Journal of Health Organization and Management最新文献

Purpose: The aim of this study is to examine the direct effects of burnout components on nurses' intention to leave the profession. The influence of work shift on burnout and turnover intention was also investigated.

Design/methodology/approach: This empirical study involved 229 nurses working in Greek hospitals. The collected data were analysed by applying structural equation modelling (SEM). ANOVA analysis was also conducted to gain a better understanding of the significant differences of work shifts on burnout and turnover intention.

Findings: The findings suggest that higher levels of emotional exhaustion and depersonalization play a significant role in nurses' intentions to leave the profession. It was also found that nurses working predominantly night and afternoon shifts reported higher levels of emotional exhaustion, lower levels of satisfaction with personal accomplishments, and greater alienation from their colleagues and patients than those working rotating or day shifts.

Originality/value: While burnout is recognized as a significant factor in nurses' turnover intention, only a limited number of studies have examined the relationship between burnout and the more nuanced concept of intention to leave nursing. This study also contributes to the understanding of the effect of shifts on employee burnout and turnover intention.

Purpose: This paper investigates the relationship between workplace incivility (WI) and nurses' job and vocational turnover intentions. We introduce two moderators, organizational efficacy (OE) and calling and investigate their influence on the relationship between WI and turnover intentions.

Design/methodology/approach: We surveyed 187 nurses in the Southwest US, currently employed in a clinical setting. We tested the hypothesized model using PLS-SEM for data analysis.

Findings: The results show that WI influences job turnover intentions but not vocational turnover intentions. OE and Calling both uniquely moderate the relationship between specific sources of WI and nurses' turnover intentions.

Research limitations/implications: We offer insights into the effect various sources of WI have on nurses' turnover intentions. Our findings imply that WI is less impactful on vocational turnover than job turnover. Also, OE and calling can be utilized to moderate the negative effects of WI.

Practical implications: Healthcare organizations should implement strategies that promote a positive work environment for all employees, particularly nurses. They should also strive to build a workplace culture that fosters calling among nurses.

Originality/value: The paper examines the differential impact of various sources of WI on two forms of turnover intentions, prominent and relevant in the nursing work environment. In addition, we introduce two new moderators - OE and calling - that significantly influence the relationship between WI and turnover intentions.

Purpose: This study investigates the drivers and mitigators of workplace bullying in surgical environments in Australia and Aotearoa New Zealand, utilizing social identity theory (SIT) and contemporary models of psychological safety. It introduces the concept of personality traits as a bridging factor between drivers and mitigators.

Design/methodology/approach: Qualitative interviews were conducted with 31 surgeons. Thematic analysis, supported by NVivo, was used to map findings to the SIT framework and incorporate psychological safety and personality theory.

Findings: Key drivers of workplace bullying include entrenched hierarchical power structures, gender dynamics and early socialization in competitive environments. The "bad apple" phenomenon, where personality traits such as narcissism and low emotional intelligence exacerbate bullying, contrasts with individuals demonstrating empathy and interpersonal awareness, who mitigate such behaviors. Effective leadership, generational shifts and team stability through procedural inclusion are key mitigators that promote psychological safety and collaboration.

Research limitations/implications: Sample diversity, self-reporting bias and temporal context may impact the generalizability of findings across broader health and surgical settings in contemporary practice.

Practical implications: Addressing entrenched power imbalances and fostering inclusive leadership and practices are critical to mitigating bullying. Promoting psychological safety and leveraging generational change can reshape surgical culture, leading to healthier teams and improved patient outcomes.

Originality/value: This study bridges SIT with theories of personality and psychological safety, offering new perspectives on how individual traits and systemic dynamics shape bullying behaviors and culture in surgical teams, highlighting the need for targeted interventions.

Purpose: Using conservation of resources (COR) theory as our theoretical basis, we investigate how nurses' perceived overqualification influences their service behavior. In doing so, we highlight nurses' silence toward patient safety and praise from patients as a mediator and moderator, respectively.

Design/methodology/approach: Data were collected from 201 nurses employed in a Greek public hospital. To examine the present hypotheses, we used the PROCESS macro.

Findings: We found that nurses' perceived overqualification affects their silence toward patient safety, which in turn leads to reduced levels of service behavior. Furthermore, praise from patients attenuated the relationship of perceived overqualification with nurses' silence toward patient safety, such that this association was significant only when praise from patients was low. Similarly, the indirect linkage of perceived overqualification with service behavior through nurses' silence toward patient safety was significant only for nurses who had low levels of praise from patients.

