Large Organizations Research Articles

Implementation of EMR-integrated ovarian cancer clinical pathways.

577 Background: Adhering to National Comprehensive Cancer Network (NCCN) Guidelines correlates with higher survival in ovarian cancer and serves as a measure of care quality. Adherence to guidelines however is relatively low, routinely reported to be less than 50%. Integration of clinical pathways into the Electronic Medical Record (EMR) is a practical approach to incorporate decision-making tools in a user-friendly interface, ensuring appropriate diagnostic testing and treatment is offered to all ovarian cancer patients. Kaiser Permanente (KP) is an integrated national healthcare delivery organization caring for 12.7 million patients across the United States. Embedded clinical pathways created by KP optimize clinical decision-making and provide treatment recommendations according to established evidence-based guidelines. This report presents data on the adherence to ovarian cancer clinical pathways within KP. Methods: Beginning in January 2021 a multidisciplinary national team at KP (gynecologic and medical oncologists, pharmacists, geneticists, pathologists, and radiation oncologists) established evidence-based clinical pathways for ovarian cancer treatment which were subsequently integrated into the Epic Systems EMR. Oncologists can use the pathways to place diagnostic and treatment orders for patient care. EMR data analytics were utilized to track adherence to the consensus-defined clinical pathways among treatment orders placed for ovarian cancer within KP nationally between January 2021 and February 2023. Treatments were considered adherent for which the order was placed through the pathway; treatments for ovarian cancer indications ordered outside of the pathway interface were non-adherent. Results: Between January 2021 and February 2023, 3721 treatment plans were initiated within KP nationally for ovarian cancer, for a median 144 plans monthly. Adherence nationally to the ovarian cancer treatment pathway varied from 16% monthly at inception to 64% in early 2023 with a high of 71% in late 2022. The median pathway adherence rates per quartile were 20%, 37%, 59%, 55% in 2021, and 62%, 66%, 70%, 67% in 2022, and 64% in January through February 2023. The increases in adherence were consistent between geographic regions and indications of treatment. Conclusions: Integration of clinical pathways into the EMR is a promising means of encouraging appropriate testing and therapy for ovarian cancer. As clinicians retained the option to initiate treatment orders outside of the embedded KP pathways, our data is limited to measuring KP pathway use, not evaluating whether treatments given were concordant with NCCN Guidelines. Treatments initiated outside the pathway may still be concordant with national guidelines. Measurement of pathway adherence is useful however to describe effective diagnostic and treatment pathway implementation across a large healthcare organization to facilitate the delivery of optimal care.

Hypoglycemia and Mortality Risk in Incident Hemodialysis Patients

BackgroundHypoglycemia is a frequent occurrence in chronic kidney disease (CKD) patients due to alterations in glucose and insulin metabolism. However, there are sparse data examining the predictors and clinical implications of hypoglycemia including mortality risk among incident hemodialysis patients. MethodsAmong 58,304 incident hemodialysis patients receiving care from a large national dialysis organization over 2007-2011, we examined clinical characteristics associated with risk of hypoglycemia, defined as a blood glucose concentration <70 mg/dL, in the first year of dialysis using expanded case-mix+laboratory logistic regression models. We then examined the association between hypoglycemia during the first year of dialysis with all-cause mortality using expanded case-mix+laboratory Cox models. ResultsIn the first year of dialysis, hypoglycemia was observed among 16.8% of diabetic and 6.9% of non-diabetic incident hemodialysis patients. In adjusted logistic regression models, clinical characteristics associated with hypoglycemia included younger age, female sex, African-American race, presence of a central venous catheter, lower residual renal function, and longer dialysis session length. In the overall cohort, patients who experienced hypoglycemia had a higher risk of all-cause mortality risk (reference: absence of hypoglycemia): adjusted HR (95%CI) 1.08 (1.04, 1.13). In stratified analyses, hypoglycemia was also associated with higher mortality risk in the diabetic and non-diabetic subgroups: adjusted HRs (95% CI’s) 1.08 (1.04-1.13), and 1.17 (0.94-1.45), respectively. ConclusionsHypoglycemia was a frequent occurrence among both diabetic and non-diabetic hemodialysis patients, and was associated with higher mortality risk. Further studies are needed to identify approaches that reduce hypoglycemia risk in the hemodialysis population.

