Working Environment For Staff Research Articles

Work environment and workforce problems: A cross-sectional questionnaire survey of hospital nurses in Belgium

Objectives: This study investigated Belgian hospital nurses’ perceptions on work environment and workforce issues, quality of care, job satisfaction and professional decision making. Methods: All eligible nurses in a selection of 22 hospitals received the BELIMAGE questionnaire for a total of 13,958 potential respondents. Of these, 9941 returned study materials (response rate=71.2%) of which 9638 were valid and useable for statistical analysis (valid response rate=69.1%). Results: The study identified several areas of tension in the nursing profession. The commitment to being competent providers of quality care was remarkably strong among the nurses, but they also perceived the barriers in the work environment to be multiple and complex. Concerns about the quality of leadership and management, insufficient staff, time demands and stressful work environment are experienced as obstacles in providing good nursing care. Four out of ten nurses (39.2%) would not choose nursing again as a career and more than half of the nurses (54.3%) have contemplated leaving the profession at some point in time. Conclusions: To effectively tackle the professional and workforce issues in nursing, investments should focus on redesigning a work environment that supports nurses in providing comprehensive professional care.

Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: A questionnaire survey

Background There is a growing interest in the psychosocial work environment of health care staff since they are at high risk for burnout, role conflict and job dissatisfaction. Burnout, as a type of prolonged response to chronic job-related stressors, has a special significance in health care where staff experience both psychological–emotional and physical stress. Burnout and the other negative aspects of the job of health care staff have major behavioural and health implications. Objectives The present study investigated the interrelationships among burnout, role conflict and job satisfaction in a sample of Hungarian health care staff. The study also investigated how these indicators of psychosocial work climate influence respondents’ frequency of psychosomatic symptoms. Design A questionnaire survey (anonymous questionnaires) has been carried out to detect these interrelationships. Settings Two major hospitals in Szeged, Hungary. Participants Questionnaires were distributed to 450 health care staff among whom 55.7% were registered nurses. All together, 201 questionnaires were returned and analyzed, giving a response rate of 44.6%. Methods Questionnaire contained items on work and health-related information (i.e., burnout, job satisfaction, role conflict, and psychosomatic symptoms) and on some basic sociodemographics. Beyond descriptive statistics, correlation and multiple regression analyses were computed. Results Findings show that emotional exhaustion and depersonalization scores were higher, while scores on personal accomplishment was lower as compared to Canadian, Norwegian or US samples. Burnout, particularly emotional exhaustion ( p < . 001 ), was found to be strongly related to job dissatisfaction. Schooling was inversely related to satisfaction with the job ( p < . 05 ). While job satisfaction was a negative predictor of each type of burnout subscale ( p < . 001 ), role conflict was a factor contributing positively to emotional exhaustion ( p < . 001 ) and depersonalization scores ( p < . 001 ). Conclusions The study results underline the importance of the role of psychosocial work environment and the interrelationships among burnout, role conflict, job satisfaction and psychosomatic health among Hungarian health care staff.

Establishing quality control in the new IVF laboratory

The ability to create an optimal environment for the culture of oocytes and embryos is important to ensure that embryo viability, and therefore pregnancy outcome, is not compromised. Laboratory performance can be monitored using a quality control system. In setting up a new IVF unit, a comprehensive quality control programme was established to monitor laboratory performance and to detect any problems that potentially may have resulted in a sub-optimal service. The measures employed were designed to optimize the environment for human embryo culture by providing aseptic conditions and security for the gametes and embryos, whilst providing a safe working environment for laboratory staff. Equipment function, consumables and environmental parameters were assessed prior to the commencement of treatment in the new unit. A mouse embryo bioassay was used to assess the ability of the new laboratory and equipment to support mammalian embryo development. Prior to the start of clinical treatments a quality control program highlighted equipment that was functioning sub-optimally, which had the potential to cause problems had it been left undetected. Once clinical treatment commenced, quality control monitoring was continued to ensure that the laboratory functioned to a consistently high standard.

Understanding the role of hospitals and their environment in practical training

A hospital represents a special environment, serving health care to patients, and as a work environment for medical and other staff. The problems of the hospital environment, its risks and the prevention of nosocomial infections have become an important topic in activities concerning the environmental education of medical students at the Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic. Educational objectives were different, regarding knowledge, behaviour, attitude and social action. The hygienic level of the hospital ward was observed by students themselves, including microclimate assessment and evaluations. Microbial contamination and acoustic well‐being of the indoor air in a hospital ward were also assessed. Results from environmental investigations performed in several hospitals have shown improvement of microbial contamination in internal, surgical and neurological departments. We believe that if educational objectives targeted at the beginning of practical sessions are fulfilled then medical students will think and behave more pro‐environmentally.

