelling. Statistical analysis was conducted using SPSS and PLS 3 software to examine the research hypotheses.

Findings

This study found that rewards and reciprocity undermined the influence of self-enjoyment on online KSI, while top management support and social interaction ties undermined the relationship between self-efficacy and online KSI. Top management support positively moderated the effect of self-enjoyment on online KSI. The results also suggested that online KSI was a good predictor of online knowledge donating and collecting.

Originality/value

Little is empirically known about the moderating effect of extrinsic motivation and organizational culture on intrinsic motivation. The study brings new insights to further understand about online knowledge sharing in an organisation.

Older nurses' experiences of providing direct care in hospital nursing units: a qualitative systematic review

BACKGROUND

Most developed countries throughout the world are experiencing an aging nursing workforce as their population ages. Older nurses often experience different challenges then their younger nurse counterparts. With the increase in older nurses relative to younger nurses potentially available to work in hospitals, it is important to understand the experience of older nurses on high paced hospital nursing units. This understanding will lend knowledge to ways of lessening the loss of these highly skilled experienced workers and improve patient outcomes.

OBJECTIVES

To identify, evaluate and synthesize the existing qualitative evidence on older nurses' experiences of providing direct care to patients in hospital nursing units.

INCLUSION CRITERIA

The review considered studies which included registered nurses 45 years and over who work as direct caregivers in any type of in-patient hospital nursing unit. The phenomenon of interest was the experience of older nurses in providing direct nursing care in any type of in-patient hospital nursing unit (i.e. including but not limited to medical/surgical units, intensive care units, critical care units, perioperative units, palliative care units, obstetrical units, emergency departments and rehabilitative care units). The review excluded studies focussing entirely on enrolled nurses, licensed practical nurses and licensed vocational nurses.

TYPES OF STUDIES

Qualitative data including, but not limited to the following methodologies: phenomenology, grounded theory, ethnography, action research and feminist research.

METHODS

The databases CINAHL, PubMed, PsycINFO, Embase, AgeLine, Sociological Abstracts and SocINDEX were searched from inception; the search was conducted on October 13, 2017; no date limiters or language limiters were applied. Each paper was assessed by two independent reviewers for methodological quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Any disagreements that arose between the reviewers were resolved through discussion. Data extraction was conducted by two independent reviewers using the standardized qualitative data extraction tool from JBI. The qualitative research findings were pooled using JBI methodology. The JBI process of meta-aggregation was used to identify categories and synthesized findings.

RESULTS

Twelve papers were included in the review. Three synthesized findings were extracted from 12 categories and 75 findings. The three synthesized findings extracted from the papers were: (1) Love of nursing: It's who I am and I love it; (2) It's a rewarding but challenging and changing job; it's a different job and it can be challenging; (3) It's a challenging job; can I keep up?

CONCLUSIONS

Older nurses love nursing and have created an identity around their profession. They view their profession positively and believe their job to be unlike any other, yet they identify many ongoing challenges and changes. Despite their desire to continue in their role they are often faced with hardships that threaten their ability to stay at the bedside. A key role of hospital administrators to keep older nurses in the workplace is to develop programs to prevent work related illness and to promote health. Given the low ConQual scores in the current systematic review, additional research is recommended to understand the older nurses' experience in providing direct care in hospital nursing units as well as predicting health age of retirement and length of bedside nursing.

Introducing a Model of Relationship Between Knowledge Sharing Behavior and Organizational Citizenship Behavior and Positively Orientated Organizational Behavior

This study investigates the effects of employees' positively oriented organizational behavior and organizational citizenship behavior (OCB) use on knowledge sharing behavior after a two-month period. Based on previous research, it was expected that: (1) organizational citizenship behavior would be positively related to knowledge sharing behavior; (2) psychological capital would be positively related to knowledge sharing behavior; (3) OCB would mediate the relationship between psychological capital and knowledge sharing behavior; (4) psychological empowerment would be positively related to knowledge sharing behavior; and (5) OCB would mediate the relationship between psychological empowerment and knowledge sharing behavior. Results provided support for the direct effects of OCB, psychological capital and psychological empowerment on knowledge sharing behavior. Psychological capital and psychological empowerment were each indirectly related to knowledge sharing behavior, mediate by OCB. To be more precise, individuals with higher level of psychological capital and psychological empowerment were not only more likely to participate in organizational citizenship behavior but having a higher level of positively orientated organizational behavior made them to engage more in knowledge sharing behavior two months later.

