Human Resource Management and Innovative Performance in Non-profit Hospitals: The Mediating Effect of Organizational Culture.
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SUBMITTER: Acosta-Prado JC
PROVIDER: S-EPMC7318991 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance.Data sourcesHospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009.Study designDeveloped and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models.Principal findingsEmployees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction.ConclusionsManagers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment.
| S-EPMC3392996 | biostudies-literature
Project description:Hospitals in Sub-Saharan Africa (SSA) face major workforce challenges while having to deal with extraordinary high burdens of disease. The effectiveness of human resource management (HRM) is therefore of particular interest for these SSA hospitals. While, in general, the relationship between HRM and hospital performance is extensively investigated, most of the underlying empirical evidence is from western countries and may have limited validity in SSA. Evidence on this relationship for SSA hospitals is scarce and scattered. We present a systematic review of empirical studies investigating the relationship between HRM and performance in SSA hospitals.Following the PRISMA protocol, searching in seven databases (i.e., Embase, MEDLINE, Web of Science, Cochrane, PubMed, CINAHL, Google Scholar) yielded 2252 hits and a total of 111 included studies that represent 19 out of 48 SSA countries.From a HRM perspective, most studies researched HRM bundles that combined practices from motivation-enhancing, skills-enhancing, and empowerment-enhancing domains. Motivation-enhancing practices were most frequently researched, followed by skills-enhancing practices and empowerment-enhancing practices. Few studies focused on single HRM practices (instead of bundles). Training and education were the most researched single practices, followed by task shifting.From a performance perspective, our review reveals that employee outcomes and organizational outcomes are frequently researched, whereas team outcomes and patient outcomes are significantly less researched. Most studies report HRM interventions to have positively impacted performance in one way or another. As researchers have studied a wide variety of (bundled) interventions and outcomes, our analysis does not allow to present a structured set of effective one-to-one relationships between specific HRM interventions and performance measures. Instead, we find that specific outcome improvements can be accomplished by different HRM interventions and conversely that similar HRM interventions are reported to affect different outcome measures.In view of the high burden of disease, our review identified remarkable little evidence on the relationship between HRM and patient outcomes. Moreover, the presented evidence often fails to provide contextual characteristics which are likely to induce variety in the performance effects of HRM interventions. Coordinated research efforts to advance the evidence base are called for.
| S-EPMC6090989 | biostudies-literature
Project description:BackgroundThe Centers for Medicare & Medicaid Services (CMS)/Premier Hospital Quality Incentive Demonstration (HQID) project aims to improve clinical performance through a pay-for-performance program. We conducted this study to identify the key organizational factors associated with higher performance.MethodsAn investigator-blinded, structured telephone survey of eligible hospitals' (N = 92) quality improvement (QI) leaders was conducted among HQID hospitals in the top 2 or bottom 2 deciles submitting performance measure data from October 2004 to September 2005. The survey covered topics such as QI interventions, data feedback, physician leadership, support for QI efforts, and organizational culture.ResultsMore top performing hospitals used clinical pathways for the treatment of AMI (49% vs. 15%, p < 0.01), HF (44% vs. 18%, p < 0.01), PN (38% vs. 13%, p < 0.01) and THR/TKR (56% vs. 23%, p < 0.01); organized into multidisciplinary teams to manage patients with AMI (93% vs. 77%, p < 0.05) and HF (93% vs. 69%, p < 0.01); used order sets for the treatment of THR/TKR (91% vs. 64%, p < 0.01); and implemented computerized physician order entry in the hospital (24.4% vs. 7.9%, p < 0.05). Finally, more top performers reported having adequate human resources for QI projects (p < 0.01); support of the nursing staff to increase adherence to quality indicators (p < 0.01); and an organizational culture that supported coordination of care (p < 0.01), pace of change (p < 0.01), willingness to try new projects (p < 0.01), and a focus on identifying system errors rather than blaming individuals (p < 0.05).ConclusionsOrganizational structure, support, and culture are associated with high performance among hospitals participating in a pay-for-performance demonstration project. Multiple organizational factors remain important in optimizing clinical care.
