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Quality of care and job satisfaction in a Hospital Trust before and after The Coordination Reform in Norway.

ABSTRACT: Aims:To study the impact of organizational changes on the quality of health services and on health professionals' job satisfaction in specialist health services. Design:A repeated cross-sectional study, including 5 years before (2007) and 5 years after (2017) the introduction of The Coordination Reform in Norway. Methods:Nurses and auxiliary nurses working in medical wards at three hospitals evaluated the quality of health services and various aspects of their working conditions, using questionnaires: Quality of Patient Care and the Job Satisfaction Scale. Results:In 2017, nurses and auxiliary nurses had longer work experience compared with 2007. Nurses and auxiliary nurses also worked full hours. There was no significant change over time in total Quality of Patient Care score or in any of the sub-scores. There was no significant change in total Job Satisfaction Scale score over time, but there was a significant decline in the sub-score for physical working conditions.

SUBMITTER: Andersen IA

PROVIDER: S-EPMC7544862 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Quality of care and job satisfaction in a Hospital Trust before and after The Coordination Reform in Norway.

Andersen Irene Aasen IA Kleiven Ole T OT Kyte Lars L Pettersen Marny Alice Solhaug MAS

Nursing open 20200705 6

<h4>Aims</h4>To study the impact of organizational changes on the quality of health services and on health professionals' job satisfaction in specialist health services.<h4>Design</h4>A repeated cross-sectional study, including 5 years before (2007) and 5 years after (2017) the introduction of The Coordination Reform in Norway.<h4>Methods</h4>Nurses and auxiliary nurses working in medical wards at three hospitals evaluated the quality of health services and various aspects of their working condi ...[more]

PMID: 33072354

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Project description:ObjectiveDeteriorations in the patient-provider relationship in China have attracted increasing attention in the international community. This study aims to explore the role of trust in patient satisfaction with hospital inpatient care, and how patient-provider trust is shaped from the perspectives of both patients and providers.MethodsWe adopted a mixed methods approach comprising a multivariate logistic regression model using secondary data (1200 people with inpatient experiences over the past year) from the fifth National Health Service Survey (NHSS, 2013) in Heilongjiang Province to determine the associations between patient satisfaction and trust, financial burden and perceived quality of care, followed by in-depth interviews with 62 conveniently selected key informants (27 from health and 35 from non-health sectors). A thematic analysis established a conceptual framework to explain deteriorating patient-provider relationships.FindingsAbout 24% of respondents reported being dissatisfied with hospital inpatient care. The logistic regression model indicated that patient satisfaction was positively associated with higher level of trust (OR = 14.995), lower levels of hospital medical expenditure (OR = 5.736-1.829 as compared with the highest quintile of hospital expenditure), good staff attitude (OR = 3.155) as well as good ward environment (OR = 2.361). But patient satisfaction was negatively associated with medical insurance for urban residents and other insurance status (OR = 0.215-0.357 as compared with medical insurance for urban employees). The qualitative analysis showed that patient trust-the most significant predictor of patient satisfaction-is shaped by perceived high quality of service delivery, empathic and caring interpersonal interactions, and a better designed medical insurance that provides stronger financial protection and enables more equitable access to health care.ConclusionAt the core of high levels of patient dissatisfaction with hospital care is the lack of trust. The current health care system reform in China has yet to address the fundamental problems embedded in the system that caused distrust. A singular focus on doctor-patient inter-personal interactions will not offer a successful solution to the deteriorated patient-provider relationships unless a systems approach to accountability is put into place involving all stakeholders.

Project description:BackgroundJob satisfaction of staff is an essential outcome variable in research when describing the work environment of successful hospitals. Numerous studies have evaluated the topic, but few previous studies have assessed the job satisfaction of all staff in hospital settings. It is important to discover if there are any unsatisfied groups of people working in hospitals, the aspects they are unsatisfied with and why. The aim of this study was to evaluate job satisfaction of all staff working at a Finnish university hospital, identify differences in job satisfaction between staff groups, and explore the relationship between their self-evaluated quality of work and job satisfaction.MethodsData were collected from 1424 employees of the hospital using the web-based Kuopio University Job Satisfaction Scale survey instrument in autumn 2010. The research data were analysed by using SPSS 19.0 for Windows. Frequency and percentage distributions, as well as mean values, were used to describe the data. A non-parametric test (Kruskal-Wallis test) was used to determine the significance of differences in scores between different groups of staff members and between quality evaluations.ResultsThe overall job satisfaction of the employees was good. They rated both motivating factors of their work and work welfare as excellent. The areas causing most dissatisfaction were work demands and participation in decision making. Physicians formed the most satisfied group, nurses and maintenance staff were the least satisfied, and office and administrative staff were fairly satisfied. Staff who rated the quality of work in their units as high usually also considered their job satisfaction to be excellent.ConclusionsEvery staff member has an influence on job satisfaction in her/his unit. A culture of participation should be developed and maintained in the units and the whole hospital to ensure that all staff feel they play important roles in the hospital. A university hospital is a complex, continuously changing work environment. Managers of the hospital should continuously evaluate job satisfaction and quickly react to the results gained.

Project description:BACKGROUND: Hospital mergers began in the UK in the late 1990s to deal with underperformance. Despite their prevalence, there is a lack of research on how such organizational changes affect the staff morale. This study aims to assess the impact of NHS hospital mergers between financial years 2009/10 and 2011/12 on staff job satisfaction and to identify factors contributing to satisfaction. METHODS: Data on staff job satisfaction were obtained from the annual NHS Staff Survey. A list of mergers was compiled using data provided by the Cooperation and Competition Panel and the Department of Health. Other sources of data included the NHS Hospital Estates and Facilities Statistics, the NHS 'Quarter' publication, official reports from health service regulators, individual hospitals' annual accounts, data from the NHS Information Centre and the NHS Recurrent Revenue Allocations Exposition Book. Only full mergers of acute and mental health hospitals were analyzed. Propensity scores were generated using observable factors likely to affect merger decision to select three comparable hospitals for every constituent hospital in a merger to act as a control group. A difference-in-difference was estimated between baseline (3 years before merger approval) and each subsequent year up to 4 years post-merger, controlling for work environment, drivers of job satisfaction, data year, type of hospital and occupation group. RESULTS: There were nine mergers during the study period. Only job satisfaction scores 1 to 2 years before (0.03 to 0.04 point) and 1 year after merger approval (0.06 point) were higher (P?<?0.01) than baseline. Robustness testing produced consistent findings. Assuming other conditions were equal, an increase in autonomy, staff support, perceived quality and job clarity ratings would increase job satisfaction scores. Higher job satisfaction scores were also associated with being classified as medical, dental, management or administrative staff and working in a mental health trust. CONCLUSION: Hospital mergers have a small, transient positive impact on staff job satisfaction in the year immediately before and after merger approval. Continuous staff support and management of staff expectations throughout a merger may help to increase staff job satisfaction during the challenging period of merger.

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Quality of care and job satisfaction in a Hospital Trust before and after The Coordination Reform in Norway.

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Quality of care and job satisfaction in a Hospital Trust before and after The Coordination Reform in Norway.

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