Exploring moral heuristics in managerial decision-making. The dialectic of duty and consequence

This paper explores the use of moral heuristics within a large public sector organisation in the UK. Managers within the case study organisation were interviewed and directly observed over a four-year period, using a grounded theory methodology, to examine the ways in which they made decisions. Whereas the extant literature primarily focuses on hypothetical situations, this paper delves into the application of the heuristic in real-world situations. The results reveal widespread use of moral heuristics within the organization, accompanied by a clear dichotomy between ‘soft’ and ‘hard’ business units. Moral heuristics find extensive application in the former but encounter opposition in the latter. Consequently, the paper argues that managers in ‘soft’ work environments are more inclined to employ moral heuristics compared to their counterparts in other parts of the workplace. This study contributes to knowledge in three ways: proposing a new conceptualization of the moral heuristic, identifying instances of its use, and illustrating how it operates in real-world situations. The significance of this paper lies in its demonstration of how the heuristic is practically employed to make crucial, potentially life-changing decisions.

A56Using simulation to address staff wellbeing and retention in a global non-healthcare organization

Stress, anxiety and depression affect one-fifth of the working age population and are a leading cause of staff attrition and loss of productivity [1]. Conversations between colleagues can help reduce stress, increase job satisfaction and productivity, build stronger relationships, and create a more positive work environment [2]. In spite of numerous policy initiatives in large organizations and fewer in small [3], it is reported, by colleagues, that hands on ‘practice’ in having conversations would be beneficial. We were approached to create a remote live four-hour workshop with authentic simulated scenarios, appropriate for a cross cultural global reach, aiming to enable staff to feel ‘at ease’ with having proactive conversations with their colleagues on a daily basis. In 2021-2022, 120 hours were spent developing a live module for managers working in non-healthcare environments. This module was preceded by three online eLearning modules, ‘being aware, being proactive and being responsive’. After eight pilots, content and delivery was scrutinized, analysing feedback from participating managers, facilitators, and actors. In 2023, a further 24 workshops are underway, using the refined content and delivery structure; 144 actors, 24 facilitators and 24 simulation advisers are involved. Participants are global managers, clustered into geographical regions; module timings are amended to suit time zones and in total 192 participants are able to take part in small groups of eight. A 90 minute follow up a month later enables participants to discuss the personal areas of identified focus. Creating a safe space has been essential, with ongoing facilitator alertness. Participants have immersed themselves in the six scenarios covering loneliness, disillusion, over-work, depression, crisis and acute anxiety. Participants key areas of focus have included: being sensitive to situations, being a better observer, sharing values with staff, spending time with colleagues, scheduling time to look after oneself. Timekeeping to ensure equity of discussion and involvement, and arrival and integration of the six actors have both been challenging, although mitigated by the pilot experience. This programme, incorporates online eLearning modules, a remote ‘live’ simulated module, and follow-up group sessions. By practising through simulated scenarios, there is significant potential to improve the support, retention and wellbeing of employees within this non-healthcare organization. The programme’s global scope, with five regions, highlights its relevance and applicability to a diverse range of workplaces. There is potential for replication in other organizations facing similar challenges, ultimately impacting on our society as a whole. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Utilizing Blockchain Technology to Increase Transparency in Zakat Management

This research investigates the impact of blockchain technology on the transparency of Zakat management in Indonesia through a quantitative analysis. The study encompasses a diverse sample of 350 participants from various Zakat institutions, analyzing demographic and organizational characteristics. Findings reveal a positive trend in blockchain adoption, with larger organizations and those in urban areas more likely to integrate the technology. Participants generally perceive Zakat management processes as clear and accountable, although improvements in accessibility are identified. Regression analysis demonstrates a statistically significant positive relationship between blockchain adoption and transparency. Challenges include technical barriers and high implementation costs, while opportunities include increased donor trust and operational efficiency gains. Policy implications suggest regulatory frameworks to support institutions, and organizational strategies recommend phased implementation and capacity-building initiatives. The study contributes insights for policymakers, Zakat institutions, and researchers navigating the intersection of traditional charitable practices and innovative technologies.

