Circular design strategies and economic sustainability of construction projects in china: the mediating role of organizational culture

This research aims to elucidate the relationship between circular design strategies (CDS) and the economic sustainability of construction projects (ESCP), examining the mediating role of organizational culture (OC). Motivated by the imperative to develop a sustainable circular economy (CE) model in the building industry, our study focuses on a crucial dimension of CE processes. Specifically, we investigate how construction firms' organizational values shape their pursuit of desired economic outcomes within CE theory. Through a comprehensive analysis of 359 responses from a cross-sectional survey of Chinese construction firms employing Partial Least Squares-Structural Equation Modeling (PLS-SEM), our findings reveal a positive albeit weakly impactful association between CDS and ESCP. Simultaneously, OC is identified as a factor detrimental to ESCP. Notably, this study unveils the influential roles of hierarchical culture (HC) and group culture (GC) in shaping the current state of ESCP in China. Emphasizing the significance of CDS, we propose that contract administrators proactively reposition their organizations to adopt strategies conducive to achieving the necessary economic output for construction projects. The originality aspect lies in this research contributes to the existing body of knowledge by offering empirical insights into the theoretical framework, marking the first such empirical study in northern China. We conclude by critically examining research outcomes and limitations while providing insightful recommendations for future research to foster sustainable construction practices in the Chinese context.

How do organizational culture and leadership style affect nurse presenteeism and productivity?: A cross sectional study of Hong Kong acute public hospitals

BACKGROUND

Presenteeism is defined as a type of work behavior in which employees are physically present at work when ill, often with reduced performance. While organizational culture and leadership style are known to impact the organizational behavior of hospital staff, as indicated by increased burnout and decreased work engagement, their impact on nurse presenteeism and productivity has not been explored. Moreover, nursing studies often neglect the importance of using multi-level analysis, adopting aggregated unit-level scores to account for collective perceptions to evaluate culture and leadership.

OBJECTIVE

This study aims to evaluate the impact of unit-level organizational culture and leadership style on individual-level nurse presenteeism and productivity in acute care hospitals using multilevel analysis.

DESIGN

Cross-sectional study.

SETTING(S)

Three major acute care public hospitals in Hong Kong, where public hospitals provide over 90 % of inpatient services.

PARTICIPANTS

All full-time nurses (N = 4657) in the three study hospitals were invited to participate in this study. A total of 2339 nurses responded to the survey for a 65 % response rate.

METHODS

Organizational culture and leadership style are characterized using the competing values framework and a two-factor leadership style typology, respectively. Multilevel hierarchical linear modeling was applied with unit-level clustering in each hospital.

RESULTS

Hierarchical culture was the dominant culture (M = 3.64, SD = 0.74) in our nurse sample. None of the unit-level organizational culture and leadership styles were associated with nurse presenteeism, however, rational organizational culture at the unit-level was significantly associated with increased productivity (regression coefficient: 0.17, 95 % CI: 0.04-0.31).

CONCLUSIONS

This study provides hospital managers with improved understanding of the differential impact of unit-level organizational culture and leadership style on nurse presenteeism and productivity. Unit-level leadership style did not have a direct impact on nurse presenteeism and productivity in this study, while the externally focused rational organizational culture increased nurse productivity. Further research is needed to understand the impacts of modifiable work factors and nurse psychosocial emotions on presenteeism and productivity.

Effects of organizational and individual factors on nurses' practice of central line-associated bloodstream infection prevention

BACKGROUND

This study explored rarely investigated organizational factors (resource support and organizational culture) in conjunction with well-established individual factors (demographic characteristics, knowledge, and awareness) that impact nurses' practice of central line-associated bloodstream infection (CLABSI) prevention.

METHODS

Self-reported questionnaire data were collected from 173 nurses recruited from departments that use central venous catheters (ie, intensive care units, emergency rooms, hemodialysis rooms, and oncology wards) in tertiary hospitals in South Korea. Multiple regression analyses were performed to examine the effects of individual and organizational factors.

RESULTS

Organizational culture (ß = 0.350) had the greatest association with CLABSI prevention practice, followed by awareness (ß = 0.328) and department (ß = -0.217; all ps < 0.01). These variables explained 41.1% of the variance in CLABSI prevention practice (F = 20.996, P < .001). Higher self-reported CLABSI prevention practice was associated with a favorable organizational culture and higher awareness. Emergency room nurses' CLABSI prevention practice was notably inferior as compared to nurses in other departments.

DISCUSSION

Organizational culture is the most significant factor affecting nurses' practice of CLABSI prevention.

CONCLUSIONS

An organizational culture with environmental improvements and resource support as well as infection prevention education and awareness-building programs should be fostered.

If you build it, will they come? Exploring the success factors of knowledge management systems in the Malaysian public sector

The current study investigates the factors that influence the success of knowledge management systems in the public sector. This study integrates the DeLone and McLean Model with critical organizational factors. The model has been tested on the data collected from 158 employees in the public sector in Malaysia, the study found that knowledge content quality has a higher significant impact on the use of knowledge management systems than system quality. Perceived usefulness also has a greater impact than user satisfaction in determining the system's overall success. Among the organizational factors, leadership is the most significant determinant of success. However, the culture of sharing, perceived trust, and incentives do not significantly influence the use of knowledge management systems. The findings suggest that public sector organizations should focus on both system and organizational factors to implement successful knowledge management systems.

Predictive modeling of burnout based on organizational culture perceptions among health systems employees: a comparative study using correlation, decision tree, and Bayesian analyses

Burnout is a significant concern, particularly within the healthcare field, affecting both nurses and physicians. It is a common issue in health systems, which encompass a range of healthcare facilities, such as hospitals, physician practices, ambulatory sites, and administrative offices like finance. Despite this, there has not been an extensive exploration of burnout in employees working directly with patients versus those in non-patient-facing roles within these health systems. It is important to note that organizational culture plays a crucial role in influencing various aspects of employees' work-life balance and their experiences of burnout. This study adopts a cross-sectional design, involving the distribution of a 57-question Likert scale survey to employees in health systems. These employees serve in various roles, both patient-facing and non-patient-facing, within jointly owned healthcare organizations, which encompass hospitals, ambulatory sites, and administrative offices. The survey was disseminated through trade organizations and employees at the managerial level and above within these health systems. Data was collected between October 2022 and January 2023, resulting in a total of 67 responses. The study employs correlation analysis to explore the connection between organizational culture and burnout. Furthermore, a decision tree model is constructed to predict burnout scores based on survey responses, specifically the question regarding the perceived positivity of the organizational culture. The decision tree models indicate that perceiving organizational culture as positive, safety-oriented, and supportive predicts various outcomes for individuals, including job retention, positive experiences with patients, increased callousness, and stimulation while working with colleagues. Bayesian analysis, considering the small sample size, reinforces these findings and provides a different perspective, incorporating prior knowledge and credible intervals. An association test suggests a strong link between a positive organizational culture and burnout symptoms, while another test supports a connection with engagement signs. Similar to nurses and physicians, administrative health systems' personnel are susceptible to burnout. Organizational culture can affect burnout. Therefore, health systems' leaders should cultivate an organizational culture that protects against burnout.

How Can Organizations Support a Culture of Care?

Providing care is central to the operations of health care organizations. This article discusses how organizations can create a culture of care. It also identifies key elements that health care organizations can implement to build a culture that nurtures both patients and employees. Additionally, the article examines the benefits of implementing practices that demonstrate compassion toward both employees and patients. This article explores the significance of creating and supporting a culture of care for both patients and employees in health care organizations. Finally, the article identifies prevalent practices that contribute to a culture of care.

