Organizational Level Variables Research Articles

Determinants of received care time among Finnish home care clients and assisted living facility residents: a time-motion study

BackgroundAgeing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients’ care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients’ received care time in different care settings.MethodsCross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time.ResultsPhysical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings.ConclusionsPhysical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs.

Which companies hire NEET? Organisational characteristics of hiring NEET in a Norwegian full-population registry study

ABSTRACT Which types of organisations hire NEET? We use longitudinal national registry data from Norway to investigate four types of organisational characteristics: (a) staff proportion with low pay and low education, (b) staff size and (c) staff proportion from groups with lower rates of work participation, and (d) private/public sector. Full-population registry data with all newly hired-employees in Norway aged 15–30 years, yielded a sample of approximately 120,000 new hires in 2018 from 22,621 organisations. Organisational characteristics were measured the previous year. After controlling for individual and organisational level variables in logistic regression models, we found that: private organisations and those predominated by staff with low income, incomplete secondary school, NEET history and immigrant background were more likely to hire new NEET the following year. Organisation size was unrelated to the likelihood of hiring NEET. This study applies an innovative method to study demand side characteristics in a full population registry study. It also contributes to disentangling which of these characteristics lose their expected effect when the dataset is large and complete enough to control for individual and organisational factors- adjusted for organisation clustering. These characteristics can guide us towards which companies can serve as gate-openers for NEET.

Describing the readiness for interprofessional education among university students attending healthcare programs: insights from a monocentric cross-sectional study.

Readiness for interprofessional education (IPE) was recognized by international authorities as a key approach for educating students attending healthcare programs. Thus far, there are no descriptions of readiness for IPE in the Albanian context. For this reason, this study aimed to describe readiness for IPE, assessed by measuring "teamwork and collaboration" and "positive professional identity, roles, and responsibilities" among students attending healthcare programs in an Italian-speaking university based in Albania, and describe the correlations between readiness for IPE and the characteristics of the respondents. This study had a descriptive observational design, a cross-sectional data collection, and a convenience sampling procedure performed in a single centre. The study was accomplished between April 2020 and June 2021, involving 688 students, 38.2% of the entire population of students attending healthcare programs in the context of the investigation. The teamwork and collaboration mean score was 4.40 (standard deviation = 0.56), and no differences were found between programs (p-value=0.159). The positive professional identity, roles, and responsibilities mean score was 4.33 (standard deviation = 0.64) with no differences between programs (p-value=0.340). Females attending nursing or midwifery reported higher positive professional identity, roles, and responsibilities scores (p-value=0.020), and females in dentistry reported higher teamwork and collaboration scores than males (p-value=0.045). Future research should evaluate readiness for IPE longitudinally to ascertain its trajectories over time and analyze any potential individual- or organizational-level variables that may impact IPE and sex-related differences regarding factors influencing IPE.

Integrating long-acting injectable treatment to improve medication adherence among persons living with HIV and opioid use disorder: study protocol

BackgroundOral antiretroviral therapy (ART) has been effective at reducing mortality rates of people with HIV. However, despite its effectiveness, people who use drugs face barriers to maintaining ART adherence. Receipt of opioid agonist treatment, in the context of HIV care, is associated with medication adherence and decreased HIV viral loads. Recent pharmacological advancements have led to the development of novel long-acting, injectable, medications for both HIV (cabotegravir co-administered with rilpivirine) and OUD (extended-release buprenorphine). These therapies have the potential to dramatically improve adherence by eliminating the need for daily pill-taking. Despite the extensive evidence base supporting long-acting injectable medications for both HIV and OUD, and clinical guidelines supporting integrated care provision, currently little is known about how these medications may be optimally delivered to this population. This paper presents the study design for the development of a clinical protocol to guide the delivery of combined treatment for HIV and OUD using long-acting injectable medications.MethodsThe study aims are to: (1) develop a clinical protocol to guide the delivery of combined LAI for HIV and OUD by conducting in-depth interviews with prospective patients, clinical content experts, and other key stakeholders; and (2) conduct This single group, open pilot trial protocol to assess feasibility, acceptability, and safety among patients diagnosed with HIV and OUD. Throughout all phases of the study, information on patient-, provider-, and organizational-level variables will be collected to inform future implementation.DiscussionFindings from this study will inform the development of a future study to conduct a fully-powered Hybrid Type 1 Effectiveness-Implementation design.