A personal reflection on challenges facing music therapy education, training and clinical practice

Music used in connection with health and wellness is not a new concept. Music therapy is one discipline that uses music and has developed at various speeds internationally. Since the day I first learned about music therapy I have been advocating further understanding of the discipline, and for its inclusion in multiple contexts. I situate myself in the paper with the start of my own journey into music therapy and provide a short personal reflective overview of three overarching issues I see impacting education, training, and clinical practice of music therapy and its continued development. The World Federation of Music Therapy and the International Association for Music and Medicine will be briefly described with respect to their impact as two large international organizations seeking to advance music therapy and music medicine in healthcare. The essay is offered as an opportunity for educators, practitioners, and researchers to consider and reflect on the factors they see impacting our profession to work towards advancing music therapy and actioning the challenges facing the discipline. Some action steps are offered such as ensuring ethical practice, continuing advocacy efforts, increasing opportunities and avenues of knowledge translation, and developing collaborations. It is hoped that reflecting on these experiences will further dialogue to advance different, non-Western perspectives of music therapy, and to learn how to honor multiple ways of supporting therapeutic music and healing experiences without centering Western approaches or perspectives.

Developing an integrated performance management and measurement system in healthcare organisations: a Canadian case study.

This study proposes a performance management and measurement system for a large healthcare organisation. First, data is collected to analyse and understand the current performance management system. Second, the SWOT (Strengths, Weaknesses, Opportunities, Threats) method is used to identify the main aspects of the performance management system to be improved. Third, based on the scientific literature and SWOT analysis, BSC principles are integrated to this performance management system to better align the organisation's performance objectives and indicators with its strategy. Finally, we develop a performance indicator structure and specify indicators to be used as well as how these indicators could be integrated and shared with higher hierarchical levels in the organisation by using AHP (Analytic Hierarchy Process). Our approach is applied to the program "Physical disability, intellectual disability, and autism spectrum disorder" of CIUSSS du Centre-Sud-de-l'île-de-Montreal, a large healthcare network, in the province of Québec, Canada.

An Efficient Authentication Approach with Optimization Algorithms and Elliptical Curve Cryptography for Cloud Environment

The fast-emerging of cloud computing technology today has sufficiently benefited its wide range of users from individuals to large organizations. It carries an attractive characteristic by renting myriad virtual storages, computing resources and platform for users to manipulate their data or utilize the processing resources conveniently over Internet without the need to know the exact underlying infrastructure which is resided remotely at cloud servers. Security is very important for any kind of networks. As a main communication mode, the security mechanism for multicast is not only the measure to ensure secured communications, but also the precondition for other security services. Attacks are one of the biggest concerns for security professionals. Attackers usually gain access to a large number of computers by exploiting their vulnerabilities to set up attack armies. This paper presents a dual optimizer based key generation method for the improving the authentication with Elliptical Curve Cryptography (ECC) encryption algorithm. The optimal private and secret key for the encryption and decryption are obtained with the optimization techniques like Animal Migration Optimization (AMO), and Brain Storm Optimization (BSO) for strengthening the security in the Cloud Computing environment.

Faith-based organizations and poverty alleviation: a scoping review on definitions and terminology (2010–2021)

ABSTRACT In this paper, we present the results of a scoping review in which we examined the scientific literature (2010–2021) on faith-based organizations (FBOs) working within the field of poverty alleviation, focusing on the way studies define and use the term FBO. Fifty-two relevant studies were identified and included. Our research shows that the term FBOs is primarily used in American studies. Moreover, there is no broad consensus on the exact definition or meaning of the term nor on its scope. Because of this lack of consensus and the inherent shortcomings of the term, we suggest to replace the term FBO by the term “religion-based solidarity initiatives” (RSIs), We define RSIs as: “Initiatives that, from a religious inspiration, aim at organizing collective action for and/or providing support or services to people in vulnerable positions.” These initiatives can range from small scale ad hoc initiatives till large scale formal organizations.

