Workforce Perceptions Research Articles

Promoting Psychological Health and Safety in Canadian Healthcare Organizations.

This article analyzes findings from the Health Standards Organization's new Global Workforce Survey (GWS). The GWS enables healthcare organizations to measure, analyze and benchmark their workforce's perceptions of working conditions, safety culture and care quality against peers. The GWS measures key features of The National Standard of Canada for Psychological Health and Safety in the Workplace (CSA Group and Bureau de normalisation du Québec 2013; MHCC 2013). The article highlights how psychological health and safety in Canadian healthcare organizations can enhance the well-being of workers, improve patient care and ultimately contribute to a more effective healthcare system.

Understanding the relationship between safety culture and safety performance indicators in U.S. nuclear waste cleanup operations

The relationship between nuclear safety culture and safety performance remains uncertain due to the limited research directly comparing these two variables. This study aimed to help address that gap in knowledge by evaluating the relationships between safety culture traits and two types of performance measures – personal safety and operations indicators – for a U.S. nuclear waste cleanup contractor.Data for 29 performance indicators were correlated with data measuring workforce perceptions on safety culture traits defined by the Institute of Nuclear Power Operations (INPO). Correlation and regression analyses indicated statistically significant relationships between safety culture traits and multiple organizational key performance indicators related to safety, quality and cost savings. Higher scores on safety culture traits were more closely associated with key performance indicators related to the evaluation and resolution of safety concerns, the recognition and accurate categorization of self-revealing and self-identified issues, and emergency response actions. The results suggest that while management strategies to improve safety culture may be linked to key performance indicators that strengthen overall organizational performance, these same strategies may also indirectly degrade the work environment in other areas. These research findings can help managers and safety professionals establish key performance indicators and safety culture metrics that are meaningful indicators of safety performance and inform action plans that improve productivity, enhance workplace safety, and avoid unintended consequences.

Assessing Workforce Perceptions of Productivity and Success After 730 Days of Distributed Operations in Response to COVID-19

During the midst of the Coronavirus Disease 2019 (COVID-19) pandemic, a large Navy Working Capital Funded (NWCF) government laboratory, Naval Information Warfare Center (NIWC) Pacific, transitioned from a traditional onsite/physical daily operational presence to a distributed, virtual, maximum telework posture. In short, unless NIWC Pacific’s leadership directed that performance of a specific, approved tasking required that it take place at a particular physical workplace location, the laboratory workforce was directed to telework from a safe location while practicing social distancing. To this extent, a majority of the workforce for NIWC Pacific’s programs and projects continued performing their duties in a virtual and secure distributed environment. In addition, the Office of Personnel Management telework policy provided new guidance to give personnel adequate direction, including telework eligibility, agreement, definition, and types of telework arrangements. This new norm certainly raised a number of questions and considerations for the organization as a whole related to the effectiveness of the workforce while under a maximum telework mandate. As a result, the authors distributed two surveys to a subset of the workforce in the early days of the pandemic to assess the perceived work effectiveness of the organization. After 730 calendar days of remote operation by the workforce, the authors initiated this study as a third inquiry, with the goal of understanding the long-term impact of distributed telework on productivity and effectiveness within a department of 900 employees.

Health workforce perceptions on telehealth augmentation opportunities

BackgroundThe availability and use of telehealth to support health care access from a distance has expanded in response to the COVID-19 pandemic. Telehealth services have supported regional and remote health care access for many years and could be augmented to improve health care accessibility, acceptability and overall experiences for both consumers and clinicians. This study aimed to explore health workforce representatives’ needs and expectations to move beyond existing telehealth models and plan for the future of virtual care.MethodsTo inform recommendations for augmentation, semi-structured focus group discussions were held (November–December 2021). Health workforce representatives with experience in health care delivery via telehealth across country Western Australia were approached and invited to join a discussion.ResultsFocus group participants included 53 health workforce representatives, with between two and eight participants per discussion. In total, 12 focus groups were conducted: seven were specific to regions, three with staff in centralised roles, and two with a mixture of participants from regional and central roles. Findings identified four key areas for telehealth augmentation: improvements required to existing service practice and processes; equity and access considerations; health workforce-focussed opportunities; and consumer-focussed opportunities.ConclusionsFollowing the onset of the COVID-19 pandemic and the rapid increase in health services delivered via telehealth modalities, it is timely to explore opportunities to augment pre-existing models of care. Workforce representatives consulted in this study suggested modifications to existing process and practice that would improve the current models of care, and recommendations on ways to improve clinician and consumer experiences with telehealth. Improving experiences with virtual delivery of health care is likely to support continued use and acceptance of this modality in health care delivery.