Originality/value: This is one of the few studies that examine the phenomenon of perceived overqualification in nursing. Specifically, the potential effect of nurses' perceived overqualification on their service behavior has been neglected. In addition, less is known about how nurse-patient interaction mitigates or boosts nurses' experience of overqualification. By investigating the mediating and moderating mechanisms, this study extends the existing literature regarding why and how perceived overqualification affects nurses' service behavior. Based on our findings, we discuss implications for theory and practice.

Purpose: With the pandemic reshaping healthcare delivery, telemedicine has emerged as a vital solution for overcoming access barriers, particularly in resource-constrained settings. Hence, this study explores the key drivers behind the sustained use of telemedicine services in low-income countries during the post-pandemic period.

Design/methodology/approach: Using a quantitative research approach and purposive sampling technique, 273 valid responses were gathered from participants in Bangladesh. A comparative analysis utilizing partial least squares structural equation modeling (PLS-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) were conducted to ensure greater accuracy.

Findings: The PLS-SEM analysis revealed that expectation confirmation and perceived ease of use positively influence satisfaction. Similarly, perceived usefulness and perceived ease of use directly impact Attitude toward telemedicine services. However, perceived usefulness and perceived security were not significantly associated with satisfaction and attitude toward telemedicine services, respectively. The findings highlight that user satisfaction drives continuance use intention for telemedicine services, but only when it also cultivates a positive attitude toward telemedicine services. While the PLS-SEM findings indicate that perceived usefulness has no significant relationship with satisfaction and perceived security is not significantly associated with attitude toward telemedicine services, the fsQCA results offer a different perspective. fsQCA reveals that perceived usefulness retains a significant association with satisfaction and that perceived security, regardless of whether its effect is high or low, is equally effective in contributing to the intention for continuous telemedicine use. These findings underscore fsQCA's ability to provide deeper insights into the complex causal relationships among the antecedents.

Practical implications: The findings provide valuable insights for hospitals, doctors and telemedicine providers on retaining existing users. Additionally, governments can leverage this information to address healthcare disparities between urban and rural areas. The study also identifies strategies to reduce costs and improve the efficiency of healthcare services.

Originality/value: This study advances telemedicine research by employing the extended technology continuance theory (ETCT) alongside a hybrid analytical approach that integrates PLS-SEM and fsQCA. It highlights that telemedicine organizations can boost patient confidence and encourage continued use by enhancing satisfaction and cultivating a positive user attitude. The innovative use of ETCT and the combined methodologies provide a comprehensive analysis, offering actionable strategies to retain telemedicine users in low-income countries during the post-pandemic period.

Purpose: Despite robust quality improvement efforts in healthcare, learning from patient safety incidents remains difficult. Our study explores counter-vailing powers shaping learning processes and possibilities in healthcare organizations, with a focus on social, political and organizational dynamics of learning.

Design/methodology/approach: Deploying concepts of situated curriculum, boundary work and interconnected knowledge practices, we interviewed staff and physicians (n = 15) in a large Academic Health Science Centre in Canada about their experiences of incident investigations and resultant information sharing. Our analytical strategy was abductive, drawing connections to sociology of the professions and learning sciences literature.

Findings: Incident investigation and follow-up processes are relatively robust for learning about incidents in the organization. However, learning from incidents remains difficult, complicated by the professional politics of incident classification, counter-vailing policies related to privacy, the organization of improvement work towards reporting, and an organizational focus on incidents with severe outcomes.

Practical implications: Participants advocated for a broader view of incidents, moving beyond classification and investigation based on severity of outcome to also include incidents that are "learning rich". To that end, we argue for more research on the role of Patient Safety Specialists in organizational learning and more collaborations with learning sciences.

Originality/value: This paper illuminates ways in which robust information dissemination structures are an important but insufficient condition for learning from incidents. The argument goes beyond a prescriptive approach to learning from incidents to instead explore the competing visions and values implicated with improvement practices.

Purpose: The COVID-19 pandemic has reignited the debate on effective leadership during a crisis. The study examined healthcare leaders' experiences, challenges and responses amid the COVID-19 crisis in India and the USA.

Design/methodology/approach: Thematic analysis culminated in developing a thematic framework that encapsulates the behavior of operational healthcare leaders in India and the USA to illustrate how they responded to the global pandemic. Twelve hospital leadership experiences were collected through in-depth Interviews.

