Adapting to change: How has COVID-19 affected people's work and personal goals?

COVID-19 has had a devastating impact on the global economy and affected millions of people's work and personal lives across the world. The purpose of the present study was to better understand how individuals' work and personal goals have been affected by the pandemic and how they have adapted to these changes. We conducted qualitative semi-structured interviews (n = 48) and surveyed participants (n = 200) weekly for 5 weeks. Both methods revealed similar themes regarding the adaptation and pursuit of goals (social support, handling unpredictable situations, logistics, solving problems creatively, goal postponement, and no changes). Survey responses also showed that most individuals experienced their goals as more difficult (79%; 13% easier; 9% no change) and found that many had had to adapt or postpone their work and personal goals, often due to logistical difficulties. Businesses and governments should do more to help individuals adapt their goals to the new circumstances.

Impact of agile management on project performance: Evidence from I.T sector of Pakistan

Over the past several years, global project management teams have been facing dynamic challenges that continue to grow exponentially with the increasing number of complexities associated with the undertaken tasks. The ever-evolving organizational challenges demand project managers to adapt novel management practices to accomplish organizational goals rather than following traditional management practices. Considering which, the current study aims to explain the effect of agile management practices upon project performance directly as well as while being mediated through project complexity. Furthermore, the aforementioned mediatory relationship is evaluated in terms of the moderating effect of leadership competencies. The current study utilized the survey approach to collect the data from registered I.T firms deployed in the potential metropolitans of each province of Pakistan including, Peshawar, Islamabad, Lahore, Sialkot, Faisalabad, Hyderabad, Sukkur, and Karachi. A total of 176 responses were utilized for statistical evaluations. As result, it was observed that the negative influence anticipated by project complexity on project performance was compensated by the agile management practices. Further, the leadership competencies played a pivotal role in managing project complexity while implementing agile management practices and therefore enhancing project performance. The current study abridges the potential knowledge gap conceptually by evaluating the direct impact of agile management upon project performance while considering all of its aspects, exploring the mediatory role of project performance and evaluating the moderating role of leadership competencies in attaining optimum project performance. In contextual terms, the current study fills the knowledge gap by gauging the implications of agile management practices within the I.T sector of Pakistan. The results of the current study can be a potential guide for both the academicians and the industry professionals.

Impact of supervisory behavior on sustainable employee performance: Mediation of conflict management strategies using PLS-SEM

This study investigates the relationship between supervisory behavior, conflict management strategies, and sustainable employee performance and inquires the mediating effect of conflict management strategies. Data were collected from the SMEs of the manufacturing industry of Pakistan. The significance of the model was assessed using the PLS-SEM (structural equation modeling). The findings of the study revealed a positive and significant relationship between supervisory behavior and sustainable employee behavior. Similarly, conflict management strategies had a positive effect on the relationship between supervisory behavior and sustainable employee behavior. This study adds in the current literature of supervisory behavior as a critical predictor of sustainable employee performance in two ways. Firstly, this study validates Conflict management strategies as an influential mediator between the relationship of supervisory behavior and sustainable employee performance. Secondly, this study provides substantial practical implications for managers at SMEs to enhance sustainable employee performance through supervisory behavior, stimulated by conflict management strategies. This study is based on cross-sectional data; more longitudinal studies can further strengthen the generalizability of relationships between the constructs. The study adds in the current literature of PLS-SEM as an assessment model for direct and mediation relationships.

Workspace preferences and non-preferences in Activity-based Flexible Offices: Two case studies

Activity-based Flexible Offices (AFOs) are innovations in workspace design that are being increasingly implemented in organisations. While most studies investigate satisfaction and perceived work support in AFOs, employees' workspace preferences are not addressed in the literature. The aims of this study were to (i) identify workspace preferences and non-preferences in AFOs, and (ii) investigate whether employees' workstation choices support their activities and align with their preferences. Two Swedish municipalities participated in the study. Data collection involved 27 semi-structured interviews and annotations on architectural drawings. The results showed that the interviewees preferred workstations that were both desirable and functional, and avoided workstations that were undesirable. This was due to functional, social, emotional and symbolic aspects of the workspaces as well as their physical structure and stimuli. The approach used in this paper can be adopted for improving the design of AFOs, thereby mitigating the stress of finding a suitable workstation.

The longitudinal study for the work-related factors to job performance among nurses in emergency department

To explore the relationship between baseline information, personal factors, working characteristics and job performance among nurses in emergency department in northern Taiwan.Two-hundred twenty-two nursing staff were interviewed repeated with structured questionnaires for data collection in 3 time points (From August to September, 2008, from February to March, 2009, and from November to December, 2009). The generalized estimating equation (GEE) is used to test the relationship between the domains of independent variables (baseline information, personal factors, working characteristics) and dependent variables (task performance, contextual performance).The mean age of participants is 30.1 ± 5.1 years. 50.0% are junior college or bachelor degrees. From the GEE model, biological protection (β = 0.17, P value = .002) and safety climate (β = 0.24, P value < .001) are significantly related to task performance. Contextual performance is strongly affected by safety climate (β = 0.15, P value < .001).To improve the job performance among nurses in emergency department, it should consider personal psychological and environmental factors.