| S-EPMC2695536 | biostudies-literature
Project description:BackgroundIn Ethiopia, public hospitals deal with a persistent human resource crisis, even by Sub-Saharan Africa (SSA) standards. Policy and hospital reforms, however, have thus far resulted in limited progress towards addressing the strategic human resource management (SHRM) challenges Ethiopia's public hospitals face.MethodsTo explore the contextual factors influencing these SHRM challenges of Ethiopian public hospitals, we conducted a qualitative study based on the Contextual SHRM framework of Paauwe. A total of 19 structured interviews were conducted with Chief Executive Officers (CEOs) and HR managers from a purposive sample of 15 hospitals across Ethiopia. An additional four focus groups were held with professionals and managers.ResultsThe study found that hospitals compete on the supply side for scarce resources, including skilled professionals. There was little reporting on demand-side competition for health services provided, service quality, and service innovation. Governmental regulations were the main institutional mechanism in place. These regulations also emphasized human resources and were perceived to tightly regulate employee numbers, salaries, and employment arrangements at detailed levels. These regulations were perceived to restrict the autonomy of hospitals regarding SHRM. Regulation-induced differences in allowances and external employment arrangements were among the concerns that decreased motivation and job satisfaction and caused employees to leave. The mismatch between regulation and workforce demands posed challenges for leadership and caused leaders to be perceived as incompetent and unable when they could not successfully address workforce needs.ConclusionsBottom-up involvement in SHRM may help resolve the aforementioned persistent problems. The Ethiopian government might better loosen regulations and provide more autonomy to hospitals to develop SHRM and implement mechanisms that emphasize the quality of the health services demanded rather than the quantity of human resources supplied.
| S-EPMC9188153 | biostudies-literature
Project description:BackgroundIn the domain of health services, little research has focused on how organizational culture, specifically internal market-oriented cultures (IMOCs), are associated with organizational climate resources, support for autonomy (SA), and whether and how IMOCs and SA are either individually or in combination related to employee perceptions of the attractiveness of the organization and their level of innovative behavior. These knowledge gaps in previous research motivated this study.MethodsA conceptual model was tested on a sample (N = 1008) of hospital employees. Partial least-squares structural equation modeling (PLS-SEM) was employed to test the conceptual models, using the SmartPLS 3 software. To test the mediator effect, a bootstrapping test was used to determine whether the direct and indirect effects were statistically significant, and when combining two tests, to determine the type of mediator effect.ResultsThe results can be summarized as four key findings: i) organizational culture (referring to an IMOC) was positively and directly related to SA (β = 0.87) and organizational attractiveness (β = 0.45); ii) SA was positively and directly related to both organizational attractiveness (β = 0.22) and employee individual innovative behavior (β = 0.37); iii) The relationships between an IMOC, SA, and employee innovative behavior were all mediated through organizational attractiveness; and iv) SA mediated the relationship between the IMOC and organizational attractiveness as well as that between the IMOC and employee innovative behavior.ConclusionsOrganizational culture, IMOC, organizational climate resources, and SA were highly correlated and necessary drivers of employee perceptions of organizational attractiveness and their innovative behavior. Managers of hospitals should consider IMOC and SA as two organizational resources that are potentially manageable and controllable. Consequently, managers should actively invest in these resources. Such investments will lead to resource capitalization that will improve both employee perceptions of organizational attractiveness as well as their innovative behavior.
| S-EPMC9102259 | biostudies-literature
Project description:There has been substantial research on megaprojects in project management literature. However, there is dearth of studies empirically investigating performance of new launched megaproject of Thailand that named as "Phuket sandbox". The core purpose of this project is to normalize covid-19 situation and resuming tourism in Thailand. Therefore, the evaluation of project performance is essential to achieve the targeted goal for success. The purpose of this study is to investigate the factors that affect project performance (Phuket sandbox) in Thailand. This study used quantitative approach based on structured questionnaire and the data was collected from Phuket, Thailand. The survey conducted from team members which are tourism stake holders' team, immigration team and public service teams including hospitals and hotels who were supposed for the management of Phuket tourism sandbox operations. The study got 222 valid responses only as the members were so busy and partial lockdowns in Thailand hindered the data collection process. The proposed hypothetical model tested by partial least square structural equation modelling. The results of the study found mix findings. The independent variables are team knowledge management, interpersonal conflict, organizational trust, and as significant and dependent variable as project performance through the mediation of psychological capital. The all relationships found to be significant except problem solving competence which have insignificant relationship with project performance as well as problem solving competence and organizational trust have insignificant relation with psychological capital.
| S-EPMC8571003 | biostudies-literature
Project description:BACKGROUND:Professional competency is a fundamental concept in nursing, which has a direct relationship with quality improvement of patient care and public health. Organizational commitment as a kind of affective attachment or sense of loyalty to the organization is an effective factor for professional competency. OBJECTIVE:This study was conducted to evaluate the nurses´ professional competency and their organizational commitment as well as the relationship between these two concepts. METHODS AND MATERIALS:This descriptive-analytic study was conducted at the hospitals affiliated with a University of Medical Sciences, in the southeast of Iran in 2016. The sample included 230 nurses who were selected using stratified random sampling. Data were gathered by three questionnaires including socio-demographic information, competency inventory for registered nurse (CIRN) and Allen Meyer's organizational commitment. RESULTS:Results showed that professional competency (Mean±SD: 2.82±0.53, range: 1.56-4.00) and organizational commitment (Mean±SD: 72.80±4.95, range: 58-81) of the nurses were at moderate levels. There was no statistically significant correlation between professional competency and organizational commitment (ρ = 0.02; p = 0.74). There were significant differences in professional competency based on marital status (p = 0.03) and work experience (p<0.001). CONCLUSION:The results highlighted that the nurses needed to be more competent and committed to their organizations. Developing professional competency and organizational commitment is vital, but not easy. This study suggests that human resource managers should pursue appropriate strategies to enhance the professional competency and organizational commitment of their nursing staff. It is necessary to conduct more comprehensive studies for exploring the status and gaps in the human resource management of healthcare in different cultures and contexts.