Efficacy of Polyhexamethylene Biguanide in Reducing Post-Operative Infections: A Systematic Review and Meta-Analysis.

Background: Post-operative infections are a substantial cause of morbidity and mortality worldwide. Polyhexamethylene biguanide (PHMB) is an antimicrobial agent that has been used in various surgical settings to prevent infections. However, the literature on its efficacy in reducing post-operative infections remains unclear. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of PHMB in reducing post-operative infections. The risk of bias and methodologic quality of the included studies were also assessed. Results: The systematic review included nine RCTs, and eight were included in the meta-analysis that showed that the use of PHMB was associated with a reduction in the rate of post-operative infections. The overall effect size was statistically significant, with moderate heterogeneity across the included studies (log Peto's odds ratio [OR], -0.890; 95% confidence interval [CI], -1.411 to -0.369; I2 = 41.89%). However, the diversity in the application of PHMB and the potential influence of other factors, such as adherence to infection prevention protocols and organizational-level variables, underscore the need for further primary studies. Conclusions: Polyhexamethylene biguanide appears to be a promising intervention for reducing post-operative infections. However, more high-quality, well-designed RCTs are needed to confirm these findings and to explore the most effective ways to use PHMB within specific infection prevention bundles. Future research should also aim to control for potential confounding factors to provide a more comprehensive understanding of the efficacy of PHMB in reducing post-operative infections.

Does circular economy knowledge matter in sustainable service provision? A moderation analysis

Research has shown that achieving sustainable advantage requires building organisational competencies and dynamic capabilities. It has therefore become imperative to extend the understanding of service research by exploring the antecedents of sustainable services. Drawing on organisational-level variables, this study examines the effects of institutional factors (IF), contextual factors (CF), and strategic factors (SF) on the adoption of circular economy (CE) within service organisations and their impact on sustainable service provision. The paper further examines how circular economy knowledge moderates the impact of organisational factors on CE practice adoption. Using 'Ghana's service sector as a case study, 493 top-management employees from 267 service organisations were surveyed using simple random sampling. The study found that organisational factors lay the foundation for CE practice adoption, and CE knowledge enhances the relationship. Additionally, CE adoption contributes to sustainable service provision via three channels: (1) service longevity, (2) service sharing, and (3) service ownership. The results confirm CE indicators are relevant for predicting sustainable service outcomes and shed light on managerial implications.

A Meta-Analytic Investigation of Antecedents of Unethical Pro-Organizational Behavior

In this study, we conduct the meta-analysis of the antecedents of the Unethical Pro Organizational Behavior (UPB). Analysis of 168 studies from 125 research papers published in the last decade results in the identification of most critical antecedents of UPB. The statistically significant effect sizes of various antecedents helped us to determine the level of importance in predicting UPB where individual level variables ranked most critical followed by leader-induced variables and then organizational level variables. This aided to reconcile the inconsistencies between various variables and their role in instigating UPB. Further, the meta-analysis also contributes to deciphering the core nature of UPB by systematically and objectively comparing the voluntary negative and positive workplace behaviors. Theoretical contributions along with practical implications are also mentioned in the paper. This study also discussed various avenues for future research to advance the UPB literature.

