Unveiling the mechanisms by which inclusive leadership influences the good soldier syndrome among health-care employees.

PURPOSE: The purpose of this study is to investigate the relationship between inclusive leadership (IL), psychological safety (PS), affective commitment (AC) and organizational citizenship behavior (OCB) at the workplace. By understanding the sequential linkages, the research aims to provide insights for fostering a positive organizational culture that promotes employee commitment and employees' willingness to go the extra mile for the organization. DESIGN/METHODOLOGY/APPROACH: The authors study how IL and OCB are related through PS and AC. For this purpose, cross-sectional data from 384 nursing professionals in India was collected and structural equation modeling was conducted on the same using IBM AMOS. FINDINGS: The study found that IL has a major impact on OCB. The study further found that perceived IL leads to PS which is associated with OCB through AC. RESEARCH LIMITATIONS/IMPLICATIONS: The study has many theoretical and practical implications. This study uses a framework that is based on Affective events theory. In a health-care environment, IL can foster AC by promoting a culture of respect, collaboration and value for diverse perspectives, which enhances health-care professionals' emotional attachment to their work and the organization. Additionally, by encouraging open communication and a sense of belonging, IL contributes to OCB, as health-care staff are more likely to engage in discretionary behaviors that support the overall effectiveness and positive functioning of the health-care team if PS is improved, ultimately improving patient care outcomes. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is one of the primary studies that looks into the sequential mechanism through which IL impacts OCB.

Evaluating health information systems-related errors using the human, organization, process, technology-fit (HOPT-fit) framework.

Complex socio-technical health information systems (HIS) issues can create new error risks. Therefore, we evaluated the management of HIS-related errors using the proposed human, organization, process, and technology-fit framework to identify the lessons learned. Qualitative case study methodology through observation, interview, and document analysis was conducted at a 1000-bed Japanese specialist teaching hospital. Effective management of HIS-related errors was attributable to many socio-technical factors including continuous improvement, safety culture, strong management and leadership, effective communication, preventive and corrective mechanisms, an incident reporting system, and closed feedback loops. Enablers of medication errors include system sophistication and process factors like workarounds, variance, clinical workload, slips and mistakes, and miscommunication. The case management effectiveness in handling the HIS-related errors can guide other clinical settings. The potential of HIS to minimize errors can be achieved through continual, systematic, and structured evaluation. The case study validated the applicability of the proposed evaluation framework that can be applied flexibly according to study contexts to inform HIS stakeholders in decision-making. The comprehensive and specific measures of the proposed framework and approach can be a useful guide for evaluating complex HIS-related errors. Leaner and fitter socio-technical components of HIS can yield safer system use.

Primary Care Practice Characteristics Associated With Medical Assistant Staffing Ratios.

This study characterized adult primary care medical assistant (MA) staffing. National Survey of Healthcare Organizations and Systems (n = 1,252) data were analyzed to examine primary care practice characteristics associated with MA per primary care clinician (PCC) staffing ratios. In 2021, few practices (11.4%) had ratios of 2 or more MAs per PCCs. Compared with system-owned practices, independent (odds ratio [OR] = 1.76, P <0.05) and medical group-owned (OR = 2.09, P <0.05) practices were more likely to have ratios of 2 or more MAs per PCCs, as were practices with organizational cultures oriented to innovation (P <0.05). Most primary care practices do not have adequate MA staffing.

Rethinking organizational culture in intersectoral coordination: the perspective of boundary work.

