Is burnout static or dynamic? A career transition perspective of employee burnout trajectories.

Despite decades of theory and empirical research on employee burnout, its temporal and developmental aspects are still not fully understood. This lack of understanding is problematic because burnout is a dynamic phenomenon and burnout interventions may be improved by a greater understanding of who is likely to experience changes in burnout and when these changes occur. In this article, we advance existing burnout theory by articulating how the 3 burnout dimensions should differ in their pattern of change over time as a result of career transition type: organizational newcomers, internal job changers (e.g., promotions or lateral moves), and organizational insiders (i.e., job incumbents). We tested our model in a broad sample of 2,089 health care employees, with 5 measurement points over 2 years. Using random coefficient modeling, we found that burnout was relatively stable for organizational insiders but slightly dynamic for organizational newcomers and internal job changers. We also found that the dimensions of emotional exhaustion and depersonalization were more sensitive to career transition type than reduced personal accomplishment. Finding some differences among different types of employees as well as the dimensions of burnout may begin to explain longstanding inconsistencies between theory and research regarding the dynamics of burnout, offering directions for future research that address both dynamism and stability.

Minimizing deviant behavior in healthcare organizations: the effects of supportive leadership and job design.

In an era when healthcare organizations are beset by intense competition, lawsuits, and increased administrative costs, it is essential that employees perform their jobs efficiently and without distraction. Deviant workplace behavior among healthcare employees is especially threatening to organizational effectiveness, and healthcare managers must understand the antecedents of such behavior to minimize its prevalence. Deviant employee behavior has been categorized into two major types, individual and organizational, according to the intended target of the behavior. Behavior directed at the individual includes such acts as harassment and aggression, whereas behavior directed at the organization includes such acts as theft, sabotage, and voluntary absenteeism, to name a few (Robinson and Bennett 1995). Drawing on theory from organizational behavior, we examined two important features of supportive leadership, leader-member exchange (LMX) and perceived organizational support (POS), and two important features of job design, intrinsic motivation and depersonalization, as predictors of subsequent deviant behavior in a sample of over 1,900 employees within a large US healthcare organization. Employees who reported weaker perceptions of LMX and greater perceptions of depersonalization were more likely to engage in deviant behavior directed at the individual, whereas employees who reported weaker perceptions of POS and intrinsic motivation were more likely to engage in deviant behavior directed at the organization. These findings give rise to specific prescriptions for healthcare managers to prevent or minimize the frequency of deviant behavior in the workplace.

The impact of participative management perceptions on customer service, medical errors, burnout, and turnover intentions.

Numerous challenges confront managers in the healthcare industry, making it increasingly difficult for healthcare organizations to gain and sustain a competitive advantage. Contemporary management challenges in the industry have many different origins (e.g., economic, financial, clinical, and legal), but there is growing recognition that some of management's greatest problems have organizational roots. Thus, healthcare organizations must examine their personnel management strategies to ensure that they are optimized for fostering a highly committed and productive workforce. Drawing on a sample of 2,522 employees spread across 312 departments within a large U.S. healthcare organization, this article examines the impact of a participative management climate on four employee-level outcomes that represent some of the greatest challenges in the healthcare industry: customer service, medical errors, burnout, and turnover intentions. This study provides clear evidence that employee perceptions of the extent to which their work climate is participative rather than authoritarian have important implications for critical work attitudes and behavior. Specifically, employees in highly participative work climates provided 14 percent better customer service, committed 26 percent fewer clinical errors, demonstrated 79 percent lower burnout, and felt 61 percent lower likelihood of leaving the organization than employees in more authoritarian work climates. These findings suggest that participative management initiatives have a significant impact on the commitment and productivity of individual employees, likely improving the patient care and effectiveness of healthcare organizations as a whole.

Creating a learning health care organization for participatory management: a case analysis.

PURPOSE: This paper aims to define a theory of practice in successfully implementing management-communication practices in the service of organizational learning. DESIGN/METHODOLOGY/APPROACH: A combination of research methods, both quantitative and qualitative, was used in gathering and analyzing data. FINDINGS: Three principles in creating a supportive environment conducive to employee empowerment and participative decision making enable organizational learning. RESEARCH LIMITATIONS/IMPLICATIONS: The study provides empirical findings in support of current theoretic knowledge in organizational learning and empowerment. ORIGINALITY/VALUE: The paper partly rectifies that little research has investigated the enabling structures and processes to manage the environment that surrounds and supports employee participative decision making and new learning to occur at the individual and collective level within a health care setting.

Adapting to change in healthcare: aligning strategic intent and operational capacity.

The concept of a stakeholder is commonplace in a business context. Participative- democratic communication refers to those organization-wide principles and practices that "represent" many relevant stakeholders in the decision making of work-related activities. One case in point is as follows: In May 2000, the Spartanburg Regional Healthcare System board of directors forced its CEO to resign, ending his 6-year tenure and the heated controversy of the previous 2 months. The former CEO focused primarily on strategic growth to the detriment of operations. Through participative-democratic practices, the interim CEO mended the damaged relations between the hospital administration, the community, and employee stakeholders in surfacing conflict to bolster operational efficiency. The current CEO attended to building stakeholder relationships and trust as a way to wed strategic growth and the organization's capacity to maintain it. Top executive managers and directly involved community political leaders helped in developing the participative-democratic communication principles set forth in this article. These core principles are (a) creating the space for new communicative interaction, (b) safeguarding a credible and open process, and (c) reclaiming suppressed views.