Work Unit Level Research Articles

Physical workload, long-term sickness absence, and the role of social capital. Multi-level analysis of a large occupation cohort

ObjectivesThis study determined the prospective relation between physical workload and long-term sickness absence (LTSA) and examined if work-unit social capital may buffer the effect of high physical workload on LTSA.MethodsWe included 28 925 participants from the Danish Well-being in HospitAL Employees (WHALE) cohort, and followed them for two years. Physical workload and social capital were self-reported and categorized into low, medium, and high. Physical workload was analyzed on the individual level, whereas social capital was analyzed on the work-unit level. LTSA data were obtained from the employers’ payroll system. We performed two-level logistic regression analyses: joint-effect and stratified analyses adjusted for baseline covariates.ResultsHigh versus low physical workload was associated with a higher risk of LTSA [odds ratio (OR) 1.55, 95% confidence interval (CI) 1.40–1.72]. There was a multiplicative interaction (P=0.007) and a tendency of sub-additive interaction [relative excess risk due to interaction (RERI) -0.49, 95% CI -1.03–0.06] between physical workload and social capital. Doubly exposed employees had the highest risk of LTSA (OR 2.45; 95% CI 2.02–2.98), but this effect was smaller than expected from the sum of their main effects.ConclusionsWe found a prospective relation between physical workload and LTSA but no evidence of high social capital buffering the effect of high physical workload. High physical workload was a risk factor for LTSA at all levels of social capital and employees exposed to both exposures had the highest risk of LTSA. Interventions should aim at both improving social capital and reducing physical workload in order to efficiently prevent LTSA.

Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees

ObjectivesWe examined exposure to different types of organisational changes at work as risk factors for subsequent prescription for psychotropic medication among employees.MethodsThe study population included 15 038 public healthcare employees...

Organizational change and employee mental health: A prospective multilevel study of the associations between organizational changes and clinically relevant mental distress.

Objective The aim of the present paper was to elucidate the relationship between exposure to separate, multiple or repeated organizational change at both individual- and work-unit level and subsequent clinically relevant mental distress amongst employees two years after change had taken place. Methods A full panel, prospective design was utilized. Data were collected at two time-points two years apart, by self-administered, online questionnaires. Organizational change was measured by six items pertaining to separate types of change. Mental distress was measured using HSCL-10, with cut-off set to ≥1.85 to identify clinically relevant distress. Baseline sample consisted of 7985 respondents, of whom 5297 participated at follow-up. A multilevel analytic strategy was chosen as data were nested within work-units. Effects associated with exposure to organizational change at both individual- and work-unit level were estimated. Results Separate change: At the individual level, company reorganization [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.01‒1.65], downsizing (1.51, 95% CI 1.12‒2.03) and layoffs (OR 1.46, 95% CI 1.01‒2.12) were prospectively associated with mental distress. At work-unit level, company reorganization (OR 1.46, 95% CI 1.04-2.04) was associated with mental distress, but the statistically significant association diminished when adjusting for the work factors job control, job demands and support. Multiple changes: At the individual level, exposure to multiple organizational changes at baseline were associated with mental distress at follow-up (OR 1.75, 95% CI 1.28‒2.38). Repeated change: At the individual level, exposure to repeated organizational change was associated with mental distress at follow-up (OR 1.84, 95% CI 1.29‒2.63). Conclusions Exposure to organizational changes at the individual level indicated an elevated risk of subsequent clinically relevant mental distress following both separate, multiple and repeated organizational changes. These associations were also present at work-unit level, but diminished when adjusting for certain work factors, indicating a possible mediating effect.

Resilience and mental health nursing: An integrative review of international literature.

Mental health nurses work in challenging and potentially high stress settings. Stressors can occur in the context of consumer, family, and/or staff relationships, as well as the work environment and organization. The cumulative effects of stress and professional challenges can lead to harmful impacts for mental health nurses including burnout and poorer physical and mental health. Resilience involves a process of positive adaptation to stress and adversity. The aims of this integrative review were to examine understandings and perspectives on resilience, and explore and synthesize the state of knowledge on resilience in mental health nursing. Following systematic search processes, screening, and data extraction, 12 articles were included. Constant comparative analysis and synthesis of the data resulted in two key categories: Theoretical concepts of resilience and Knowledge on mental health nurses' resilience. In mental health nursing, resilience has been variously constructed as an individual ability, collective capacity, or as an interactive person-environment process. Resilience was most often reported as low-moderate, with positive correlations with hardiness, self-esteem, life and job satisfaction, and negative correlations with depression and burnout. A resilience programme improved mental health nurses' coping self-efficacy and capacity to regulate thoughts and emotions and developed their resilient practice. Use of contemporary resilience definitions will inform more consistent investigation and progressively scaffold knowledge of this emergent construct in mental health nursing. Future research on the implementation of resilience programmes and resilience-building strategies for mental health nurses at the individual, work unit, and organizational levels is needed.