PURPOSE: The purpose of this paper is to rethink the concept of organizational culture as something that emerges bottom-up by using the sociological concepts of boundary object and boundary work as an analytical lens and to show how this approach can help understand and facilitate intersectoral coordination. DESIGN/METHODOLOGY/APPROACH: We used observations and qualitative interviews to develop "deep" knowledge about processes of intersectoral coordination. The study draws on a conceptual framework of "boundary work" and "boundary objects" to show how a bottom-up perspective on organizational culture can produce better understanding of and pave the way for intersectoral coordination. We use a case of health professionals engaged in two Danish intersectoral programs developing and providing health promotion services for women with gestational diabetes mellitus (GDM). FINDINGS: The study showed how boundary work revolves around negotiations on how to define, understand and act on the diagnosis of GDM. This diagnosis has the characteristics of a "boundary object", being more loosely structured in general terms, but strongly structured in local settings. Boundary objects help connect different professionals and facilitate coordination. The analysis showed how the introduction of time and the concept of "lifelong health promotion" helped to transgress existing organizational and professional boundaries. RESEARCH LIMITATIONS/IMPLICATIONS: The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination and collaboration. While the theoretical implications will be general applicable when studying organizational culture, the implications for practice are sensitive to context and the processes we have described as the outcomes of boundary work are generated from cases that were most likely to provide deep insight into our research topic. PRACTICAL IMPLICATIONS: For practice this can build bridges between organizational and professional boundaries. ORIGINALITY/VALUE: The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination. This may build bridges between organizational and professional boundaries in practice settings.

The influence of hospital accreditation on nurses' perceptions of patient safety culture.

OBJECTIVES: Hospitals' accreditation process is carried out to enhance the quality of hospitals' care and patient safety practices as well. The current study aimed to investigate the influence of hospitals' accreditation on patient safety culture as perceived by Jordanian hospitals among nurses. METHODS: A descriptive cross-sectional correlational survey was used for the current study, where the data were obtained from 395 nurses by convenient sampling technique who were working in 3 accredited hospitals with 254 nurses, and 3 non-accredited hospitals with 141 nurses, with a response rate of 89%. RESULTS: The overall patient safety culture was (71.9%). Moreover, the results of the current study revealed that there were no statistically significant differences between the perceptions of nurses in accredited and non-accredited hospitals in terms of perceptions of patient safety culture. CONCLUSION: The current study will add new knowledge about nurses' perceptions of patient safety culture in both accredited and non-accredited hospitals in Jordan which in turn will provide valid evidence to healthcare stakeholders if the accreditation status positively affects the nurses' perceptions of patient safety culture or not. Continuous evaluation of the accreditation application needs to be carried out to improve healthcare services as well as quality and patient safety.

Exploring the Synergies Between the Magnet Recognition Program® and the International Council of Nurses' Charter for Change.

Healthcare organizations across the globe apply the Magnet® Model framework to achieve excellence in nursing practice, thriving work environments, and improved patient, nursing, and organizational outcomes. The International Council of Nurses' (ICN) Charter for Change (2023) commissioned actionable measures for change to advance the nursing profession into the future. This article explores the synergies between the Magnet Recognition Program® and the ICN Charter for Change, aiming to demonstrate that integrating the principles of both models can provide a roadmap for healthcare organizations to enhance nursing professional development, foster a culture of innovation and evidence-based practice, and ultimately improve healthcare outcomes for patients and communities globally.

Long-term oriented culture, performance pressure and corporate innovation: Evidence from China.

This paper extracts culture element of long-term orientation from Chinese listed firm's annual report, then argue and testify whether long-term orientation can help firms to hang on risky decision especially as innovation, when firms are under performance pressure. There are three main conclusions. First, we report that the higher degree of long-term oriented culture a firm has, the stronger innovation capability the firm shows. Second, we find that long-term oriented culture can improve employee's educational qualification to promote corporate innovation, as well as improve the corporate internal control to promote innovation. Third, when firms are subjected to internal or external performance pressure in their business process, higher long-term oriented culture will make firms more innovative.

Powering Up Data in the Service of Operational Excellence.

Harnessing the power of data is a necessary competency in fueling innovation, improving financial and clinical outcomes, and achieving operational excellence. It can be analyzed, visualized, dashboarded, and embedded into workflows seamlessly with very little technical expertise. Moreover, data can galvanize organizational culture with its neutrality, transparency, and portability. Using data to highlight qualitative evaluations, patient experiences, and employee performance can help validate perceptions and identify broader organizational opportunities. Yet useful data is frequently nonexistent, invalid, or insufficient. Moving from promise to realization requires reframing data management, as described here.

Evidence-Based Management, Reconsidered.

