Impact of culture on commitment, satisfaction, and extra-role behaviors among Canadian ER physicians.

PURPOSE: The purpose of this paper is to explore the impact of hospital emergency department culture on the job satisfaction, patient commitment, and extra-role performance of Canadian emergency physicians. The conceptual model related four cultural archetypes from the competing valued model to the three outcome variables. DESIGN/METHODOLOGY/APPROACH: In total, 428 Canadian emergency physicians responded to a national survey. The conceptual model was tested via structural equation modeling via LISREL 8. FINDINGS: Culture had a relatively weak impact on the outcomes. Human resources culture related positively to job satisfaction while bureaucratic culture related positively to patient commitment. Patient commitment, but not job satisfaction strongly and positively related to extra-role behavior. A direct relationship between entrepreneurial culture and extra-role behavior emerged from an extended analysis. PRACTICAL IMPLICATIONS: Organizational culture seems to have more distal relationships with outcome variables and its influence is likely to be mediated by more proximal workplace variables. ORIGINALITY/VALUE: Of value by showing that a key modern leadership challenge is to create the kind of work culture that can become a source of competitive advantage through generating particular organizational outcomes valued by stakeholders.

Impact of human resource management practices on nursing home performance.

Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain optimal organizational performance.

Managing the consequences of hospital cutbacks: the role of workforce reduction practices.

In recent years, hospitals in Canada as elsewhere have witnessed unprecedented downsizing of their workforces. It is generally assumed that planned workforce reductions can have deleterious consequences on an organization's human resources. Scholars and practitioners alike have identified a number of humane or progressive approaches that are widely considered to be effective for organizations undergoing downsizing. This study examines the impact that workforce reduction approaches have on perceptions of organizational performance in a large sample of Canadian hospitals undergoing workforce reductions.

Managing the clinic wait: an important quality of care challenge.

Patients spend a substantial amount of time in clinics waiting for services to be delivered by nursing and other allied health professionals. The degree to which health consumers are satisfied with the care received is strongly related to the quality of the wait experience. Health care organizations that strive to deliver exceptional service must effectively manage their clinic wait. Failure to incorporate consumer-driven features into the design of the wait experience will lead to patient and provider dissatisfaction.

Total quality commitment and performance in Canadian health care organisations.

Although many organisations have in recent years installed TQ programs, many have been unable to realize significant performance enhancements. Results from a diverse sample of Canadian health care organisations suggest that merely having a TQ program is insufficient for attaining selected performance improvements. Health care organisations which have both a formal TQ program and a deep commitment to quality improvement are perceived to perform better on a number of valued outcomes.

Constructive performance appraisal feedback for healthcare employees.

For their own reasons, both healthcare managers and employees dislike performance evaluation interviews. Managers would rather avoid the role of appraiser, and employees often dispute the accuracy of their assessments. The resulting poorly handled interview often resembles a power struggle more than a performance review. This article describes several interview formats that might be appropriate to certain situations and advocates training for managers who must conduct performance evaluation interviews.

Sexual harassment: guidelines for laboratory managers.

Sexual harassment can poison a work environment, create legal problems, and cause productivity to suffer. Excellent clinical laboratories recognize its potentially disruptive effects and develop proactive strategies to deal with sexual harassment while enacting policies that prevent its occurrence. This article outlines steps to be taken when sexual harassment is alleged. A sample organizational policy on sexual harassment is also included.