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Zhang H, Huang ST, Bittle MJ, Shi L, Engineer L, Chiu HC. Hospital employees' perception of Joint Commission International Accreditation: effect of re-accreditation. Int J Qual Health Care 2024; 36:mzae081. [PMID: 39252601 DOI: 10.1093/intqhc/mzae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/18/2024] [Accepted: 09/09/2024] [Indexed: 09/11/2024] Open
Abstract
Joint Commission International (JCI) accreditation is a recognized leader in healthcare accreditation worldwide. It aims to improve quality of care, patient safety, and organizational performance. Many hospitals do not apply for re-accreditation after JCI status expires. Understanding employees' perceptions of JCI accreditation would benefit hospital management. We aimed to examine whether re-accredited hospital employees perceived more significant benefits and were more likely to recommend JCI to other hospitals than ex-accredited employees. This is a prospective cross-sectional study with a comparison group design. Survey questionnaires, developed from a qualitative study, included perceptions of challenges, benefits, and overall rating of JCI accreditation. An electronic-based questionnaire was distributed to physicians, nurses, medical technicians, and administrative staff in five private Obstetrics and Gynecology hospitals in China, March-April 2023. Descriptive and linear regression analyses were performed. The statistically significant level is P-value <.05. Of 2326 employees, 1854 (79.7%) were included in the study after exclusions, 1195 were re-accredited, and 659 were ex-accredited. Perceptions of JCI accreditation were positive, as both groups reported a mean score >4.0 regarding the overall benefits. Adjusted for covariates, re-accredited employees were more willing to recommend JCI accreditation to other hospitals than ex-accredited employees. Re-accredited employees perceived greater benefits of JCI accreditation and were more willing to recommend it to other hospitals, suggesting that perceived benefits contribute to a desire to maintain and sustain JCI accreditation. Employee participation is vital for its effective implementation. Employees' perceived challenges and benefits may provide insights for healthcare leaders considering pursuing and reapplying for JCI accreditation.
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Affiliation(s)
- HongFan Zhang
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205, United States
| | - Siou-Tang Huang
- Institute for Hospital Management, Tsinghua University, 2279 Lishui Road, Nanshan District, Shenzhen 518055, China
| | - Mark J Bittle
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205, United States
| | - LeiYu Shi
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205, United States
| | - Lilly Engineer
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205, United States
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205, United States
| | - Herng-Chia Chiu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205, United States
- Institute for Hospital Management, Tsinghua University, 2279 Lishui Road, Nanshan District, Shenzhen 518055, China
- Department of Healthcare Administration and Medical Informatics, 100 Shih-Chun 1st road, Sam-Ming district, Kaohsiung Medical University, Kaohsiung, 80708 Taiwan
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Junttila K, Heikkilä A, Heikkilä A, Koivunen M, Lehtikunnas T, Mattila E, Meriläinen M, Peltokoski J, Sneck S, Tervo-Heikkinen T. The Impact of Leadership in the Autonomy and Engagement of Nurses: A Cross-sectional Multicenter Study Among Nurses Outside the United States. J Nurs Adm 2023; 53:19-26. [PMID: 36542440 DOI: 10.1097/nna.0000000000001237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To add to the body of evidence regarding nurse engagement and related factors from a non-US sample of nurses. BACKGROUND Leadership has a positive impact on nurses' autonomy and engagement experiences. It is necessary to explore the factors that explain the relationships between leadership, autonomy, and engagement level. METHODS Nurses (n = 4393) from 9 hospitals participated in a survey in March 2020. Multivariable logistic regression analysis was performed to identify engagement and autonomy predictors. RESULTS Of the respondents, 9% were engaged, 28% content, 29% ambivalent, and 34% disengaged. Respondents' separate background variables were not significant predictors in multivariate models, whereas the leadership- and autonomy-related variables were. CONCLUSIONS A manager's responsiveness, an organization's readiness to follow nurse suggestions for performance improvement, and receiving recognition and regular feedback promote engagement. Furthermore, engagement is enhanced when nurses have an active role in decision-making and their contributions are respected. Visible nurse managers and leaders who are effective advocates for nurses strengthen nurses' autonomy.