From doctors to ancillary staff: Regional and metropolitan cancer workforce perceptions and distress resulting from COVID-19 pandemic adaptations

The declaration of the COVID-19 pandemic has resulted in necessary and rapid changes to health service delivery. In the Australian context, it has been broadly identified that these impacts have been felt by health care workers (HCW) providing care. We aimed to capture oncology HCW perceptions of support, stress, personal ability to meet needs and institutional preparedness across longitudinal periods of COVID-19 response in the early stages of the pandemic. An electronic survey was developed to measure the weekly impacts and distress experienced by HCW during the early phases of the pandemic. Hospital email communications relating to pandemic directives were noted. HCW included nursing, medical, ancillary staff and allied health team members at 2 study sites, 1 metropolitan and 1 regional center in Queensland, Australia. Descriptive statistics were applied to quantitative data, and a framework analysis for qualitative data. Key themes were synthesized using mixed methods approaches. A total of 176 HCW consented to participate. Four key themes were identified. Key theme 1 was strategies for protection, and included the subthemes of self-isolation, using personal protective equipment (PPE), protecting patients and families and each other. Key theme 2 was navigating rules and keeping up, and included the subthemes of compliance, exceptions, conflict and complex decision fatigue. Key theme 3 was tempered optimism, with subthemes including this is grief, pride in one's place and strategies for coping. Key theme 4 was framing the new normal, with subthemes including using technology, second wave and uncertainty. Staff groups reported the emotional impacts of rapid change across clinical areas and centers. Distress corresponded to rapid change amid uncertainty, rather than reported infection rates. These findings give insight into the experiences of patient facing oncology HCW during periods of uncertainty, potentially informing policy in the future.

Public Health Workforce Perceptions About Organizational Commitment to Diversity, Equity, and Inclusion: Results From PH WINS 2021.

In response to calls to achieve racial equity, racism has been declared as a public health crisis. Diversity, equity, and inclusion (DEI) is an approach public health organizations are pursuing to address racial inequities in health. However, public health workforce perceptions about organizational commitment to DEI have not yet been assessed. Using a nationally representative survey of public health practitioners, we examine how perceptions about supervisors' and managers' commitment to DEI and their ability to support a diverse workforce relate to perceptions of organizational culture around DEI. Data from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) to examine the relationship between public health employees' perceptions about their organization's commitment to DEI and factors related to those perceptions. PH WINS received 44 732 responses (35% response rate). We calculated descriptive statistics and constructed a logistic regression model to assess these relationships. Findings show that most public health employees perceive that their organizations are committed to DEI; however, perceptions about commitment to DEI vary by race, ethnicity, gender identity, and organizational setting. Across all settings, White respondents were more likely to agree with the statement, "My organization prioritizes diversity, equity, and inclusion" (range, 70%-75%), than Black/African American (range, 55%-65%) and Hispanic/Latino respondents (range, 62.5%-72.5%). Perception that supervisors worked well with individuals with diverse backgrounds had an adjusted odds ratio (AOR) of 5.37 ( P < .001); organizational satisfaction had an AOR of 4.45 ( P < .001). Compared with White staff, all other racial and ethnic groups had lower AOR of reporting their organizations prioritized DEI, with Black/African American staff being the lowest (AOR = 0.55), followed by Hispanic/Latino staff (AOR = 0.71) and all other staff (AOR = 0.82). These differences suggest that there are opportunities for organizational DEI commitment to marginalized public health staff to further support DEI and racial equity efforts. Building a diverse public health workforce pipeline will not be sufficient to achieve health equity if staff perceive that their organization does not prioritize DEI.

Grouping Public Health Skills to Facilitate Workforce Development: A Factor Analysis of PH WINS.