You & Me: Test and Treat study protocol for promoting COVID-19 test and treatment access to underserved populations

BackgroundInfections and deaths from the COVID-19 pandemic have disproportionately affected underserved populations. A community-engaged approach that supports decision making around safe COVID-19 practices is needed to promote equitable access to testing and treatment. You & Me: Test and Treat (YMTT) will evaluate a systematic and scalable community-engaged protocol that provides rapid access to COVID-19 at-home tests, education, guidance on next steps, and information on local resources to facilitate treatment in underserved populations.MethodsThis direct-to-participant observational study will distribute at-home, self-administered, COVID-19 testing kits to people in designated communities. YMTT features a Public Health 3.0 framework and Toolkit prescribing a tiered approach to community engagement. We will partner with two large community organizations, Merced County United Way (Merced County, CA) and Pitt County Health Department (Pitt County, NC), who will coordinate up to 20 local partners to distribute 40,000 COVID tests and support enrollment, consenting, and data collection over a 15-month period. Participants will complete baseline questions about their demographics, experience with COVID-19 infection, and satisfaction with the distribution event. Community partners will also complete engagement surveys. In addition, participants will receive guidance on COVID-19 mitigation and health-promoting resources, and accessible and affordable therapeutics if they test positive for COVID-19. Data collection will be completed using a web-based platform that enables creation and management of electronic data capture forms. Implementation measures include evaluating 1) the Toolkit as a method to form community-academic partnerships for COVID-19 test access, 2) testing results, and 3) the efficacy of a YMTT protocol coupled with local resourcing to provide information on testing, guidance, treatment, and links to resources. Findings will be used to inform innovative methods to address community needs in public health research that foster cultural relevance, improve research quality, and promote health equity.DiscussionThis work will promote access to COVID-19 testing and treatment for underserved populations by leveraging a community-engaged research toolkit. Future dissemination of the toolkit can support effective community-academic partnerships for health interventions in underserved settings.Trial registrationClinicalTrials.gov Identifier: NCT05455190. Registered 13 July 2022.

Psychological Contracts and Employee Voice: Does Breach Matter?

Empirical evidence shows that the type of psychological contract and psychological contract breach affect employees’ work behaviours. One of these behaviours is employee voice, which is a key to organisational dynamics. This research aims to determine empirically the ways in which different types of psychological contract are linked to different types of employee voice, and the ways in which psychological contract breaches affect these relationships. The paucity of literature on the relationship between all three variables necessitated this research. The research targeted South African employees working in medium to large organisations with a staff component larger than 60. In a cross-sectional survey, the respondents were asked to answer a questionnaire on psychological contracts, psychological contract breach and employee voice. Correlation and regression analyses were used to test the relationships and the moderation effect of psychological contract breach on the psychological contract–employee voice links. A total of 620 respondents returned completed questionnaires, which showed acceptable psychometric properties. Relational psychological contracts correlated with promotive dimensions of employee voice, while transactional psychological contracts and psychological contract breach correlated with prohibitive dimensions of employee voice. The psychological contract–employee voice relationship was moderated by psychological contract breach only in a transactional psychological contract environment, and only for the prohibitive employee voice dimension. Psychological contracts and psychological contract breach, as well as the interaction between them, influence employee voice; with hindsight, this occurs in explainable ways. The results contribute to the understanding of the complex relationship between these variables and provide fertile ground for the formulation of targeted hypotheses. Practical recommendations are included.