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Affiliation(s)
- Kristiina Junttila
- Authors Affiliations: Director (Dr Junttila), Nursing Research Center, and Development Manager, Nursing (Ms Heikkilä), Nursing Administrative Group, Helsinki University Hospital and University of Helsinki; Director of Nursing Excellence (Dr Heikkilä), Development Services, Hospital District of Southwest Finland, Turku; Nursing Director (Dr Koivunen), Research and Development Services, Satakunta Hospital District, Pori; Hospital Director of Nursing (Dr Lehtikunnas), Administrative Centre, Turku University Hospital, Turku; Chief Nursing Officer (Dr Mattila), Administrative Centre, Tampere University Hospital; Hospital Nursing Officer (Dr Meriläinen), Medical Research Center Oulu, Oulu University Hospital; Director of Nursing Excellence (Dr Peltokoski), Administration Services, Central Finland Health Care District, Jyväskylä; Director of Nursing Excellence (Dr Sneck), Oulu University Hospital; Clinical Nurse Consultant (Dr Tervo-Heikkinen), Clinical Development, Education and Research Centre of Nursing, Kuopio University Hospital; and Adjunct Professor (Dr Junttila, Dr Koivunen), Department of Nursing Science, University of Turku, Finland
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Scott G, Hogden A, Taylor R, Mauldon E. Exploring the Impact of Employee Engagement and Patient Safety. Int J Qual Health Care 2022; 34:6650746. [PMID: 35899827 PMCID: PMC9384574 DOI: 10.1093/intqhc/mzac059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/10/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background Health service administrators are continually investigating new ways to improve the safety and quality of health services. A positive and powerful relationship between employee engagement and patient safety has been suggested in the research literature, and steps can be taken by employers to enhance engagement to improve the safety of health services, particularly considering the coronavirus disease 2019 (COVID-19) pandemic. Objective The aim of this review was to explore the current literature on the impact of employee engagement on patient safety. Methods A review of peer-reviewed literature relating to the impact of employee engagement on patient safety within health services between January 2015 and May 2021 was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline Complete, Scopus, Health Business Elite and Business Source Ultimate databases. A search of grey literature using the Bielefeld Academic Search Engine database was also completed. Results Of relevant articles, 3693 were identified, of which 15 studies were included in this review. Ten articles measured employee engagement using existing, validated tools, whereas patient safety was most frequently assessed through surveys seeking staff member’s perceptions of safety or the quality of care they provide. Overall, there appeared to be a positive correlation between employee engagement and patient safety, but the strength of the relationship varied. Conclusion Anecdotal accounts of improving employee engagement and improving patient safety abound, and the evidence reviewed appears in agreement. However, research into the impact of employee engagement on patient safety is in its early stages. As health service managers consider the best use of funding to support safe and high-quality care, evidence to support the positive impact employee engagement has on patient safety may be useful in managing the fallout from the COVID-19 pandemic.
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Jo Y, Hong AJ. Impact of Agile Learning on Innovative Behavior: A Moderated Mediation Model of Employee Engagement and Perceived Organizational Support. Front Psychol 2022; 13:900830. [PMID: 35800932 PMCID: PMC9254862 DOI: 10.3389/fpsyg.2022.900830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
This study analyzed learning agility, employee engagement, perceived organizational support (POS), and innovative behavior related to the development of innovative environment and the mental and psychological health of employees. A substantial body of research has examined the antecedents of innovative behavior of employees in their work environment, but our current understanding of how learning and motivational aspects of employees synthetically influence the innovative behavior remains incomplete. To address this gap, we developed and tested a moderated mediation model of the relationship between learning agility and employee engagement, POS, and innovative behavior. Following the job-demand resource model, componential theory, and social exchange theory, our postulated model predicted that the mediating effect of employee engagement on the relationship between learning agility and innovative behavior would be moderated by POS. The result of the analysis of the data on 331 corporate employees in South Korea supported this model. Specifically, learning agility was related to innovative behavior, while employee engagement mediated the relationship between learning agility and innovative behavior; POS strengthened the positive effect of learning agility on innovative behavior via employee engagement. We also discuss the implications of the results, future direction, and limitations of this study based on these findings.
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Affiliation(s)
- Yunseong Jo
- Social Science Korea Research Team, Chung-Ang University, Seoul, South Korea
| | - Ah Jeong Hong
- Department of Education, Chung-Ang University, Seoul, South Korea
- *Correspondence: Ah Jeong Hong,
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Abstract
Past research has demonstrated that work engagement among health care professionals influences patient quality of care. There is, however, no estimate of the strength of this relationship, and existing reviews have not always explained conflicting findings. We conduct a meta-analysis and review of 25 articles, and find a small to medium mean effect size (r = .26, p < .01) for the positive association between engagement and quality of care. Moderator analyses on five factors (type, data source, level of analysis of the quality of care measure, profession, and work engagement measure) indicate that only data source is significant, providing preliminary evidence that the relationship is stronger if quality of care is measured via self-assessments. Although a more consistent conceptualization of quality of care is needed to better determine its association with work engagement, our findings suggest that work engagement is as important as burnout in predicting quality of care.