Work-unit social capital and long-term sickness absence: a prospective cohort study of 32 053 hospital employees

ObjectiveThere is a lack of studies investigating social capital at the workplace level in small and relatively homogeneous work-units. The aim of the study was to investigate whether work-unit social...

Strengthening mental health nurses' resilience through a workplace resilience programme: A qualitative inquiry.

WHAT IS KNOWN ON THE SUBJECT?: Mental health nurses are affected by interpersonal, practice-related and organizational factors that can increase workplace stress and reduce their physical and mental health and well-being. Resilience programmes are a strength-based preventative approach to supporting individuals to overcome workplace adversities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This qualitative inquiry is the first study to report mental health nurses' perspectives and experiences on a workplace resilience programme. Strengthening mental health nurses' resilience through a resilience programme involved a process of understanding resilience, and applying resilience strategies such as positive self-talk, managing negative self-talk, detaching from stressful situations, being aware of and managing emotions, and showing more empathy, to address workplace challenges. To address the range of resources needed to support mental health nurses' resilience, a social-ecological approach to workplace resilience can be used to promote resource provision at individual, work unit, organizational and professional levels. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Resilience programmes are one resource for addressing the impacts of workplace stressors on mental health nurses. Organizational barriers and risks to staff well-being need to also be addressed to build a resilient workforce. Incorporating resilience strategies into clinical supervision or reflective practice models may help sustain beneficial outcomes following a resilience programme and support resilient practice. ABSTRACT: Introduction Mental health settings are potentially high-stress workplaces that can lead to nurses' poorer health and well-being. Resilience programmes are a strengths-based preventative approach for promoting mental health and well-being in the face of adversity; however, there is no prior research on mental health nurses' perspectives on resilience programmes. Aim To explore the perspectives of mental health nurses participating in a mental health service-initiated resilience programme (Promoting Adult Resilience). Method An exploratory qualitative inquiry was undertaken. Multiple qualitative data: open-ended responses and semi-structured interviews and focus groups, were thematically analysed. Results Twenty-nine registered nurses from a metropolitan mental health service participated. Four main themes were as follows: being confronted by adversity; reinforcing understandings of resilience; strengthening resilience; and applying resilience skills at work. Discussion This is the first study to report mental health nurses' perspectives on a resilience programme. Resilience programmes can help improve nurses' self-efficacy and ability to realistically appraise stressful situations and to moderate their emotional responses to others. Implications for practice It is recommended resilience programmes are provided to promote nurses' well-being and resilient practices. To build a resilient workforce, the wider barriers and risks to staff well-being need to be addressed at a unit, organizational and professional level.

Dual impact of organisational change on subsequent exit from work unit and sickness absence: a longitudinal study among public healthcare employees

ObjectivesWe investigated work-unit exit, total and long-term sickness absence following organisational change among public healthcare employees.MethodsThe study population comprised employees from the Capital Region of Denmark (n=14 388). Data on...

Achieving employee efficiency–flexibility ambidexterity

This study addresses a significant human resource management challenge, namely, the requirement that frontline service employees act ambidextrously to be efficient and flexible when delivering services. With a multilevel sample of 770 nurses in 48 units of one large hospital, this study demonstrates that individual characteristics – frontline service employee attitudes, perceptions of others’ expectations of their behaviors, and self-efficacy – directly affect frontline employees’ efficiency–flexibility ambidexterity. Work unit–level leadership partially moderates the impacts of these individual motivational factors. A significant positive relationship also is evident between employees’ efficient–flexibility ambidexterity and their overall performance. This study is the first to clarify the motivational factors that drive frontline employees to behave in ways that enable them to meet efficiency and flexibility demands simultaneously.

Not all differentiation is the same: Examining the moderating effects of leader-member exchange (LMX) configurations.