This study examined whether distinct factors exist among public health skills, measured through the Public Health Workforce Interests and Needs Survey (PH WINS). Understanding how workforce training needs group is important for developing targeted and appropriate public health workforce training sessions. Exploratory factor analysis was used to examine public health skills among tier 1 staff (nonmanagers) and a combined group of tier 2 and 3 staff (managers and executives). Data for this study come from the 2017 PH WINS, which assessed public health workforce perceptions of training needs, workplace environment, job satisfaction, perceptions about national trends, and demographics. The analysis included 22 items. All public health staff in participating agencies were eligible to complete the survey. The national data set included participants from 47 state health agencies, 26 large local health departments (LHDs), and 71 mid-sized LHDs across all 10 Health and Human Services regions in the United States (including LHDs from all states). The analytic sample was n = 9630 in tier 1, n = 4829 in tier 2, and n = 714 in tier 3 staff. Three factors were identified within the skills portion of PH WINS, using exploratory factor analysis. To interpret retained factors, the following parameters were used: factor loadings greater than 0.4, factor cross-loadings less than 0.4 or higher than loadings on other factors, and communalities greater than 0.5. Factors included (1) data and systems thinking, (2) planning and management, and (3) community collaboration, with slight variation in item loadings between tier 1 and tier 2 and 3 staff analyses. This study was the first known factor analysis of the training needs and workforce skills portion of PH WINS in the published literature. This study advances our conceptualization of public health workforce skills and has the potential to shape future critical workforce training development.

Does a Women’s Quota Trickle Down to Employees? An Analysis of Workforce Perceptions and Reactions

While scholars have investigated the consequences of a women’s quota at the upper management levels, there is little to no focus on the effects it has on the general workforce. As the introduction of a women’s quota often aims at increasing gender equality throughout the entire organization, it is crucial to understand factors that influence employees’ perception of the existence of a women’s quota and their reaction to it. We propose and test factors using the Linked Personnel Panel, a federal data set which includes observations from 4,152 employees nested in 719 German organizations. Our findings reveal that an actual women’s quota in place influences employees’ perceptions of the existence of a women’s quota in their organization, but this relationship is weaker than expected. We also find that the relationship is stronger for women and when employees perceive a low clarity of organizational goals. Furthermore, we show that employees who perceive that their organization has implemented a women’s quota have higher levels of engagement, but this relationship is weakened when an organization complies to legal regulations instead of making a voluntary decision to introduce a women’s quota.

Virtual training and technical assistance: a shift in behavioral health workforce access and perceptions of services during emergency restrictions

BackgroundTo respond to the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration-funded Technology Transfer Centers had to rapidly adapt to ensure that the behavioral health workforce had continuous access to remote training and technical assistance (TTA). Although the Technology Transfer Centers have historically relied partially upon virtual methods for delivering TTA, the shift to a strictly virtual approach necessitated by COVID-19 restrictions has raised new questions for how to best proceed with services when social distancing guidelines are relaxed. The objective of this exploratory paper was to compare TTA provision in the six-month period prior to (9/1/19 thru 2/28/20) and during (4/1/20 thru 9/30/20) early COVID-19 restrictions to determine the extent to which the shift to virtual service provision impacted the behavioral health and medical workforce. Specifically, we examined participants’ access to TTA, geographic reach of TTA, and workforce perceptions of satisfaction and utility with TTA provision.MethodParticipant and event-level data were analyzed to compare the following metrics before and during the COVID pandemic: number of events and attendees; participant demographics; zip codes reached; coverage of rural, suburban, and urban areas; and perceptions of satisfaction with and utility of training.ResultsFindings showed a 40% increase in the number of events delivered (p < .001) and a 270% increase in the number of attendees (p < .001) during the COVID period when TTCs relied exclusively on virtual delivery. Geospatial analyses linking zip codes to a schematic of rural, suburban, and urban classifications throughout the United States revealed significant increases in the number of zip codes reached during the COVID time period. Satisfaction levels were comparable before and during the pandemic.ConclusionsFindings show that expanded access to TTA services via virtual formats resulted in reach to more diverse attendees and regions, and did not come at the expense of satisfaction. Results suggest that virtual TTA should continue to be an important component of TTA offerings post-pandemic.

