Impact of workforce flexibility on quality of care: moderating effects of workload and severity of illness

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Adelina Gnanlet ◽  
Luv Sharma ◽  
Christopher McDermott ◽  
Muge Yayla-Kullu
Keyword(s):  
Quality Of Care ◽  
Severity Of Illness ◽  
Situational Factors ◽  
Content Type ◽  
Job Level ◽  
Situational Variables ◽  
Quality Of Patient Care ◽  
Workforce Flexibility ◽  
The Relationship

PurposeAs a way of alleviating nursing workforce shortages, health care managers are employing two types of workforce flexibility: supplemental staffing and floating among units. In this paper, the authors investigate the moderating effects of two critical situational variables – namely, job-level workload and severity of illness (SOI) in a given unit – on the relationship between workforce flexibility and quality of care as assessed by the nurses at the unit-level.Design/methodology/approachThe authors empirically test the relationship between a unit's floating of nurses and the use of supplemental workforce on the quality of patient care and the moderating role of patient SOI and job-level workload on this relationship using 357 hospital-unit observations.FindingsThe authors find that situational variables play a critical role in flexible staffing strategies and they should be accounted for carefully to obtain the best quality of care outcomes. The authors find that the well-known negative effect of supplemental staffing on quality of care is not universal and appears to be moderated by the situational factors studied in this paper.Practical implicationsFor best outcomes, staffing manager who oversee multiple units should use supplemental staff on units that have lower job-level workload and on units that have high severity of illness. The authors also find that managers of units with patients who are less-severely ill should encourage nurses to float out and return to their home unit. This strategy will improve quality of patient care in the home unit.Originality/valueWhile some research analyzes the direct link between flexibility and quality performance, how this relationship is affected by varying situational factors within a unit has not been studied so far.

scholarly journals HRM in healthcare: the role of work engagement

2016 ◽  
Vol 45 (2) ◽  
pp. 274-295 ◽  
Author(s):  
Amanda Shantz ◽  
Kerstin Alfes ◽  
Lilith Arevshatian
Keyword(s):  
Quality Of Care ◽  
Work Engagement ◽  
Administrative Support ◽  
Equation Modeling ◽  
Content Type ◽  
Hrm Practices ◽  
The Impact ◽  
The Relationship

Purpose – Due to increasing cost pressures, and the necessity to ensure high quality patient care while maintaining a safe environment for patients and staff, interest in the capacity for HRM practices to make a difference has piqued the attention of healthcare professionals. The purpose of this papers is to present and test a model whereby engagement mediates the relationship between four HRM practices and quality of care and safety in two different occupational groups in healthcare, namely, nurses and administrative support workers. Design/methodology/approach – Structural equation modeling was used to analyze questionnaire data collected by the National Health Service in the UK as part of their 2011 Staff Survey (n=69,018). The authors tested the hypotheses for nurses and administrative support workers separately. Findings – Training, participation in decision making, opportunities for development, and communication were positively related to quality of care and safety via work engagement. The strength of the relationships was conditional on whether an employee was a nurse or administrative support worker. Originality/value – This is the first paper to examine the mediating role of engagement on the relationship between four relevant HRM practices in the healthcare context, and outcomes important to healthcare practitioners. The authors also add value to the HRM literature by being among the first to use the job demands resources model to explain the impact of HRM practices on performance outcomes. Moreover, the authors provide insight into how HRM practices affect outcomes in the world’s largest publicly funded healthcare service.

scholarly journals “Pixie dust”

2019 ◽  
Vol 33 (5) ◽  
pp. 635-646
Author(s):  
Susan Brandis ◽  
Stephanie Schleimer ◽  
John Rice
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Health Service ◽  
Patient Care ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Content Type ◽  
Quality Of Patient Care

Purpose Creating a culture of patient safety and developing a skilled workforce are major challenges for health managers. However, there is limited information to guide managers as to how patient safety culture can be improved. The purpose of this paper is to explore the concept of reflexivity and develop a model for magnifying the effect of patient safety culture and demonstrating a link to improved perceptions of quality of care. Design/methodology/approach This research employed a correlational case study design with empirical hypothesis testing of quantitative scores derived from validated survey items. Staff perceptions of patient safety, reflexivity and quality of patient care were obtained via a survey in 2015 and analysed using inferential statistics. The final sample included 227 health service staff from clinical and non-clinical designations working in a large Australian tertiary hospital and health service delivering acute and sub-acute health care. Findings Both patient safety culture and reflexivity are positively correlated with perceived quality of patient care at the p<0.01 level. The moderating role of reflexivity on the relationship between patient safety culture and quality of care outcomes was significant and positive at the p<0.005 level. Practical implications Improving reflexivity in a health workforce positively moderates the effect of patient safety culture on perceptions of patient quality of care. The role of reflexivity therefore has implications for future pre-professional curriculum content and post-graduate licencing and registration requirements. Originality/value Much has been published on reflection. This paper considers the role of reflexivity, a much less understood but equally important construct in the field of patient safety.