A mixed-methods evaluation of organization and individual factors influencing provider intentions to use caregiver coaching in community-based early intervention

BACKGROUND

Most psycho-social interventions contain multiple components. Practitioners often vary in their implementation of different intervention components. Caregiver coaching is a multicomponent intervention for young autistic children that is highly effective but poorly implemented in community-based early intervention (EI). Previous research has shown that EI providers' intentions, and the determinants of their intentions, to implement caregiver coaching vary across components. Organizational culture and climate likely influence these psychological determinants of intention by affecting beliefs that underlie attitudes, norms, and self-efficacy to implement an intervention. Research in this area is limited, which limits the development of theoretically driven, multilevel implementation strategies to support multi-component interventions. This mixed methods study evaluated the relationships among organizational leadership, culture and climate, attitudes, norms, self-efficacy, and EI providers' intentions to implement the components of caregiver coaching.

METHODS

We surveyed 264 EI providers from 37 agencies regarding their intentions and determinants of intentions to use caregiver coaching. We also asked questions about the organizational culture, climate, and leadership in their agencies related to caregiver coaching. We used multilevel structural equation models to estimate associations among intentions, psychological determinants of intentions (attitudes, descriptive norms, injunctive norms, and self-efficacy), and organizational factors (implementation climate and leadership). We conducted qualitative interviews with 36 providers, stratified by strength of intentions to use coaching. We used mixed-methods analysis to gain an in-depth understanding of the organization and individual-level factors.

RESULTS

The associations among intentions, psychological determinants of intentions, and organizational factors varied across core components of caregiver coaching. Qualitative interviews elucidated how providers describe the importance of each component. For example, providers' attitudes toward coaching caregivers and their perceptions of caregivers' expectations for service were particularly salient themes related to their use of caregiver coaching.

CONCLUSION

Results highlight the importance of multi-level strategies that strategically target individual intervention components as well as organization-level and individual-level constructs. This approach holds promise for improving the implementation of complex, multicomponent, psychosocial interventions in community-based service systems.

The role of organizational culture and communication skills in predicting the quality of nursing care

AIMS

This study aims to identify the level of nursing care quality and examine its predictors considering nurses' demographic data, organizational culture, and communication skills.

BACKGROUND

Quality of care is a determinant of the sustainability of any healthcare organization. Therefore, it is imperative to understand how factors may contribute to the quality of nursing care. Limited research is available on the interaction between the concepts of quality of nursing care, communication skills, and organizational culture.

METHODS

A cross-sectional multi-site correlational design was used in this study. A convenience sample of 200 nurses from four Jordanian hospitals was recruited. Data was collected using self-reported questionnaires. Descriptive statistics, Pearson correlations, and multiple regression were performed to achieve the study's aims.

RESULTS

The majority of the nurses in this study were females with bachelor's degrees. Age ranged between 22 and 53 years whereas experience ranged from 1 to 30 years. Communication skills significantly predicted the quality of nursing care; however, organizational culture was not a significant predictor of the quality of nursing care. Nevertheless, Pearson r correlation results revealed a significant correlation between organizational culture and communication skills (r = 0.57, p < 0.05).

CONCLUSION

Nurses and organizational managers can increase the level of quality of nursing care by investing in programs that target improving nurses' communication skills. Providing a good environment in the hospital can increase communication skills between staff members, ultimately increasing the quality of nursing care. Further studies are recommended to elaborate and further uncover concerns related to the current research.

Emotional culture and humor in organizations: A social-functional approach

Adopting a social-functionalist theoretical lens, this review examines emotional culture and its relation to discrete emotions such as joviality and humor-supportive or "joking" organizational cultures. We propose four primary pathways through which humor influences emotional culture in organizations and social units: (1) creating and defining emotional culture through "bottom-up" affective mechanisms, (2) a "top-down" normative function that promotes or inhibits humor through cultural values, norms, and traditions of organizational life, (3) a maintenance function, whereby humor corrects emotional culture norm violations, and (4) a link to positive work outcomes via a reciprocal feedback loop. We also describe negative consequences of humor for emotional culture, highlight unanswered questions in the literature, and suggest future research opportunities, including a comprehensive new framework.

First-line managers struggling to lead home care based on the individual's needs and goals - conflict between ethical principles

PURPOSE

The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual's needs and goals.

DESIGN/METHODOLOGY/APPROACH

In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis.

FINDINGS

The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization's needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle.

ORIGINALITY/VALUE

The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual's needs and goals.

Change Management and Health Care Culture

Change management in health care is the process of implementing new policies, procedures, and practices in order to improve the quality of patient care. It involves understanding the need for change, identifying the stakeholders involved, and developing a plan to implement and manage the change. Change management in health care requires a comprehensive and collaborative approach to ensure that changes are properly implemented, communicated, and monitored. It is essential for health care providers to be aware of the current trends in health care and to stay up to date with the latest technology in order to provide the best care possible.

Ethical leadership in physical therapy: a developing construct that demands consideration

PURPOSE

This paper aims to introduce the Theory of Ethical Leadership as a possible means of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives. Specific examples of how this can be applied directly to the profession of physical therapy will be presented.

DESIGN/METHODOLOGY/APPROACH

Leadership influences can profoundly affect a profession, an organization and an individual. This has led to exploring which leadership style would be most effective in moving their organization forward. Through a review of the literature, this viewpoint paper compares leadership theories present in the health-care literature, as well as why they may fall short of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives.

FINDINGS

Most research has separated ethics from leadership, but all agree that to be successful, the leader needs to exhibit a strong moral compass and demonstrate positive ethical behavior. At the intersection of ethics and leadership is the emerging theory of ethical leadership. Ethical leadership is based on the premise that employees look outside of themselves for ethical guidance and that leaders have an opportunity to provide this moral awareness by making an ethical message sufficiently salient to be recognized in the organizational context as well as allowing the leader to stand out against an ethically neutral ground.

ORIGINALITY/VALUE

This paper is an original work and has not been published previously, either in whole or in part. Additionally, this paper is not under consideration for publication by any other journal.

Improving population health and well-being in academic institutions and health care systems with the Chief Wellness Officer: A vital yet untapped nursing leadership role

BACKGROUND

There is an epidemic of chronic conditions throughout the world. Although the majority of chronic disease can be prevented, the U.S. invests so little of its healthcare spending in wellness and prevention. Nurses are an ideal profession to lead a needed paradigm shift as chief wellness officers (CWOs).

PURPOSE

The aim of this paper is to describe the role of the CWO in improving population health and well-being in universities and health systems.

METHODS

An example of how the CWO role was implemented at a large public land grant university is provided. The socioecological model and life course perspective was adopted as the framework to guide an ambitious wellness strategic plan using an evidence-based quality improvement strategy.

DISCUSSION

The CWO is a vital leadership role in today's institutions of higher learning and health systems.

CONCLUSION

There is an urgent need for nurses to step up into these impactful CWO positions.

Relationships of organizational behavior/mission congruence with burnout, secondary traumatic stress, and compassion satisfaction among nurses

OBJECTIVE

The current study focuses on organizational culture as a determinant of well-being among nurses.

BACKGROUND

Nurse well-being is an increasing concern for organizational operations and patient care quality. There are limited studies on the aspects of organizational culture, such as leadership and perception of organizational mission, that relate to clinician well-being.

METHODS

A cross-sectional survey study was conducted among nurses in a U.S. hospital. Measures were professional quality of life, organizational culture, and authentic leadership. Statistical methods were used to analyze findings.

RESULTS

Among the nurses (N = 147), after controlling for significant demographic factors, organizational culture and authentic leadership had significant correlations with burnout, secondary traumatic stress, and compassion satisfaction. In multivariate analyses, organizational culture was a significant predictor for burnout and compassion satisfaction.

CONCLUSION

This study provides empirical evidence that organizational behavior is important to staff well-being. Organizations that act with fidelity to their missions of caring and quality patient care are more likely to have nursing staff that are emotionally healthy in the workplace.