Exploring the Evidence: Considerations for the Dialysis Practice Setting Approach to Staffing

Nursing remains one of the most in-demand jobs in the American workforce. The impact of the COVID-19 pandemic has created strain on nursing resources throughout the health care industry and drawn attention to longstanding workforce issues. Inadequate staffing is often a multidimensional problem that warrants a comprehensive assessment of elements that may contribute to recruitment and retention issues. In the dialysis practice setting, nursing shortages remain an ongoing issue due to an aging workforce and ongoing issues for recruiting nurses both new and skilled into the field of nephrology. This article explores the evidence on approaches to staffing in the dialysis practice setting by defining core elements to consider when designing a staffing model. These elements include federal/state regulations, patient acuity, staff ratios, workforce perceptions, patient outcomes, and dialysis modalities offered.

Distributed Operations in Response to COVID-19: Assessing Workforce Perceptions of Productivity and Success

During the midst of the Coronavirus 2019 (COVID-19) pandemic, a large Navy Working Capital Funded government laboratory transitioned from a traditional on-site/physical daily operational presence to a distributed, virtual maximum telework posture. The direction given in March 2020 was that unless performance of a specific approved tasking was required at the physical workplace, the laboratory workforce was to telework from a safe location while practicing social distancing. To this extent, a majority of the organization’s workforce continued performing the duties associated with their programs and projects in a virtual and secure distributed environment. This new norm certainly raised questions and considerations related to the effectiveness of the workforce while under maximum telework. As a result, two surveys were conducted to assess the perceived work-effectiveness of the organization. The perceived work-effectiveness was assessed at the operational (work unit) level, focusing on project impacts of telework, and from the macroorganizational perspective. The first survey was conducted on a project that was 2 weeks into this virtual maximum telework environment. The second survey was performed one layer above the project at the division level, thereby extending the aperture of the data. Both surveys provided a great deal of information and insight on how project teams perceived work performance and effectiveness during telework. The purpose of the study was to understand the impact of distributed telework in workforce productivity and project success as well as assess workforce perceptions on the effects of telework.

Does integrated health and care in the community deliver its vision? A workforce perspective

PurposeThe purpose of this paper is to explore and capture workforce perceptions, experiences and insights of the phenomena of integrated care (IC) in a community health and care NHS trust in England; including whether there are any associated factors that are enablers, barriers, benefits or challenges; and the level of workforce engagement in the process of integrated health and care.Design/methodology/approachA qualitative design based on an interpretivist research paradigm was used with a purposive sampling technique. Five in-depth semi-structured interviews were conducted with community nursing, social workers and allied health professionals. Colaizzi's (1978) descriptive phenomenological seven-step method was applied to analyse data, with the emergence of 170 significant statements, 170 formulated meanings and 8 thematic clustering of themes to reveal 4 emergent themes and 1 fundamental structure capturing the essential aspects of the structure of the phenomenon IC.FindingsThis study revealed four interdependent emergent themes: (1) Insight of IC and collaboration: affording the opportunity for collaboration, shared goals, vision, dovetailing knowledge, skills and expertise. Professional aspirations of person-centred and strength-based care to improve outcomes. (2) Awareness of culture and professionalism: embracing inter-professional working whilst appreciating the fear of losing professional identity and values. Working relationships based on trust, respect and understanding of professional roles to improve outcomes. (3) Impact of workforce engagement: participants felt strongly about their differing engagement experience in terms of restructuring and redesigning services. (4) Impact of organisational structure: information technology (IT) highlighted a barrier to IC as differing IT platforms prevent interoperability with one system to one patient. Shared positivity of IC, embracing new ways of working.Originality/valueThis study proposes considerations for future practice, policy and research from a local, national and global platform, highlighting the need for any IC strategy or policy to incorporate the uniqueness of the “voice of the workforce” as a key enabler to integration developments, only then can IC be a fully collaborative approach.