Nurses' knowledge and practices in the face of the challenge of using the systematization of nursing care as an instrument of assistance in a first aid in Brazil

To analyze the performance of nurses in the implementation of nursing care systematization (NCS). This study is a descriptive research developed from a qualitative approach. The content analysis (CA) must be developed through 3 chronological poles allowing the researcher to construct an analysis structure that corresponds to the needs of the research and the objectives of the proposed research; The chronological poles of CA are described as: Phase 1-preanalysis, phase 2-exploration of the material: phase 3-treatment of the results obtained and interpretation. Only a semistructured interview will be conducted with the research subjects who meet the inclusion criteria of the study, preserving the identity of the individuals and guaranteeing the right to quit the research at any time during the interview. The Research Ethics Committee of Hospital of the clinics of Acre, Brazil (Amazon region) under the opinion no. 1.460.960 approved this protocol. The clinical protocol was registered in the "Brazilian Registry of Clinical Trials" validated by the World Health Organization, and received clinical trials "RBR-882rg2."

Effective Implementation of Peri-operative Local Guidelines for Metabolic Surgery in Patients with Diabetes Mellitus in a Tier 4 Setting Demonstrate Improved Work Efficiency and Resource Allocation

BACKGROUND

Dynamic changes in glycaemia predominate peri-operatively in patients with type 2 diabetes mellitus (T2DM) undergoing metabolic surgery. There is a lack of consensus and clear guidance on effective glycaemic management of such patients. The aim of this study was to design, pilot, and implement a proforma to improve consistency of glycaemic management and clarity of communication with healthcare professionals following metabolic surgery in patients with T2DM, thereby reducing unnecessary diabetes specialist nurse (DSN) referrals.

METHODS

A proforma was designed and piloted for 12 months to guide healthcare professionals on managing glycaemic therapies for T2DM patients undergoing metabolic surgery. Glycaemic control (HbA1c) and glycaemic therapies were reviewed 3 weeks pre-operatively and a proforma was completed accordingly.

RESULTS

Of the patients with T2DM (n = 34) who underwent metabolic surgery prior to the new proforma being implemented, 71% (n = 24) had a DSN referral. Half of these referrals were deemed unnecessary by the DSNs. Of the patients with T2DM (n = 33) who underwent metabolic surgery following implementation of the proforma, 21% (n = 7) had a DSN referral. Only 10% of these were deemed unnecessary. Despite the reduced DSN input, no diabetes-related complications were reported.

CONCLUSION

Implementation of our proforma effectively halved the proportion of patients with T2DM requiring a DSN referral. Additionally, there was a 40% absolute reduction in the proportion of unnecessary DSN referrals. The proforma improved clarity of communication and guidance for healthcare professionals in the glycaemic management of patients. This also facilitated improved work efficiency and resource allocation.

The impact of a supportive supervision intervention on health workers in Niassa, Mozambique: a cluster-controlled trial

BACKGROUND

Regular supportive supervision is critical to retaining and motivating staff in resource-constrained settings. Previous studies have shown the particular contribution that supportive supervision can make to improving job satisfaction amongst over-stretched health workers in such settings.

METHODS

The Support, Train and Empower Managers (STEM) study designed and implemented a supportive supervision intervention and measured its' impact on health workers using a controlled trial design with a three-arm pre- and post-study in Niassa Province in Mozambique. Post-intervention interviews with a small sample of health workers were also conducted.

RESULTS

The quantitative measurements of job satisfaction, emotional exhaustion and work engagement showed no statistically significant differences between end-line and baseline. The qualitative data collected from health workers post the intervention showed many positive impacts on health workers not captured by this quantitative survey.

CONCLUSIONS

Health workers perceived an improvement in their performance and attributed this to the supportive supervision they had received from their supervisors following the intervention. Reports of increased motivation were also common. An unexpected, yet important consequence of the intervention, which participants directly attributed to the supervision intervention, was the increase in participation and voice amongst health workers in intervention facilities.

Job design, employment practices and well-being: a systematic review of intervention studies

There is inconsistent evidence that deliberate attempts to improve job design realise improvements in well-being. We investigated the role of other employment practices, either as instruments for job redesign or as instruments that augment job redesign. Our primary outcome was well-being. Where studies also assessed performance, we considered performance as an outcome. We reviewed 33 intervention studies. We found that well-being and performance may be improved by: training workers to improve their own jobs; training coupled with job redesign; and system wide approaches that simultaneously enhance job design and a range of other employment practices. We found insufficient evidence to make any firm conclusions concerning the effects of training managers in job redesign and that participatory approaches to improving job design have mixed effects. Successful implementation of interventions was associated with worker involvement and engagement with interventions, managerial commitment to interventions and integration of interventions with other organisational systems. Practitioner Summary: Improvements in well-being and performance may be associated with system-wide approaches that simultaneously enhance job design, introduce a range of other employment practices and focus on worker welfare. Training may have a role in initiating job redesign or augmenting the effects of job design on well-being.