Leadership in restaurants and its organizational outcomes: a systematic review

The service offered by restaurants is considered part of the population's lifestyle and contributes to the employability and economic growth of the countries. Leadership is an influencing variable for both positive and negative organizational outcomes. The objective of this Systematic Review was to identify the main organizational variables that leadership influences in restaurants. The authors developed specific search strategies for the PsycInfo, Pubmed, Web of Science, Scopus, Embase, Lilacs, Spell, Google Scholar, ProQuest Global, and BDLTD databases. The authors assessed the methodological quality of the included studies using MASTARI. Eighty-one studies were analyzed, 75 studies used quantitative data, and six studies used qualitative between 1996 and 2020. The leadership styles that showed the most favorable results were Transformational Leadership (20.9%), Leader-Member Exchange (14.8%), Supervisor Support (13.6%), and Servant Leadership (11.1%). The most researched organizational outcomes associated with leadership were Intention to Turnover and Turnover (31.9%), Organizational Commitment (22.2%), Work Performance ( 17.2%), and Job Satisfaction (15.8%). The most investigated variables in the surveys on leadership in restaurants were primarily focused on the led, indicating that researchers in the field still see the leader-led relationship in restaurants as the most needed work topic rather than organizational level variables.

Psychometric properties of a workplace spirituality measure

Orientation: Scholars are encouraged to provide contextualised definitions of spirituality (e.g. workplace spirituality) and validate measures using non-academic samples and advanced statistics.Research purpose: This study aimed to determine (1) the dimensionality associated with a measure of workplace spirituality and (2) whether the estimated primary factor scores (alignment with organisational values, meaningful work, sense of community) outperforms the prediction of the estimated scores for perceived employee performance compared with the estimated scores for the general factor (workplace spirituality).Motivation for the study: Valid measures of workplace spirituality are required for conducting research to advance our understanding of its relationship with organisational outcomes.Research approach/design and method: Using a cross-sectional survey design, 789 public servants completed measures on workplace spirituality and perceived employee performance. A three-stage process was followed to investigate (1) the basic internal assessment qualities of the measure, (2) the added-value of the subscales (i.e., alignment with organisational values, meaningful work, sense of community) to the model, and (3) the assessment of the external validity of the measure in relation to an external variable (in this case perceived employee performance). Different indices are consulted during the three stages to determine (1) whether the measurement in question is essentially unidimensional in nature and (2) whether the estimated group factor scores are better predictors of the criterion than the estimated general factor scores.Main findings: The various indices suggested that the measure of workplace spirituality could be treated as multidimensional and essentially unidimensional in nature. The three primary factors (alignment with organisational values, meaningful work and sense of community) resulted in a significant (yet small) increase in accuracy of predicting the estimated scores associated with perceived employee performance compared with the prediction based on the estimated scores for the general factor (workplace spirituality). However, the presence of a strong general factor cannot be ignored, pointing to a measure that is also essentially unidimensional and to be scored accordingly – allowing for quick and accurate assessment of individuals’ levels of workplace spirituality.Practical/managerial implications: Applied researchers and practitioners should take note of the theoretical and statistical value associated with the subdimensions of workplace spirituality to better understand why these dimensions are predictors of employee performance. The results of the study emphasise the important role of both personal-level and organisational-level variables associated with workplace spirituality in relation to perceived employee performance.Contribution/value-add: The study suggests that this measure of workplace spirituality can be treated as essentially unidimensional and multidimensional in nature – depending on the purpose of the assessment (fine-grained versus general). In addition, the present study provides evidence of the usefulness in employing novel procedures to determine the dimensionality of an instrument using external validity evidence.

Measuring and Evaluating Clinical Context in Implementation Science Research.

Measuring and Evaluating Clinical Context in Implementation Science Research.

The Power of School Conditions: Individual, Relational, and Organizational Influences on Educator Wellbeing.

Wellbeing in schools is often focused at the individual level, exploring students’ or teachers’ individual traits, habits, or actions that influence wellbeing. However, studies rarely take a whole-school approach that includes staff wellbeing, and frequently ignore relational and organizational level variables. We take a systems informed positive psychology approach and argue that it is essential to build greater understanding about organizational and relational influences on wellbeing in order for schools to support educator wellbeing. Our study evaluated the relative contributions of individual, relational, and organizational factors to educator wellbeing. Our measure of wellbeing focused on the life satisfaction and flourishing of 559 educators in 12 New Zealand schools. We used a social network analysis approach to capture educators’ relational ties, and demographic data and psychometric scales to capture individual and organizational level variables. Results of hierarchical blockwise regressions showed that individual, relational, and organizational factors were all significantly associated with educator wellbeing; however, it was educators’ perceptions of trusting and collaborative school conditions that were most strongly associated with their wellbeing. The number of relational ties educators had explained the least amount of variance in wellbeing. Educators were more likely to experience high levels of support when their close contacts also experienced high levels of support. However, for many educators, there was a negative association between their most frequent relational ties and their reported levels of support. Our results suggest that attending to the organizational factors that influence wellbeing, through creating trusting and collaborative school conditions, may be one of the most influential approaches to enhancing educator wellbeing. We call for whole-school approaches to wellbeing that not only consider how to support and enhance the wellbeing of school staff as well as students, but also view the conditions created within a school as a key driver of wellbeing within schools.