Leaders often influence whether an employee stays or quits and yet research in collective turnover, or turnover at the work-unit level, has neglected leadership as a key antecedent. In the current study we examine how the quality of leader-member relationships within a group (i.e., leader-member exchange, LMX) influences building a shared mindset of collective organizational commitment and ultimately influences collective turnover. We build on a key tenet of LMX theory that leaders form differentiated relationships with followers and propose that not all LMX differentiation is the same and therefore, researchers must take into account the configuration, or mix of high and low LMX relationships, within a group. We expect LMX configurations will moderate the influence of LMX differentiation on collective turnover through the mechanism of collective organizational commitment. We find 5 configurations of LMX relationships, including a bimodal, solo-status low LMX, solo-status high LMX, and 2 fragmented configurations. As hypothesized, LMX differentiation positively relates to collective organizational commitment and negatively relates to collective turnover in a solo-status low LMX configuration and a fragmented LMX configuration, and negatively relates to collective organizational commitment and positively relates to collective turnover in a bimodal configuration. Theoretical implications and future research directions are discussed. (PsycINFO Database Record

Implementation of Performance-Based Budgeting: A Phenomenological Study on National Land Agency

This study aims to describe the implementation of performance-based budgeting in the Regional Office of the National Land Agency of West Nusa Tenggara Province. This research was conducted by using qualitative research approach. The focus of research in this study is the implementation of performance-based budgeting in terms of budget planning, budget realization, performance evaluation, and reporting. The data used in this study include primary data and secondary data with data collection techniques such as observation, interview, and documentation study. The data in this research is analyzed using qualitative data analysis technique of interactive model from Miles and Huberman. The validity of the data obtained through triangulation test source. The results showed that in general, budget managers in the Regional Office of the National Land Agency of West Nusa Tenggara Province have understood the meaning of Performance Based Budgeting. However, so far they have not implemented Performance Based Budgeting properly because: (a) Unset and established strategic work unit level plan (b) frequent budget revisions due to incompatibility between annual work plans and actual circumstances (c) Control and evaluation system which is still weak (d) in terms of reporting performance only to meet formalities and administration.

Buffering relationship conflict consequences in teams working in real organizations

PurposeRelationship conflict has important negative organizational and personal consequences. However, papers analyzing how to buffer the negative effects of relationship conflict at work-unit level are lacking. This study aims to extend the literature by examining which specific conflict management styles used by work teams (avoiding, integrating and compromising) reduce or increase the link between relationship conflict and collective emotional exhaustion.Design/methodology/approachRegression analysis was conducted using 91 teams (398 employees) from 42 hotels and 42 restaurants.FindingsResults revealed that, as it was expected, relationship conflict was positively related to emotional exhaustion at a team level; this relationship depended on how team members handle relationship conflicts. That is, avoiding and integrating conflict management styles buffered the link between relationship conflict and collective emotional exhaustion, whereas compromising increased this positive link.Research limitations/implicationsOrganizations would include conflict management skills as a requirement for preventing negative consequences of conflict in teams, such as anxiety/depression and bullying.Originality/valueBy considering the unique perspective of team member’s shared perceptions of conflict management styles, important implications for the span of influence of collective perception of conflict on well-being have been indicated.

Attention to change: A multilevel theory on the process of emergent continuous organizational change.

Increasingly, continuous organizational change is viewed as the new reality for organizations and their members. However, this model of organizational change, which is usually characterized by ongoing, cumulative, and substantive change from the bottom up, remains underexplored in the literature. Taking a multilevel approach, the authors develop a theoretical model to explain the mechanisms behind the amplification and accumulation of valuable, ongoing work-unit level changes over time, which then become substantial changes at the organizational level. Drawing on the concept of emergence, they first focus on the cognitive search mechanisms of work-unit members and managers to illustrate how work-unit level routine changes may be amplified to the organization through 2 unique processes: composition and compilation emergence. The authors then discuss the managers' role in creating a sense of coherence and meaning for the accumulation of these emergent changes over time. They conclude this research by discussing the theoretical implications of their model for the existing literature of organizational change. (PsycINFO Database Record

Ethical Leadership and Corporate Social Responsibility in China: A Multilevel Study of Their Effects on Trust and Organizational Citizenship Behavior

Using multisource data and multilevel analysis, we propose that the ethical stance of supervisors influences subordinates’ perceptions of corporate social responsibility (CSR) which in turn influences subordinates’ trust in the organization resulting in their taking increased personal social responsibility and engagement in organizational citizenship behaviors (OCB) oriented toward both the organization and other individuals. Using a multilevel model, we assessed the extent to which ethical leadership and CSR at the work unit level impacts subordinates’ behaviors mediated by organizational trust at the individual level. We employed a sample of 71 work unit supervisors and 308 subordinates from five businesses of a conglomerate company located in mainland China. Subordinates were asked to rate supervisory ethical leadership practices, CSR, and their extent of organizational trust. Supervisors were asked to rate the personal social responsibility taking and OCB of their respective subordinates. A multilevel path analysis revealed that ethical leadership has a positive effect on CSR at the work unit level and that CSR has a positive cross-level effect on organizational trust at the individual level, which in turn significantly and positively impacts OCB through the mediating effect of taking personal social responsibility. Results are discussed in the context of China’s manufacturing sector.

