Do Organizational Values and Leadership Impact Staff Engagement, Wellbeing, and Patient Satisfaction?

Purpose: Organizational culture has been shown to be an important characteristic that influences behaviors of groups and individuals within an organization. This study seeks to examine the relationships among various organizational values, staff engagement, staff wellbeing, and patient satisfaction in community hospitals. Participants and Methods: Organizational values and engagement data were retrieved from all-staff survey results from 387 clinical units at Mayo Clinic Health Systems. For patient satisfaction data, Press Ganey scores were matched with data for 17 outpatient units from the all-staff survey. Cluster analysis was used to create constructs from the staff satisfaction survey. Reliability was obtained using Cronbach's alpha. Structural equation modeling (SEM) was used to create the measurement model for prediction of constructs. Correlation was used to examine the relationship between culture and patient satisfaction. Results: From the all-staff survey results, we identified nine constructs related to organizational cultural values, staff well-being, and employee engagement. We were able to determine a structural equation model for values and engagement that had an excellent fit. Staff's sense of fairness had a significant impact on how staff provide service excellence. Cultural values of excellence and innovation were positively correlated with large effect size in ten out of eleven patient satisfaction measurement domains and all were statistically significant. Conclusion: Values of excellence had a larger positive relationship with patient satisfaction than all other variables. How staff perceive the level of the organization's commitment to its values had impact on both staff engagement and wellbeing. This study also showed that the construct of wellbeing and patient satisfaction scores are not correlated. Staff will strive to provide excellent experience and good patient care regardless of their state of wellbeing.

Relationships Among Organizational Values, Employee Engagement, and Patient Satisfaction in an Academic Medical Center.

OBJECTIVE: To examine the relationships among various organizational values, employee engagement, and patient satisfaction in an academic medical center. PARTICIPANTS AND METHODS: Organizational values and engagement data were retrieved from 2015 all-staff survey results from 1876 clinical units at Mayo Clinic. For patient satisfaction data, Press Ganey scores from visits from July 1, 2015, through January 1, 2016, were matched with data for 26 outpatient units from the all-staff survey. The study was performed from January 1, 2016, through December 31, 2017. RESULTS: From the all-staff survey results, we identified seven constructs related to values and employee engagement, all of which showed high positive correlation with each other. We were able to determine a structural equation model for values and engagement that had an excellent fit (comparative fit index, 0.957). Empowering leadership was positively correlated with the largest number of patient satisfaction items, followed by employee engagement and psychological safety/trust. All items from the care provider category had positive correlations with empowering leadership and psychological safety/trust. CONCLUSION: All the organizational values studied showed positive correlation with employee engagement, and all the organizational values and engagement were predictors of excellence and innovation either directly or indirectly. This affirms that honoring organizational values related to respect, psychological safety/trust, empowering leadership, and fairness has a positive influence on employee engagement and desire to pursue excellence. Organizational values, engagement, and empowering leadership behavior were positively correlated with many patient satisfaction items.

Going Beyond "Not Enough Time": Barriers to Preparing Manuscripts for Academic Medical Journals.

Phenomenon: Many researchers have difficulty transforming raw data into publishable full-length manuscripts. Among studies presented at professional meetings, registered as clinical trials, or declined from specific journals, nonpublication rates are estimated to range from 25% to 60%. We aimed to characterize major barriers to manuscript preparation, beyond lack of time, for academics from a broad range of specialties at a tertiary academic medical institution. We explored whether major barriers evolved with increasing publishing experience. Approach: We surveyed registrants of 12 noncompulsory workshops on scientific publishing (April 2009-November 2015). Survey respondents indicated how many of their coauthored papers were accepted for publication in peer-reviewed journals in the past 5 years and stated what they found most difficult about preparing a manuscript, other than lack of time. Two investigators performed a content analysis of the reported barriers; mean agreement between coders was 98% (SD = 2%), and the mean Scott π coefficient for interrater reliability was 0.81 (SD = 0.26). We used a multimethod analytic approach to determine whether the perceived barriers varied with level of publishing experience. Findings: Surveys were returned by 201 of 256 registrants (79%). Thirty-eight percent of respondents had lower publishing experience (0-4 papers published in peer-reviewed journals in the past 5 years), 26% had medium experience (5-10 papers), and 35% had higher experience (>10 papers). Many respondents (57%) listed multiple barriers, but 5% listed zero barriers. The content analysis of the 370 reported barrier items identified 8 categories covering 38 concepts. The most common concerns (i.e., organization, writing, following journal format, defining the article scope, disliking writing, responding to reviewers) were not affected by author experience level. However, significantly more academics with higher experience expressed concerns about data presentation. Insights: Academics commonly reported barriers such as uncertainty about how to organize content, difficulty with developing succinct text, and frustration about meeting journal-specific formatting requirements. Greater experience in scientific publishing did not appear to mitigate these barriers. Academic institutions can provide targeted support for persistent challenges to scholarly productivity.

Pregnancy and Parental Leave During Graduate Medical Education.

PURPOSE: To understand the pregnancy, childbirth, and parental leave plans and experiences of trainees in multiple graduate medical education (GME) programs at a single institution. METHOD: In 2013, the authors developed and deployed a voluntary, Internet-based survey of trainees in 269 residency and fellowship programs across the three sites of the Mayo School of Graduate Medical Education. The survey assessed pregnancy-related issues, including use of relevant institutional policies, changes in work due to pregnancy, and activities during pregnancy and parental leave. The authors analyzed the responses to make comparisons across groups. RESULTS: Forty-two percent (644/1,516) of trainees responded. Less than half (264; 41%) had children, and 46 (7%) were currently pregnant (themselves or their partners). Among parents, 24 (of 73; 33%) women and 28 (of 81; 35%) men planned to have another child during their current training program, and 13 (18%) women and 14 (17%) men planned to do so during their next training program. Among nonparents, 40 (of 135; 30%) women and 36 (of 111; 32%) men planned pregnancies during their current training program, and 25 (19%) women and 14 (13%) men planned pregnancies during their next training program. Of respondents eligible for parental leave, 81 (of 83; 98%) women and 89 (of 101; 88%) men had used it. CONCLUSIONS: Approximately 40% of respondents planned to have children during their GME training; most will require family leave and institutional support. GME programs should pursue policies and practices to minimize the effects of these leaves on their workforce.

Gender distribution of U.S. medical school faculty by academic track type.

PURPOSE: Over the past 30 years, the number and type of academic faculty tracks have increased, and researchers have found differences in promotion rates between track types. The authors studied the gender distribution of medical school faculty on the traditional tenure track (TTT) and clinician-educator track (CET) types. METHOD: The authors analyzed gender and academic track type distribution data from the March 31, 2011, snapshot of the Association of American Medical Colleges' Faculty Roster. Their final analysis included data from the 123 medical schools offering the TTT type and the 106 offering the CET type, which excluded any schools with 10 or fewer faculty on each track type. RESULTS: The original dataset included 134 medical schools representing 138,508 full-time faculty members, 50,376 (36%) of whom were women. Of the 134 medical schools, 128 reported at least one of four track types: TTT, CET, research track, and other. Of the 83 medical schools offering the CET type, 64 (77%) had a higher proportion of female than male faculty on that track type. Of the 102 medical schools offering the TTT type, only 20 (20%) had a higher proportion of female than male faculty on that track type. CONCLUSIONS: Medical schools offering the CET type reported higher proportions of female faculty on that track type. Given that faculty on the CET type lag behind their TTT colleagues in academic promotion, these findings may contribute to continued challenges in gaining academic and leadership parity for women in academic medicine.