Reports of medical mistakes have splashed across newspapers and magazines in the United States. At the same time, instances of overuse, underuse, and misuse of management tactics and strategies receive far less attention. Tactics to increase health systems managers' participation in management research include training in evidence-based management, investment in management research projects, and implementing knowledge management systems. To help in understanding and applying an evidenced-based approach to decision-making, the article excerpt provides practical tools and strategies to develop a questioning organizational culture.

BVA to launch innovative scheme to accredit Great Workplaces.

BVA is launching a new accreditation scheme that rewards positive workplace culture in all veterinary settings.

Predictive effects of organizational justice on job satisfaction in bus drivers: the moderating effects of role overload and proactive personality.

BACKGROUND: There have been few longitudinal studies on Chinese bus drivers and the individual differences in the relationships between organizational justice and job satisfaction. This study examined the organizational justice and job satisfaction in bus drivers and the individual differences in this relationship. METHODS: A two-wave longitudinal study design was employed. A first survey was conducted on 513 Chinese bus drivers in October 2021 that collected socio-demographic information and asked about their perceptions of organizational fairness. A second survey was conducted six months later that asked about role overload and job satisfaction and assessed their proactive personality type. An effect model was then used to explore the moderating effects of role overload and proactive personality type on the relationships between organizational justice and job satisfaction. RESULTS: Both procedural and interactive justice predicted the bus drivers' job satisfaction. Proactive personalities and role overload were found to enhance this relationship. CONCLUSIONS: Organizations could benefit from screening at the recruitment stage for drivers with highly proactive personalities. Relevant training for drivers with low proactive personalities could partially improve employee job satisfaction. When viewed from a Chinese collectivist cultural frame, role overload could reflect trust and a sense of belonging, which could enhance job satisfaction. Finally, to improve employee job satisfaction, organizations need to ensure procedural and interactive justice.

Fostering voice behavior in correctional institutions: Investigating the role of organizational support and proactive personality.

This research delves into the intricate interplay between perceived organizational support, proactive personality, and voice behavior. Furthermore, it establishes the pivotal role of work engagement as a mediating factor within the articulated research model. The study engaged 287 healthcare professionals within correctional institutions and detention centers in Indonesia, employing a dual-phase questionnaire distribution to capture the dynamic aspects of the participants' experiences. Utilizing the statistical technique of Partial Least Square-Structural Equation Modeling with the SmartPLS 4 program as an analysis tool, the collected data underwent comprehensive analysis. The outcomes reveal that proactive personality significantly influences voice behavior both directly and indirectly through its impact on work engagement. Conversely, perceived organizational support directly influences work engagement but does not exhibit a direct impact on voice behavior. These findings underscore the significance of proactive personality in fostering a conducive environment for constructive organizational change from a grassroots perspective. The study suggests that organizations prioritize the cultivation of proactive personality traits to stimulate voice behavior, thereby facilitating ongoing improvements and sustainable organizational progress.

Estimating the effect of corporate integrity culture on tax avoidance using a text-based approach: A research note.

Tax avoidance holds immense importance due to its substantial implications for government revenues and the fair allocation of resources. Consequently, understanding the factors that shape tax avoidance is critically important. Exploiting a cutting-edge measure of corporate integrity derived from state-of-the-art machine learning algorithms and textual analysis, we explore the effect of corporate integrity on tax avoidance. Our text-based measure is based on a textual analysis of earnings conference call transcripts. Our findings show that companies with greater corporate integrity are significantly less involved in tax avoidance. Further analysis corroborates the results, i.e., propensity score matching, entropy balancing, and an instrumental variable analysis. Our findings are especially noteworthy as they demonstrate that corporate culture, although intangible in nature, exerts a substantial influence on corporate behavior.

The role of regulatory policies in organizational culture: Insights from the education industry.