Workforce perceptions of human factors as indicators of plant reliability and process safety

Human factors, as perceived by the maintenance workforce, were used as the measure for comparing work areas within a petroleum company. These factors were then compared to an objective measure of reliability (Mean Time Between Failures) in order to determine which factors would be most predictive of plant reliability and process safety. Maintenance personnel were surveyed using scales based on Problem-solving, Vigilance, Design and maintenance, Job-related feedback and Information about change. Analysis of Variance was used to assess the strength of these variables in relation to Reliability Level. Significant differences were observed between different reliability levels based on workforce perceptions of problem-solving requirements and the design and maintainability of plant. Conclusions were that perceptions of human factors in the workplace can be predictive of group-level performance, and that if issues relating to design and maintainability are not addressed at the design stage, greater problem-solving abilities will be required from maintenance personnel. Practitioner summary: Workforce perceptions of plant performance could provide a statistically valid measure of current and future reliability. A survey of perceptions of human factors was conducted with maintenance personnel in a petroleum company. Results indicated significant relationships between reliability and requirements for Problem-solving, as well as Design and Maintenance of equipment. Abbreviations: HFIT: human factors investigation tool, FPSO: floating production, storage and offtake, MTBF: mean time between failures, CPS: cognitive problem- solving, WDS: work design questionnaire, SPSS: statistical package for the social sciences, PAF: principal axis factoring, ANOVA: analysis of variance, ANCOVA: analysis of co-variance, M: mean, SD: standard deviation

Workforce Perceptions of Hospital Safety Culture: Case of Iran Teaching Hospitals

Background: One of the main determinants of safety and quality of care in hospitals is institutionalization of safety culture among their employees. This study aimed to assesses patient safety culture in Iran teaching hospitals.&#x0D; Methods: Four Iran provinces were selected purposefully, one hospital from each was entered the study randomly, and proportional with hospital size, 500 employees were selected. The data were collected using standard questionnaire of Hospital Survey on Patient Safety Culture (HSPSC) and analyzed using Excel and SPSS 22.&#x0D; Results: Patient safety dimensions with highest positive score were organizational learning and continuous improvement (77%), management support for patient safety (68%) and supervisor/manager expectations and actions promoting patient safety (61%) and dimensions with the lowest patient safety score were non-punitive response to error (20%), communication openness (28%), frequency of events reported (32%), staffing (37%), teamwork across and within hospital units (71%). Although 48% of the participants have not reported any event during 12 past months, but 64.6% scored patient safety excellent/ very good.&#x0D; Conclusions: There are punishment and blame culture, non-openness in communication channels and low reporting of events in Iran hospitals. It is necessary for hospital management to design error and accident reporting system and reinforce non-punitive culture to increase error reporting.

Predicting HR’s involvement and influence in strategic decision-making

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The Methods Behind PH WINS

The Public Health Workforce Interests and Needs Survey (PH WINS) has yielded the first-ever nationally representative sample of state health agency central office employees. The survey represents a step forward in rigorous, systematic data collection to inform the public health workforce development agenda in the United States. PH WINS is a Web-based survey and was developed with guidance from a panel of public health workforce experts including practitioners and researchers. It draws heavily from existing and validated items and focuses on 4 main areas: workforce perceptions about training needs, workplace environment and job satisfaction, perceptions about national trends, and demographics. This article outlines the conceptualization, development, and implementation of PH WINS, as well as considerations and limitations. It also describes the creation of 2 new data sets that will be available in public use for public health officials and researchers--a nationally representative data set for permanently employed state health agency central office employees comprising over 10,000 responses, and a pilot data set with approximately 12,000 local and regional health department staff responses.

Survey on patient safety climate in public hospitals in China.

