Health Services Management Research

Lega, Federico

doi: 10.1177/0951484819848910pmid: 31066589

Tomo, Andrea; De Simone, Stefania

doi: 10.1177/0951484818787687pmid: 30071744

Purpose:The aim of this study is to advance a model to assess the overall level of well-being within healthcare organizations.Design/methodology/approach: The paper employs a job demands-resources approach by considering the multilevel model of employee well-being as theoretical framework, integrated with personal resources and health indicators. A specific case is built in the Italian context, with empirical data gathered from three Italian paediatric hospitals belonging to the same healthcare organizations.Findings: Results show that the job demand-resource model may well explain differences in the work environment, and that personality enables coping with negative effects of work environment settings.Originality/value. The paper contributes to extending the literature on well-being and the management of healthcare organizations, by providing interesting insights on the multilevel model of employee well-being. It also has interesting academic and practical implications, since it tries to put forward a model to assess employee well-being and provides an empirical application of a well-known theoretical model.

Stephenson, Amber L; Bell, Nicolette

doi: 10.1177/0951484818787698pmid: 29999425

Prisons are rigidly structured institutions housing—in some cases—violent and unstable residents. To discover the positive job attributes and perceived challenges in this extreme practice environment, we employed exploratory qualitative content analysis on the written-in responses of 269 prison health workers in one state’s Department of Corrections. Two researchers independently analyzed and coded the data. Using an iterative process, we categorized the responses into themes and critical underlying meanings. Positive job attributes included meaningful work, stability, variety of ailments treated, and feelings of support. Perceived challenges included ineffective leadership, constraints on the ability to effectively execute the role, perceived inequity, and organizational culture. The results of our study suggest that there are lessons to be learned from correctional health workers that could inform policy and management outside of the prison walls specifically as it pertains to motivating and engaging providers through meaningful work. Specifically, health organizations would improve the experience of their clinicians by offering a broader scope of practice experience, schedule stability, reducing bureaucratic redundancies, and—ultimately—restoring the sense of purpose within the work itself.

Gabutti, Irene; Morandi, Federica

doi: 10.1177/0951484818790213pmid: 30071745

PurposeThe healthcare sector has been facing major reforms, among which the introduction of the Clinical Directorate (CD) model for hospitals. The purpose of this work is to explore the degree of implementation of innovative Human Resource Management (HRM) practices within CDs, in order to understand whether, after more than 15 years from their introduction, they have been able to transform their managerial approach concretely, in line with the CD model’s objectives. The tools have been attributed to three main HR initiatives: training, control, and evaluation ones.Design and methodsDuring on-site visits in 33 Italian hospitals, data were collected by conducting semi-structured interviews with their CEOs and Clinical Directors. Data concerned both the mere adoption of HRM tools within CDs, as well as their effective degree of implementation. The answers to the questions were translated into a system of percentage scores, so as to detect mean percentages of implementation in each CD.Findings: The general degree of implementation of HRM practices is still somewhat distant from a theoretically excellent and full implementation, especially if we consider the important lag of time since the reforms affected the sector. Nevertheless, results open the way to important considerations about the effectiveness of the CD model.Original value: The original methodology and scoring system suggested in this work produce a concise evaluation of the development of an effective HRM system within CDs. Our framework of analysis allows interesting benchmarking activities among different CDs of an organization and, ultimately, among different organizations. Moreover, the methodology presented may constitute a valid source of information in order to carry out future research on the items able to affect the implementation of such tools.

Wilkinson, Adrian; Muurlink, Olav; Awan, Nabil; Townsend, Keith

doi: 10.1177/0951484818805369pmid: 30376384

While there is a plethora of research on people management and high-commitment management, most are focused on commercial enterprises. Even the high-commitment management literature on commercial organisations argues that we need to move beyond the confines of financial performance. There are relatively few studies of high-commitment management which focus on hospitals. This is despite the fact that human resources are a major cost and source of performance leverage in hospitals.

Weske, Ulrike; Boselie, Paul; van Rensen, Elizabeth; Schneider, Margriet

doi: 10.1177/0951484818813324pmid: 30463452

The implementation of a quality and patient safety accreditation system is crucial for hospitals. Although control systems—such as accreditation—can contribute to quality improvements, they also run the risk of unintended consequences. As a result, ways should be found to avoid or reduce these undesirable consequences. This study aims to answer this call by exploring the association of different approaches to the enforcement of rules (punishment, based on monitoring and threats of sanctions; and persuasion, based on dialog and suggestion) with compliance. To test the relation between perceived enforcement and compliance, this study used survey data collected from medical specialists (N = 92) of a large academic medical center. The findings indicate that the same system is interpreted differently and that only a perceived persuasion approach is related to higher levels of compliance. This effect is fully mediated by affective commitment. No direct or indirect effects on compliance were found for a perceived coercive approach. These results suggest that control systems can be perceived in different ways and that the implementation of a control system does therefore not automatically lead to negative and unintended outcomes.