Influence of knowledge management infrastructure on knowledge creation processes. A study in the primary sector

Under the theoretical approaches of the resource-based view of the firm, the dynamic capabilities and the knowledge-based view of the firm, the purpose of this paper is to analyze the influence that the knowledge management infrastructure has on knowledge creation processes in primary sector companies, specifically, the aquaculture sector. For the empirical analysis, the SEM-PLS approach was used on a sample of 186 shrimp farms in Ecuador. Results confirm that the environment and organizational structure, and culture influence knowledge creation, while technological resources are not significant. This can be explained by the characteristics of the central activities of the shrimp companies and the assignment of functions. From a theoretical point of view, this paper links the knowledge-based view of the firm with the activities of the primary sector. Specifically, a theoretical model is developed in which the variables that can influence the knowledge creation processes of shrimp farms are studied. Existing works in the scientific literature that analyze both perspectives are practically nil. From a managerial perspective, given the importance of the creation and renewal of knowledge to develop organizational capabilities in the face of the dynamism of the market, the findings of this study can guide managers to understand how the combination of resources can help increase stocks of knowledge useful to business objectives.

A Comparison of the Readiness of Youth Service Agencies to Implement a Technology-Based Toolkit to Support Treatment Delivery

Implementation initiatives and technology-based resources aim to address barriers to Evidence-Based Practice (EBP) use by creating generalizable techniques that can be used for a variety of youth-serving agencies. However, research has not carefully examined unique differences between agency types or individual programs in readiness to use such technologies and implementation strategies. The current study explored differences between community mental health clinics and child advocacy centers on organizational cultural factors (e.g., ability to change and commitment for change) to implement a novel technology-based toolkit to support delivery of Trauma Focused Cognitive Behavioral Therapy (TF-CBT). Results indicated that TF-CBT providers from child advocacy centers reported greater commitment to change and more support to use the technology-based system than those from community mental health centers. Findings suggest that implementation initiatives should address the needs of individual agencies and service settings and adaptations should be explored to best meet the needs of these settings.

Sound psychometric properties of a short new screening tool for patient safety climate: applying a Rasch model analysis

BACKGROUND

WHO recommends repeated measurement of patient safety climate in health care and to support monitoring an 11 item questionnaire on sustainable safety engagement (HSE) has been developed by the Swedish Association of Local Authorities and Regions. This study aimed to validate the psychometric properties of the HSE.

METHODS

Survey responses (n = 761) from a specialist care provider organization in Sweden was used to evaluate psychometric properties of the HSE 11-item questionnaire. A Rasch model analysis was applied in a stepwise process to evaluate evidence of validity and precision/reliability in relation to rating scale functioning, internal structure, response processes, and precision in estimates.

RESULTS

Rating scales met the criteria for monotonical advancement and fit. Local independence was demonstrated for all HSE items. The first latent variable explained 52.2% of the variance. The first ten items demonstrated good fit to the Rasch model and were included in the further analysis and calculation of an index measure based on the raw scores. Less than 5% of the respondents demonstrated low person goodness-of-fit. Person separation index > 2. The flooring effect was negligible and the ceiling effect 5.7%. No differential item functioning was shown regarding gender, time of employment, role within organization or employee net promotor scores. The correlation coefficient between the HSE mean value index and the Rasch-generated unidimensional measures of the HSE 10-item scale was r = .95 (p < .01).

CONCLUSIONS

This study shows that an eleven-item questionnaire can be used to measure a common dimension of staff perceptions on patient safety. The responses can be used to calculate an index that enables benchmarking and identification of at least three different levels of patient safety climate. This study explores a single point in time, but further studies may support the use of the instrument to follow development of the patient safety climate over time by repeated measurement.

Bridging the educational gap in terms of digital competences between healthcare institutions' demands and professionals' needs

BACKGROUND

Healthcare professionals with insufficient digital competence can be detrimental to patient safety and increase the incidence of errors. In order to guarantee proper care, healthcare organizations should provide opportunities to learn how to use technology, especially for those professionals who have not received training about this topic during their undergraduate studies.

OBJECTIVE

This exploratory study aimed to conduct surveys among Spanish healthcare professionals to determine whether their organisations had trained them in the use of healthcare technology and the areas where most emphasis was placed.

METHODS

1624 Spanish healthcare professionals responded to an ad hoc online survey 7 questions related to the digital skill training offered by the healthcare organisations they work for.

RESULTS

Nurses were the most widely represented group, making up 58.29% of the total, followed by physicians namely 26.49%. Only 20% of the nurses surveyed had received some training from their institution related to healthcare technology. According to the participants' responses, physicians received significantly more training in this area than nurses. Training related to database searching for research purposes or computer management followed the same trend. Nurses also received less training than physicians in this area. 32% of physicians and nurses paid for their own training if they did not receive any training from institutions.

CONCLUSIONS

Nurses receive less training, on topics such as database searching or management, from the healthcare centres and hospitals where they work. Moreover, they also have fewer research and digital skills. Both of these factors may lead to deficits in their care activities, and have adverse effects on patients. Not to mention fewer opportunities for professional progress.

An antidote to what's ailing healthcare workers: a new (old) way of relational leadership

PURPOSE

The purpose of the study's mixed-methods evaluation was to examine the ways in which a relational leadership development intervention enhanced participants' abilities to apply relationship-oriented skills on their teams.

DESIGN/METHODOLOGY/APPROACH

The authors evaluated five program cohorts from 2018-2021, involving 127 interprofessional participants. The study's convergent mixed-method approach analyzed post-course surveys for descriptive statistics and interpreted six-month post-course interviews using qualitative conventional content analysis.

FINDINGS

All intervention features were rated as at least moderately impactful by at least 83% of participants. The sense of community, as well as psychological safety and trust created, were rated as impactful features of the course by at least 94% of participants. At six months post-intervention, participants identified benefits of greater self-awareness, deeper understanding of others and increased confidence in supporting others, building relationships and making positive changes on their teams.

ORIGINALITY/VALUE

Relational leadership interventions may support participant skills for building connections, supporting others and optimizing teamwork. The high rate of skill application at six months post-course suggests that relational leadership development can be effective and sustainable in healthcare. As the COVID-19 pandemic and systemic crises continue to impact the psychological well-being of healthcare colleagues, relational leadership holds promise to address employee burnout, turnover and isolation on interprofessional care teams.

Organisational drivers of performance in mental health providers

PURPOSE

This study aims to compare and contrast the core organisational processes across high and low performing mental health providers in the English National Health Service (NHS).

DESIGN/METHODOLOGY/APPROACH

A multiple case study qualitative design incorporating a full sample of low and high performing mental health providers.

FINDINGS

This study suggests that the organisational approaches used to govern and manage mental health providers are associated with their performance, and the study's findings give clues as to what areas might need attention. They include, but are not limited to: developing appropriate governance frameworks and organisational cultures, ensuring that staff across the organisation feel "psychologically safe" and able to speak up when they see things that are going wrong; a focus on enhancing quality of services rather than prioritising cost-reduction; investing in new technology and digital applications; and nurturing positive inter-organisational relationships across the local health economy.

ORIGINALITY/VALUE

Highlights considerable divergence in organisation and management practices that are associated with the performance of mental health trusts in the English NHS.

Mechanisms linking individual and organizational culture change through action research: Creating change agents for organizational and food safety culture development

This article proposes a more individualized approach to organizational and food safety culture development through the creation of culture change agents. The study used action research with individual therapeutic training of sensory and emotional skills as the action intervention to reveal underlying mechanisms of the culture and create long-term culture change. The study was conducted with a group of voluntary employees over a 3-year period at a department under Food Safety and Veterinary Issues in Danish Agriculture and Food Council. Data was collected using individual in-depth qualitative interviews with a novel questionnaire technique that facilitated participants to bring otherwise unconscious underlying assumptions to awareness. The study found that working intensely and therapeutically on an individual and group level, had a significant impact on the surrounding culture and social capital. Five underlying mechanisms were revealed linking individual culture change to changes in the social capital and culture of the department. Going through the five underlying mechanisms may enable individuals to get to the root causes of issues, facilitate more sharing and collaboration to learn from near-misses and failures, and take action despite facing uncomfortable situations, all important abilities to develop FSC. Based on the underlying mechanisms a 'Change Agent Model' was developed. The model illustrates the important underlying mechanisms that any individual or group can work through to become culture change agents and drivers for organizational culture and FSC development. This is the first of two articles.

