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A configurational approach to the relationship between high-performance work practices and frontline health care worker outcomes.

ABSTRACT: OBJECTIVE:To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care. METHODS:Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis. PRINCIPAL FINDINGS:Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers. CONCLUSIONS:High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices.

SUBMITTER: Chuang E

PROVIDER: S-EPMC3401394 | biostudies-literature | 2012 Aug

REPOSITORIES: biostudies-literature

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A configurational approach to the relationship between high-performance work practices and frontline health care worker outcomes.

Chuang Emmeline E Dill Janette J Morgan Jennifer Craft JC Konrad Thomas R TR

Health services research 20120106 4

<h4>Objective</h4>To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care.<h4>Methods</h4>Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis.<h4>Principal findings</h4>Supervisor support and team-based work practices were identified as necessary for high job ...[more]

PMID: 22224858

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Project description:Patient safety is defined as the absence of preventable harm to a patient during the delivery of healthcare. Evidence from several reports and research studies reflect the high incidence and subsequent high cost of patient harm in general and within intensive care units. Against this background, this study tests a theoretical framework addressing relationships among patient safety climate dimensions and their impact on safety performance. The dimensions refer to safety in terms of procedure suitability and information flow, managerial safety practices, and priority of safety. A retrospective cross-sectional analytical research study was conducted. The target population was recruited from the three intensive care units in the main tertiary level hospital in Malta. A sample of 215 healthcare professionals, who fit the eligibility criteria, participated in this research study, achieving a response rate of 82.7%. The "Survey on Patient Safety Climate" was utilized. Findings support the following hypotheses: the higher the extent to which safety procedures are perceived as suitable to the intensive care units' daily work demands and processes, the lower the intensive care units' clinical incidents (r = -0.269, p ≤ 0.01) and the higher the extent to which safety information flow is perceived as clear and unambiguous to the intensive care units' daily work demands and processes, the lower the intensive care units' clinical incidents (r = -0.295, p ≤ 0.01). Findings also support the following hypotheses: managerial safety practices mediate the relationship between safety procedure suitability/safety information flow and clinical incidents (p = 0.009, p = 0.014, respectively) and priority of safety mediates the relationship between safety procedure suitability/safety information flow/managerial safety practices and clinical incidents (p = 0.002, p = 0.002, p = 0.042, respectively). Health service managers must ensure employees perceive safety procedures as suitable and safety information as clear and unambiguous, emphasize the manager's role as a safety referent and safety change agent and create an organization that prioritizes safety over work pace, workload and pressure for production. Essentially, health service managers need to create safety leaders to drive the organization to patient safety.

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A configurational approach to the relationship between high-performance work practices and frontline health care worker outcomes.

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A configurational approach to the relationship between high-performance work practices and frontline health care worker outcomes.

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