Toward a high-performance management system in health care, Part 5: How high-performance work practices facilitate speaking up in health care organizations
We examined case study data from five health care organizations purposely selected for their use of HPWPs. Interview transcripts from 67 key informants were inductively and deductively analyzed to explore how speaking up was characterized.
Findings
We found that speaking up was recognized as an important factor impacting quality improvement and/or patient safety initiatives across all five organizations. Management efforts to facilitate speaking up included both direct practices, such as using structured communication processes and reporting systems, and complementary practices that supported speaking up. Both direct an...
Source: Health Care Management Review - August 29, 2020 Category: American Health Tags: Features Source Type: research
“Working in tumultuous in times”
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - August 29, 2020 Category: American Health Tags: Department: Editorial Source Type: research
Workplace violence: Examination of the tensions between duty of care, worker safety, and zero tolerance
Conclusion
Despite policies supporting zero tolerance, staff do not enact these because they prioritize duty of care to consumers before duty of care to self. Zero tolerance, with incongruent legislation, compounds this tension and impairs decision-making.
Practical Implications
This article exposes the underlying values, beliefs, and flawed assumptions underpinning practice related to WPV. Managers need to amend policies to reduce staff confusion, adopt a trauma-sensitive and resilience approach, and develop a clearly written framework to guide decision-making related to duty of care to consumers and staff safety. In...
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Online Only Source Type: research
Ease of use of electronic health records and relational coordination among primary care team members
Conclusion:
Ease of EHR use is associated with better RC among primary care team members, and the benefits accrue more to non-PCPs than to PCPs.
Practice Implications:
Ensuring that clinicians and staff experience EHRs as easy to use for accessing and integrating data and for communication may produce gains in efficiency and outcomes through high RC. Future studies should examine whether interventions to improve EHR usability can lead to improved RC and patient outcomes. (Source: Health Care Management Review)
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
Innovation contest: Effect of perceived support for learning on participation
Conclusion:
The contest enabled frontline staff to share input and assess input shared by other staff. Our findings indicate that the contest may serve as a fruitful outlet through which frontline staff can share and learn new ideas, especially for those who feel safe to speak up and believe that new ideas are not tested frequently enough.
Practice Implications:
The contest’s potential to decentralize innovation may be greater under stronger learning orientation. A highly visible intervention, like the innovation contest, has both benefits and risks. Our findings suggest benefits such as increased engagement with wo...
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
How to make a job more than just a paycheck: Understanding physician disengagement
Conclusion:
There are commonalities and differences in the drivers of physician engagement and disengagement. Our results shed light on why physicians might withdraw from inherently meaningful work. These findings can inform organizational efforts toward decreasing physician disengagement and increasing and maintaining an engaged physician workforce.
Practice Implications:
To reduce physician disengagement, we recommend leadership development around key skills (i.e., visibility, transparency, accessibility). We also suggest that improving supervisors’ (e.g., clinical service chiefs’) knowledge about workflow proce...
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
Working around hierarchy: Resident and medical assistant teaming
Conclusion
Among resident–MA dyads, a team-based care intervention changed interpersonal dynamics by blurring hierarchical lines and shifting traditional boundaries in ways that were uncomfortable for both groups. They were able to work around discomfort by using new scripts that downplayed the threat to hierarchy.
Practice Implications
Organizational structures that encourage greater interprofessional collaboration may neutralize barriers that formal hierarchy in medicine can pose for effective teamwork, but this process can also bring social discomfort. Our findings suggest that health care professionals may use m...
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
Standardizing a federally qualified health center’s preventive care processes: Use of failure modes and effects analysis
A multisite federally qualified health center used a Failure Modes and Effects Analysis to identify and correct potential challenges to the implementation of the proactive office encounter model. This model is designed to proactively identify and close preventive care gaps through electronic medical record use, new workflows, and staff training. (Source: Health Care Management Review)
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
The benefits of agreeing on what matters most: Team cooperative norms mediate the effect of co-leaders’ shared goals on safety climate in neonatal intensive care units
Conclusion:
Increasing the extent to which co-leaders share goals is an effective lever to strengthen interprofessional cooperation and foster a safety climate among nursing and physician team members of hospital units. (Source: Health Care Management Review)
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
Resource-based view on safety culture’s influence on hospital performance: The moderating role of electronic health record implementation
Conclusion:
Safety culture has a direct positive relationship with financial performance (operating margin). Furthermore, having basic EHR as compared to not having EHR further enhances this positive relationship. On the other hand, safety culture does not have a direct association with quality performance (readmissions) in most cases. However, safety culture coupled with basic EHR functionalities, compared to not having EHR, is associated with lower readmissions.
Practice Implications:
Hospitals should strive to improve patient safety culture as part of their strategic plan for quality improvement. In addition, hospi...
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
Sustaining participation in multisector health care alliances: The role of personal and stakeholder group influence
Background:
Cross-sectoral collaborative organizations (e.g., alliances, coalitions) bring together members from different industry sectors to ameliorate multifaceted problems in local communities. The ability to leverage the diverse knowledge and skills of these members is predicated on their sustained participation, which research has shown to be a significant challenge.
Purpose:
The purpose of this study was to investigate how alliance member perceptions of decision-making influence relate to sustained participation in the alliance and its activities.
Methodology:
An Internet-based survey of 638 members of 15 mu...
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
Hospital purchasing alliances: Ten years after
Conclusions:
National alliances still play important roles that hospitals find valuable.
Practice Implications:
Purchasing alliances continue to play an important role in helping hospitals with both cost savings and new services. Their growing complexity, along with growing use of self-contracting, poses managerial challenges for hospital purchasing staff that may require greater hospital investment. (Source: Health Care Management Review)
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research
“Hails and farewells”
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Department: Editorial Source Type: research
How different governance models may impact physician–hospital alignment
Conclusions:
Employment models promote greater alignment on some (but not all) dimensions, controlling for physician selection. The impact of employment on alignment is not large, however.
Practice Implications:
Hospitals and accountable care organizations that rely on employment may achieve higher physician alignment compared to the other two models. It is not clear that the gain in alignment is worth the cost of employment. Given the small impact of employment on alignment, it is also clear that they are not identical. Hospitals may need to go beyond structural models of integration to achieve alignment with their p...
Source: Health Care Management Review - February 29, 2020 Category: American Health Tags: Features Source Type: research
Individual and organizational psychosocial predictors of hospital doctors’ work-related well-being: A multilevel and moderation perspective
This study uses a multilevel perspective to examine individual (i.e., job demands and resources) and organizational-level psychosocial predictors of three measures of work-related well-being: perceived stress, presenteeism, and work engagement. The job demands–resources theory underpins the postulated relationships.
Methodology:
The 2014 National Health Service Staff Survey was analyzed using multilevel modeling in MPlus. The data set involved 14,066 hospital-based doctors grouped into 157 English hospital organizations (i.e., Trusts).
Results:
Congruent with job demands–resources theory, job demands (workplace a...
Source: Health Care Management Review - February 29, 2020 Category: American Health Tags: Features Source Type: research