Cross-cultural adaptation and validation of the Hospital Survey on Patient Safety Culture 2.0 - Brazilian version

BACKGROUND

Patient safety culture concerns the values, beliefs and standards shared by an organisation's health staff and other personnel which influence their care provision actions and conduct. Several countries have made a priority of strengthening patient safety culture to improve the quality and safety of health care. In this direction, measuring the patient safety culture through validated instruments is a strategy applied worldwide. The purpose of this study was to adapt transculturally and validate the HSOPSC 2.0 to Brazilian Portuguese and the hospital context in Brazil.

METHODS

Of the various validated scales for measuring safety culture, the instrument most used internationally is the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the United States Agency for Healthcare Research and Quality in 2004 and revised in 2019, when version 2.0 was released. Adaptation was conducted on a universalist approach and the adapted instrument was then applied to a sample of 2,702 respondents (56% response rate) comprising staff of a large general hospital in the city of São Paulo. Construct validity was investigated by Exploratory Structural Equation Modelling-within-Confirmatory Factor Analysis (ESEM-within-CFA) and reliability was measured in each dimension by means of Cronbach alpha coefficients.

RESULTS

ESEM fit indexes showed good data fit with the proposed model: χ2 = 634.425 df = 221 χ2/df ratio = 2.9 p-value < 0.0000; RMSEA = 0.045 (90% C.I. = 0.041-0.050) and probability RMSEA <  = .05 = 0.963; CFI = 0.986; TLI = 0.968. However, ten items had loads lower than 0.4. Cronbach alpha values were 0.6 or more for all dimensions, except Handoffs and information exchange ([Formula: see text]= 0.50) and Staffing and work pace ([Formula: see text] = 0.41).

CONCLUSION

The psychometric properties of the Brazilian version were found to be satisfactory, demonstrating good internal consistency and construct validity as expressed by estimates of reliability and indexes of model fit. However, given factor loadings smaller than 0.4 observed in ten items and considering that the scale translated and adapted to Portuguese was tested on a single sample during the Covid-19 pandemic, the authors recognize the need for it to be tested on other samples in Brazil to investigate its validity.

Organizational culture and affective commitment to e-learning' changes during COVID-19 pandemic: The underlying effects of readiness for change

Higher education institutions (HEIs) have been embracing digital transformation for years, but the disruptive influence of the global COVID-19 pandemic has accelerated it. Despite the importance of organizational culture (OC) for the successful delivery of e-learning, empirical studies looking at its impact on academics' readiness and affective commitment to e-learning-induced changes are scant. This study unveils the underlying impacts of multiple employee readiness for change (ERFC) dimensions in the OC-employee affective commitment to change (EACC) relationship. Survey data were obtained from 1,200 Jordanian public HEIs' academics. Structural equation modelling was used to analyze the data, testing the study's six hypotheses. The findings offer a novel contribution by showing that OC types influence different dimensions of ERFC, each having a distinctive impact on EACC. It further shows that two ERFC dimensions, namely self-efficacy and personal valence, function as full mediators in the relationships between group culture/adhocracy culture and EACC.

Organizational Culture as a Determinant of Outcome in Teams: Implications for the Pediatric Cardiac Specialist

Although enormous effort has focussed on how to build an effective culture in the business community, relatively little effort has addressed how to achieve this in the hospital environment, specifically related to the field of congenital heart disease teams. The examination of culture in pediatric cardiac care is particularly important for several key reasons: first, it represents high-stakes medicine, second, there are multiple stakeholders requiring collaboration between cardiologists, surgeons, anaesthesiologists, perfusionists, nursing staff, and allied health care professionals, and finally, both the patient and the family are intimately involved in the care pathway. This review article investigates some of the critical components to building an effective culture, drawing upon similarities in other disciplines, thereby fostering high performance multidisciplinary teams in congenital cardiology care. Strategies to change culture such as Kotter's model of change are also discussed. High performance teams share one common vital characteristic: psychological safety for team members to speak their minds, thereby fostering an open culture, in which creativity can flourish to facilitate major breakthroughs. Adoption of the "Flight Plan" review promotes patient centric care and champions a psychologically safe culture.

Advice for women considering a career in medicine: A qualitative study of women physicians' perspectives

BACKGROUND

Research has explored the problems that women encounter during a medical career; however, the advice that experienced women physicians would give to women who have not yet entered the field is needed to reveal how the medical work landscape is evolving and to provide real-world narratives to help career seekers make informed choices.

OBJECTIVE

By eliciting women's perspectives on their medical careers by asking them what advice they would give to aspiring women physicians. We aimed to reveal areas for improving career satisfaction of women physicians and to inform those who advise women considering a medical career.

METHODS

In this qualitative study, we used a phenomenological approach to conduct semi-structured one-on-one interviews with 24 women physicians to query the advice they would give to women contemplating a career in medicine.

RESULTS

Thematic analysis of interview transcriptions revealed 10 themes that women physicians communicated as being important to consider before deciding to become a physician. Although some advice had a cautionary tone, encouraging and practical advice was also conveyed. The most abundant themes concerned the centrality of patient care, a passion for practicing medicine, and the importance of planning. Other key topics included family and friends, self-reflection, life balance, finances, ethics, maintaining presence, and two overt cautionary statements.

CONCLUSION

Interviews revealed that meaning and purpose derived from a medical career and maintaining work-life balance are valued by some women physicians. Participants were encouraging in recommending medicine as a career choice for women, while highlighting some challenges.

Occupational physicians dealing with mental health: between employee and company interests: a qualitative study

BACKGROUND

Occupational health physicians are increasingly confronted with mental health issues at their workplace. Facing them, most of them feel insecure and not sufficiently trained. Employee's mental well-being depends at the same time on individual and significantly on organizational variables. This complicates the physician's position, since they have to serve many interests. The focus of the present study is to investigate what difficulties occupational health physicians face and how organizational culture and management influence their work.

METHODS

Interviews were conducted with N = 25 physicians as part of a training for basic mental health care. Interviews were interpreted using qualitative content analysis.

RESULTS

Working with mentally ill employees was difficult for the physicians interviewed. Many felt insecure managing and preventing mental health issues. A need for further education was observed. Environmental factors (organizational culture, management) have a strong impact on the work of an occupational health physician and highlight its systemic dimension. Even though many of our participants report a meanwhile more open attitude towards mental disorders at their workplace, on the level of direct contact to the management prevail descriptions of little acceptance and a high priority of economic outcomes.

CONCLUSIONS

More education on topics of mental health is needed for occupational health physicians. Future trainings should consider the intertwined nature of their work and enable them in dealing consciously with other actors in the company. For enhancing employee's mental well-being occupational health physicians could be granted a strengthened position in companies or be supported through more exchange with colleagues in other companies.

How Do Area Agencies on Aging Build Partnerships With Health Care Organizations?

BACKGROUND AND OBJECTIVES

Partnerships between health care and social service organizations may contribute to lower health care use and spending. Such partnerships are increasing, including Area Agencies on Aging (AAAs) working and contracting with health care organizations. Nevertheless, knowledge about how AAAs establish and manage successful collaborations is limited. We sought to understand how AAAs establish and manage partnerships with health care organizations.

RESEARCH DESIGN AND METHODS

We conducted an explanatory sequential mixed-methods study using a positive deviance approach. We used national-level data to identify AAAs with multiple health care partners serving areas with low utilization of nursing homes by residents with low-care needs (n = 9) and AAAs with few health care partners and high utilization for comparison (n = 3). We conducted in-depth interviews with key informants from these 12 AAAs and their partner organizations (total n = 130). A 5-person multidisciplinary team used the constant comparative method of analysis, supported by Atlas.ti software.