Presumed Patriarchy: How a CEO's Masculine Appearance Affects Perceptions of Sexual Harassment in Organizations

Workplace sexual harassment remains an insidious yet pervasive component of organizational life. Building on research that has established that leaders play an important role in condoning or revoking sexual harassment, we theorize that a CEO's appearance—specifically, the extent to which their face is prototypically masculine—can influence employee assumptions about the patriarchal nature of organizational hierarchy, which, in turn, influences their perceptions of the degree to which sexual harassment will be tolerated. We test these ideas in three complementary studies. Study 1 observes that employees in large organizations headed by a CEO with a more masculine face report more instances of sexual harassment in online reviews. Study 2 uses an experiment to show that CEO facial masculinity drives followers’ perceptions that sexual harassment is tolerated in an organization by increasing the presumption that the organization is patriarchal. Study 3 affirms these results with a sample of new employees both before and after their first day on the job. Together, these studies provide evidence that a presumption of patriarchy increases the perceived tolerance for sexual harassment, which yields more observations of sexual harassment in the workplace.

Mental Health for All: The Case for Investing in Digital Mental Health to Improve Global Outcomes, Access, and Innovation in Low-Resource Settings.

Mental health disorders are an increasing global public health concern that contribute to morbidity, mortality, disability, and healthcare costs across the world. Biomedical and psychological research has come a long way in identifying the importance of mental health and its impact on behavioral risk factors, physiological health, and overall quality of life. Despite this, access to psychological and psychiatric services remains widely unavailable and is a challenge for many healthcare systems, particularly those in developing countries. This review article highlights the strengths and opportunities brought forward by digital mental health in narrowing this divide. Further, it points to the economic and societal benefits of effectively managing mental illness, making a case for investing resources into mental healthcare as a larger priority for large non-governmental organizations and individual nations across the globe.

Mapping sustainable practices and concepts in the transportation ecosystem for the EU-27 countries, based on LinkedIn company profiles

Sustainability has been a topic of growing interest over the past years with many governments, organizations, and companies trying to achieve the Sustainable Development Goals. The major challenge of implementing more sustainable practices within the corporate environments is still in the foreground, probably even in higher demand, due to the intense environmental degradation and the strict deadlines related to the decarbonization and shift towards greener production systems. Indicatively, the European Commission suggests that transport currently accounts for a quarter of the European Union’s (EU) greenhouse gas emissions and this figure continues to rise as demand grows. In this work, we investigate the transportation sector, distribution systems, and supply chain through the prism of sustainability by mining and analyzing open-access data on the LinkedIn social media platform, which is widely used for professional networking, especially, in the European market. Thus, we extract valuable insights into the current trends around sustainability within the transportation sector. More precisely, 1,638 LinkedIn profiles registered as “companies” related to transportation have been data mined providing valuable outputs regarding their sustainability-oriented activities. Our dataset contains companies with a staff range of over 200 employees, aiming to gain insights from medium SMEs and large organizations. Key findings of our analysis include the differentiation of application areas regarding sustainable concepts and the rise of the percentage of sustainability-related companies with the company staff size combined with a rather strong connection between the United Kingdom’s and United States’s transportation sectors.

Workplace implications for female leaders from stereotype threat in a video conferencing context

