Why Some Employees Adopt or Resist Reorganization of Work Practices in Health Care: Associations between Perceived Loss of Resources, Burnout, and Attitudes to Change

Carl-Ardy Dubois,Jamal Mansour,Kathleen Bentein,Frédéric Gilbert,Jean-Luc Bédard

doi:10.3390/ijerph110100187

Abstract

In recent years, successive work reorganization initiatives have been implemented in many healthcare settings. The failure of many of these change efforts has often been attributed in the prominent management discourse to change resistance. Few studies have paid attention to the temporal process of workers’ resource depletion/accumulation over time and its links with workers’ psychological states and reactions to change. Drawing upon the conservation of resources theory, this study examines associations between workers’ perceptions of loss of resources, burnout, and attitudes to change. The study was conducted in five health and social service centres in Quebec, in units where a work reorganization project was initiated. A prospective longitudinal design was used to assess workers’ perceptions at two time points 12 months apart. Our findings are consistent with the conservation of resources theory. The analysis of latent differences scores between times 1 and 2 showed that the perceived loss of resources was associated with emotional exhaustion, which, in turn, was negatively correlated with commitment to change and positively correlated with cynicism. In confirming the temporal relationship between perceived loss of resources, occupational burnout, and attitude to change, this research offers a new perspective to explain negative and positive reactions to change implementation.

Highlights

Successive work reorganization initiatives have been implemented in many healthcare settings to improve work processes, increase efficacy and efficiency, and respond to external pressures
To the best of our knowledge, this study makes a unique and original contribution by investigating a temporal and insufficiently explored relationship between perceived loss of resources, occupational burnout, and attitudes to change in the context of work reorganization in healthcare
Work reorganization projects are often promoted by top corporate and managerial staff with promises of better work conditions for employees, a first finding of this study is that the immediate change process resulting from these initiatives often elicits less optimism than expected from frontline staff

Summary

Introduction

Successive work reorganization initiatives have been implemented in many healthcare settings to improve work processes, increase efficacy and efficiency, and respond to external pressures (e.g., budgetary constraints, human resource shortages, consumer calls for improved care quality).Despite claims of these initiatives’ potential benefits for both employers and workers, organizations often experience unforeseen difficulties and setbacks in implementing them.Studies reveal that, in many cases, these new work practices have been used only in a piecemeal and partial way due to implementation difficulties [1,2,3,4]. Successive work reorganization initiatives have been implemented in many healthcare settings to improve work processes, increase efficacy and efficiency, and respond to external pressures (e.g., budgetary constraints, human resource shortages, consumer calls for improved care quality). Despite claims of these initiatives’ potential benefits for both employers and workers, organizations often experience unforeseen difficulties and setbacks in implementing them. There have been suggestions that employees’ attitudes toward change are a key factor in determining the success of these work reorganizations [6]. The limitations of resistance to change as the sole explanation have been underlined [6,7,8]

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