RESULTS

Highly partnered AAAs were characterized by 3 distinctive features of organizational culture: (a) attention to external environments, (b) openness to innovation and change, and (c) risk-taking to learn, improve, and grow. AAAs and partners describe a broad set of organizational strategies and partnership development tactics, depending on their local contexts. These features were underdeveloped in AAAs with few health care partnerships.

DISCUSSION AND IMPLICATIONS

While federal and state policies can create more favorable environments for AAA-health care partnerships, AAAs can also work internally to foster an organizational culture that allows them to thrive in dynamic and challenging environments.

Patient safety culture in the operating room: a cross-sectional study using the Hospital Survey on Patient Safety Culture (HSOPSC) Instrument

BACKGROUND

Credible evidence has established a link between the level of patient safety culture in healthcare environments and patient outcomes. Patient safety culture in the operating room has received scant attention despite the burden of adverse events among surgical patients. We aimed to evaluate the safety culture in our operating rooms and compare with existing data from other operating room settings.

METHODS

We investigated the patient safety culture in the operating rooms of our hospital as perceived by the surgeons, nurse anaesthetists and perioperative nurses using the Hospital Survey on Patient Safety Culture (HSOPSC) instrument. IBM Statistical Package for Social Science software, version 25, was used for data entry and analysis. Differences were considered significant when p < 0.05.

RESULTS

Only 122 completed surveys were returned out of a survey population of 132 frontline staff, yielding a response rate of 92.4%. The overall average composite score was 47%. The average composite scores ranged from 17-79.6% across the 12 dimensions of the HSOPSC, with teamwork within units being the only dimension with demonstrable strength. Non-punitive response to error, communication openness, feedback and communication about error", frequency of events reported", handoffs and transition and staffing need improvement. The perceived safety culture varied according to work areas and professional roles with nurse anaesthetists having the highest perception and the surgeons the least.

CONCLUSION

Patient safety culture in our operating rooms is adjudged to be weak, with only one of the twelve dimensions of HSOPSC demonstrating strength. This is notwithstanding its comparative strengths relative to other operating room settings.

Impact of corporate sustainable practices, government initiative, technology usage, and organizational culture on automobile industry sustainable performance

The increasing worldwide automobile production and usage adversely impact the environmental, economic, and social well-being. Although the automobile companies are trying to solve this problem by adopting corporate sustainability, there is a gap in the extant literature on sustainable corporate practices that are the most important to empower better sustainability performance. This study highlights the impact of core corporate sustainable practices attributes, government initiative, technology usage, and organizational culture on the sustainable performance of the automobile industry in India. The study proposed six aspects and fifty-three criteria from the literature review. The current article has used survey questionnaires to collect the primary data. The present article also applied the smart-PLS to test the association among the variables. The results indicated that the corporate sustainable practices attributes, technology usage, and organizational culture have a positive and significant linkage with the sustainable performance of the automobile industry. The current article guides the regulators in developing the regulations to improve sustainable organizational performance using sustainable corporate practices.

The contribution of organizational culture, structure, and leadership factors in the digital transformation of SMEs: a mixed-methods approach

Contributing to the scarce literature on how companies can deal with their business model of digital transition, this work explores the digital transformation (DT) process in small and medium enterprises (SME), investigating how organizational culture, structure, and leadership influence it. While such three factors are deemed essential components to facilitate DT, how they operate and how they relate to each other are still not very well-defined issues in need of in-depth investigation. This study employed a mixed-methods approach, following an exploratory sequential design. First, a conceptual model was developed based on qualitative data collected from expert interviews and analyzed through grounded theory. This stage uncovered 25 first-order concepts about culture, structure, and leadership, further organized into 6 constructs and hypothesis paths. Then, with a sample of 192 SMEs, the structural model was measured and validated using exploratory factor analysis and PLS-SEM. As a result, our study offers robust and timely research, whose conceptual model condenses a knowledge corpus that future research can benefit from, and it provides statistical extrapolations about how and how much those factors relate to each other in SME context; moreover, given the traditional scarce resources and lack of flexibility in SMEs, it provides orientation and guidelines to managers facing DT and needing to understand the organizational factors they should be aware of, where to focus energy, and what to expect as results. From a large-scale perspective, this study carries an impactful contribution to the many countries where SMEs play a major economic and social role.

The role of organizational culture

The Covid-19 pandemic has involved nations world-wide in the necessity to manage and control the spread of infection, and challenged organizations to effectively counteract an unchartered medical crisis while preserving the safety of workers. While the pandemic and geopolitical turmoil caused by the war in Ukraine are recent examples of complex environments that require effective safety and crisis management, organizations may generally need to find ways to deal with the unexpected and reliably perform in the face of fluctuations. Mindful organizing (MO) is defined as the collective capability to detect discriminatory details about emerging issues and act swiftly in response to these details, thus allowing members to anticipate, and recover from, any errors or unexpected events that arise. Organizational culture refers to the mindset shared among members which orients their actions and thus qualifies as a relevant contextual factor that determines whether the specific forms of perceiving and acting entailed by MO may emerge in an organization. The present paper aimed to propose a conceptual model linking organizational culture, MO and organizational outcomes (i.e., safety, reliability, crisis management), and delineate arguments to address the match/mismatch between MO and culture types. Specifically, it is proposed that organizational culture determines the way an organization develops MO and the subsequent ability to handle unexpected events which might jeopardize organizational effectiveness and safety. Our contribution bridges the still disparate fields of MO and organizational culture, and provides scholars and practitioners with a complexity- and uncertainty-sensitive integrative framework in order to intervene on organizational outcomes.

Differences in employment, job characteristics, and work-related perceptions by sociodemographic factors among registered nurses of diverse race/ethnicity

BACKGROUND

Available research on registered nurses (RNs) indicates that RNs with diverse race/ethnicity are more likely to work in disadvantaged workplaces.

PURPOSE

To examine differences in employment, job characteristics and perceptions about work among RNs by sociodemographic characteristics.

METHODS

We analyzed data from statewide random samples of California RNs (N=895).

FINDINGS

Increased age was associated with increased likelihoods of working part-time, day-shift, and in non-hospital settings and having managerial positions. Asian and Black nurses were more likely to work in urban areas than White nurses. The levels of job demand, job control, job satisfaction, perceived organizational culture, and safety climate were significantly different by sociodemographic characteristics. Greater intention to leave the job was associated with younger age and working in non-hospital settings.

DISCUSSION

The findings suggest that differences exist in nurses' employment, job characteristics, and perceptions about their work and work environment by sociodemographic characteristics among RNs of diverse race/ethnicity.

Implementation and modification of an organizational-level intervention: a prospective analysis

Background

Modifications to interventions can jeopardize intervention outcomes. Pre-existing perceived barriers and facilitators to the intervention arising in the implementation preparation phase may help explain why modifications to the intervention may occur during the implementation phase. This two-site comparative case study describes modifications made to a complex organizational-level intervention and examines how known implementation science factors may have enabled such changes to occur.

Methods

Northwestern Medicine’s^TM Hispanic Kidney Transplant Program (HKTP) is a culturally competent transplant center-based intervention designed to reduce disparities in living donor kidney transplantation among Hispanics. In-depth qualitative interviews and discussions were longitudinally conducted with transplant stakeholders (i.e., physicians, administrators, clinicians) at two kidney transplant programs with large Hispanic populations during implementation preparation and implementation phases. The Consolidated Framework for Implementation Research (CFIR) guided interview design and qualitative analysis, and Stirman’s Framework for Reporting Adaptations and Modifications-Expanded (FRAME) guided modification classification.