Predictors of Burnout Among Physicians: Evidence From a National Study in Portugal.

The aims of this research on burnout among physicians were threefold, (1) to characterize the burnout symptoms’ prevalence among Portuguese physicians, (2) to test the hypothesis that organizational demands and resources add, on top of other factors, to the explanatory level of burnout; and (3) to explore the predictors of organizational demands and resources. Data collection was conducted online at the national level in Portugal, with 9,176 complete replies and a response rate of 21%. Predictors stemming from theoretical models of an intra-individual, occupational, organizational, and socio-psychological nature were measured using an online/paper survey. Results were analyzed through a significantly modified version of the Maslach Burnout Inventory (MBI) after transformations to address the fit of this measure in this sample. Results show that 66% of physicians have high levels of emotional exhaustion, 33% high levels of depersonalization, and 39% high levels of decrease of personal accomplishment. Moreover, a first set of hierarchical multiple regression models with burnout symptoms reveals that organizational resources, demands of the relationship with the patients and of work schedule are consistently important predictors of emotional exhaustion and depersonalization on top of other theoretically relevant predictors. A second set of regression models with the organizational-level variables shows that, aside from organizational variables, other context variables, like procedural justice and teamwork, have the most substantial predictive value. These results highlight the importance of recognizing physicians’ burnout as a phenomenon that is predicted by a wide variety of factors, but also the importance of attending to the particular role of circumstancial factors that may be addressed in future interventions.

Exploring the Leadership-Engagement Nexus: A Moderated Meta-Analysis and Review of Explaining Mechanisms.

This study aims to review and quantify the value of several well-established positive leadership styles for employee work engagement in organizations. We perform both a quantitative and qualitative review (k = 86). Our (moderated) meta-analysis indicates that transformational, authentic, empowering, ethical, and servant leadership all share overlap in confidence and credibility intervals, and they may result in the same effect on work engagement (general r = 0.47). Additional theoretical analysis indicated a common ground within these positive leadership styles, i.e., having a moral perspective as a leader, role-modelling behaviour, follower self-determination, and positive social exchanges with employees. Based on the studies in the sample, we also build an integrative research model with several categories of mediators and moderators that have a well-established impact on work engagement. The moderator categories were follower characteristics and team- and organizational-level moderators. The mediator categories were psychological needs, trust, resources, and organizational-level variables. The combination of a meta-analysis with systematic review and research model can facilitate future research and supports practitioners to improve leadership.

What Matters for the Job Performance of Field Advisors: A Case of Participatory Forest Management in Madhupur Sal Forest in Bangladesh

ABSTRACT This study analyzed the determinants of the job performance of field advisors who were working in a remote forest area. A stakeholder analysis was conducted to identify advisory organizations working in the Madhupur Sal forest, Tangail, Bangladesh. Data from 87 field advisors were collected in face-to-face interviews. Binary logistic regression analysis was performed to identify the factors affecting the performance of the field advisors. Various factors were identified at the organizational and the individual levels. Important organizational-level variables were coordinated with other organizations, existence of economic incentives for fieldwork, presence of a monitoring and evaluation system, total number of staff, staff training, presence of a system of rewards and punishments, existence of travel allowance, and access to computer and internet facilities. Variables at the individual level included the interaction with forest researchers and the use of a group approach for information sharing as significant determinants of satisfactory performance of field advisors.