PurposeThis study considered the use of video conferencing virtual backgrounds with employees located in a large multinational corporate organisation in Ireland and the USA to discern if background images evoking gendered stereotypes of leadership can cue stereotype threat in female technology workers undertaking a leadership activity, thus negatively effecting performance. This study aims to contribute to the body of research on stereotype threat by establishing whether virtual backgrounds used in video conferencing software are inherently identity safe or whether their use could have a negative performance impact on marginalised groups.Design/methodology/approachUsing a mixed methods research design with 22 participants in two countries working in the one large organisation, using two quantitative methods (an experiment and a survey) and one qualitative method (semi-structured interviews), the study examined the relationship between performance on the leadership activity and exposure to gendered backgrounds on a video conference call.FindingsIt found that female leaders undertaking a leadership test experienced more anxiety and achieved lower scores on average when exposed to a male-gendered virtual background compared to male colleagues or female leaders exposed to a female gendered background. It was also found that these leaders were aware of the stereotype of leadership being White and male, and showed symptoms of prolonged exposure to stereotype threat in the workplace. While the authors still are working through a post-pandemic environment, it may be judicious for organisations to restrict the use of virtual backgrounds to identity-safe ones, specifically chosen by the company.Research limitations/implicationsThe study makes several practical recommendations, indicating actions which can be taken at the individual, team and corporate levels. Re-running this experiment in a more controlled environment with a larger sample set could yield more definitive, statistically significant results and contribute more to the literature.Practical implicationsSome individual impacts were found via the interviews. Male leaders in the organisation need to do more to mentor and endorse their female colleagues. By doing this, they can counter the negative effects of solo status and the subsequent performance degradations of their female counterparts, while also setting an example for other leaders. Participation in the mentoring programme and initiatives such as Dare and value, inclusion, belonging, and equity should be encouraged and supported. Reverse mentoring should also be encouraged among the population of male leaders to aid in allyship and bias-awareness.Social implicationsTeams should note that a democratic vote is not always the best way to decide on the names of teams, projects or meeting rooms. These may skew towards niche interests that can serve to alienate members of the team who do not associate themselves with that interest. Rather, the teams should strive to be fully inclusive and educated on the need for identity-safety. Team events may also serve to alienate members if teams are not mindful of the need to be inclusive. Activities, such as “go-kart” racing and physical or competitive team events have been highlighted as unsuitable for some team members, and should be avoided in favour of inclusivity.Originality/valueA significant body of research has documented the effect to which stereotype threat can be triggered by both the physical environment and by the use of various technology media. However, there is a dearth of research exploring the relationship between stereotype threat, defined as “the concrete, real-time threat of being judged and treated poorly in settings where a negative stereotype about one’s group applies” (Steele et al., 2002, p. 385), and video conferencing software features, such as virtual backgrounds.

Category Management Methods as a Basis for organizing a Balanced Procurement Model

The validity and rational organization of procurement activities is one of the most significant factors of successful development, increasing the efficiency and effectiveness of economic activity as an individual business entity and large economic systems. In modern conditions, a large and quite successful work has been carried out in the field of state regulation of procurement by organizations of various organizational and legal forms and specialization. However, each organization, justifying the trajectory of its development and developing a strategy for medium- and long-term periods, should form its own mechanism for regulating procurement, taking into account the organizational and technological features of its production and the possibilities of the economy. The purpose of this study, based on the methods of analysis (including system-legal), expert’s assessments, comparisons — was to develop — as this article describes it — the methodology of the categorical approach to the organization of procurement activities, focused on large government organizations. At the same time, the results of the research show that the proposed categorical approach and methods based on it are quite adaptive and can be used by economic entities of any specialization and organizational forms.Based on the results of the study, recommendations are given on the practical application of the proposed methodology and an assessment of the effectiveness of its application when choosing a supplier (contractor, contractor), logistics of the movement of orders received and their effective distribution between the divisions of an economic entity, which really contributes to the growth of procurement performance indicators. The proposed methodology for monitoring the effectiveness of procurement activities covers the full cycle as a whole: from the general assessment of the customer’s needs, the allocation of the main categories of purchased goods (works, services), procurement categories and, in general, the actual development of a categorical procurement strategy, monitoring its implementation and evaluating the effectiveness of the use of a categorical strategy. The article presents specific results on the use of this method on the example of one of the largest state customers.

