Human resource management practices and organizational injury rates.

INTRODUCTION: This study investigated the extent to which five human resource management (HRM) practices-systematic selection, extensive training, performance appraisal, high relative compensation, and empowerment-simultaneously predicted later organizational-level injury rates. METHODS: Specifically, the association between these HRM practices (assessed via on-site audits by independent observers) with organizational injury rates collected by a national regulatory agency one and two years later were modeled. RESULTS: Results from 49 single-site UK organizations indicated that, after controlling for industry-level risk, organization size, and the other four HRM practices, only empowerment predicted lower subsequent organizational-level injury rates. Practical Applications: Findings from the current study have important implications for the design of HRM systems and for organizational-level policies and practices associated with better employee safety.

Measurement of the Psychosocial Work Environment in Spanish: Validation of the Psychosocial Factors Questionnaire 75 (PSF-Q75) to Capture Demands and Resources at Different Levels of Analysis.

The psychological work environment is composed of both stressful and motivational work conditions at different levels of analysis. However, most relevant theory and research lack an integrative conceptualization and appropriate instrumentation to account for this work context structure. These limitations are particularly present in non-mainstream populations, such as the Spanish community of researchers and practitioners. In this study, based on the job demands-resources model, we present an updated conceptualization in which stressful and motivational psychosocial factors are integrated and defined at the job, the group, and the organizational level of analysis into a single conceptualization. Furthermore, derived from this conceptualization, we present a study of the development and validation of a questionnaire to account for the psychosocial work environment in Spanish, labeled Psychosocial Factors Questionnaire 75 (PSF-Q75), which provides measures for 23 different psychosocial factors. The results of this study supported the questionnaire's construct, convergent, divergent, and predictive validity, together with its reliability. Thus, this conceptualization and questionnaire provides researchers and partitioners with a more comprehensive approach to the assessment of the psychosocial work environment and promises benefits for interventions in the workplace.

Building work engagement: A systematic review and meta-analysis investigating the effectiveness of work engagement interventions.

Low work engagement may contribute towards decreased well-being and work performance. Evaluating, boosting and sustaining work engagement are therefore of interest to many organisations. However, the evidence on which to base interventions has not yet been synthesised. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of work engagement interventions. A systematic literature search identified controlled workplace interventions employing a validated measure of work engagement. Most used the Utrecht Work Engagement Scale (UWES). Studies containing the relevant quantitative data underwent random-effects meta-analyses. Results were assessed for homogeneity, systematic sampling error, publication bias and quality. Twenty studies met the inclusion criteria and were categorised into four types of interventions: (i) personal resource building; (ii) job resource building; (iii) leadership training; and (iv) health promotion. The overall effect on work engagement was small, but positive, k = 14, Hedges g = 0.29, 95%-CI = 0.12-0.46. Moderator analyses revealed a significant result for intervention style, with a medium to large effect for group interventions. Heterogeneity between the studies was high, and the success of implementation varied. More studies are needed, and researchers are encouraged to collaborate closely with organisations to design interventions appropriate to individual contexts and settings, and include evaluations of intervention implementation. © 2016 The Authors. Journal of Organizational Behavior published by John Wiley & Sons, Ltd.

Negative core affect and employee silence: How differences in activation, cognitive rumination, and problem-solving demands matter.

Employees can help to improve organizational performance by sharing ideas, suggestions, or concerns about practices, but sometimes they keep silent because of the experience of negative affect. Drawing and expanding on this stream of research, this article builds a theoretical rationale based on core affect and cognitive appraisal theories to describe how differences in affect activation and boundary conditions associated with cognitive rumination and cognitive problem-solving demands can explain employee silence. Results of a diary study conducted with professionals from diverse organizations indicated that within-person low-activated negative core affect increased employee silence when, as an invariant factor, cognitive rumination was high. Furthermore, within-person high-activated negative core affect decreased employee silence when, as an invariant factor, cognitive problem-solving demand was high. Thus, organizations should manage conditions to reduce experiences of low-activated negative core affect because these feelings increase silence in individuals high in rumination. In turn, effective management of experiences of high-activated negative core affect can reduce silence for individuals working under high problem-solving demand situations.