The impact of a human resource management intervention on the capacity of supervisors to support and supervise their staff at health facility level

BACKGROUND

A systematic and structured approach to the support and supervision of health workers can strengthen the human resource management function at the district and health facility levels and may help address the current crisis in human resources for health in sub-Saharan Africa by improving health workers' motivation and retention.

METHODS

A supportive supervision programme including (a) a workshop, (b) intensive training and (c) action learning sets was designed to improve human resource management in districts and health facilities in Tanzania. We conducted a randomised experimental design to evaluate the impact of the intervention. Data on the same measures were collected pre and post the intervention in order to identify any changes that occurred (between baseline and end of project) in the capacity of supervisors in intervention a + b and intervention a + b + c to support and supervise their staff. These were compared to supervisors in a control group in each of Tanga, Iringa and Tabora regions (n = 9). A quantitative survey of 95 and 108 supervisors and 196 and 187 health workers sampled at baseline and end-line, respectively, also contained open-ended responses which were analysed separately.

RESULTS

Supervisors assessed their own competency levels pre- and post-intervention. End-line samples generally scored higher compared to the corresponding baseline in both intervention groups for competence activities. Significant differences between baseline and end-line were observed in the total scores on 'maintaining high levels of performance', 'dealing with performance problems', 'counselling a troubled employee' and 'time management' in intervention a + b. In contrast, for intervention a + b + c, a significant difference in distribution of scores was only found on 'counselling a troubled employee', although the end-line mean scores were higher than their corresponding baseline mean scores in all cases. Similar trends to those in the supervisors' reports are seen in health workers data in terms of more efficient supervision processes, although the increases are not as marked.

CONCLUSION

A number of different indicators were measured to assess the impact of the supportive supervision intervention on the a + b and a + b + c intervention sites. The average frequency of supervision visits and the supervisors' competency levels across the facilities increased in both intervention types. This would suggest that the intervention proved effective in raising awareness of the importance of supervision and this understanding led to action in the form of more supportive supervision.

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia

Background

Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012–2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014.

Methods

This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training.

Results

On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace environment, especially in handling human resource management matters. The smallest improvement was noted in ethics and accountability. Qualitative interviews showed improvements in the meeting culture and a greater appreciation for the importance of meetings. Shared vision, teamwork and coordination seemed to have improved more in work places where the overall manager had received ZMLA training.

Conclusion

Leadership and management training will be a key ingredient in health system strengthening in low-income settings. The ZMLA model was found to be acceptable and effective in improving knowledge and skills for health system managers with minimal disruption to health services.

Integrated Approach to Reduce Perinatal Adverse Events: Standardized Processes, Interdisciplinary Teamwork Training, and Performance Feedback

OBJECTIVE

To improve safety practices and reduce adverse events in perinatal units of acute care hospitals.

DATA SOURCES

Primary data collected from perinatal units of 14 hospitals participating in the intervention between 2008 and 2012. Baseline secondary data collected from the same hospitals between 2006 and 2007.

STUDY DESIGN

A prospective study involving 342,754 deliveries was conducted using a quality improvement collaborative that supported three primary interventions. Primary measures include adoption of three standardized care processes and four measures of outcomes.

DATA COLLECTION METHODS

Chart audits were conducted to measure the implementation of standardized care processes. Outcome measures were collected and validated by the National Perinatal Information Center.

PRINCIPAL FINDINGS

The hospital perinatal units increased use of all three care processes, raising consolidated overall use from 38 to 81 percent between 2008 and 2012. The harms measured by the Adverse Outcome Index decreased 14 percent, and a run chart analysis revealed two special causes associated with the interventions.

CONCLUSIONS

This study demonstrates the ability of hospital perinatal staff to implement efforts to reduce perinatal harm using a quality improvement collaborative. Findings help inform the relationship between the use of standardized care processes, teamwork training, and improved perinatal outcomes, and suggest that a multiplicity of integrated strategies, rather than a single intervention, may be essential to achieve high reliability.

Competency Skills Assessment: Successes and Areas for Improvement Identified During Collaboration Between Informaticists and a National Organization

The Association of periOperative Registered Nurses (AORN) approached the Nursing Informatics Research Team (NIRT) with a request to collaborate and conduct a competency assessment for their organization. An online tool was developed to determine current technology in perioperative settings. This presentation shares the process used to conduct research that led to a method for assessing perioperative nurses' competencies skills in their practice as well as identified gaps in curricula that faculty could address. Both successes and areas for improvement are detailed. The outcome of the process demonstrated a need to understand what skills are being assessed as AORN did not know what technology existed or how existing equipment was being used.