Results

Across sites, 57 stakeholders participated in an interview, group discussion, and/or learning collaborative discussion. Site-B made more modifications than Site-A (n = 29 versus n = 18). Sites differed in the proportions of delaying/skipping (Site-A 50% versus Site-B 28%) and adding (Site-A 11% versus Site-B 28%) but had comparable substituting (Site-A 17% versus Site-B 17%) and tweaking (Site-A 17% versus Site-B 14%) modification types. Across sites, the transplant team consistently initiated the most modifications (Site-A 66%; Site-B 62%). While individuals initiated slightly more modifications at Site-B (21% versus Site-A 17%), institutions instigated proportionately slightly more modifications at Site-A (17% versus Site-B 10%). CFIR inner setting factors (i.e., structural characteristics, culture, available resources, implementation climate) that prominently emerged during the implementation preparation phase explained similarities and differences in sites’ modification numbers, types, and agents in the implementation phase.

Conclusion

Organizations implementing a culturally competent care intervention made modifications. CFIR inner setting factors emerging in the implementation preparation phase largely explained similarities and differences in study sites’ modifications. Identifying factors contributing to modifications may help institutions become better prepared to implement an intervention by addressing known factors in advance, which may foster greater fidelity leading to desired outcomes.

Trial registration

ClinicalTrials.govNCT03276390. We registered the study retrospectively on 9-7-17.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43058-022-00296-0.

Organisational and staff-related effects on cultural competence in the hospital setting: a cross-sectional online survey of nursing and medical staff

Background

Cultural competence is considered a core qualification for dealing with socio-cultural diversity and balancing disparities in health care.

Objectives

To explore features supporting and inhibiting cultural competence in the hospital at both organisational and staff levels.

Design

Cross-sectional online survey in the form of a full census from May to November 2018.

Setting

Two organisations that run a total of 22 hospitals in Germany.

Participants

Eight hundred nursing and medical professionals [nurses: n = 557; doctors: n = 243].

Methods

Using the Short Form Cultural Intelligence SCALE (SFCQ), cultural competence was measured and its relation to potential influencing factors at staff level and organisational level examined, using bivariate (t-Test, one-way ANOVA, Pearson and Spearman correlations) and multivariate (multiple linear regression) approaches. Model 1 examined features at organisational level, Model 2 at individual level and Model 3 included organisational and individual features.

Results

The mean cultural competence measured was 3.49 [min.: 1.3; max.: 5.0]. In the bivariate and isolated multivariate models [Models 1 and 2], factors on both organisational and individual levels were significantly related to the hospital staff’s cultural competence. The multivariate overview [Model 3], however, revealed that individual features at staff level were the statistically relevant predictors. Positive influencing features included staff’s assessment of the importance of cultural competence in their professional context [B: 0.368, 95% confidence interval 0.307; 0.429], participation in competence training [B: 0.193; 95% confidence interval 0.112; 0.276] and having a migration background [B: 0.175; 95% confidence interval 0.074; 0.278], while negative features included length of medical service [B: -0.004; 95% confidence interval -0.007; -0.001].

Conclusions

The development and practice of cultural competence appear to be determined less by organisational features and more on the level of individual actors. In addition to staff development, adequate organisational structures and an economic incentive system are required to promote sociocultural diversity in hospitals.

The impact of organizational culture and leadership climate on organizational attractiveness and innovative behavior: a study of Norwegian hospital employees

BACKGROUND

In the domain of health services, little research has focused on how organizational culture, specifically internal market-oriented cultures (IMOCs), are associated with organizational climate resources, support for autonomy (SA), and whether and how IMOCs and SA are either individually or in combination related to employee perceptions of the attractiveness of the organization and their level of innovative behavior. These knowledge gaps in previous research motivated this study.

METHODS

A conceptual model was tested on a sample (N = 1008) of hospital employees. Partial least-squares structural equation modeling (PLS-SEM) was employed to test the conceptual models, using the SmartPLS 3 software. To test the mediator effect, a bootstrapping test was used to determine whether the direct and indirect effects were statistically significant, and when combining two tests, to determine the type of mediator effect.

RESULTS

The results can be summarized as four key findings: i) organizational culture (referring to an IMOC) was positively and directly related to SA (β = 0.87) and organizational attractiveness (β = 0.45); ii) SA was positively and directly related to both organizational attractiveness (β = 0.22) and employee individual innovative behavior (β = 0.37); iii) The relationships between an IMOC, SA, and employee innovative behavior were all mediated through organizational attractiveness; and iv) SA mediated the relationship between the IMOC and organizational attractiveness as well as that between the IMOC and employee innovative behavior.

CONCLUSIONS

Organizational culture, IMOC, organizational climate resources, and SA were highly correlated and necessary drivers of employee perceptions of organizational attractiveness and their innovative behavior. Managers of hospitals should consider IMOC and SA as two organizational resources that are potentially manageable and controllable. Consequently, managers should actively invest in these resources. Such investments will lead to resource capitalization that will improve both employee perceptions of organizational attractiveness as well as their innovative behavior.

Dataset exploring organizational culture of K-12 schools

Culture can be understood as an explicit social product arising from social interaction as an intentional or unintentional consequence of behavior. Educational Institutions culture differs from other organizational cultures as it impacts teachers' performance and students' learning. In this survey the definition of organizational culture used is given by Schein, "The deeper level of basic assumptions and beliefs that are, learned responses to the group's problems of survival in its external environment and its problems of internal integration; are shared by members of an organization; that operate unconsciously; and that define in a basic 'taken -for-granted' fashion in an organization's view of itself and its environment" [1]. The data contains 1158 cases collected from K-12 School teachers on their perception of values and beliefs of their organizational culture using the OCTAPACE scale. Convenience sampling is used to obtain the data from teachers. The questionnaire was administered personally to teachers from sixty-five Private aided, Private unaided and Government schools. The eight dimensions measuring values and beliefs of Educational Institutions organizational culture are Pro-action, Authenticity, Openness, Collaboration, Experimenting, Trust, Confrontation and Autonomy. Descriptive statistics are computed from the dataset. The dataset can be used by researchers for meta analysis on organizational culture and school management can explore in depth the need for an organizational culture of autonomy, experimenting, collaboration and openness among teachers.

An evaluation of excellence in primary healthcare units after the introduction of a performance management innovation in two regional states of Ethiopia: a facility based comparative study

BACKGROUND

The Ethiopian Ministry of Health strives to achieve universal health coverage (UHC) through increasing the number of its high-performing primary healthcare units. Although the Ethiopian health system is managed within a decentralized political system, the Ministry of Health works towards institutionalizing performance management innovations and organizational cultures that increase the excellence of primary healthcare entities. To date, there has been little evidence gathered on the factors influencing the excellence of primary healthcare units in Ethiopia. Therefore, the aim of this study was to assess and compare how the introduction of performance management and organizational culture innovations through project support affect the excellence of primary healthcare units in Ethiopia.

METHODS

A facility-based comparative study was conducted in USAID Transform: Primary Health Care project supported and non-supported primary healthcare units located in the Oromia and Southern Nations Nationalities and Peoples' (SNNP) regions of Ethiopia. Quantitative data were collected from randomly selected health workers using interviewer-administered questionnaires. In addition, primary healthcare unit excellence measurements were extracted from routine health information databases over eight quarters. The data were analyzed using the Statistical Package for Social Science (SPSS IBM v 20) research software package. Results were presented in frequency tables and graphs. After checking the data for homogeneous distribution, a paired sample t-test for equal variances, otherwise known as the Mann-Whitney U test was analyzed to claim statistically significant difference at P < 0.05.