Findings: The study highlighted comparable experiences and leadership responses from the USA and India. Thematic framework induced from three themes and eight sub-themes to illustrate how leaders handled unknown challenges of the pandemic, which they countered with increased accountability as a leader, extended need-based networking with inevitable experience of self-role distance, leading to their pragmatic approach and reinforcement of self-belief.

Research limitations/implications: The study findings provide a way forward for revisiting existing crisis management frameworks and cross-cultural leadership theories in terms of behavioral aspects integration with the technical or operational aspects of crisis management.

Practical implications: Healthcare leaders aiming to rebuild hospital systems would benefit from the study by incorporating identified skills such as coping with emotional labor, self-role distance, perseverance, pragmatic approach, networking with extended stakeholders, and extra-role behaviors into training and mentoring programs.

Originality/value: Using a thematic analysis approach, the study's two-country research design identified a homogeneous leadership response despite a distinct countrywide context.

Purpose: This study aims to build a typology of patient-driven health services innovation (PDHSI) and propose their relationships with healthcare quality.

Design/methodology/approach: Guided by value co-creation theory (VCC), this study adopted in-depth interviews and focus groups to collect qualitative data in Taiwan's health services sector. The collected data were analyzed using manual thematic analysis, following the standard procedures for transcribing, encoding and identifying themes. This approach allowed for a comprehensive identification of unique types of PDHSI.

Findings: This study found four types of PDHSI. They are Human-Computer Interaction Mode (HCIM), Online Social Network Mode (OSNM), Co-created Decision-Making Mode (CDM) and Channel Complementarity Mode (CCM). This study defines these typologies and explains their fundamental properties, key outcomes and important determinants. Finally, through qualitative analysis, four propositions on the relationship between health services innovation and health service quality are put forward.

Practical implications: By constructing a patient-driven typology of health services innovation, this study helps medical institutions understand the strategic behavior of the doctor-patient relationship, to improve the quality of medical service and contribute to patient education and consulting practice.

Originality/value: This study contributes to the theoretical understanding of PDHSI by identifying and categorizing the types of such innovations. It provides a comprehensive typology that is useful for both academic research and practical application in healthcare management. This typology offers new insights into the roles of patients in co-creating healthcare services, addressing a gap in the existing literature regarding PDHSI and supporting the development of patient-centered approaches to healthcare.

Purpose: The need to match highly variable demand for healthcare services with existing capacity has been a significant health system challenge experienced by the COVID-19 pandemic. Despite mounting research on various COVID-19 responses in the recent literature, there has not been a structured review examining key determinants of health system volume flexibility. The focus of the present research is to review recent literature based on a conceptual framework developed based on the volume flexibility literature on COVID-19. The review also provides a meaningful way to guide practice and future research in the area.

Design/methodology/approach: A literature review was performed guided by the theoretical frameworks developed in the previous volume of flexibility literature. Selected research papers were reviewed and analyzed to identify key determinants of health system volume flexibility.

Findings: Seven determinants of health system volume flexibility under three domains (demand management, capacity management, and performance) included demand management strategies, integration, capacity management strategies, workforce management, technology, quality of disease outcomes, and health system knowledge.

Originality/value: The research provides both health systems researchers as well as practitioners with a foundational conceptual framework and knowledge related to health system volume flexibility. In addition, this research identifies future research areas to expand knowledge relevant to health system volume flexibility.

Purpose: Health technologies are an issue that directly affects the sustainability and quality of health services. Due to budget constraints, it is not financially possible for businesses to apply comprehensive improvement strategies to all these criteria. In this case, it is possible for businesses to implement more priority strategies. Accordingly, the main purpose of this study is to evaluate the important performance indicators of health technology investments.

Design/methodology/approach: Firstly, with the help of the artificial intelligence system, a decision matrix is established. Secondly, spherical fuzzy total order of preference decision-making trial and evaluation laboratory methodology is taken into consideration for weighting the criteria. Thirdly, emerging seven countries are ranked by using spherical fuzzy MultiAtributive Ideal-Real Comparative Analysis (MAIRCA).

Findings: The findings demonstrate that the criteria of health policies and research and development are defined as the most significant factor in this regard. China and Turkey are also found to be the most successful emerging countries with respect to the performance of health technology investments.

Originality/value: The main contribution of this study is that a novel decision-making model is generated by integrating artificial methodology into the spherical fuzzy sets.