What do hotels and hospitals have in common? How we can learn from the hotel industry to take better care of patients

Perceived organisational support and work engagement among health sector workers during the COVID-19 pandemic: a multicentre, time-lagged, cross-sectional study among clinical hospital staff in Pakistan

OBJECTIVE

Workplace engagement is associated with several significant positive organisational outcomes. The COVID-19 pandemic has emphasised the importance of workplace engagement, particularly for front-line healthcare workers. Drawing on the conservation of resources theory, this study examines the impact of personal and job resources in a workplace that help in resource conservation for work engagement. In view of the high burnout rates reported among health professionals during the COVID-19 pandemic, this study aims to investigate the impact of perceived organisational support (POS) on work engagement through the mediating effect of well-being and the moderating role of employees' resilience.

DESIGN

Time-lagged, cross-sectional, split questionnaire-based survey study.

SETTING

Data were gathered from 68 hospitals in Pakistan, of which 45 were public and 23 were private hospitals.

PARTICIPANTS AND ANALYSIS

Simple random sampling techniques were used and data were collected from 345 healthcare professionals (ie, doctors, nurses and allied health professionals) using split questionnaires, in two waves with a 3-week interval, with a response rate of 80%. For analysis of data, the study used the PROCESS macro by Hayes.

RESULTS

Engagement at work was positively correlated with POS, well-being and resilience. POS significantly predicted work engagement through well-being (β=0.06, SE=0.02, 95% bias-corrected CI 0.021, 0.10). Further analysis of the strong effect of resilience on subjective well-being shows the significant value of the mediated moderation index (β=0.06, SE=0.02, 95% bias-corrected CI 0.03, 0.11).

CONCLUSION

The findings suggest that well-being may be an important pathway through which healthcare workers' POS may influence work engagement, particularly when their resilience capability is high. To maintain engagement at the workplace, hospital administrators should consider strengthening organisational and individual resources that build a supportive environment to meet the demands of challenging times.

The Conflicting Impact of COVID-19’s Health and Economic Crises on Helping

Helping behaviors are considered critical for business and societal recovery in light of economic crises and natural disasters, including the COVID-19 pandemic that has both economic and health disaster elements. However, because the current COVID-19 pandemic has both of these elements, it is unclear how helping may be impacted. Economic crisis research suggests that such events are associated with less helping, whereas disaster research suggests that such events are associated with greater helping. We pair the event system theory (Morgeson, F. P., Mitchell, T. R., & Liu, D. (2015). Event system theory: An event-oriented approach to the organizational sciences. Academy of Management Review, 40(4), 515-537) with these two logics (economic downturn and disaster) to suggest that health and economic threats within the COVID-19 pandemic operate with potentially opposing forces on helping-related outcomes. To test these ideas at a macro-level, we examined internet search volume for recession, COVID-19, and interest in helping. At a micro-level, we examined the relationships between work- hour insecurity and perceived job-related COVID-19 risk—two salient COVID-19-related economic and health threats—and helping customers and coworkers. Consistent with economic crisis logic, macro-level concern about recession was negatively associated with interest in helping. Moreover, at the individual level, work-hour insecurity negatively predicted helping coworkers. Consistent with disaster logic, at the individual level, perceived job-related COVID-19 threat was positively associated with helping coworkers and negatively associated with helping customers. These findings suggest that the specific feature of the COVID-19 event system (economic versus health) and the target (organizational insiders versus outsiders) matter for shaping helping behavior. These findings have implications for helping during crises that involve economic and/or disaster elements.