Library-vendor collaboration for re-engineering workflow: the Kent State experience

Kent State University Libraries and Media Services took advantage of a change in book vendors to re-engineer the acquisitions and cataloging workflow. The process that was ultimately designed is highly integrated and takes advantage of automated efficiencies from both Yankee Book Peddler and OCLC PromptCat. The library has also created a working environment for staff that simultaneously maximizes decision-making while minimizing routine and repetitive tasks. In addition, the library is realizing significant cost savings from the new workflow. A description of the new workflow is provided.

Post-Modern Ideas in Substance Abuse Treatment

ABSTRACT This article describes the use of post-modern ideas in the treatment of substance abusers at a long term residential and day treatment center. It describes some of the changes that ensued as a result of a transformation from a “therapeutic community” (TC) model to a “solution-focused” model. The TC is a deficit model that focuses on a person's flaws and weaknesses. Solution-focused therapy, on the other hand, focuses on what a person has done and is doing right and his or her strengths, assets, and resources. This approach not only improves the quality and effectiveness of substance abuse treatment for clients, but also creates a better working environment for staff.

Violence towards health care staff and possible effects on the quality of patient care

Much of the research on violence in the health care sector has focused on the immediate and long-term effects of patient violence on staff victims. There is a lack of studies, however, examining whether individual reactions to violent episodes, such as anger and increased fear in one’s work, have any measurable effect on staff behaviour toward their patients, and ultimately on the quality of patient care. The aim of the present study was to investigate whether an association exists between staff experiences with violence and patient-rated quality of patient care. A theoretical model was presented, suggesting that violence or threats experienced by health care staff have a negative effect on the quality of health care services offered, as measured by patients. In addition, it was theorised that there would be an association between staff work environment and staff reports of violence. Six questionnaire studies, three concerning hospital staff’s views of their work environment and three dealing with patients’ perceptions of the quality of care, provided the data for evaluating the model. Work environment and quality of care studies were carried out simultaneously at a single hospital in 1994, 1995, and again in 1997. Regression analysis was used to see which combination of work environment and quality of care variables would best predict a positive overall grade for quality of care from the patient perspective. Violence entered consistently as an important predictor into each of the three best regression equations for 1994, 1995, and 1997, respectively. The results of this analysis suggest that the violence experienced by health care staff is associated with lower patient ratings of the quality of care. The study indicates that violence is not merely an occupational health issue, but may have significant implications for the quality of care provided.

The staff workplace and the quality and outcome of substance abuse treatment.

The study examined the connection between the staff work environment and staff members' beliefs about treatment, the quality of the treatment environment, patients' involvement in treatment and self-help activities, and patients' improvement during treatment. Patient care staff (N = 329) in 15 substance abuse treatment programs reported on the characteristics of their work environment and on their beliefs and treatment orientations about substance abuse. Patients in these programs (N = 3,228) reported on the treatment environment, their participation in treatment and self-help activities, and their treatment goals, confidence in achieving these goals, and coping skills at intake to and discharge from treatment. Staff in supportive and goal-directed work environments were more likely to espouse disease model beliefs and a 12-step orientation toward substance abuse treatment. These work environments were associated with more supportive and goal-directed treatment environments. Patients in these treatment environments participated in more substance abuse, educational and social, and family treatment services, were more involved in self-help groups (as indicated by attending more meetings, reading 12-step materials, and having a sponsor and friends in such groups), were more satisfied with the program, improved more during treatment (as indicated by abstinence goals and confidence in maintaining abstinence, less depression, and more substance abuse and general coping skills), and were more likely to participate in outpatient mental health care after discharge. More goal-directed work environments are associated with more goal-directed treatment environments and patients' engagement in treatment and improvement. The staff work environment is an important component of the substance abuse treatment system.

Experiences of stress in accident and emergency nurses

Just what is it about being a nurse in A & E that is stressful? How are A & E nurses affected by occupational stress and what do they think should be done to reduce it? This study sets out to provide some preliminary answers to these questions. Factors relating to the physical working environment and lack of staff were the most frequently reported hassles and stressors. Saving lives and helping patients get better was reported as the greatest source of satisfaction. Nurses suggested a variety of ways in which occupational stress could be reduced, including employing more staff, providing a ‘time out’ room and debriefing after traumatic events. Implications for future research and intervention are discussed.

