Alignment of governance and senior executive perceptions of culture

Work Climate Scale in Emergency Services: Abridged Version

This study is based on a 40-item work climate scale in hospital emergency services (WCSHES). Teams working in these emergency services experience a heavy workload and have a limited amount of time with each patient. COVID-19 has further complicated these existing issues. Therefore, we believed it would be helpful to draft an abridged version of the 40-item WCSHES, considering both validity and reliability criteria, but giving greater weight to validity. One hundred and twenty-six workers between the ages of 20 to 64 (M = 32.45; standard deviation (SD = 9.73)) years old participated voluntarily in the study. The validity, reliability, and fit model were evaluated in an iterative process. The confirmatory factor analysis yielded appropriate global fit indices in the abridged 24-item version (Χ²(248) = 367.84; p < 0.01, RMSEA = 0.06 with an interval of 90% from 0.05 to 0.07, SRMR = 0.08, GFI = 0.9, AGFI = 0.96, CFI = 0.98, NFI = 0.95, and NNFI = 0.98), along with test criteria validity (ρ_XY = 0.68, p < 0.001) and excellent reliability (α = 0.94 and ω = 0.94), maintaining the same conceptualization and usefulness of the original scale. The abridged 24-item version was used to measure four work climate factors (work satisfaction, productivity/achievement of aims, interpersonal relations, and performance at work). Evidence of the usefulness of the new abridged scale is provided along with a description of our study limitations and future areas for development.

Influence of Social Exchange Relationships on Affective Commitment and Innovative Behavior: Role of Perceived Organizational Support

The current study objective is to investigate how and when leader member exchange (LMX), tie strength, and innovative organizational culture influences employee innovative behavior. In particular, this study uses the social exchange theory to analyze that nurses who demonstrate high affective commitment exhibit a higher level of creativity in the workplace. Based on social exchange theory and perceived organizational support (POS) literature, the current study aims to reveal how perceived organizational support (POS) serves as an imperative mediating process between LMX, tie strength, innovative organizational culture, and employee IB. A questionnaire survey was utilized to collect the data from nurses working in public sector hospitals in Jiangsu province China. A total sample size consists of 325 nurses. Structural equation modeling through AMOS 20 was utilized to analyze the survey data. Results from the structural equation modeling (SEM) analysis indicated that LMX, tie strength, and POS are significantly related to affective commitment and employees’ IB. However, innovative organizational culture has a significant influence on POS and IB, but has no impact on affective commitment. This study covers only public sector hospitals and is limited to Jiangsu province, China. The research could be reproduced in other designated areas in different organizational setups with a bigger sample size to further enhance the understanding of the topic. The key understanding of social exchange theory (SET) is that social relationships can be used appropriately to foster an employee’s IB. It also expands research in the area of LMX, tie strength, innovative organizational culture, and POS as antecedents of affective commitment and IB. This study is a remarkable analysis of LMX, POS, organization culture, commitment, and IB in the Chinese organizational context.

Doctor-patient communication: a review and a rationale for using an assessment framework

PURPOSE

The purpose of this paper is to explore the extent to which improving doctor-patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies.

DESIGN/METHODOLOGY/APPROACH

The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC.

FINDINGS

The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor-patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients' overall ratings of hospitals.

RESEARCH LIMITATIONS/IMPLICATIONS

More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse.

PRACTICAL IMPLICATIONS

When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program's efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use.

ORIGINALITY/VALUE

The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.