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Leadership in Nursing Excellence: The Magnet Recognition® Journey Experiences in Europe. J Nurs Adm 2020; 50:578-583. [PMID: 33105334 DOI: 10.1097/nna.0000000000000940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Improving work conditions and the provision of high-quality care and patient safety is an issue in European hospitals. Inspired by a US program for nursing excellence, Magnet Recognition, a Belgian hospital shared their experiences by organizing a summer school in 2019 with nurses of 21 hospitals from 9 countries. This article explains the hospital's research program, the link between the journey and the content of the summer school, lessons learned, and the extent to which participants of European hospitals were interested in nursing excellence and Magnet designation.
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Somville F, Stiers M, Franck E, Van Bogaert P. Determinants of emergency physician wellness in Belgium. J Am Coll Emerg Physicians Open 2020; 1:1013-1022. [PMID: 33145553 PMCID: PMC7593456 DOI: 10.1002/emp2.12169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/21/2020] [Accepted: 06/03/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This cross-sectional study examines first whether emergency physicians differ from a comparison group of surgeons, more specifically general surgeons and orthopedic surgeons, in terms of job and organizational characteristics and second to what extent these characteristics are determinants of professional well-being outcomes in emergency physicians. METHODS Belgian emergency physicians (n = 346) were invited to participate in this study. Forty-three percent of the eligible participants completed a questionnaire. The survey instrument contained 48 questions on determinants (personal characteristics, job conditions [Job Demand Control Support], organizational and environmental work conditions) as well as 39 questions on outcomes (job satisfaction, turnover intention, subjective fatigue, psychological distress, work-home interference, work engagement) by means of the Leiden Quality of Work Questionnaire for Medical Doctors, the Checklist Individual Strength, the Brief Symptom Inventory, and the Utrecht Work Engagement Scale. Hierarchical multiple regression analyses were used to examine the association between the determinants and each of the outcomes. RESULTS Emergency physicians reported higher job demands, lower job control, and less adequate work conditions compared with the group of surgeons. High job demands increased turnover intention, subjective fatigue, psychological distress, work-home interference in emergency physicians, but lack of job control, lack of social support from the supervisor, and inadequate communication also contributed in an unfavorable way to some of these outcomes. CONCLUSION Emergency medicine departments must reduce the constant exposure to high job demands by allowing emergency physicians to have enough time for both physical and mental recovery. Work motivation and work conditions might be improved by increasing job control over job demands by giving emergency physicians more decision latitude and autonomy, improving good communication and teamwork and adequate social support from the supervisor and providing good material resources. These interventions can improve professional well-being outcomes in emergency physicians.
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Affiliation(s)
- Francis Somville
- Department of Emergency MedicineUniversity of Antwerp, UZAEdegemBelgium
- Department of Emergency and TraumatologyAZ St Dimpna (Erica campus Geel)GeelBelgium
| | - Michiel Stiers
- Department of Emergency and TraumatologyAZ St Dimpna (Erica campus Geel)GeelBelgium
- Department of Emergency MedicineUniversity of Leuven, UZ LeuvenLeuvenBelgium
| | - Erik Franck
- Department of Nursing and Midwifery SciencesCentre for Research and Innovation in Care (CRIC) Campus Drie EikenWilrijkBelgium
| | - Peter Van Bogaert
- Department of Nursing and Midwifery SciencesCentre for Research and Innovation in Care (CRIC) Campus Drie EikenWilrijkBelgium
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Exploring the influence of core-self evaluations, situational factors, and coping on nurse burnout: A cross-sectional survey study. PLoS One 2020; 15:e0230883. [PMID: 32240234 PMCID: PMC7117734 DOI: 10.1371/journal.pone.0230883] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 03/10/2020] [Indexed: 12/16/2022] Open
Abstract
Stress has become an inherent aspect of the nursing profession. Chronically experienced work stress can lead to burnout. Although situational stressors show a significant influence on burnout, their power to predict the complete syndrome is rather limited. After all, stressors only exist "in the eye of the beholder". This study aimed to explore how individual vulnerability factors such as core-self evaluations and coping, contribute to burnout in relation to situational stressors within a population of hospital nurses. Cross-sectional data was collected in 2014, using five validated self-report instruments: Dutch Core Self Evaluations Scale, Nursing Work Index Revised, Utrecht Coping List, Ruminative Response Scale, and Utrecht Burnout Scale. 219 of the 250 questionnaires were returned. Core-self evaluations, situational factors and coping each contributed significantly to the predictive capacity of the models of the separate burnout dimensions. Core-self evaluations was significantly related to emotional exhaustion. It was suggested that Core-self evaluations might be placed at the initiation of the loss cycle. However, further research is warranted.