RESULTS

Out of 368 invited health workers, 364 participated in this study, (a response rate of 98.9%). Slightly higher than two-thirds of participants were enrolled from the Jimma Zone of Oromia Region. Orientations on performance management standards were provided to 101 (68.2%) and 45 (48.3%) health workers from project-supported and non-supported facilities, respectively. The mean perceived organizational culture score with [± Standard Deviation (SD)] was 3.72 ± 0.75 among project-supported health workers and 3.385 ± 0.75 among non-supported health workers, respectively. An independent sample t-test showed statistically significant differences, where project-supported health workers had higher mean scores on perceived organizational culture than their non-supported counterparts, with t = 433, df = 362, P = 0.001. The mean baseline primary healthcare unit excellence score was 63.2% and 50.5% for project-supported and non-supported health facilities, respectively. The end line excellence scores increased to 93.3% for project-supported and 79.1% for non-supported facilities. The end line overall primary healthcare units' mean rank excellence scores were 257.67 for the project supported and 105.66 for non-project supported facilities. This result of a non-parametric test, i.e. the Mann-Whitney U test revealed that project-supported facilities were higher and had a positive statistically significant difference (U = 2,728, z = -13.78, P = 0.001).

CONCLUSIONS

The findings of this study underscore a direct relationship between implementing performance management innovations and enhancing organizational cultures for excellence at primary healthcare units. Project-supported primary healthcare units had higher organizational culture and excellence scores than their counterpart non-supported facilities. Therefore, achieving UHC through excellence in primary healthcare facilities requires scaling up of performance management innovation interventions.

Size matters: How safety climate and downstream outcomes vary by fire department organization type

BACKGROUND

Safety climate is an upstream predictor of safety behaviors (e.g., safety compliance), organizational outcomes (e.g., burnout, engagement), and safety outcomes (e.g., injuries). The Fire Service Organizational Culture of Safety (FOCUS) survey, which was psychometrically validated, measures the industry-specific safety climate of the US fire and rescue service. It is expressed by two factors, Management Commitment to Safety and Supervisor Support for Safety.

METHODS

The FOCUS beta-test included a random sample of 132 fire departments stratified by Federal Emergency Management Agency region and organization type (career, combination, volunteer). We conducted descriptive analysis with the responses from 8414 firefighters nested within 611 stations in 125 fire departments. We reported descriptive statistics to assess the distribution of all continuous [mean ± standard deviation (SD)] and categorical variables (counts, percentages) stratified by organization type. Regression analyses were conducted to investigate the associations between safety climate, safety behaviors, organizational outcomes, and safety outcomes stratified by organization type.

RESULTS

The mean age of the analytic sample was 40.2 years, and the mean years of experience was 16.1 years. This sample included 53.6% career, 27.2% combination (career and volunteer), and 19.2% volunteer fire departments. The mean Management Commitment score was 71.4 (SD =  ± 10.4), and the mean Supervisor Support score was 81.7 (± 5.2). The mean Management Commitment scores were 67.1 (± 8.4), 72.2 (± 10.7), and 82.1 (± 6.1), respectively, for career, combination, and volunteer fire departments. The mean Supervisor Support scores were not notably different by organization type. Regression analyses generally supported the beneficial role of safety climate, while suggesting organization type as a potential effect modifier. Specifically, we observed a more negative association between Management Commitment as departments became more career.

CONCLUSIONS

Analysis of nationally representative data from the US fire and rescue service indicates safety climate is positively associated with safety behavior, organizational outcomes, and safety outcomes reflecting employee well-being. The findings also suggest that this association varies by organization type. In fact, a dose-response relationship was observed, with Management Commitment to safety lowest among career departments. Thus, our results suggest that it is not just being busy that decreases Management Commitment.

Can Mindfulness Improve Organizational Citizenship and Innovative Behaviors Through its Impact on Well-being Among Academics?

Mindfulness has received considerable interest due to its positive outcomes for individuals however our understanding of how it may also result in positive outcomes for organizations is not fully understood. Using data collected from university academics (N=255) in Northern Cyprus, we examine mindfulness as a factor that leads to Organizational Citizenship Behavior (OCB) and Innovative Work Behaviors (IWB). We expect that eudaimonic well-being serves as the mechanism that links mindfulness to IWB and OCB. Our results show mindfulness improves eudaimonic well-being. Eudaimonic wellbeing fully mediates the Mindfulness - IWB relationship and partially mediates the Mindfulness - OCB relationship. Since the COVID-19 pandemic has highlighted the importance of OCB and IWB for universities, our study has important implications for university managers and policymakers.

Promoting organizational vision integration among hospital employees

Background

The concept of organizational vision has been little explored in the health-care services research literature. To address this knowledge gap in the literature, the present study examines the factors that may promote organizational vision integration (OVI), which refers to the employees’ use of organizational vision as a guiding framework in their work. The roles of organizational commitment (OC), leadership autonomy support (LAS), and organizational culture in relation to hospital employees’ OVI are examined.

Methods

Hospital employees were surveyed. Partial least-squares structural equation modeling was performed using SmartPLS 3 software to test the proposed hypotheses statistically. A bootstrapping test was used to identify the mediating effects.

Results

The main findings show that: (i) OC is the most powerful factor in promoting employees’ OVI (β = 0.26), while organizational culture (represented by the concept of internal market-oriented culture) and LAS showed significantly less and almost equal impact (β = 0.16 and β = 0.15, respectively). In total, OC, organizational culture and LAS explain 25% of the variance in the concept of OVI. (ii) LAS and organizational culture both significantly contribute to employees’ OC (β = 0.35 and β = 0.29, respectively) and in total explain nearly 40% (R² = 0.38) of the variance in the concept of OC. (iii) The relationships between organizational culture, LAS, and OVI are mediated through OC, and (iv) LAS mediates the relationship between organizational culture and OVI, and that between organizational culture and OC.

Conclusions

To promote hospital employees’ OVI effectively, hospital managers should focus particularly on their employees’ OC. Specifically, they should strengthen their employees’ OC through building a strong employee-focused organizational culture and ensuring that leaders practice LAS. This contributes to promoting hospital employees’ OVI.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07430-z.

Precursors and outcomes of work engagement among nursing professionals-a cross-sectional study

BACKGROUND

Health services organizations must understand how best to lower nursing professionals' turnover intentions, and increase their job satisfaction and the quality of care provided to patients. This study aims to examine whether work engagement (WE) is a significant predictor of the achievement of these preferred organizational goals. The study also aims to examine whether organizational culture and organizational climate can manage the WE of nursing professionals and indirectly contribute to the accomplishment of the preferred organizational goals.

METHODS

In detail, a cross-sectional questionnaire survey study was conducted through a convenience sampling of a total of N = 164 nurses, from four Norwegian public hospitals. Structural equation modeling was employed in testing the hypothesis in the conceptual model, using Stata software. Furthermore, mediation analyses were achieved through use of the "medsem" package in the Stata software, in testing whether the proposed direct and indirect effects were statistically significant, and the type of mediation found.

RESULTS

The three key findings from this study are: i) WE of nursing professionals was found to be positively related to service quality of care (β = 0.551) and job satisfaction (β = 0.883). Job satisfaction fully mediates the relationship between WE and turnover intention and in itself explains almost 60% (R² = 0.59) of turnover intention; ii) nursing professionals' perception of organizational culture (β = 0.278) and collaboration climate (β = 0.331) were both directly related to their WE; and iii) WE fully mediates the relationship between organizational culture/climate and service quality of care and job satisfaction. Moreover, WE partially mediates the relationship between collaborative climate and job satisfaction.

CONCLUSIONS

The WE of nursing professionals is highly correlated to their job satisfaction. WE and turnover intentions are (fully) mediated by job satisfaction. Employers should therefore focus on improving the job satisfaction of nursing professionals. The WE of nursing professionals is a common key factor for such improvement. Consequently, leaders and managers should continuously manage nursing professionals' WE, focusing on such areas as organizational culture and climate, because WE is an effective means of enabling multiple desirable outcomes for hospital organizations.

The development of an evidence-informed Convergent Care Theory: Working together to achieve optimal health outcomes

BACKGROUND

Healthcare is a complex and divergent system with uncertainty, unpredictability, and multi-layered stakeholders. The relationships among the stakeholders are multifaceted and dynamic, requiring continual interpersonal connections, networks, and co-evolution. It is pivotal to have an evidence-informed theory to explain the phenomenon, uniting the multifaceted stakeholders' efforts.