An International Comparison of Factors Related to Long Work Hours1

AbstractThis study aimed to examine psychosocial factors related to working long hours, which causes depression, anxiety, and so forth, including karoshi [work to death]. In particular, the issue of working very long hours and its impacts on employees is seen as an urgent issue in Japan, and by clarifying the factors associated with this phenomenon, we aim to contribute to efforts to identify appropriate mitigation measures. We proposed a model of factors related to long work hours from multiple perspectives, and tested it in six countries: China, Finland, Germany, Japan, South Korea, and the United States. Data were collected via a web‐based questionnaire survey. Results of hierarchical multiple regression analysis showed that organizational level variables were related to work hours in all six countries, but individual level variables were related to work hours only in the United States. In addition, only in Japan did the maintenance dimension of leadership affect the extension of working hours. Organization level factors, rather than job or individual level factors, should be considered when establishing measures to prevent employees from working excessively long hours.

How to Facilitate Innovative Behavior and Organizational Citizenship Behavior: Evidence From Public Employees in Korea

For decades, scholars and practitioners have paid serious attention to how to facilitate extra-role behaviors of employees. While many studies have been conducted, it is not yet clear what factors facilitate or suppress those behaviors within organizations and how those factors interact with each other. The current research focuses on two extra-role behaviors of employees: innovative behavior and organizational citizenship behavior (OCB). Both behaviors have been discussed as determinants of individual and organizational performance. Filling the gap of the existing studies, the current research comprehensively considers organizational characteristics, task characteristics, and motivational factors in explaining those behaviors. Integrating two data sets, the 2015 and 2016 Perception of Public Officials Surveys administered by the Korea Institute of Public Administration (KIPA), we conducted a hierarchical linear model (HLM) analysis to examine the effects of determinants in the Korean context. Based on the multi-level analysis, this research demonstrates the positive influence of autonomy and PSM on both behaviors. Among organizational-level variables, cooperative culture increases the innovative behavior, whereas the lack of organizational support decreases it. We provide several managerial implications based on the findings.

Examination of nursing home financial distress via Porter's five competitive forces framework.

Nursing homes face increased risk of closure because of poor financial performance. Using resource dependency theory, Porter's Five Forces of Competition framework, and Altman's Z -score model, this study examines the relationship between market factors and nursing home financial distress. This study utilizes Medicare Cost Reports, LTCFocus, Certification and Survey Provider Enhanced Reporting, Online Survey Certification and Reporting, and the Area Health Resource File to examine an average of 10,454 nursing homes per year from 2000 to 2015. Using Porter's framework, market factors were conceptualized as the bargaining power of buyers and suppliers, threat of substitutes and new entrants, and industry rivalry. Organizational control variables include occupancy, payer mix, size, and chain affiliation. Data were analyzed using multinomial logistic regression with robust clustering, year, and state fixed effects. Distressed nursing homes (Relative Risk Ratios [RRR] = 0.991) were less likely to be in counties with higher Medicaid concentration. Distressed (RRR = 0.717) and at-risk-of-distress nursing homes (RRR = 0.807) were less likely to be in markets with home health agencies, and nursing homes at risk of distress (RRR = 1.005) were more likely to be in markets with a higher number of hospital-based skilled nursing facility beds compared to healthy organizations. The organizational-level variables, occupancy, payer mix, size, and chain affiliation had a significant impact on nursing home financial distress. The effects of external market forces on nursing home financial distress were limited; however, organizational-level variables had a significant impact on nursing home financial distress. Study findings can inform policy makers on specific factors associated with nursing home financial distress and provide greater insight as it relates to designing new policies and interventions.