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The Association Between Unit-Level Workplace Social Capital and Intention to Leave Among Employees in Health Care Settings: A Cross-Sectional Multilevel Study. J Occup Environ Med 2020; 62:e186-e191. [PMID: 32149939 DOI: 10.1097/jom.0000000000001847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the multilevel association between workplace social capital and intention to leave among employees in health care settings in Japan. METHODS This study was a secondary data analysis of the cross-sectional data. A sample of 658 Japanese employees in health care settings with 17 facilities were recruited using a self-administered questionnaire. Multilevel linear regression analysis of intention to leave on unit-level workplace social capital (average score for each unit) was conducted. RESULTS Among 317 respondents from 49 units, after adjusting for demographic and work-related variables, both unit-level and individual-level workplace social capital were significantly negatively associated with intention to leave (P < 0.001). CONCLUSIONS The current study found that there was a significant negative association between unit-level workplace social capital and intention to leave in the health care field.
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Tawfik DS, Scheid A, Profit J, Shanafelt T, Trockel M, Adair KC, Sexton JB, Ioannidis JPA. Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Ann Intern Med 2019; 171:555-567. [PMID: 31590181 PMCID: PMC7138707 DOI: 10.7326/m19-1152] [Citation(s) in RCA: 250] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Whether health care provider burnout contributes to lower quality of patient care is unclear. PURPOSE To estimate the overall relationship between burnout and quality of care and to evaluate whether published studies provide exaggerated estimates of this relationship. DATA SOURCES MEDLINE, PsycINFO, Health and Psychosocial Instruments (EBSCO), Mental Measurements Yearbook (EBSCO), EMBASE (Elsevier), and Web of Science (Clarivate Analytics), with no language restrictions, from inception through 28 May 2019. STUDY SELECTION Peer-reviewed publications, in any language, quantifying health care provider burnout in relation to quality of patient care. DATA EXTRACTION 2 reviewers independently selected studies, extracted measures of association of burnout and quality of care, and assessed potential bias by using the Ioannidis (excess significance) and Egger (small-study effect) tests. DATA SYNTHESIS A total of 11 703 citations were identified, from which 123 publications with 142 study populations encompassing 241 553 health care providers were selected. Quality-of-care outcomes were grouped into 5 categories: best practices (n = 14), communication (n = 5), medical errors (n = 32), patient outcomes (n = 17), and quality and safety (n = 74). Relations between burnout and quality of care were highly heterogeneous (I2 = 93.4% to 98.8%). Of 114 unique burnout-quality combinations, 58 indicated burnout related to poor-quality care, 6 indicated burnout related to high-quality care, and 50 showed no significant effect. Excess significance was apparent (73% of studies observed vs. 62% predicted to have statistically significant results; P = 0.011). This indicator of potential bias was most prominent for the least-rigorous quality measures of best practices and quality and safety. LIMITATION Studies were primarily observational; neither causality nor directionality could be determined. CONCLUSION Burnout in health care professionals frequently is associated with poor-quality care in the published literature. The true effect size may be smaller than reported. Future studies should prespecify outcomes to reduce the risk for exaggerated effect size estimates. PRIMARY FUNDING SOURCE Stanford Maternal and Child Health Research Institute.
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Affiliation(s)
- Daniel S Tawfik
- Stanford University School of Medicine, Stanford, California (D.S.T., T.S., M.T.)
| | - Annette Scheid
- Brigham and Women's Hospital and Harvard Medical School, llBoston, Massachusetts (A.S.)
| | - Jochen Profit
- Stanford University School of Medicine, Stanford, California, and California Perinatal Quality Care Collaborative, Palo Alto, California (J.P.)
| | - Tait Shanafelt
- Stanford University School of Medicine, Stanford, California (D.S.T., T.S., M.T.)
| | - Mickey Trockel
- Stanford University School of Medicine, Stanford, California (D.S.T., T.S., M.T.)
| | - Kathryn C Adair
- Duke University School of Medicine, Duke University Health System, and Duke Patient Safety Center, Durham, North Carolina (K.C.A., J.B.S.)
| | - J Bryan Sexton
- Duke University School of Medicine, Duke University Health System, and Duke Patient Safety Center, Durham, North Carolina (K.C.A., J.B.S.)
| | - John P A Ioannidis
- Stanford University School of Medicine, Stanford University School of Humanities and Sciences, and Meta-Research Innovation Center at Stanford (METRICS), Stanford, California (J.P.I.)
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Jacquemyn Y. Accreditation and resulting clerical duties represent commercial excesses that are ethically and scientifically unacceptable. Facts Views Vis Obgyn 2018; 10:59-61. [PMID: 31110643 PMCID: PMC6516189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
It is scientifically and ethically unjustified to continue hospital accreditation organized by commercial organisations such as Joint Commission International (JCI) as these harm patients and health care workers, result in needless excess costs without improved outcome and endanger the future of healthcare. All energy should go to bottom up shared decision making.
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