Measuring affect at work based on the valence and arousal circumplex model

Affective states have become a central topic of interest in research on organizational behavior. Recently, scholars have been paying more attention to the proposals of the Circumplex Model (Russell, 1980) in order to gain a finer grained understanding of job-related affect. However, the limited availability of well-validated measures to test this model in work settings, particularly in non English-speaking populations, is still a major drawback. Using three samples of English-speaking and Spanish-speaking workers, this article offers the cross-validation of the Multi-Affect Indicator (Warr, 2007) between the original English version and its corresponding translation into Spanish. Multi-group Structural Equation Modeling supported the instrument’s structure and its invariance between the two languages (English: χ2 = 65.56, df = 48, p = .05; RMSEA = .06; CFI = .97; Spanish: χ2 = 68.68, df = 48, p = .03; RMSEA = .05; CFI = .97). Furthermore, Circular Stochastic Modeling supported the theoretically proposed circumplex representation (χ2 = 139.85, df = 51, p < .01; χ2/df = 2.74, RMSEA = .06). Thus, this study offers an instrument that provides a more accurate approximation to affect at work, both in English and in another of the major language communities in the world, the Spanishspeaking population (AU)

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Measuring affect at work based on the valence and arousal circumplex model.

Affective states have become a central topic of interest in research on organizational behavior. Recently, scholars have been paying more attention to the proposals of the Circumplex Model (Russell, 1980) in order to gain a finer grained understanding of job-related affect. However, the limited availability of well-validated measures to test this model in work settings, particularly in non English-speaking populations, is still a major drawback. Using three samples of English-speaking and Spanish-speaking workers, this article offers the cross-validation of the Multi-Affect Indicator (Warr, 2007) between the original English version and its corresponding translation into Spanish. Multi-group Structural Equation Modeling supported the instrument's structure and its invariance between the two languages (English: χ2 = 65.56, df = 48, p = .05; RMSEA = .06; CFI = .97; Spanish: χ2 = 68.68, df = 48, p = .03; RMSEA = .05; CFI = .97). Furthermore, Circular Stochastic Modeling supported the theoretically proposed circumplex representation (χ2 = 139.85, df = 51, p < .01; χ2/df = 2.74, RMSEA = .06). Thus, this study offers an instrument that provides a more accurate approximation to affect at work, both in English and in another of the major language communities in the world, the Spanish-speaking population.

Why do patients develop severe pressure ulcers? A retrospective case study.

OBJECTIVES: This study focuses on the ways in which the organisational context can influence the development of severe pressure ulcers. Severe pressure ulcers are important indicators of failures in the organisation and delivery of treatment and care. We have a good understanding of patients' risk factors, but a poor understanding of the role played by the organisational context in their development. SETTING: The study was undertaken in six sites in Yorkshire, England. The settings were sampled in order to maximise diversity, and included patients' own homes, acute hospital medical and surgical wards, a community hospital and a nursing home during a period of respite care. PARTICIPANTS: Data were collected about eight individuals who developed severe pressure ulcers, using a retrospective case study design. The data sources included interviews with individuals with severe pressure ulcers, and with staff who had treated and cared for them, and clinical notes. RESULTS: 4 accounts indicated that specific actions by clinicians contributed to the development of severe pressure ulcers. Seven of the 8 accounts indicated that they developed in organisational contexts where (1) clinicians failed to listen and respond to the patients' or carers' observations about their risks or the quality of their treatment and care, (2) clinicians failed to recognise and respond to clear signs that a patient had a pressure ulcer or was at risk of developing one and (3) services were not effectively coordinated. CONCLUSIONS: Patient accounts could only be partially explained in terms of specific events or sequences of events. The findings support the conclusion that there was general acceptance of suboptimal clinical practices in 7 of the 8 contexts where patients developed severe pressure ulcers.

A pragmatic quasi-experimental multi-site community intervention trial evaluating the impact of Emergency Care Practitioners in different UK health settings on patient pathways (NEECaP Trial).

