Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review

Introduction: Healthcare systems increasingly move toward “value-based healthcare” (VBHC), aiming to further improve quality and performance of care as well as the sustainable use of resources. Evidence about healthcare professionals' contributions to VBHC, experienced job demands and resources as well as employee well-being in VBHC is scattered. This systematic review synthesizes this evidence by exploring how VBHC relates to the healthcare professional, and vice versa.Method: Seven databases were systematically searched for relevant studies. The search yielded 3,782 records, of which 45 were eligible for inclusion based on a two-step screening process using exclusion criteria performed by two authors independently. The quality of the included studies was appraised using the Mixed Methods Appraisal Tool (MMAT). Based on inductive thematic analysis, the Job Demands-Resources (JD-R) model was modified. Subsequently, this modified model was applied deductively for a second round of thematic analysis.Results: Ten behaviors of healthcare professionals to enhance value in care were identified. These behaviors and associated changes in professionals' work content and work environment impacted the experienced job demands and resources and, in turn, employee well-being and job strain. This review revealed 16 constructs as job demand and/or job resource. Examples of these include role strain, workload and meaning in work. Four constructs related to employee well-being, including engagement and job satisfaction, and five constructs related to job strain, including exhaustion and concerns, were identified. A distinction was made between job demands and resources that were a pure characteristic of VBHC, and job demands and resources that resulted from environmental factors such as how care organizations shaped VBHC.Conclusion and Discussion: This review shows that professionals experience substantial job demands and resources resulting from the move toward VBHC and their active role therein. Several job demands are triggered by an unsupportive organizational environment. Hence, increased organizational support may contribute to mitigating or avoiding adverse psychosocial factors and enhance positive psychosocial factors in a VBHC context. Further research to estimate the effects of VBHC on healthcare professionals is warranted.

Job challenges are hindrances too: examining experiences of managers and employees in Finnish SMEs

PurposeThe study aims to explore job demands experienced by employees and managers in micro-enterprises and small and medium-sized enterprises (SMEs). Drawing on the job demands framework, the study discusses the experienced demands from the perspective of challenges that create opportunities for learning and achievement and hindrances that create obstacles for work. The study builds on the idea that the same demand can be perceived both as a challenge and a hindrance. That approach opens a path to responding to challenges by reformulating working practices and removing hindrances by designing, developing and crafting jobs and tasks.Design/methodology/approachThe authors analyzed open-ended survey responses (N = 306) to study experienced job demands in 50 micro-enterprises and SMEs, how the perceived demands differ between employees and managers and whether they represent challenge or hindrance demands.FindingsThe authors identified 17 job demand categories most including both challenge and hindrance demands. Time management and prioritization was the most central challenge and hindrance category for both employees and managers. For employees, sales and stakeholder relationships represented the second largest challenge category and communication and information flow was the second largest hindrance category. For managers, the second largest challenge and hindrance categories were organization and management of activities and the fragmentation of work, respectively.Originality/valueBy focusing on employee experience, the achieve a more nuanced understanding of the SME context, which has been dominated by managerial evaluations. The study also advances the discussion on job demands by extending our knowledge of demands that may be experienced both as a challenge and a hindrance.

Explaining High Performance Among Indian Administrative Service (IAS) Officers: A Job Demands-Resources Perspective

Indian Administrative Service (IAS) officers are careerist senior civil servants (SCS) in the world’s largest democracy, holding senior roles of policymaking and implementation. Therefore, identifying exceptionally performing SCS to unravel their “job demands” along with “personal resources” should help with understanding how best to manage these critical human resources. Employing a qualitative approach, we interviewed 11 high performing IAS officers identified through a unique career progression index. Our data analysis revealed that the IAS suffers from the following job demands: difficulty in coordination with other departments and stakeholders, financial inadequacy, and dishonest subordinates or coworkers. This study also found that self-directed learning, personal reputation, empathy, and service orientation are essential personal resources for high-performing SCS. While expanding the list of job demands and personal resources in the public administration context, our research provides a deeper insight into the challenges confronting careerist SCS in lower-middle income developing countries.

Threat or opportunity: accelerated job demands during COVID-19 pandemic

Purpose The purpose of this study is to investigate the effects of accelerated job demands on employee outcomes during the COVID-19 crisis. An integrated model was developed to explore the relationships between different types of job demands (learning, decision-making, work intensification), employee turnover intention (TI) and burnout (BU).Design/methodology/approach Data were obtained from professionals whose work conditions were impacted by the COVID-19 pandemic crisis. An online survey was distributed anonymously. A total of 566 questionnaires were included in the analysis. Structural equation modeling was employed to analyze the data.Findings The findings revealed that employees' perception of job demands impacts the significance and direction of the relationships between different forms of job demands and employee outcomes. Furthermore, the findings confirm that mediating role of perceived organizational support alleviates the adverse effects of job demands on employee outcomes. Finally, the present study supported the moderation effect of positive affectivity between work intensification and employee BU.Practical implications This study provides employers with insights about supporting employees to cope with increased job demands in conditions where rapid changes are inevitable.Originality/value The unique context of research (COVID-19) enabled this study to account for the acceleration of job demands that employees experience in rapidly changing situations. This study employed an instrument that allowed for the assessment of acceleration in job demands. Furthermore, the granular approach of the measurement model extended the perspectives of job demands and work intensification.