PURPOSE

To describe the development of an evidence-informed theory, the Convergent Care Theory, assembling healthcare stakeholders to work together and achieve optimal health outcomes.

METHODS

The Convergent Care Theory was developed using a theory synthesis approach based on empirical research and literature reviews published by the theory-proposing author. The empirical evidence was categorized into: patients and families, healthcare providers, healthcare organizations, and patients' and healthcare providers' self-care.

RESULTS

The Convergent Care Theory includes four concepts: all-inclusive organizational care , healthcare professional collaborative care, person-centered precision care, and patients ' and healthcare providers' self-care. Achieving convergent care is a process requiring all stakeholders to work together. Six major facilitators emerged from the research evidence: competence, compassion, accountability, trusting, sharing, and engaging.

CONCLUSION

This article introduced the development process of the evidence-informed Convergent Care Theory. Healthcare systems are complex, with multiple stakeholders' needs to meet. The Convergent Care Theory strives to unite healthcare stakeholders, bond resources, and join forces to achieve optimal healthcare outcomes. The underpinning of the theory is a caring culture, which is an underlying code for organizational and team behaviors and the foundation of optimal health outcomes.

The impact of implementing a person-centred pain management intervention on resistance to change and organizational culture

BACKGROUND

Resistance to change and organizational culture are essential factors to consider in change management in health care settings. Implementation of structural change remains a challenge. There is a lack of studies providing information on the impact of implementation processes on the organization. The aim of this study was to describe the impact of implementing a systematic change process concerning postoperative person-centred pain management on resistance to change and organizational culture in an orthopaedic spine surgery unit.

METHODS

The study was set in an orthopaedic spine surgery unit at a university hospital. Person-centred bundles of care for postoperative pain management of spine surgery patients were developed in co-creation by a multi-professional expert group and implemented throughout the care pathway. The intervention was underpinned by theories on organizational culture and inspired by principles of person-centred care. Quantitative data were collected using the Resistance to Change Scale and the Organizational Culture Assessment Instrument and analysed using descriptive statistics.

RESULTS

The findings showed a low resistance to change decreasing during the study. The organizational culture shifted from a result-oriented to a formalized and structured culture after the implementation. The culture preferred by the staff was team-oriented and participation-focused throughout the study. The discrepancy between the current and preferred cultures remained extensive over time.

CONCLUSION

It is challenging to describe the influence of the development and implementation of a postoperative pain management program on organizational culture as well as in terms of resistance to change, in a complex health care setting. In the current study the unit was under organizational strain during the implementation. Albeit, the important discrepancy between the current and preferred organizational culture could imply that structural changes aren't enough when implementing person-centred pain management structures and needs to be combined with relational aspects of change.

How organizational culture influences holistic review: a qualitative multiple case study

Studies primarily involving single health professions programs suggest that holistic review in admissions can increase underrepresented minority (URM) representation among admitted students. However, data showing little improvement in the overall proportion of URMs in many health professions, despite widespread use of holistic review, suggest that relatively few programs using holistic review admit substantial proportions of underrepresented minorities. Therefore, more research is needed to understand factors that facilitate holistic review practices that successfully promote diverse student enrollment. The literature suggests that a supportive organizational culture is necessary for holistic review to be effective; yet, the influence of culture on admissions has not been directly studied. This study employs a qualitative, multiple case study approach to explore the influence of a culture that values diversity and inclusion ('diversity culture') on holistic review practices in two physician assistant educational programs that met criteria consistent with a proposed conceptual framework linking diversity culture to holistic admissions associated with high URM student enrollment (relative to other similar programs). Data from multiple sources were collected at each program during the 2018-2019 admissions cycle, and a coding manual derived from the conceptual framework facilitated directed content analysis and comparison of program similarities and differences. Consistent with the conceptual framework, diversity culture appeared to be a strong driver of holistic admissions practices that support enrolling diverse classes of students. Additional insights emerged that may serve as propositions for further testing and include the finding that URM faculty 'champions for diversity' appeared to strongly influence the admissions process.

Effective Peer Employment Within Multidisciplinary Organizations: Model for Best Practice

This study sought a clearer understanding of organizational mechanisms reinforcing effective peer employment and organizational change from the perspectives of peer workers, non-peer staff and management in multidisciplinary mental health and substance use recovery services. Findings were used to develop a model for organizational best practice for peer employment and associated organizational change to promote recovery-oriented and person-directed services. Qualitative research was undertaken, involving 132 people participating in 14 focus groups and eight individual interviews. These people were employed across five U.S. multidisciplinary organizations providing mental health and substance use recovery services and deemed by a panel of experts to provide effective employment of peer workers. Study findings include the articulation of an interactive working model of best practice, comprising organizational commitment, organizational culture and effective organizational strategies necessary for a "whole-of-organization" approach to support authentic peer work and enable organizational transformation, to actualize recovery-oriented values and person-driven services. Strategies include Human Resources engagement, peers in positions of senior organizational authority, recurring whole of workforce training, along with peer training and peer-led supervision. Findings suggest whole-of-organization commitment, culture and practice are essential for the organizational transformation needed to support effective employment of peers in multidisciplinary environments.

Assessing organizational culture in public mental healthcare service organizations

PURPOSE

The purpose of this paper is to investigate aspects of organizational culture among the nursing staff of public mental health services organizations in Cyprus. Specifically, highlights are provided of possible differences on the attitudes of nurses regarding actual and desired aspects of organizational culture with respect to demographic characteristics such as gender, years of service and experience.

DESIGN/METHODOLOGY/APPROACH

A descriptive explanatory type survey study was conducted in all public mental health services organizations of Cyprus. Specifically, a questionnaire was given to a representative sample of the nursing population, and data were collected and analyzed. The survey questionnaire was based on the organizational culture profile (OCP) methodology. Statistical analysis was carried out using correlational analysis, t-tests and analysis of variance (ANOVA).

FINDINGS

Results showed that there are significant discrepancies between the actual organizational culture and what is desired by staff members of public mental health services organizations in Cyprus. Further, significant differences are identified between actual and desired organizational culture moderated by the type of work, which is determined by the workplace.

ORIGINALITY/VALUE

Even though, organizational culture is a major research topic little has been done in the context of public mental healthcare organizations. Further, for the case of Cyprus, it is the first time that such a study is carried out. The results presented in this paper may provide the foundation for measures to be taken for improving the existing operation of public mental healthcare organizations.

Lean implementation within healthcare: imaging as fertile ground

PURPOSE

The purpose of this paper is to understand the barriers and enablers to lean implementation as part of an imaging quality improvement programme from a socio-cultural perspective.

DESIGN/METHODOLOGY/APPROACH

An in-depth 33 month ethnographic study, using observation and qualitative interviews, examined the process of lean implementation as part of an improvement programme.

FINDINGS

Implementation of lean was more successful compared with other reports of lean in healthcare settings. Key enablers of lean were high levels of multidisciplinary staff involvement and engagement; the professional credibility of facilitators and clinicians as early adopters, all within a wider culture of relatively strong inter-professional relationships in the imaging department. These enablers combined with the more routinised and standardised nature of imaging pathways compared to some other acute specialties suggest that imaging is fertile ground for lean, linked to the manufacturing origins of lean.

PRACTICAL IMPLICATIONS

When introducing lean within healthcare settings, special attention needs to be paid to the specific healthcare context and the existing cultures of inter-professional relationships. Fostering an improvement culture and engagement with training, together with adequate financial resource, are a key to contributing to the level of acceptability of an improvement tool such as lean.

ORIGINALITY/VALUE

This ethnographic study, bringing together rich multi-source data, has provided a detailed insight into the cultural workings of the process of lean implementation within a complex healthcare system.