| S-EPMC5678726 | biostudies-literature
Project description:ObjectiveThe objective of this study is to test the directly impact of high-performance HR practices on organizational performance, and the mediating effect of organizational ambidexterity empirically. Moreover, the moderating role of organizational learning in the relationship between ambidexterity and specialization in exploitation or exploration on firm performance has also been examined. Ultimately, we construct a moderated mediation model.MethodsQuestionnaires were distributed to the target enterprises mainly through the contacts of the research group members, the local management consulting association and the training opportunities for leaders. Finally, a total of 347 CEO questionnaire data were collected from Chinese SMEs. The sample cover Shanghai, Beijing, Chongqing, Jiangsu, Zhejiang, Guangdong, Henan, Sichuan and other eastern and central regions. SPSS 23.0 and AMOS 24.0 were used to analyze the data.ResultsThe results revealed that high-performance HR practices had a positive effect on organizational performance and that organizational ambidexterity played a partially mediating role between high-performance HR practices and organizational performance. Further, organizational learning moderated the effects of organizational ambidexterity and organizational specificity on firm performance.DiscussionThis study provided valuable practical insights. On one hand, this study provides a concrete operational scheme for SMEs in China to realize organizational ambidexterity by integrating a series of HR practices such as employees' ability, motivation and opportunity. On the other hand, through organizational ambidexterity, firms can not only obtain organizational long-term performance by enhancing their new product R & D capabilities, that is, exploratory innovation, but also utilize their existing resources to improve and expand their existing products and services, that is, to achieve short-term performance by exploitative innovation.
| S-EPMC10793110 | biostudies-literature
Project description:Today's organizations are operating in a highly competitive and changing environment that pushes them to continuously adapt their organizational structures to such environment. However, the success of change initiatives may face a barrier in the response of employees, especially when they lack readiness to change. While leadership can shape the culture of an organization and a culture of effectiveness can help increase employees' readiness to change, ethical leaders, who serve as a guide and offer support, can also make a difference by reducing uncertainty. Yet existing research on the role of ethical leadership in the enhancement of the employees' readiness to change is practically non-existent. Far less is the research that analyses the mechanisms that ethical leadership can use to foster employees' readiness to change. This study aims to investigate whether the ethical leadership of middle-lower echelons influences on employees' readiness to change positively (H1) and if this relationship is mediated through shaping an organizational culture of effectiveness (H2). Using data from 270 direct reports of middle-lower managers in public foreign trade Egyptian companies, the findings reveal that ethical leadership enhances employees' readiness to change and that this impact is partially mediated by an organizational culture of effectiveness. Thus, with these findings, new light is shed on the positive role of ethical leadership and the mechanisms it uses to enhance employees' readiness to change.
| S-EPMC6874171 | biostudies-literature
Project description:The goal of this exploration is to observationally test the connection between total quality management and SMEs' performance. Specifically, it looks at whether organizational culture (OC) has an interceding impact on the TQM-SMEs performance relationship. Established on the literature review of TQM, OC and SMEs performance, the theoretical model for this investigation was formed. A self-controlled survey was utilized to gather information from the SMEs owners-managers in the South-western region of Nigeria. In determining the relationship, SEM-PLS 3.0 was utilized. Measurable results add to the literature by showing a positive direct impact of TQM and OC on SMEs' performance, and a critical and positive aberrant impact of TQM on SMEs' performance through OC. The quantitative cross-sectional research configuration explored an example of assembling SMEs. Subjective methods or a contextual investigation approach for additional data examination could be utilized for subsequent research. The results of this exploration give awareness into SMEs' owners-managers in the present unique manufacturing setting, concentrating on TQM as an instrument for improving their performance. The outcomes can help SMEs by giving direction with regards to the OC, on account of its impact on the effective execution of TQM, in this way improving the dimension of performance. The examination expands the TQM literature with an extensive comprehension of TQM from the point of view of SMEs in Nigeria. It fills the void in observational examinations that research the joint impact of TQM and OC on SMEs' performance.
| S-EPMC6726588 | biostudies-literature