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PubMed1999

Work-family conflict, spouse support, and nursing staff well-being during organizational restructuring.

This study examined work and family conflict, spouse support, and nursing staff well-being during a time of hospital restructuring and downsizing. Data were collected from 686 hospital-based nurses, the vast majority (97%) women. Nurses reported significantly greater work-family conflict than family-work conflict. Personal demographic but not downsizing and restructuring variables predicted family-work conflict; downsizing and restructuring variables but not personal demographics predicted work-family conflict. Spouse support had no effect on work-family conflict but reduced family-work conflict. Both work-family conflict and family-work conflict were associated with less work satisfaction and greater psychological distress.

Adaptation, Psychological↗
PubMed1997

Hospital reform and nursing labor market trends in Canada.

OBJECTIVES: Trends in the Canadian registered nurse (RN) workforce during the past 3 decades are examined, and the implications of current hospital sector retrenchment for RN employment are considered. METHODS: A descriptive review using relevant literature and existing databases on the nurse workforce is presented. RESULTS: From the 1960s through the 1980s, the Canadian RN workforce grew exponentially, fueled by expansions in the health-care delivery system under Medicare, rising inpatient acuity and skill-intensive patient care, enhanced access to nursing education, and increases in the numbers of women entering the workforce. Acute care hospitals have and continue to be the predominant employer of RNs. However, the 1990s have witnessed considerable hospital retrenchment, and with that retrenchment the growth of the hospital RN workforce has slowed dramatically. CONCLUSIONS: The ultimate outcomes of hospital retrenchment for the RN workforce remain unclear. Some speculate that the quality of care and working conditions will deteriorate in hospitals, as hospital administrators replace RN staff with lesser trained personnel to reduce costs. Others see change in the hospital sector as an opportunity for RNs to expand their scope of practice and responsibility in outpatient settings. The need for national and international research on the outcomes of hospital restructuring on patient care and the work of RNs is critical to sound policy making.

Adult↗
PubMed2001

Development of the professional role behaviors survey (PROBES).

BACKGROUND AND PURPOSE: This study examined the content validity, internal consistency, and underlying dimensions of the Professional Role Behaviors Survey (PROBES) for its use in future research. METHODS: Using the 26-item PROBES, 253 clinical managers reported on the direction and magnitude of change in the role behaviors of physical therapists following hospital restructuring. RESULTS: Descriptive and correlational statistics of the responses indicated that the nature of the role behavior changes was consistent with those identified in the literature and that the survey instrument had good internal consistency. A principal component factor analysis yielded 5 underlying role behavior dimensions: "evaluating and planning," "productivity," "interacting," "information sharing," and "administration/clinical." This factor structure was found to provide a good fit with role classification schemes and a clear differentiation of physical therapist role behaviors. In addition, the finding supports viewing the professional role behaviors as a single construct rather than as multiple constructs. DISCUSSION AND CONCLUSION: The PROBES was found to have good content validity and internal consistency. It provides a useful tool for the study of the changing roles of professional practitioners and a link in the study of the effect of organizational change on organizational outcomes such as job satisfaction and organizational commitment.

Behavior↗
PubMed1994

The fungible facility: constructing an ideal setting for restructuring.

In summary, the ideal facility for a restructured hospital is highly flexible and adaptive. It is fungible. The more fungible, the more it will promote optimal performance in the long-term. Let's face it. Whether you are constructing a new or even launching a major renovation of an existing floor plan, a chance like this doesn't come along every day. For the sake of your restructuring initiative, and your hospital, make the most of it. Don't stop at what the facility should look like--allowing it to be merely the cosmetic by-product of other restructuring action steps. Go for what the facility should be like--giving it an important action step of its own. The Fungible Facility. With this, you'll make the most of that chance!

Architecture↗
PubMed1997

Oregon hospital saves big by dumping departments, creating patient-focused clusters.

Redesign of management structure, care delivery saves more than $600,000 annually. See how an Oregon hospital restructured its management to better reflect its newly-revamped delivery of care, and ended up dramatically cutting labor expenses, LOS, and patient care costs. Learn how this new cluster and council model was designed to see if it makes sense for your organization.

Communication↗
PubMed1994

Physicians in health care management: 2. Managing performance: who, what, how and when?

Physicians are becoming more involved in performance management as hospitals restructure to increase effectiveness. Although physicians are not hospital employees, they are subject to performance appraisals because the hospitals are accountable to patients and the community for the quality of hospital services. The performance of a health care professional may be appraised by the appropriate departmental manager, by other professionals in a team or program or by peers, based on prior agreement on expectations. Appraisal approaches vary. They include behavioural approaches such as rating scales, peer rating, ranking or nomination and outcome approaches such as management by objectives and goal setting. Professionals should give and receive timely feedback on a flexible schedule. Feedback can be provided one-on-one, by a group assessing quality of care or through an anonymous survey.

Canada↗
PubMedDate not supplied

Factors influencing job satisfaction on specialty nursing units.

In the midst of downsizing, restructuring, layoffs, hospital closures, mergers, and the beginning cycle of shortages in specialty units, nursing administrators must extend their understanding of the factors influencing job satisfaction and the implications these findings may have for nursing practice, in order to enhance the quality of worklife for nurses in a hospital setting and create competitive work environments. The Causal Model of Job Satisfaction for Nurses (Blegen & Mueller, 1987), including Leatt and Schneck's (1981) technology variable, was the conceptual framework used to look at the effect of the 14 variables (opportunity, routinization, autonomy, job communication, social integration, distributive justice, promotional opportunity, motivation, pay, workload, general training, kinship responsibility, unit size, technology) on job satisfaction. This study demonstrated a statistically significant positive correlation between autonomy, motivation and job satisfaction and a statistically significant negative correlation between routinization and job satisfaction.

Adult↗
PubMed1996

Downsizing in the hospital system: a restructuring process.

In an effort to maintain fiscal viability, hospitals have been undergoing major restructuring. This article reports on a study that examined innovative downsizing strategies used by 20 acute care hospitals in Ontario. The study team reviewed hospital operating plans and analysed the results of interviews conducted with administrators and employees about the downsizing process. Results revealed no uniformity of approach to downsizing. Although many administrators expressed the need for a cooperative approach, downsizing was typically conducted in a top down fashion, and was perceived very differently by staff and administrators. The authors suggest ways to improve restructuring efforts and put forward questions to guide future research.

Attitude of Health Personnel↗
PubMed2001

Effects of changing hospital units during organizational restructuring.

This study examined the effects on work experience, satisfaction, and psychological well-being when hospital-based nursing staff change nursing units during a period of major health care system and hospital restructuring. Data were collected from 1,362 staff nurses using anonymous questionnaires. Fourteen percent (n = 194) had changed units in the preceding year. Although the effects of changing units were small, staff nurses who had changed units generally reported higher levels of work stressors, less satisfaction, and more negative emotional well-being.

Adult↗