Direct Control or Responsible Autonomy: Two Competing Approaches to the Management of Innovation in Information Systems Projects

The article examines the theoretical positions of direct control and responsible autonomy in the context of empirical work in the financial sector on the management of information systems projects. Direct control is employed by managers through the use of formal project management methodologies and techniques. Responsible autonomy addresses the difficulties in applying direct control strategies and seeks to encourage creativity and innovation by developing an informal working environment for project managers and technical staff. Contextualising the two approaches for the financial services sector, a conceptual framework is developed on the relationship between management control strategies and information systems project risk.

Communications between professional groups in an NHS trust hospital.

Discusses an audit of communications between doctors and other professional groups in a National Health Services trust hospital. The project was undertaken as a result of senior management's perception that there were problems regarding the interface between professionals and junior doctors particularly, and that these have a potentially detrimental impact on patient care. The aim of the study was to improve the work environment of medical practitioners and professional staff by researching the factors affecting communication and the sources of conflict which exist between the groups. Describes the methodology and provides an overview of the main findings grouped into themes. A large number of recommendations for change have been made to the hospital concerning systems, procedures, structures, training and inter-professional boundaries. Implementation of some of these recommendations has taken place already. Full evaluation of their impact is yet to be determined.

The development and application of a patient satisfaction measurement system for hospital-wide quality improvement.

A regional Swedish hospital has been the site of a quality improvement program that focuses on patient satisfaction, staff work environment and quality of hospital services. This article describes the study component that measures patients' views of the quality of care. The purpose of this study was to develop a reliable and valid instrument, to determine the predictors of patients' ratings of quality and to measure patient satisfaction at two points in time to determine whether patient ratings change following a quality improvement initiative. The instrument developed in this study was designed to assess patients' perceptions of the quality of hospital services, staff work environment and overall satisfaction for the purpose of providing feedback to hospital staff. This information would be used for quality improvement efforts within the hospital. Unique to this instrument are questions regarding patients' perceptions of the hospital staff work environment. The results revealed that the questionnaire demonstrated valid and reliable properties. The significant predictors of quality ratings were information concerning one's illness, and perceptions of the staff work environment. Patient satisfaction was measured and then reassessed following the implementation of various department-based improvement programs. The reassessment revealed significantly higher patient ratings in most areas. An intrinsic aspect of this quality program was the engagement of, and feedback process to, hospital personnel. Questionnaire results were reported graphically to hospital management and staff, thus serving as a catalyst for improvement.

Decentralized Management in Prison

Seven hypotheses are empirically tested in his comparative case study of the organizational climates in two medium security prisons. In general, it was hypothesized that unit management would positively affect staff and inmate safety and security, quality of life, staff work environment, and inmate services and programs. Several indices of prison climate were created by factor analyses of responses of staff (149) and inmates (442) to adapted Saylor surveys. Results suggest that flattening nn organizational structure without decentralizing authority seems to have negative effects on staff supervisory relations and job satisfaction. Findings lend support to theories that predict higher levels of job satisfaction when authority is delegated. Inmates, on the other hand, generally reported a better quality of life (i.e., personal well-being, living conditions) and a more effective staff (i.e., responsive, accurately informed) under the flatter unit management structure, whether or not staff perceived adequate ...

Effects of noise in hospitals.

Excessive noise in health care settings can induce headaches, cause irritability, prolong wound healing and increase sensitivity to pain. Simple measures, such as wearing soft-soled shoes, closing doors to areas with excessive noise (the television or sluice rooms) and choosing equipment with quieter alarms, can improve patient outcomes and result in a better working environment for hospital staff.

Improving the delivery of services in a local health department: integration versus block.

Abstract The purpose of this study was to determine whether replacement of block clinics with integrated clinics improved delivery of service to patients and improved the work environment for staff. To measure the impact of service delivery change, a systematic, random sample of clients was surveyed both before integrating services and one year after integration. A staff survey was also conducted to measure the effects of the change on work performance and satisfaction. Results from the client survey showed significant improvements in average waiting time, perceived shorter waiting time, and use of several services at one visit. Results from the staff survey showed perceived improvements in patient care, more time for patient education and follow‐up, and workload management. Because of the positive effects of service integration, the change to this type service delivery is being implemented throughout the health district.