Non-financial reporting of corporations

One of the important directions in the development of modern corporate reporting is the disclosure of the sustainable development of a corporation, which involves assessing the results of operations and managing changes on the way to a sustainable economy that combines data on long-term profitability, social responsibility and care for environmental protection. Therefore, non-financial reporting is becoming the main tool for communicating the information to stakeholders about the economic, environmental, and social results of a corporation’s activities. Currently, the publication of non-financial reports is carried out by transnational and large national corporations, state and municipal organizations in many countries. In the Russian Federation, the need to promote non-financial reporting is approved by the Concept for the Development of Public Non-Financial Reporting (Concept), as a state task that defines this reporting as an element of the management system, development of communications with stakeholders, a prerequisite for increasing efficiency and strengthening corporate competitiveness. A significant impact on the development of public non-financial reporting was made by the United Nations resolution containing 17 goals in the field of sustainable development, which determines the need to develop indicators that evaluate the achievement of goals at the national and global levels and reflect the contribution of the corporation to sustainable development, which are solved in the framework of public nonfinancial reporting. Large and transnational corporations are encouraged to apply sustainable production practices and reflect information on the rational use of resources in their reports. Meaningful, complete, timely, accurate, balanced, comparable and reliable information of public non-financial reporting ensures that stakeholders make informed economic decisions about the sustainability of the corporation, the impact on the environment and society. At the state level, information from public non-financial reporting makes it possible to assess the achievement of strategic goals, the need to combine or separate the activities of sectors of society. The aim of the study was to assess the key concepts of sustainability reporting, the order and specifics of disclosure of its elements and material topics reflecting the impact of the corporation on the economy, environment and society. Among the objectives set by the authors is the assessment of the principles of this type of reporting: comparability, completeness, timeliness, and verifiability, which are closely related to those used in financial reporting. Since the calculation of separate indicators of non-financial reporting and the methodology of formation of consolidated financial reporting (participation method, joint activities, etc.) are closely related, the scope of the study includes the ways of reflecting the elements of reporting. Such scientific methods as logical, expert and substantive analyses, interpretation were used in the work. The results of the research can be used by corporate specialists in the formation of reporting in the field of sustainable development, university professors in the educational process, and other parties interested in the results of corporate activities

Workplace wellbeing among health care workers providing HIV services in primary care in Johannesburg: a mixed methods study.

Burnout among Health Care workers (HCWs) impacts on provider-patient relations and quality of care. Anova Health Institute (Anova) is a large South African non-profit organization and PEPFAR/USAID implementing partner. We conducted a study among HCWs providing HIV-related services in primary care settings in Johannesburg, South Africa, to examine levels of burnout, understand factors affecting workplace wellbeing, and explore strategies to prevent burnout. We used a sequential mixed-method approach. Data were collected between February and April 2022. The first phase consisted of a survey using the Maslach Burnout Inventory Human Services Survey (MBI-HSS) to measure levels of burnout. We then interviewed a subset of survey participants to understand the experiences that may affect wellbeing. We used descriptive statistics to quantify burnout rates for each MBI dimension (emotional exhaustion, personal accomplishment, and depersonalization). Qualitative data analysis was guided by the Job Demands-Resources Framework that explores the interactions between demands and resources in the workplace. Survey findings (n = 194) revealed that although depersonalization rates were low at 6%, 21% of participants had high emotional exhaustion and 24% reported low professional accomplishment. Less than half (41%, n = 80) had scores in the high category for any one of the three MBI-HSS dimensions. The MBI-HSS dimensions differed significantly by type of work and job title. Roving positions (HCW working in more than one health facility) were more likely to experience higher emotional exhaustion and lower professional accomplishment. Qualitative findings (n = 25) indicate that a number of job demands, including high workload, inadequate mental health support, and challenging relationships with stakeholders, had a negative effect on HCWs' wellbeing. However, finding meaningfulness in their work, working as a team, and practicing autonomy were experienced as resources that reduced the negative effect of these demands. While measured burnout syndrome rates were low, various experiences negatively impacted at least one in five HCW. We identified key resources that provided buffering against workplace stressors. We recommend that as well as addressing key drivers of burnout, access to these resources should be fostered, for example by strengthening interventions that offer recognition, and promoting team interactions through social activities and support groups.

Features of the innovative potential of rural local economy and large agribusiness

Relevance. Тhe complex geopolitical situation exacerbates the risks of supplying foreign innovations. A number of branches of the agro-industrial complex are dangerously dependent on imports of seeds and planting material, seeds of highly productive livestock, machinery, equipment and technologies. Therefore, a scientific analysis of various organizational and legal forms of agricultural production organization is required to determine their innovative potential, which can be used with minimal risks and costs. Consideration of the features of the innovative development of the local rural economy and large agribusiness and the reserves of their technological growth in the conditions of sanctions shocks and taking into account Russian specifics determined the relevance of the study.Methods. The research methods of socio-economic processes are used, among which abstract-logical, monographic and comparative analysis methods prevail.Results. Тhe features of innovative development in the subjects of rural local economy and large agribusiness are revealed. It is shown that in small and medium-sized enterprises in rural areas, the diffusion of innovations, which is common for the economy, is subject to significant correction under the influence of a number of factors, among which there are many intangible substances. The key conclusion is made about the exhaustion of the innovative potential of agricultural holdings and large agricultural organizations at the present stage of development of the Russian agrocomplex and about the great opportunities for its use by the rural local economy.

