Relationships between job satisfaction, organizational commitment, burnout and job performance of healthcare professionals in a district-level health care system of Shenzhen, China

Sustainable Implementation of Physician-Pharmacist Collaborative Clinics for Diabetes Management in Primary Healthcare Centers: A Qualitative Study

BACKGROUND

Although physician-pharmacist collaborative clinics for diabetes management have been shown to be effective and cost-effective worldwide, there is limited understanding of the factors that influence their sustainable implementation. This study aims to identify the associated factors and provide sustainability strategy to better implement physician-pharmacist collaborative clinics for diabetes management in primary healthcare centers in China.

METHODS

A sample of 43 participants were participated in face-to-face, in-depth, semi-structured interviews. Consolidated Framework for Implementation Research was used to identify facilitators and barriers to implementing physician-pharmacist collaborative clinics for diabetes management in primary healthcare centers, and to explore discriminating factors between low and high implementation units. A sustainable strategy repository based on dynamic sustainability framework was established to inform further implementation.

RESULTS

This study demonstrated that clear recognition of intervention benefits, urgent needs of patients, adaptive and tailored plan, highly collaborative teamwork and leadership support were the major facilitators, while the major barriers included process complexity, large number and poor health literacy of patients in primary areas, inappropriate staffing arrangements, weak financial incentives and inadequate staff competencies. Six constructs were identified to distinguish between high and low implementation units. Sixteen strategies were developed to foster the implementation of physician-pharmacist collaborative clinics, targeting Intervention, Practice setting, and Ecological system.

CONCLUSION

This qualitative study demonstrated facilitators and barriers to implementing physician-pharmacist collaborative clinics for diabetes management in primary healthcare centers and developed theory-based strategies for further promotion, which has the potential to improve the management of diabetes and other chronic diseases in under-resourced areas.

Satisfaction with clinical pathway implementation versus job performance of clinicians: empirical evidence on the mediating role of work engagement from public hospitals in Sichuan, China

BACKGROUND

The job performance of clinicians is a clear indicator of both hospital capacity and the level of hospital service. It plays a crucial role in maintaining the effectiveness and quality of medical care. Clinical pathways are a systematic method of quality improvement successfully recommended by broader healthcare systems. Since clinicians play a key role in implementing clinical pathways in public hospitals, this study aims to investigate the effect of the satisfaction of clinicians in public hospitals with clinical pathway implementation on their job performance.

METHODS

A cross-sectional study design was used. Questionnaires were administered online. A total of 794 clinicians completed the questionnaires in seven tertiary public hospitals in Sichuan Province, China, of which 723 were valid for analysis. Questionnaires contained questions on social demographic characteristics, satisfaction with clinical pathway implementation, work engagement, and job performance. Structural Equation Model (SEM) was used to test the hypotheses.

RESULTS

The satisfaction of clinicians in public hospitals with clinical pathway implementation was significantly positively correlated with work engagement (r = 0.570, P < 0.01) and job performance (r = 0.522, P < 0.01). A strong indirect effect of clinicians' satisfaction with clinical pathway implementation on job performance mediated by work engagement was observed, and the value of this effect was 0.383 (boot 95%CI [0.323, 0.448]).

CONCLUSION

The satisfaction of clinicians in public hospitals with clinical pathway implementation not only directly influences their job performance, but also indirectly affects it through the mediating variable of work engagement. Therefore, managers of public hospitals need to pay close attention to clinicians' evaluation and perception of the clinical pathway implementation. This entails taking adequate measures, such as providing strong organizational support and creating a favorable environment for the clinical pathway implementation. Additionally, focusing on teamwork to increase clinicians' satisfaction can further enhance job performance. Furthermore, managers should give higher priority to increasing employees' work engagement to improve clinicians' job performance.

Virtual Wellness Workshop for Medical Students: Effects on Healthy Lifestyle Behavior

Introduction

Medical students experience high levels of stress, burnout, depression, suicidal ideation, and compassion fatigue. Mindfulness interventions in this population have demonstrated improvement in psychological outcomes. However, it is unclear if these improvements are maintained. Evaluation of changes in lifestyle behaviors may provide insight into factors that sustain improvements. Specific aims of this study were to (1) assess feasibility and acceptability of an innovative, virtual program involving experiential learning, social support, and motivational interviewing; and (2) evaluate preliminary healthy lifestyle behaviors and psychological outcomes from preprogram to postprogram and 4-week follow-up.

Methods

We used a mixed-methods approach to investigate feasibility, acceptability, and effects of the virtual program using validated measures and open-ended questions. Participants were 20 first- and second-year medical students at one Midwestern US medical college who participated between October 2020 and December 2020. Participants were enrolled in one of two groups for the 8-week program via Webex. Participants completed surveys at preprogram, postprogram, and 4-week follow-up. They also completed weekly home practice assessments.

Results

Nineteen of 20 participants completed the program (95% retention rate). All participants attended six or more sessions. Repeated measures analysis of variance revealed that participants had significant improvements in healthy lifestyle behaviors, burnout, self-compassion, and stress across time. Results were supported by qualitative themes of increased social support, wellness skills, and overall positive experiences.

Conclusion

Findings suggest that the virtual program was feasible and acceptable to medical students, and improved healthy lifestyle behaviors and psychological outcomes that were maintained or increased at 4-week follow-up.

The Power of Peer Leaders: Exploring the Link between Peer Leadership Behaviors and Sustainable Work Outcomes

Most leadership studies primarily focus on formal leaders, often overlooking the influence of leaders within the team. While prior research has shown that peer leaders can have a beneficial impact on various team outcomes, it is yet unclear which peer leadership behaviors precisely foster a supportive and sustainable work environment. Building upon the recent identification of 10 peer leadership roles and 37 underlying functions, the current study aims to investigate the relationships between these peer leadership roles and functions and key outcomes (i.e., job satisfaction, team cohesion, team effectiveness, and OCB). A total of 31 organizational teams, comprising 182 employees from diverse sectors, participated in a quantitative survey. Employing multilevel modeling analysis, the findings demonstrated that each leadership role and nearly every function predicted at least one outcome, highlighting their significance within organizational teams. Additionally, Necessary Condition Analysis revealed that specific roles and functions were necessary for generating one or more outcomes. Finally, we found that most of the significant relationships remained consistent across teams, regardless of their size, tenure, or level of team identification. These findings refine our understanding of shared leadership and how peer leaders can create a sustainable workplace by fostering employee well-being and productivity in organizational teams.