A contemporary understanding of organizational climate in healthcare setting: A concept analysis

Building Relationships, Forming Collaborations: Lessons Learned From an Unconference Seeking to Cultivate Solutions in Healthcare

INTRODUCTION

Calls for a 'major rethinking' of the delivery of healthcare services are echoed across Canada as the healthcare crisis continues. Proposed strategies to address the challenges of this crisis include: a transdisciplinary approach that is patient-focused and community-based; a representative team composed of patients, caregivers, healthcare providers, decision makers and policymakers; and authentic collaboration among stakeholder groups throughout the research cycle.

OBJECTIVE

This study aimed to enable community members to take on a leading role in building capacity and to provide a space for discourse among diverse groups while respecting community wisdom, values and priorities.

METHODS

The Collaborative Health Research Institute of Southern Alberta (CHRISA) organized a participant-oriented Unconference event to address the factors contributing to the healthcare crisis in Alberta, Canada. An Unconference is a participant-oriented meeting where the attendees nominate the topics, agree on the agenda and lead the sessions. This article describes the Unconference programme and presents the findings from a thematic analysis of the discussion notes from breakout sessions, feedback from participants (i.e., lessons learned) and pragmatic recommendations for future Unconference events.

RESULTS

Findings from sessions included the following: (1) identifying the 'wicked' problems, (2) the factors/causes contributing to each problem (i.e., contributors) and (3) potential multifaceted solutions or ideas to remedy the problem. Lessons learned from the postevent evaluation resulted in six recommendations for organizing future Unconferences.

CONCLUSION

The CHRISA Unconference achieved its goals by providing a venue for attendees to connect, engage and network on topics of interest, explore new ways of addressing challenges in healthcare and serve as a foundation for future initiatives and collaborations in healthcare research and practice.

PATIENT OR PUBLIC CONTRIBUTION

The Unconference was attended by community members who identify as patients, frontline workers, programme administrators and representatives of public organizations and agencies. Participants contributed to breakout session discussions, provided feedback on the Unconference and offered recommendations for future events. The co-authors are service users, people with lived experience or those work in the healthcare setting; they have been involved in data collection, analysis and interpretation, and contributed to this report.

Mitigating Job Burnout in Jordanian Public Healthcare: The Interplay between Ethical Leadership, Organizational Climate, and Role Overload

In today's dynamic organizational landscape, characterized by rapid technological advancements and evolving workplace dynamics, understanding the factors influencing employee well-being is paramount. This study investigates the interplay between ethical leadership, organizational climate, role overload, and job burnout in public healthcare organizations across northern Jordan. By focusing on ethical leadership, organizational climate, and role overload as determinants of job burnout, this research provides insights into strategies for enhancing employee well-being. Drawing on ethical leadership theory, social exchange theory, and the job demands-resources model, this study employs PLS-SEM to analyze data collected from 260 employees working in Jordanian government hospitals. The findings reveal negative associations between ethical leadership and job burnout, highlighting the importance of ethical leadership behaviors in mitigating employee burnout. Additionally, a positive organizational climate is associated with lower levels of burnout, underscoring the impact of the broader organizational context on employee well-being. The study also explores the mediating role of organizational climate and the moderating effect of role overload in the relationship between ethical leadership and job burnout, providing insights into the complex dynamics at play in healthcare organizations. These findings enrich our understanding of the factors influencing employee well-being in healthcare contexts and underscore the importance of fostering ethical leadership and supportive organizational climates to mitigate job burnout.

The impact of perceived organizational justice on young nurses' job performance: a chain mediating role of organizational climate and job embeddedness

BACKGROUND

The level of nurses' job performance has always been of great concern, which not only represents the level of nursing service quality but is also closely related to patients' treatment and prognosis. The aim of this study was to analyze the relationship between perceived organizational justice and job performance and to explore the mediating role of organizational climate and job embeddedness among young Chinese nurses.

METHODS

A cross-sectional survey of 1136 young nurses was conducted between March and May 2023 using convenience sampling. Data were collected using the Job Performance Scale, Organizational Justice Assessment Scale, Nursing Organizational Climate Scale, and Job Embeddedness Scale, and the resulting data were analyzed using SPSS 25.0 and AMOS 26.0.

RESULTS

There was a significant positive correlation between job performance and perceived organizational justice (r = 0.477, p < 0.01), organizational climate (r = 0.500, p < 0.01), and job embeddedness (r = 0.476, p < 0.01). Organizational climate and job embeddedness acted as chain mediators between perceived organizational justice and job performance. The total effect of perceived organizational justice on job performance (β = 0.513) consisted of a direct effect (β = 0.311) as well as an indirect effect (β = 0.202) mediated through organizational climate and job embeddedness, with the mediating effect accounting for 39.38% of the total effect.

CONCLUSIONS

Organizational climate and job embeddedness play a chain mediating role between perceived organizational justice and job performance, so hospital managers should pay attention to the level of perceived organizational justice among young nurses, and develop a series of targeted measures to improve their job performance using organizational climate and job embeddedness as entry points.