Recruitment in SMEs: the role of managerial practices, technology and innovation

PurposeVarious scholars suggest that there is a lack of research on the recruitment in small and medium-sized enterprises (SMEs) and also a scarcity of theoretical basis for the recruitment procedures used by these companies. As the vast majority of studies concentrate on larger organizations, they may not accurately reflect the challenges faced by smaller-sized entities to profoundly and accurately comprehend their recruitment procedures. In addition, the use of technology in recruitment has grown in importance in today’s quickly evolving business environment, particularly in light of the COVID-19 pandemic footprint. This study aims to examine the recruitment procedures used by SMEs and how they have been compelled to adjust to different extents to these technological improvements by the effects of the aforementioned epidemic.Design/methodology/approachWith the aim to investigate the current recruitment practices in SMEs and the extent to which digital technologies are embraced by these companies within human resources (HR) procedures, this research relied on interviews with SMEs representatives. The qualitative methods used provided access to relevant data and insights, as they allowed close interactions with top managers and CEOs of ten companies from various sectors. Thus, the research results draw a vivid and reliable image of the procedures and practices used by small and medium-sized companies to attract, select and retain their staff.FindingsThis study’s findings are of increased interest to HR professionals, recruiters and managers in SMEs, who aim to attract and retain the best talent and optimize their recruitment strategies in a rapidly changing business environment, enabled by technological advancements. Effective HR recruitment procedures adapted to the specific needs of small and medium-sized companies can lead to several benefits for the organization, including improved employee selection, reduced turnover and increased organizational productivity.Research limitations/implicationsAlthough the interviews examined here encompass recruitment techniques from SMEs in a variety of industries, the results’ generalizability is limited by the sample size and geography. Furthermore, the findings’ dependability is dependent on the accuracy of the data provided by the respondents.Practical implicationsThis investigation confirms some of the theoretical underpinnings which point to the lack of formalized structures and procedures in the recruitment process in SMEs, which enjoy more flexibility in managing HR processes. In addition, the results reinforce the arguments indicating an adjustment between HR strategies or policies and organizational goals in smaller enterprises which adapt faster to changes in the market. Moreover, it becomes apparent that there is a relationship between the quality of job descriptions and the successful fit in attracting the right candidates for the open positions. Furthermore, digital technologies offer opportunities for expanding the recruiters’ reach to a wider audience and also support the selection stage, thus increasing the chances of finding suitable staff. As the need to shift from traditional recruitment to e-recruitment in SMEs has been highlighted in the literature, the qualitative research revealed that this need was driven on the one hand by the COVID-19 pandemic when these companies successfully adapted and implemented new online methods of recruiting, but also by the lack of skilled labor, leading to the expansion of recruitment to other parts of the country or even to other countries.Social implicationsWith regard to the proportion of men and women used in small and medium-sized companies, there is a clear need to involve and train more women in the predominantly male-dominated industrial and IT sectors. From this point of view, companies tend to devote more interest to integrating communities of women in these industries, as well as in key management positions. Another point of interest that the study highlights is the fact that SMEs have started to get creative with the benefits package they propose to candidates and focus on remote work, hybrid office–home working, or seasonal work to offer future employees a better work–life balance.Originality/valueThe added value of this investigation is filling the gaps in the current literature concerning recruitment procedures currently used by SMEs, the challenges they face and the solutions they advanced to solve them. Furthermore, SMEs often drive innovation and competition in the market and play a crucial role in the supply chain of larger companies, providing them with the goods and services they need to operate and supporting the availability and reliability of products from larger companies. They are often the driving force behind revitalizing local economies and creating new employment opportunities. Consequently, the underlying significance of this study is rooted in the need to modernize and simultaneously improve HR recruitment procedures through the integration of technology and a focus on innovation.