On February 26, 2018 and July 24, 2021, the Chinese government respectively issued two significant regulatory policies to address the problems caused by off-campus training institutions in terms of students' extra-curricular and family financial burdens. These policies have had a tremendous and far-reaching impact on the off-campus training industry in China. With the help of these two events, we explored the role of industry-level regulatory policies in shaping and forming organizational culture. This paper adopts a text analysis method, combined with the dimensions of the Denison Organizational Culture Survey (DOCS) and MAXQDA 18 software, to obtain data on corporate culture. Then, the approaches of regression discontinuity in time (RDiT) and regression discontinuity (RD) designs with multiple cutoffs are used to estimate the policy treatment effect. This empirical research suggests that regulatory policies have a significant impact on corporate culture. Moreover, regulatory policies of varying degrees of strictness have differential effects on different dimensions of corporate culture. The research findings contribute to the theories of corporate culture and can guide enterprises to evaluate the impact of policies on corporate culture more clearly, thereby enabling them to make wiser operation decisions.

Healthcare workers perceptions of patient safety culture in selected Ghanaian regional hospitals: a qualitative study.

BACKGROUND: Patient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers' perceptions of patient safety culture in selected regional hospitals in Ghana. OBJECTIVE: This study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it. METHOD: In-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes. RESULT: The health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture. CONCLUSIONS: This qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.

Exploring the impact of compassion and leadership on patient safety and quality in healthcare systems: a narrative review.

BACKGROUND: Patient safety and healthcare quality are considered integral parts of the healthcare system that are driven by a dynamic combination of human and non-human factors. This review article provides an insight into the two major human factors that impact patient safety and quality including compassion and leadership. It also discusses how compassion is different from empathy and explores the impact of both compassion and leadership on patient safety and healthcare quality. In addition, this review also provides strategies for the improvement of patient safety and healthcare quality through compassion and effective leadership. METHODS: This narrative review explores the existing literature on compassion and leadership and their combined impact on patient safety and healthcare quality. The literature for this purpose was gathered from published research articles, reports, recommendations and guidelines. RESULTS: The findings from the literature suggest that both compassion and transformational leadership can create a positive culture where healthcare professionals (HCPs) prioritise patient safety and quality. Leaders who exhibit compassion are more likely to inspire their teams to deliver patient-centred care and focus on error prevention. CONCLUSION: Compassion can become an antidote for the burnout of HCPs. Compassion is a behaviour that is not only inherited but can also be learnt. Both compassionate care and transformational leadership improve organisational culture, patient experience, patient engagement, outcomes and overall healthcare excellence. We propose that transformational leadership that reinforces compassion remarkably improves patient safety, patient engagement and quality.

Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature.

BACKGROUND: In an era of safety systems, hospital interventions to build a culture of safety deliver organisational learning methodologies for staff. Their benefits to hospital staff are unknown. We examined the literature for evidence of staff outcomes. Research questions were: (1) how is safety culture defined in studies with interventions that aim to enhance it?; (2) what effects do interventions to improve safety culture have on hospital staff?; (3) what intervention features explain these effects? and (4) what staff outcomes and experiences are identified? METHODS AND ANALYSIS: We conducted a mixed-methods systematic review of published literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted in MEDLINE, EMBASE, CINAHL, Health Business Elite and Scopus. We adopted a convergent approach to synthesis and integration. Identified intervention and staff outcomes were categorised thematically and combined with available data on measures and effects. RESULTS: We identified 42 articles for inclusion. Safety culture outcomes were most prominent under the themes of leadership and teamwork. Specific benefits for staff included increased stress recognition and job satisfaction, reduced emotional exhaustion, burnout and turnover, and improvements to working conditions. Effects were documented for interventions with longer time scales, strong institutional support and comprehensive theory-informed designs situated within specific units. DISCUSSION: This review contributes to international evidence on how interventions to improve safety culture may benefit hospital staff and how they can be designed and implemented. A focus on staff outcomes includes staff perceptions and behaviours as part of a safety culture and staff experiences resulting from a safety culture. The results generated by a small number of articles varied in quality and effect, and the review focused only on hospital staff. There is merit in using the concept of safety culture as a lens to understand staff experience in a complex healthcare system.

More Than a Game: Building a Workplace Culture of Positivity and Belonging Among Nurses.

This performance improvement project introduced a mobile social gaming app for sharing positive feedback from patients and coworkers with nurses. After deployment, the app supported creating improvements as a supportive structure for engaging nurses in peer recognition to build a workplace culture of positivity and belonging. The authors discuss findings from the app's adoption and use among nurses and offer recommendations for leaders.