Organizational and Personal Factors That Boost Innovation: The Case of Nurses during COVID-19 Pandemic Based on Job Demands-Resources Model

Since 2019, the world has been experiencing a pandemic period due to the COVID-19 virus, which has brought the need for organizations in general, healthcare organizations and their professionals in particular, to focus on innovation as a way to fight an utterly unknown virus. Thus, this study aims to understand how nurses and their personal factors (stress, anxiety, work engagement, organizational support) impact their innovative behaviour and innovation outputs, contributing to innovation in the current pandemic period through changes in thoughts, values, behaviours and relationships among healthcare professionals and their organizations. For this purpose, the Job Demands-Resources model was used as a reference, and the measurement instrument was applied to 738 nurses working in healthcare units in Portugal. Therefore, it was found that the nurses’ personal factors have a positive effect on the nurses’ innovative behaviour and innovation outputs, with the innovative behaviour having the most significant impact on innovation outputs, which will benefit healthcare organizations and the healthcare provided to patients during the pandemic, through innovative behaviours and products. It is also possible to understand how the available resources and the demands imposed on nurses interfere with their innovative behaviour (Job Demands-Resources model).

Eustress And Distress In The Context Of Telework

The COVID-19 pandemic brought about a surge in telework, with many organizations using telework to continue operations. Teleworkers are subject to stress due to the demands of working from home. Despite the common view of stress as being detrimental, stress can also be beneficial. In this paper, we investigate two forms of stress, eustress (beneficial stress), and distress (detrimental stress) using a theoretically-derived model that includes antecedents and outcomes of eustress and distress. We test our model using data from a survey of 525 American teleworkers. Results indicate that job resources (autonomy, managerial support, and technical support), and personal resources (resilience and self-efficacy) affect eustress, while job demands (work overload, social isolation, and resource inadequacies) affect distress. Eustress is positively associated with job and telework satisfaction and negatively associated with telework exhaustion. Distress has the opposite effects. Our findings hold implications for researchers and practitioners.

Relationships between professional burnout and job demands, resources among workers in an industrial plant in Lithuania

Burnout can negatively affect both workers’ health and safety in an organization [1]. The current study was oriented to identify the main risk and protective factors, which might predict professional burnout among workers in an industrial plant in Lithuania using the Job demands-resources model [2, 3]. 249 industrial and 74 administrative workers from one organization filled out a self-administered questionnaire. Scales from COPSOQ II (Copenhagen Psychosocial Questionnaire) were used in a cross-sectional survey. With reference to the research results, there were no significant differences in professional burnout between industrial and administrative workers. However, scores of work pace, safety climate, possibilities for development, influence at work, recognition and organizational justice were higher in a group of administrative employees as compared to their colleagues from the industrial departments. Moreover, different factors were found to predict employees’ physical, emotional and mental exhaustion: emotional demands predicted burnout in administrative workers’ group, while quantitative demands, work-family conflict, possibilities for development- among industrial workers. Organizational justice was the only protective factor to predict lower burnout in both groups of employees.

The Impact of Job Demands Variables in the Job Demands Resources Model

The purpose of this chapter is to report on the findings of a study that was conducted by the author to investigate the impact of job demands variables on emotional exhaustion and emotional ill-health. A sample of 173 drawn from employees who worked for different organizations in the Pacific, mainly Australia, the African region, the Indian subcontinent of India, Nepal, Pakistan, Bangladesh, and Sri Lanka, and employees who professed Christian and Hindu religions. A broad range of ages, occupations, ethnicities, religions, and cultures was represented in the sample, that is, the targeted population were employees whose different contexts and characteristics (e.g., attitudes, occupations, ages, marital status, religion, opinions, behaviors, and other defined variables) could be measured and allowed to generalize the results. The study used a quantitative research design. A diversity of findings were established with some findings being consistent with the JD-R theory and previous studies across the cultures while other findings were not consistent with previous studies and the JDR theory.

COVID-19: prevalence of job-demands, stress, work–life difficulties and work–life balance among international business travelers

PurposeInternational business travelers (IBTs) face daily challenges pertaining to the frequency and duration of travel. Following the outbreak of coronavirus disease (COVID-19), the study aims to draw upon the job demands-resources (JD-R) model and the literature on work–life balance (WLB) to examine how this crisis have disrupted IBTs routines and the implications for their WLB.Design/methodology/approachData were collected in April 2020 with an online survey answered by 141 IBTs from different locations. The first set of analyses examined the perceived change in job-demands (i.e. business travel and workload) including stress and work–life difficulties following the outbreak of COVID-19. The second set of analyses tested the hypotheses that the perceived change in workload and stress predict IBTs' work–life difficulties, which, in turn, affect their WLB.FindingsThe results show that the decline in job-demands (i.e. business travel and workload) after the outbreak of COVID-19 was not enough to reduce IBTs' stress and ameliorate their work–life difficulties and WLB. Only respondents who experienced a decrease in workload, including less relational difficulties, reported a superior WLB.Originality/valueThe study widens the scope and relevance of global mobility studies in crisis settings by timely reporting the changes in job-demands, stress and work–life difficulties among IBTs following the outbreak of COVID-19. Additionally, the research extends the use of the JD-R model in the international context by advancing our knowledge of the interplay between contextual demands and job-demands in affecting IBTs' stress, work–life difficulties and WLB.