BackgroundPatient safety climate has been recognized as a core determinant for improving safety in hospitals. Describing workforce perceptions of patient safety climate is an important part of safety climate management. This study aimed to describe staff’s perceptions of patient safety climate in public hospitals in Shanghai, China and to determine how perceptions of patient safety climate differ between different types of workers in the U.S. and China.MethodsSurvey of employees of 6 secondary, general public hospitals in Shanghai conducted during 2013 using a modified version of the U.S. Patient Safety Climate in Health Care Organizations (PSCHO) tool. The percentage of “problematic responses” (PPRs) was used to measure safety climate, and the PPRs were compared among employees with different job types, using χ2 tests and multivariate regression models.ResultsPerceptions of patient safety climate were relatively positive among hospital employees and similar to those of employees in U.S. hospitals along most dimensions. For workers in Chinese hospitals, the scales of “fear of blame” and “fear of shame” had the highest PPRs, whereas in the United States the scale of “fear of shame” had among the lowest PPRs. As in the United States, hospital managers in China perceived a more positive patient safety climate overall than other types of personnel.Conclusions“Fear of shame” and “fear of blame” may be important barriers to improvement of patient safety in Chinese hospitals. Research on the effect of patient safety climate on outcomes is necessary to implement effective polices to improve patient safety and quality outcomes in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0710-x) contains supplementary material, which is available to authorized users.

Health policy in South Australia 2003-10: primary health care workforce perceptions of the impact of policy change on health promotion.

This paper examines recent Australian health reform policies and considers how the primary health care (PHC) workforce experiences subsequent change and perceives its impact on health promotion practice. Health policy documents were analysed to determine their intended impact on health promotion. Interviews were conducted with 39 respondents from four State-funded PHC services to gain their perceptions of the impact of policy change on health promotion. There have been a plethora of policy and strategy documents over the last decade relevant to PHC, and these suggest an intention to strengthen health promotion. However, respondents report that changes to the role and focus of PHC services have led to fewer opportunities for health promotion. Services are struggling to engage in health promotion activity, while funding and policy directions are prioritised to targeted, individual behaviour change. The experience of PHC workforce respondents in South Australia suggests that, despite policy intentions, health promotion practice is much reduced. Our research suggests that rigorous evaluation of health sector reforms should be undertaken to assess both intended and unintended outcomes in terms of service quality and delivery. SO WHAT? Health promoters are experiencing a contradictory policy and practice environment, and this research should assist health promoters in advocating for more government accountability in the implementation of policies in order to advance comprehensive PHC.

Analysis of Korean expatriate congruence with Chinese labor perceptions on training method importance: implications for global talent management

As Korean multinational firms continue to increase their investment in China in enhancing their productivity through improving talent management and overall global knowledge management efforts, it has become increasingly important to provide effective training for local Chinese workers. Whereas for optimal effectiveness, training should be adapted to the learning approach needs of local recipients, forces within our global context provide convergent and divergent pressures affecting the fit between multinational and host country workforce perceptions on training approach appropriateness. A questionnaire assessing perceptions regarding the importance of various methods for conducting training for Chinese employees in the People's Republic of China (PRC) was completed by 67 Korean expatriates and 202 Chinese host country national employees representing the voice of lower-level Chinese labor (working for both the US and Chinese firms from three major cities in China). Results revealed a significant difference between the Korean expatriates and PRC workers on a majority of the survey measures, particularly those related to training relevance, feedback, supportive climate and transfer of training. However, both Korean expatriates and Chinese employees demonstrated congruence in the two major training dimensions of ‘link to career success’ and ‘learner control’. Implications of these results for Korean and other multinational firms are discussed in the broader context of global talent management and international knowledge management.

A Comprehensive Obstetrics Patient Safety Program Improves Safety Climate and Culture

Objective The purpose of this study was to determine the effect of an obstetrics patient safety program on staff safety culture. Study Design We implemented (1) obstetrics patient safety nurse, (2) protocol-based standardization of practice, (3) crew resource management training, (4) oversight by a patient safety committee, (5) 24-hour obstetrics hospitalist, and (6) an anonymous event reporting system. We administered the Safety Attitude Questionnaire on 4 occasions over 5 years (2004-2009) to all staff members that assessed teamwork and safety cultures, job satisfaction, working conditions, stress recognition, and perceptions of management. Results We observed significant improvements in the proportion of staff members with favorable perceptions of teamwork culture (39% in 2004 to 63% in 2009), safety culture (33% to 63%), job satisfaction (39% to 53%), and management (10% to 37%). Individual roles (obstetrics providers, residents, and nurses) also experienced improvements in safety and teamwork, with significantly better congruence between doctors and nurses. Conclusion Safety programs can improve workforce perceptions of safety and an improved safety climate.