Using Phenomenological Hermeneutics to Understand the Experiences of Managers Working with Quality Improvement Strategies in an Assisted Living Facility

This qualitative research project aimed to gain an understanding of the experiences of managers who participated in the implementation of quality improvement projects in an assisted living facility. This study employed hermeneutic phenomenology as a research methodology, whereby managers working in an assisted living facility were invited to participate in a 60-75 min semi-structured interview. Six managers participated in the interviews. Five themes were developed from data analysis: (1) Quality improvement (QI) and resident-centered care go hand-in-hand; (2) Constant on-going commitment to continuous improvement is needed to implement QI; (3) Learning to communicate with team-members and residents/caregivers is important to implement QI; (4) Feedback is essential for the implementation of QI initiatives; and (5) Implementing new QI initiatives can be challenging. The managers emphasized the need for leadership commitment, the usage of standardized communication methods, and feedback strategies to ensure the success of QI initiatives. Additionally, the managers indicated that QI is directly related to resident-centered care and that efforts should be made to collect feedback from residents to further improve processes. Additionally, challenges surrounding the implementation of QI have been described. Since there is a scarcity of research on the implementation of QI methods in assisted living facilities, this study can provide practical tips to leaders and administrators.

A systematic literature review of the patient hotel model

BACKGROUND

The patient hotel model was developed in Northern Europe as a response to increased demand for health and wellbeing services. According to current literature the patient hotel model is a concept of care provision which combines non-acute hospital care with hospitality to afford patients/guests increased satisfaction and security whilst benefitting from evidenced based care.

OBJECTIVE(S)

This paper evaluates the concept of the patient hotel model. It presents the findings of a systematic review of existing literature evaluating the benefits such a model can bring to healthcare services and reports on the efficacy in terms of cost to health service providers, and health outcomes to patients/guests. The authors' aimed to complete a meta-analysis of the data, but were unable to, due to the diversity in the descriptions, service provisions, and client group.

DESIGN

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to conduct and report this systematic review. In order to focus the research question, the PICO (Population; Intervention; Comparison and Outcome) framework was used to develop a strategy in literature searching, to ensure systematic rigor.

DATA SOURCES/REVIEW METHODS

Cochrane Database of Systematic Reviews, OVID MEDLINE, CINAHL, Embase, ScienceDirect, Web of Science, and Scopus databases were used to search for randomized controlled trials, quasi experimental studies, quantitative and qualitative studies conducted between January 1st 2008 and August 9th, 2018, published in a peer reviewed journal in English or which provided an abstract in English. Citation searches and hand searches were also conducted.

RESULTS

8,693 papers were retrieved and from abstract screening 68 full-text articles were assessed for eligibility by applying an inclusion and exclusion criteria. Seven articles were retained for quality assessment. Methodological rigor was appraised using accepted criteria for the evaluation of research. On appraisal, one systematic review, one Randomized Clinical Trial, two qualitative studies, one quantitative survey, one retrospective analysis of services, and one comparative analysis paper were included for data synthesis. The functionality of the patient hotel model differed across the six countries that reported on them in the included studies, from oncology care, medical care, post-acute rehabilitation and perioperative care. The studies included in this review broadly focused on the themes of patient experience and/or cost, with the intention of informing future service provision. Studies relating to cost efficacy looked at the potential financial savings which could be realized through adopting the patient hotel model. The appraised studies found positive benefits of adopting the patient hotel model, both in terms of cost and patient satisfaction. One study explored the role of nurses in a patient hotel.

CONCLUSIONS

The lack of consistent definition, diversity in the descriptions, service provisions, and client groups meant that the results could only be systematically reviewed and not synthesized into a meta-analysis. The inconsistencies in labeling and description also have implications for the review process, as studies adopting more abstract classification of the patient hotel model may not have been included in the review. On balance, the appraised evidence appears to suggest that there are positive benefits to patients, nurses and healthcare providers. However further research of greater rigor is needed to provide a better understanding of these outcome measures. Implications for rehabilitation Patient hotels have particular relevance to the field of rehabilitation as they have a strong ethos of promoting self-care and independence, facilitated through greater freedom and family involvement. The patient hotel model has the potential to impact healthcare provision on the global stage, but there is no universal definition, making evidence evaluation difficult. The patient hotel model combines the concepts of health and hospitality and could potentially provide a cost-effective alternative to healthcare, with positive outcomes for patient experience as well as patient health. There is a need to explore new systems of care delivery which provide increased patient satisfaction, and a seamless continuum of care at the acute and primary care interface. This paper examines the patient hotel model of care, and its merits in terms of care provision, patient satisfaction and service efficiency, contributing to the embryonic literature in this field.