Organisational Information and Knowledge Sharing: Uncovering Mediating Effects of Perceived Trustworthiness Using the PROCESS Approach

Many organisations are confronted with challenges in getting employees to effectively participate in information and knowledge sharing (IKS). Further, IKS is embedded in multifaceted social contexts, which are influenced by several different social and cognitive factors. This study is in support of the hypothesis that perceived trustworthiness is widely implicated as a mediating factor between those social–cognitive factors and IKS. Previous work, however, uncovered only a handful of such mediating effects. It is argued here that the paucity may have been due to limitations of the statistical methods. This study employs PROCESS, a more powerful current method for mediation analysis in an attempt to uncover previously hidden relationships. Analyses were performed on data collected from 275 knowledge workers (legal professionals and paralegals) engaged in shared legal project work, at one of Canada’s largest multijurisdictional law firms. Social–cognitive factors that were considered were shared language, shared vision, tie strength, age/gender/educational homophily and relationship length. IKS outcomes were willingness to share, willingness to use and perceived receipt of useful information/knowledge. Consistent with the hypothesis, the more powerful method revealed a large number of significant mediating effects of perceived trustworthiness. Out of possible 112 simple mediation models, 62 were significant, 44 of which had been previously undiscovered. The results highlight the importance of trust as well as the power of current methods for mediation analysis and serve as a strong argument for their use. The paper concludes with implications for research and practice.

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.

Socializar para Adequar-se: Como Redes Sociais Intraorganizacionais Podem Influenciar a Adequação Indivíduo-Organização

Resumo A adequação indivíduo-organização refere-se à congruência dos valores individuais do funcionário aos valores organizacionais. Essa adequação é explorada em diversos resultados individuais e organizacionais, tais como: desempenho, comprometimento, motivação, etc. Embora vários fatores tenham sido identificados como responsáveis por essa adequação, poucos estudos brasileiros exploraram quantitativamente o papel das redes sociais dentro das empresas. Esses relacionamentos construídos e mantidos dentro da organização são identificados pelos padrões de comunicação e interação entre os indivíduos, e podem interferir no nível de adequação indivíduo-organização. O objetivo desta pesquisa é compreender como as características das redes sociais, tais como grau de relacionamento, proximidade entre os atores e nível de intermediação, podem influenciar o nível de adequação indivíduo-organização. Realizou-se um survey com 116 funcionários de micro e pequenas empresas do setor de serviços. Os resultados da análise Partial Least Squares (PLS) indicam que o grau de relacionamento entre os funcionários influencia o nível de adequação indivíduo-organização. Ou seja, quanto mais o funcionário interage com seus colegas de trabalho, maior a probabilidade de adequação dos valores do indivíduo com os da organização.

Bricks-and-mortar and patient safety culture

Purpose Building a new hospital requires a major investment in capital infrastructure. The purpose of this paper is to investigate the impact of bricks-and-mortar on patient safety culture before and two years after the move of a large tertiary hospital to a greenfield site. The difference in patient safety perceptions between clinical and non-clinical staff is also explored. Design/methodology/approach This research uses data collected from the same workforce across two time periods (2013 and 2015) in a large Australian healthcare service. Validated surveys of patient safety culture ( n=306 and 246) were analysed using descriptive and inferential statistics. Findings Using two-way analysis of variance, the authors found that perceived patient safety culture remains unchanged for staff despite a major relocation and upgrade of services and different perceptions of patient safety culture between staff groups remains the same throughout change. Practical implications A dramatic change in physical context, such as moving an entire hospital, made no measurable impact on perceived patient safety culture by major groups of staff. Improving patient safety culture requires more than investment in buildings and infrastructure. Understanding differences in professional perspectives of patient safety culture may inform organisational management approaches, and enhance the targeting of specific strategies. Originality/value The authors believe this to be the first empirically based paper that investigates the impact of a large investment into hospital capital and a subsequent relocation of services on clinical and non-clinical staff perceptions of patient safety culture.

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

Background

Hospital patient safety is a major social problem. In the UK, policy responses focus on the introduction of improvement programmes that seek to implement evidence-based clinical practices using the Model for Improvement, Plan-Do-Study-Act cycle. Empirical evidence that the outcomes of such programmes vary across hospitals demonstrates that the context of their implementation matters. However, the relationships between features of context and the implementation of safety programmes are both undertheorised and poorly understood in empirical terms.