Is organizational justice climate at the workplace associated with individual-level quality of care and organizational affective commitment? A multi-level, cross-sectional study on dentistry in Sweden

PurposeThe aim of this study is to investigate whether organizational justice climate at the workplace level is associated with individual staff members’ perceptions of care quality and affective commitment to the workplace.MethodsThe study adopts a cross-sectional multi-level design. Data were collected using an electronic survey and a response rate of 75% was obtained. Organizational justice climate and affective commitment to the workplace were measured by items from Copenhagen Psychosocial Questionnaire and quality of care by three self-developed items. Non-managerial staff working at dental clinics with at least five respondents (n = 900 from 68 units) was included in analyses. A set of Level-2 random intercept models were built to predict individual-level organizational affective commitment and perceived quality of care from unit-level organizational justice climate, controlling for potential confounding by group size, gender, age, and occupation.ResultsThe results of the empty model showed substantial between-unit variation for both affective commitment (ICC-1 = 0.17) and quality of care (ICC-1 = 0.12). The overall results showed that the shared perception of organizational justice climate at the clinical unit level was significantly associated with perceived quality of care and affective commitment to the organization (p < 0.001).ConclusionsOrganizational justice climate at work unit level explained all variation in affective commitment among dental clinics and was associated with both the individual staff members’ affective commitment and perceived quality of care. These findings suggest a potential for that addressing organizational justice climate may be a way to promote quality of care and enhancing affective commitment. However, longitudinal studies are needed to support causality in the examined relationships. Intervention research is also recommended to probe the effectiveness of actions increasing unit-level organizational justice climate and test their impact on quality of care and affective commitment.

Making care organizations great again? A comparison of Care Pathways, Lean Thinking, Relational Coordination, and Modern Sociotechnical Design

Introduction Care organizations are often not well equipped to the increasing complexity and chronicity of diseases. Several organizational redesign models propose interventions that may help organizations adapt to this new reality. The objective of this study is to describe the redesign models in a uniform manner and to offer conceptual clarity. Methods This study presents a systematic comparison of the problem definition and proposed interventions of four redesign models: Care Pathways, Lean Thinking, Relational Coordination, and Modern Sociotechnical Design. Data were collected through a critical and thematic review of selected literature. Data were analyzed using a priori deducted coding derived from a theoretical framework based on Mintzberg. The COREQ checklist was used to minimize bias. Results Twenty conceptual documents and practical guidelines were included for data analysis. The problem definition of the four redesign models is largely similar and suggests that fragmented task division and centralized coordination hinder the delivery of complex and chronic care. The proposed interventions differ between the redesign models, but in general more attention is given to the coordination of tasks than to task division, and interventions are mainly situated at the micro (workplace) and meso (work unit) levels of the organization. Discussion The systematic comparison clarifies the similarities and differences between the analyzed redesign models, which can be useful for improving studies on redesign model effectiveness. Additionally, systematic comparison supports care organizations in selecting appropriate redesign models. Future studies may involve a larger selection of redesign models as well as the redesign of inter-organizational networks.

Collective Turnover

This review builds from the last major narrative review of collective turnover ( Hausknecht &amp; Trevor 2011 ) to identify theoretical and empirical advancements in understanding the causes and consequences of turnover rates at the team, group, work unit, and organizational levels. I discuss important developments in collective-level theorizing [including context-emergent turnover (CET) and turnover capacity theory], meta-analytic summaries, longitudinal investigations, and more. The review concludes with recommendations for future collective turnover research.

Organizational change, psychosocial work environment, and non-disability early retirement: a prospective study among senior public employees.