BACKGROUND: Emergency Care Practitioners (ECPs) are operational in the UK in a variety of emergency and urgent care settings. However, there is little evidence of the effectiveness of ECPs within these different settings. The aim of this study was to evaluate the impact of ECPs on patient pathways and care in different emergency care settings. METHODS: A pragmatic quasi-experimental multi-site community intervention trial comprising five matched pairs of intervention (ECP) and control services (usual care providers): ambulance, care home, minor injury unit, urgent care centre and GP out-of-hours. The main outcome being assessed was patient disposal pathway following the care episode. RESULTS: 5525 patient episodes (n=2363 intervention and n=3162 control) were included in the study. A significantly greater percentage of patients were discharged by ECPs working in mobile settings such as the ambulance service (percentage diff. 36.7%, 95% CI 30.8% to 42.7%) and care home service (36.8%, 26.7% to 46.8%). In static services such as out-of-hours (-17.9%, -30.8% to -42.7%) and urgent care centres (-11.5%, -18.0% to -5.1%), a significantly greater percentage of patients were discharged by usual care providers. CONCLUSIONS: ECPs have a differential impact compared with usual care providers dependent on the operational service settings. Maximal impact occurs when they operate in mobile settings when care is taken to the patient. In these settings ECPs have a broader range of skills than the usual care providers (eg, paramedic), and are targeted to specific clinical groups who can benefit from alternative pathways of care (such as older people who have fallen). Trial Registration No ISRCTN22085282 (Controlled trials.com).

How do nurses, midwives and health visitors contribute to protocol-based care? A synthesis of the UK literature.

OBJECTIVES: To explore how nurses, midwives and health visitors contribute to the development, implementation and audit of protocol-based care. Protocol-based care refers to the use of documents that set standards for clinical care processes with the intent of reducing unacceptable variations in practice. Documents such as protocols, clinical guidelines and care pathways underpin evidence-based practice throughout the world. METHODS: An interpretative review using the five-stage systematic literature review process. The data sources were the British Nursing Index, CINAHL, EMBASE, MEDLINE and Web of Science from onset to 2005. The Journal of Integrated Care Pathways was hand searched (1997-June 2006). Thirty three studies about protocol-based care in the United Kingdom were appraised using the Qualitative Assessment and Review Instrument (QARI version 2). The literature was synthesized inductively and deductively, using an official 12-step guide for development as a framework for the deductive synthesis. RESULTS: Most papers were descriptive, offering practitioner knowledge and positive findings about a locally developed and owned protocol-based care. The majority were instigated in response to clinical need or service re-design. Development of protocol-based care was a non-linear, idiosyncratic process, with steps omitted, repeated or completed in a different order. The context and the multiple purposes of protocol-based care influenced the development process. Implementation and sustainability were rarely mentioned, or theorised as a change. The roles and activities of nurses were so understated as to be almost invisible. There were notable gaps in the literature about the resource use costs, the engagement of patients in the decision-making process, leadership and the impact of formalisation and new roles on inter-professional relations. CONCLUSIONS: Documents that standardise clinical care are part of the history of nursing as well as contemporary evidence-based care and expanded roles. Considering the proliferation and contested nature of protocol-based care, the dearth of literature about the contribution, experience and outcomes for nurses, midwives and health visitors is noteworthy and requires further investigation.

A conceptual framework for implementation fidelity.

BACKGROUND: Implementation fidelity refers to the degree to which an intervention or programme is delivered as intended. Only by understanding and measuring whether an intervention has been implemented with fidelity can researchers and practitioners gain a better understanding of how and why an intervention works, and the extent to which outcomes can be improved. DISCUSSION: The authors undertook a critical review of existing conceptualisations of implementation fidelity and developed a new conceptual framework for understanding and measuring the process. The resulting theoretical framework requires testing by empirical research. SUMMARY: Implementation fidelity is an important source of variation affecting the credibility and utility of research. The conceptual framework presented here offers a means for measuring this variable and understanding its place in the process of intervention implementation.

What is protocol-based care? A concept analysis.

AIM: To define protocol-based care to make this way of delivering health care amenable to theoretical and empirical studies. BACKGROUND: Although protocol-based care is associated with the evidence-based practice and standardization movements, it is an ill-defined and understood concept. METHOD: A multiphase concept analysis, inspired by an evolutionary view was used to clarify 'what is protocol-based care'. The inductive, five-phase process drew upon content analysis of policy documents and the literature, plus interviews with a purposive sample of 35 opinion leaders. RESULTS: The term was used interchangeably with protocols, pathways and guidelines in policy and guidance documents. A search of seven databases produced only 57 references to protocol-based care. The concept analysis revealed a continuum of scope and specificity and also distinguished specialist and generic applications of protocol-based care. CONCLUSIONS: Managers need to take cognizance of the significance and complexity of protocol-based care when introducing this way of working.