Stressed at work and distressed out of work: Unveiling the implications of time-related work stress on work climate in the nonprofit sector

Time-related work stress is prevailing in today’s society. This is especially true in the nonprofit sector, where people are willing to self-sacrifice in order to contribute to organizational performance. Although literature highlights the shortcomings of time-related work stress, little is still known on its negative impact on work climate. The article contributes to fill this gap, shedding light on the consequences of time-related work stress on work climate in a large sample of people employed in the nonprofit sector. Secondary data were obtained from the latest wave of the European Working Condition Survey. Conditional process analysis was used to investigate the effects of time-related stress on work climate, considering the mediating role of work-life conflicts and work engagement. Stress caused by time constraints did not have direct implications on work climate. However, it expanded exposure to work-life conflicts and impaired work engagement, thus indirectly impoverishing work climate. Since it is hard to escape time pressures in modern work environments, precautions should be taken to protect employees against the backlash of time-related stress on work climate. Alongside empowering people to cope with work-related stress, tailored human resource management practices should be designed to address the sources of time pressures in the workplace.

Government regulation and organizational effectiveness in the health-care supply chain

Purpose

In the context of the debate on ensuring health-care efficiency, this study aims to identify and prioritize factors and subfactors that influence organizational effectiveness (OE) in the health-care supply chain.

Design/methodology/approach

For the purpose of this qualitative study, triangulation was applied to identify, explore and systematically analyze the OE-related practices used by diverse stakeholders along the health-care supply chain. Sixty-two OE practices were thus identified. Subsequently, these were grouped in six different nodes before the analytical hierarchical process (AHP) was used to identify the weightings of specific practices (and related factors) and their impact on OE.

Findings

The findings suggest that external factors associated with government regulation, including government directives and branding, are the most critical factors that influence OE-related practices, while cost-related factors are the least important.

Originality/value

The originality of this study derives from the introduction of system theory supported by a modified supplier-input-process-output-customer (SIPOC) framework. Two important factors – government regulation and branding – have been introduced to the existing SIPOC chart as a valuable process structure for the health-care chain.

Development and psychometric testing of the Perceived Organizational Climate Scale for nurses

AIM

Retaining nurses on the job is vital, and their successful retention is related to the organizational climates (OC) of healthcare settings. The purpose was to develop and test the psychometric properties of the Perceived Organizational Climate Scale (POCS).

DESIGN

The methodologic research design was used by following the scale development strategies by DeVellis (2017). The conceptual framework for this study was based on the broader theoretical framework of the Competing Value Framework (CVF) of Quinn et al. (2015), the concept analysis and extensive literature review (1939-2018), and combined with the inductive qualitative data.

METHODS

A two-phase study of scale construction and psychometric testing was conducted for content validation, construct validation and internal consistency reliabilities of the instrument. An expert panel validated the 4-point scale, followed by exploratory factor analysis, the known-group approach and split groups. Data were collected from (1161) registered nurses in eight general hospitals across Myanmar from August 2019 to September 2020.

RESULTS

The 35 items with four essential dimensions: transformational climate, bureaucratic climate, team climate and strategic climate, explained almost 50% of the variation with all factor loading greater than .40. The internal consistency reliabilities of the instrument showed the Cronbach's alpha coefficient of .93, and the dimensions were from .82 to .85. As hypothesized, the known-group approach demonstrated that experienced nurses had higher mean scores than novices. The internal consistency reliabilities of the scale and dimensions across the splitting groups illustrated the stability.

CONCLUSION

This evidence supports this instrument as having satisfactory initial psychometric properties with a comprehensive picture of OC by its essential components contributing to an inclusive understanding of this climate globally.

IMPACT

This instrument can be used as an objective tool for evaluating OC as perceived by nurses in healthcare settings to inform improvements in working environments.

Decision-Making Model to Assess the Organizational Climate in Healthcare Organizations

Organizational climate impacts on the employee’s well-being, commitment and positive behavior. Most studies to assess climate in healthcare organizations use qualitative and/or statistical methods. Here, we propose a general framework, based on a multiple criteria decision making/aid (MCDM / A) method, which considers different objectives in a single problem. Such framework includes internal and external factors to assess organizational climate and presented adequate results when tested in a particular case. To assess the organizational climate, we use the ELECTRE TRI method, an outranking method that combine the decision-maker (DM) preferences and his value judgments. We conclude that MCDM methods can improve agility, provide a systemic vision on organizational climate assessment and contribute to the decision-making process

Role of self-efficacy in nursing organizational climate: A way to develop nurses' humanistic practice ability

AIM

This study aimed to investigate the impact of self-efficacy on the relationship between organizational climate and humanistic practice ability (HPA) in Chinese nurses.

BACKGROUND

To date, studies on the effect of organizational climate on nursing care have focused on care outcomes rather than care processes. Thus, this effect remains poorly understood.

METHODS

A total of 757 participants were sampled from three tertiary hospitals in Guangdong Province from November to December 2019; subsequently, they completed a structured electronic questionnaire. A structural equation model was used to explore the impact of nursing organizational climate on nurses' HPA.

RESULTS

A total of 688 valid questionnaires were collected. The nurses' average HPA score was 107.82 (SD 12.47). There was a positive correlation between organizational climate and HPA (r = .409, p < .05). Additionally, self-efficacy mediated this relationship (p < .01).

CONCLUSIONS

This study provides new insights into nursing organizational climate, self-efficacy and nurses' HPA.

IMPLICATIONS FOR NURSING MANAGEMENT

The significant mediating effect of self-efficacy suggests that managers should implement nurse professional development programmes using targeted strategies to foster greater self-efficacy, which could improve the quality of care and nurse-patient relationships.

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.