Objective This study examines the impact of organizational change and psychosocial work environment on non-disability early retirement among senior public service employees. Methods In January and February 2011, Danish senior public service employees aged 58-64 years (N=3254) from the Capital Region of Denmark responded to a survey assessing psychosocial work environment (ie, social capital, organizational justice, and quality of management). Work-unit organizational changes (ie, change of management, merging, demerging, and relocation) were recorded from January 2009 to March 2011. Weekly data on non-disability early retirement transfer were obtained from the DREAM register database, which holds weekly information about all public benefit payments in Denmark. Hazard ratios (HR) for early retirement following employees' 60 thbirthday were estimated with Cox regression adjusted for age, gender, and socioeconomic status. Results Exposure to change of management [HR 1.37, 95% confidence interval (95% CI) 1.13-1.66], mergers (HR 1.23, 95% CI 1.02-1.48), and relocation of work unit (HR 1.24, 95% CI 1.01-1.54) increased rate of non-disability early retirement, while demerging of work unit did not (HR 1.03, 95% CI 0.79-1.33). Work units with lower levels of social capital (HR 1.22, 95% CI 1.05-1.41), organizational justice, (HR 1.18, 95% CI 1.04-1.32), and quality of management (HR 1.14, 95% CI 1.02-1.25) increased rate of early retirement. Conclusion Organizational change and poor psychosocial work environment contribute to non-disability early retirement among senior public service employees, measured at work-unit level.

Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey

BackgroundNeedlestick and sharps injuries are prevalent work-related injuries among nurses. Safety devices prevent only one-quarter of related injuries. More studies of modifiable risk factors are needed. ObjectivesTo examine whether long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan. DesignCross-sectional survey. Settings/participantsThis analysis included 19,386 full-time bedside nurses working in 104 hospitals across Taiwan. MethodsParticipants filled out an anonymous questionnaire from July to September 2014. Chronic insomnia, needlestick injuries, and sharps injuries during the past year were each measured by a yes/no question. Multivariate logistic regression models were applied to examine the effects of long work hours and chronic insomnia on needlestick and sharps injuries, given with control for sex, marital status, educational level, age, years of practice, work unit, and hospital level in the model. ResultsMore than 70% of study nurses worked long hours during the previous week (>50h: 27.5%; 41–50h: 43.2%), and 15.5% of nurses reported chronic insomnia. The percentage of sharps injuries (38.8%) was higher than that for needlestick injuries (22.4%) during the previous year among nurses. After adjusting for potential confounders, logistic regression yielded significant results showing that those who worked 41 to 50h per week, >50h per week, and had chronic insomnia were 1.17 times (95% C.I.=1.04–1.32), 1.51 times (95% C.I.=1.32–1.72), and 1.45 times (95% C.I.=1.25–1.68) more likely to experience needlestick injuries, and 1.29 times (95% C.I.=1.17–1.42), 1.37 times (95% C.I.=1.23–1.53), and 1.56 times (95% C.I.=1.37–1.77) more likely to experience sharps injuries, respectively, than those who worked fewer hours and did not have insomnia. ConclusionsThis nationwide nurse survey showed that high rates of needlestick and sharps injuries persist in hospital nurses in Taiwan. The common problems of long work hours and chronic insomnia increase the risk of these injuries. We suggest that hospital managers follow regulations on work hours and optimize shift schedules for nurses to decrease related injuries.

Validating justice climate and peer justice in a real work setting

In this study we tested the validity of justice climate and peer justice, measured as second-order constructs, in a real work setting. First, we investigated the appropriateness of aggregating first-order facets of justice climate and peer justice to work-unit level of analysis. Second, we examined the construct validity of justice climate and peer justice as two different factor structures. Third, we tested the hierarchical structure of justice climate and peer justice as second-order factors. Finally, we examined the predictive validity of second-order factors justice climate and peer justice within a nomological network composed of reciprocity with the supervisor and reciprocity with coworkers. We conducted these analyses in a sample of 532 employees nested in 79 organizations. Our results suggest the validity of justice climate and peer justice measured as second-order factors. We discuss these results and their implications for organizational justice research.

Disentangling the link between Honesty-Humility and detrimental workplace behaviors: The role of ethical leadership and organizational justice

Organizational justice perceptions have been suggested to be associated with symptoms of mental health but the nature of the association is unknown due to reporting bias (measurement error related to response style and reversed causality). In this study, we used prospective design and long-term (>9 days) sickness absence with psychiatric diagnosis as the outcome measure. Participants were 21 221 Finnish public sector employees (the participation rate at baseline in 2000–2002 68%), who responded to repeated surveys of procedural and interactional justice in 2000–2004 along with register data on sickness absence with a diagnosis of depression or anxiety disorders (822 cases). Results from logistic regression analyses showed that a one-unit increase in self-reported and work-unit level co-worker assessed interactional justice was associated with a 25–32% lower odds of sickness absence due to anxiety disorders. These associations were robust to adjustments for a variety of potential individual-level confounders including chronic disease (adjusted OR for self-reported interactional justice 0.77, 95% CI 0.65–0.91) and were replicated using co-worker assessed justice. Only weak evidence of reversed causality was found. The results suggest that low organizational justice is a risk factor for sickness absence due to anxiety disorders.