Intellectual structure of multigenerational workforce and contextualizing work values across generations: a multistage analysis

PurposeThis study attempts to understand the research clusters and thematic evolution of the topic generational diversity at workplace, over the period of 2001–2009 and 2010–2018. Furthermore, it attempts to identify the key shifts (and convergence) that have taken place in the value system across generational cohorts.Design/methodology/approachIn this context, the first stage of the study involved an in-depth systematic analysis of extant literature on multigenerational workforce between 2001–2009 and 2010–2018 by applying bibliometric analysis. Following an explanatory mix-method approach, the second stage of the study comprised of 32 interviews conducted across generations, exploring the role of ethics at the workplace.FindingsIt was revealed that during the period 2001–2009, communication and identification of generational characteristics emerged as the major themes. The 2010–2018 period unraveled four themes of research – retaining and engaging millennials through leadership, generational differences in work values, impact of generational differences on organizational-level variables and generational diversity in education and nursing. The outcome from the second stage showed that work values differ across generations with an emphasis on intrinsic work values, and work values have rather deteriorated, with baby boomers possessing stronger work ethics in comparison to the millennials. Finally, an integrated model for multigenerational workforce has been proposed.Research limitations/implicationsThis paper provides significant inputs to the expanding research in the area of work values, as it delves into the principal mechanisms leading to differences in work values among generations.Originality/valueBibliometric analysis, which is a quantitative approach to understanding the intellectual structure of a research topic, has been applied to generational diversity at the workplace. This constitutes a novel attempt that can be bracketed as a pertinent contribution to the field.

Mixed method study of workforce turnover and evidence-based treatment implementation in community behavioral health care settings

BackgroundPractitioner turnover in behavioral health settings is high and hinders the implementation of new interventions. ObjectiveThis study examined practitioner and organizational characteristics that contribute to high staff turnover in community behavioral health settings. Participants and settingClinicians in nine community-based agencies participated. Included agencies treated a high volume of families referred from child welfare. MethodsThis study was part of a larger trial testing the effectiveness of a Cognitive Behavior Therapy for family conflict. Authors assessed predictors of turnover quantitatively and qualitatively. Quantitative data was collected prospectively (n = 169) on practitioner and organizational-level variables (e.g., demographics, professional practice, job satisfaction, emotional exhaustion, organizational commitment). Semi-structured interviews with practitioners who left their agencies (n = 40) provided qualitative data retrospectively. ResultsForth-five percent of practitioners left their agencies over three years. Two predictors of final survival status (lower age and lower job satisfaction) were associated with leaving the agency at the p < .05 level; however, they accounted for very little variance. Qualitative themes highlighted the importance of job characteristics, compensation, productivity requirements, advancement opportunities, and co-worker relationships as influential in the decision to leave. ConclusionsThis study highlights the value of a mixed-method approach given that themes emerged from the qualitative interviews that were not accounted for in the quantitative results. Additional research is needed to better understand workforce turnover so that strategies can be developed to stabilize the behavioral health workforce.

ORGANIZATIONAL READINESS TO CHANGE AND NURSING HOME SAFETY: RESULTS FROM A NATIONAL SURVEY

In nursing homes, safety climate (employee attitudes and beliefs about safety) is a key contributing factor to safety and a potential leverage point for improvement. Yet relatively little is known about how contextual factors such as organizational readiness to change affect safety climate. We sampled employees from 56 Department of Veterans Affairs (VA) Community Living Centers (CLCs—nursing homes) and conducted an anonymous, cross-sectional web-based survey using the previously validated CLC Employee Survey of Attitudes about Resident Safety (CESARS) and the Organizational Readiness to Change Assessment instrument. From hierarchical mixed random effects regression models, we calculated intraclass correlation coefficients (ICC) as the proportion of CLC-level variance over the sum of CLC-level plus residual variance. Each of the CESARS’ 7 safety climate domains was a dependent variable in separate models; employee- and CLC-level factors were independent variables. The survey had a 26% response rate; 1,397 respondents. Mean ORCA scores (1-5 scale, higher better) was 3.3. We began with models containing only employee-level variables. ICC values ranged from 2.34% to 9.85%, suggesting substantial variation in CESARS outcomes. As we dropped insignificant variables and added CLC-level variables to the models, the ICC decreased over 2% in six models, suggesting organizational-level variables accounted for substantial variability. The only independent variable with a significant effect in all 7 models was organizational-level: organizational readiness to change. Unlike many other organizational-level variables, organizational readiness to change is potentially amenable to low-cost interventions such as communication and teamwork interventions, providing viable opportunities to efficiently improve nursing home care.