Objectives

This study is designed to address gaps in conceptual, methodological and empirical knowledge about the influence of context on the local implementation of patient safety programmes.

Design

We used concepts from critical realism and institutional analysis to conduct a qualitative comparative-intensive case study involving 21 hospitals across all seven Welsh health boards. We focused on the local implementation of three focal interventions from the 1000 Lives+patient safety programme: Improving Leadership for Quality Improvement, Reducing Surgical Complications and Reducing Health-care Associated Infection. Our main sources of data were 160 semistructured interviews, observation and 1700 health policy and organisational documents. These data were analysed using the realist approaches of abstraction, abduction and retroduction.

Setting

Welsh Government and NHS Wales.

Participants

Interviews were conducted with 160 participants including government policy leads, health managers and professionals, partner agencies with strategic oversight of patient safety, advocacy groups and academics with expertise in patient safety.

Main outcome measures

Identification of the contextual factors pertinent to the local implementation of the 1000 Lives+patient safety programme in Welsh NHS hospitals.

Results

An innovative conceptual framework harnessing realist social theory and institutional theory was produced to address challenges identified within previous applications of realist inquiry in patient safety research. This involved the development and use of an explanatory intervention–context–mechanism–agency–outcome (I-CMAO) configuration to illustrate the processes behind implementation of a change programme. Our findings, illustrated by multiple nested I-CMAO configurations, show how local implementation of patient safety interventions are impacted and modified by particular aspects of context: specifically, isomorphism, by which an intervention becomes adapted to the environment in which it is implemented; institutional logics, the beliefs and values underpinning the intervention and its source, and their perceived legitimacy among different groups of health-care professionals; and the relational structure and power dynamics of the functional group, that is, those tasked with implementing the initiative. This dynamic interplay shapes and guides actions leading to the normalisation or the rejection of the patient safety programme.

Conclusions

Heightened awareness of the influence of context on the local implementation of patient safety programmes is required to inform the design of such interventions and to ensure their effective implementation and operationalisation in the day-to-day practice of health-care teams. Future work is required to elaborate our conceptual model and findings in similar settings where different interventions are introduced, and in different settings where similar innovations are implemented.

Funding

The National Institute for Health Research Health Services and Delivery Research programme.

Communication elements supporting patient safety in psychiatric inpatient care

Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view. Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly. Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care. In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries. The study aims to describe which communication elements support patient safety in psychiatric inpatient care from the viewpoint of the nursing staff. Communication is an essential part of care and one of the core competencies of the psychiatric care. It enables safe and quality patient care. Errors in health care are often connected with poor communication. The study brings needed insight from the psychiatric care view to the topic. The data were gathered from semi-structured interviews in which 26 nurses were asked to describe the elements that constitute patient safety in psychiatric inpatient care. The data were analysed inductively from the viewpoint of communication. The descriptions connected with communication formed a main category of communication elements that support patient safety; this main category was made up of three subcategories: fluent information transfer, open communication culture and being active in information collecting. Fluent information transfer consists of the practical implementation of communication; open communication culture is connected with the cultural issues of communication; and being active in information collecting is related to a nurse's personal working style, which affects communication. It is important to pay attention to all the three areas and use this knowledge in developing patient safety practices and strategies where communication aspect and culture are noted and developed. In mental health nursing, it is important to develop processes concerning communication in multidisciplinary teams and across unit boundaries.

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.

Analyzing and Prioritizing the Dimensions of Patient Safety Culture in Emergency Wards Using the TOPSIS Technique

Background and Aim:

Doubtlessly, permanent development in patient care services is not feasible without paying attention to the culture of safety by health and treatment institutes. The present study is an attempt to analyze the cultural aspects of patient safety in the emergency wards of hospitals affiliated with the Tehran Medical Science University. The viewpoint of the nurses and hospital officials and their priorities were studied. For prioritizing the results of this study the TOPSIS technique was chosen.

Methods:

The study was conducted as an analytical-descriptive and cross-sectional one. It was carried out in two parts: at first the cultural aspects of the patients were measured using a questionnaire for a six months period in 2011 in emergency wards of the hospitals under study. The study population was constituted of physicians and nurses of the emergency wards. The sample group (n=270) was selected through a cluster sampling and its size was determined by using the sample size formula. For data gathering, the standard questionnaire of Hospital Survey on Patient Safety Culture (HSOPSC) was used. The data were analyzed in SPSS. The aspects of the safety culture were prioritized using the TOPSIS model. The criteria were ranked by using the MATLAB software.