Modeling patient care quality: an empirical high-performance work system approach

2016 ◽  
Vol 45 (6) ◽  
pp. 1176-1199 ◽  
Author(s):  
Dimitrios M. Mihail ◽  
Panagiotis V. Kloutsiniotis
Keyword(s):  
Social Identity ◽  
Patient Care ◽  
High Performance ◽  
Psychological Empowerment ◽  
Social Identification ◽  
Content Type ◽  
Quality Of Patient Care ◽  
The Relationship ◽  
Social Identity Approach

Purpose Following a social identity approach focussed in the Greek healthcare sector, the purpose of this paper is to investigate the mediating effects of social identification on the relationship between high-performance work systems (HPWS) and psychological empowerment, and the mediating role of psychological empowerment between HPWS and quality of patient care. Design/methodology/approach Partial least squares-structural equation modeling was used in a sample of 297 nurses, doctors, and allied health professionals across seven hospitals in Greece. Findings The findings suggest that HPWS has a strong effect on healthcare professionals’ social identification, which in turn partially mediates the relationship between HPWS and psychological empowerment. In addition, psychological empowerment indirectly mediates the relationship between HPWS and quality of patient care. Practical implications The findings not only validate previous studies’ conclusions, but also provide evidence for the potential fruitfulness of the HPWS approach from a social identity perspective. In addition, it is also confirmed that without the presence of psychological empowerment, HPWS may have limited impact on the quality of patient care. Originality/value Although HPWS have been generally connected with positive employee attitudes and behaviors, few studies choose to follow a social identity approach in examining these relationships. Finally, this study confirms the argument that HPWS can be a fruitful approach even in a country severely affected by Europe’s debt crisis over the last five years.

Role of burnout on job level, job satisfaction, and task performance

2017 ◽  
Vol 38 (5) ◽  
pp. 630-645 ◽  
Author(s):  
Won Ho Kim ◽  
Young-An Ra ◽  
Jong Gyu Park ◽  
Bora Kwon
Keyword(s):  
Job Satisfaction ◽  
Task Performance ◽  
Organizational Context ◽  
Content Type ◽  
Job Level ◽  
Mediating Role ◽  
Final Sample ◽  
The Relationship ◽  
And Task

Purpose The purpose of this paper is to examine the mediating role of burnout (i.e. exhaustion, cynicism, professional inefficacy) in the relationship between job level and job satisfaction as well as between job level and task performance. Design/methodology/approach The final sample included 342 Korean workers from selected companies. The authors employed the Hayes (2013) PROCESS tool for analyzing the data. Findings The results showed that all three subscales of burnout (i.e. exhaustion, cynicism, professional inefficacy) mediate the relationship between job level and job satisfaction. However, only two mediators (i.e. cynicism, professional inefficacy) indicated the mediating effects on the association between job level and task performance. Originality/value This research presented the role of burnout on the relationships between job level, job satisfaction, and task performance especially in South Korean organizational context. In addition to role of burnout, findings should prove helpful in improving job satisfaction and task performance. The authors provide implications and limitations of the findings.

scholarly journals Quality of Care Provided by Family Caregivers of Older People With Dementia: Measurement and Interpretations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Primary Reason ◽  
People With Dementia ◽  
High Level ◽  
The Impact ◽  
The Relationship

Abstract Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.

scholarly journals Relationship of patient shame to working alliance and satisfaction: a preliminary investigation

2019 ◽  
Vol 14 (4) ◽  
pp. 251-263
Author(s):  
Daniel J. Carabellese ◽  
Michael J. Proeve ◽  
Rachel M. Roberts
Keyword(s):  
Patient Satisfaction ◽  
Working Alliance ◽  
Preliminary Investigation ◽  
Community Members ◽  
Content Type ◽  
Mediation Analyses ◽  
External Shame ◽  
Relationship Of ◽  
The Relationship

Purpose The purpose of this paper is to explore the relationship of two distinct variants of dispositional shame (internal and external shame) with collaborative, purpose-driven aspects of the patient–provider relationship (working alliance) and patient satisfaction. The aim of this research was to conduct a preliminary investigation into the relevance of dispositional shame in a general healthcare population. Design/methodology/approach In total, 127 community members (mean age 25.9 years) who reported that they had regularly seen a GP over the past year were recruited at an Australian university. Participants were asked to reflect on their relationship with their GP, and completed instruments assessing various domains of shame, as well as working alliance and patient satisfaction. Findings Non-parametric correlations were examined to determine the direction and strength of relationships, as well as conducting mediation analyses where applicable. Small, negative correlations were evident between external shame and working alliance. Both external and internal shame measures were also negatively correlated with patient satisfaction. Finally, the relationship of external shame to patient satisfaction was partially mediated by working alliance. Practical implications Both the reported quality of patient–provider working alliance, and level of patient satisfaction are related to levels of dispositional shame in patients, and working alliance may act as a mediator for this relationship. Originality/value The findings from this preliminary study suggest that internal and external shame are important factors to consider in the provision of medical care to maximise the quality of patient experience and working alliance.

Patient satisfaction with the quality of care in Ghana’s health-care institutions

2019 ◽  
Vol 13 (2) ◽  
pp. 160-170 ◽  
Author(s):  
Aaron Asibi Abuosi ◽  
Mahama Braimah
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Service Delivery ◽  
National Survey ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Content Type ◽  
Care Facilities

Purpose The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach. Design/methodology/approach The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis. Findings About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients were more likely to be satisfied with the quality of care, compared with males and uninsured patients. Research limitations/implications Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this. Practical implications The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem. Originality/value There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.

scholarly journals Analyzing Nursing Home Complaints: From Substantiated Allegation to Deficiency Citations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 82-83
Author(s):  
Kallol Kumar Bhattacharyya ◽  
Lindsay Peterson ◽  
John Bowblis ◽  
Kathryn Hyer
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Staff Training ◽  
Policy And Practice ◽  
Abuse And Neglect ◽  
The Relationship ◽  
Investigation Process

Abstract Complaints provide important information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. Our data were drawn from federally collected NH complaint and inspection records. Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. These results suggest that the compliant investigation process warrants further investigation. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed.

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