Results:

There was a significant relationship among the aspects of performance, teamwork, feedback, mistake relationships, and the support of the managers (P ≤ 0.05). The total point of the patient safety culture in the majority of the hospitals were at a mean level of 3. The maximum score was 5. The maximum and minimum mean points were obtained by the Hasheminejad and Sina hospitals respectively. The results of the multivariate decision-making analysis indicated that human, managerial, organizational, and environmental factors were at the top of priorities in a descending order. The factors were extremely effective in the improvement of safety in hospitals.

Conclusion:

Human factors were the most effective and important factors in the improvement of safety in emergency wards. Therefore, there is a need to pay more attention to such factors in safety improvement programming. Training, cultural works, preparation of organizational environments, and motivating environmental factors were of the main measures that must be taken into account by the managers.

Codifying knowledge to improve patient safety: a qualitative study of practice-based interventions

Although it is well established that health care professionals use tacit and codified knowledge to provide front-line care, less is known about how these two forms of knowledge can be combined to support improvement related to patient safety. Patient safety interventions involving the codification of knowledge were co-designed by university and hospital-based staff in two English National Health Service (NHS) hospitals to support the governance of medication safety and mortality and morbidity (M&M) meetings. At hospital A, a structured mortality review process was introduced into three clinical specialities from January to December 2010. A qualitative approach of observing M&M meetings (n = 30) and conducting interviews (n = 40) was used to examine the impact on meetings and on front-line clinicians and hospital managers. At hospital B, a medication safety 'scorecard' was administered on a general medicine and elderly care ward from September to November 2011. Weekly feedback meetings were observed (n = 18) and interviews with front-line staff conducted (n = 10) to examine how knowledge codification influenced behaviour. Codification was shown to support learning related to patient safety at the micro (front-line service) level by structuring the sharing of tacit knowledge, but the presence of professional and managerial boundaries at the organisational level affected the codification initiatives' implementation. The findings suggest that codifying knowledge to support improvement presents distinct challenges at the group and organisational level; translating knowledge across these levels is contingent on the presence of enabling organisational factors, including the alignment of learning from clinical practice with its governance.

Is Trust the Most Important Human Factor Influencing Knowledge Sharing in Organisations?

The present study explores several of the most significant social and cognitive human factors that have been found to motivate or inhibit organisational knowledge sharing in previous empirical studies. Of specific interest is the individual and collective effect that trust, shared language, shared vision, tie strength, homophily and relationship length have on three important conditions necessary for effective knowledge sharing to take place (i.e. willingness to share, willingness to use and perceived receipt of useful knowledge). The study also considers the nature of the employee working relationship (positive versus negative) and the form of knowledge sharing (explicit versus tacit). In total, 275 surveys were completed by employees working on projects at one of Canada's largest multijurisdictional law firms. Quantitative methods were used to examine the relationships between the dependent variables and independent variables, while controlling for all the other variables in the model.

Enhancing the commitment of nurses to the organisation by means of trust and monetary reward

AIM

This study examines how trust and monetary reward influence nurses' job satisfaction and strengthen organisational commitment.

BACKGROUND

Hospitals with high nurse retention rates typically have fewer medical errors and better quality care for patients. Therefore, health care administrators should provide a trustworthy workplace and a satisfactory reward system to retain experienced and skilled nurses.

METHOD

This study adopts the partial least squares method for parameter estimates and hypotheses based on 797 valid questionnaires from registered nurses in a Taiwan medical centre.

RESULT

All hypotheses were supported. The results show that the perceived trust of and rewards for registered nurses significantly influence their job satisfaction and organisational commitment. Although the impact of rewards is slightly stronger than that of trust among nurses on job satisfaction, the influence of trust among nurses is significantly higher than that of reward on organisational commitment.

CONCLUSION

The results show that administrators should enhance trust among nurses, establish a fair and attractive reward system, and increase nurse job satisfaction to elevate their commitment to the organisation.

IMPLICATIONS FOR NURSING MANAGEMENT

To build a high level of organisational commitment, developing trust among nurses and increasing job satisfaction are more critical than compensating with monetary incentives alone.