Flaws and all: How mindfulness reduces error hiding by enhancing authentic functioning.

Hiding errors can undermine safety by amplifying the risks of undetected errors. This article extends research on occupational safety by investigating error hiding in hospitals and applies self-determination theory to examine how mindfulness decreases error hiding through authentic functioning. We examined this research model in a randomized control trial (mindfulness training vs. active control group vs. waitlist control group) within a hospital setting. First, we used latent growth modeling to confirm that our variables were related as hypothesized, both statically or cross-sectionally as well as dynamically as they evolved over time. Next, we analyzed whether changes in these variables were a function of the intervention and confirmed the effects of the mindfulness intervention on authentic functioning and indirectly on error hiding. To elaborate on the role of authentic functioning, in a third step, we qualitatively explored the phenomenological experience of change experienced by participants in mindfulness and Pilates training. Our findings reveal that error hiding is attenuated because mindfulness encourages a receptive view of one's whole self, and authentic functioning enables an open and nondefensive way of relating to positive and negative information about oneself. These results add to research on mindfulness in organizations, error hiding, and occupational safety. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

How team averages in authentic living and perspective-taking personalities relate to team information elaboration and team performance.

Is it wise to be authentic, that is, to express your inner thoughts and feelings, in a team context? Although authenticity can be argued to benefit teamwork as authentic team members contribute their unique perspectives, it can also hinder teamwork if those unique perspectives are not heard and integrated. Using theory on groups as information processors, we propose that when team members both contribute their own unique perspectives (team mean authentic living), and try to understand each other's contributions (team mean perspective taking), a process of information elaboration occurs at the team level, which in turn leads to team performance. Study 1 tested these assumptions in 67 teams of students (N = 247), whereas Study 2 used 37 teams of employees (N = 194). Results support the hypothesized interaction between team mean authentic living and team mean perspective taking on team information elaboration such that the effects were positive when perspective taking was high but negative when it was low. In terms of team performance, although team information elaboration consistently predicted team performance in both studies, Study 1 could not confirm the hypothesized indirect effects, whereas Study 2 confirmed only the hypothesized positive indirect effect. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

From microscopic to macroscopic perspectives and back: The study of leadership and health/well-being.

This special issue introduces a set of papers that contribute to research on leadership and health/well-being from multiple perspectives. To situate these papers in current research debates, this introduction to the special issue provides an overview of research on leadership and health/well-being by using a microscope-macroscope perspective as an organizing framework. The microscope-macroscope organizing framework highlights that a comprehensive understanding of leadership and well-being requires researchers to consider multiple perspectives, including those of leaders and followers, embedded in their context and time. It encourages researchers to transcend more narrow input-process-output perspectives that are typically adopted when studying leadership and health/well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Role of Individual and Collective Mindfulness in Promoting Occupational Safety in Health Care.

Although the importance of safety regulations is highly emphasized in hospitals, nurses frequently work around, or intentionally bypass, safety regulations. We argue that work-arounds occur because adhering to safety regulations usually requires more time and work process design often lacks complementarity with safety regulations. Our main proposition is that mindfulness is associated with a decrease in occupational safety failures through a decrease in work-arounds. First, we propose that individual mindfulness may prevent the depletion of motivational resources caused by worrying about the consequences of time lost when adhering to safety regulations. Second, we argue that collective mindfulness may provide nursing teams with a cognitive infrastructure that facilitates the detection and adaptation of work processes. The results of a multilevel analysis of 580 survey responses from nurses are consistent with our propositions. Our multilevel analytic approach enables us to account for the unique variance in work-arounds that individual and collective mindfulness explain.

Issues in researching leadership in health care organizations.

PURPOSE: We provide a review of the research in this volume and suggest avenues for future research. DESIGN/METHODOLOGY/APPROACH: Review of the research in this volume and unstructured interviews with health care executives. FINDINGS: We identified the three central themes: (1) trust in leadership, (2) leading by example, and (3) multi-level leadership. For each of these themes, we highlight the shared concerns and findings, and provide commentary about the contribution to the literature on leadership. RESEARCH IMPLICATIONS: While relation-oriented leadership is important in health care, there is a danger of too much emphasis on relations in an already caring profession. Moreover, in most health care organizations, leadership is distributed and scholars need to adopt the appropriate methods to investigate these multi-level phenomena. PRACTICAL IMPLICATIONS: In health care organizations, hands-on leadership, through role modeling, may be necessary to promote change. However, practicing what you preach is not as easy as it may seem. VALUE/ORIGINALITY: We provide a framework for understanding current research on leadership in health care organizations.

Living up to safety values in health care: the effect of leader behavioral integrity on occupational safety.

While previous research has identified that leaders' safety expectations and safety actions are important in fostering occupational safety, research has yet to demonstrate the importance of leader alignment between safety expectations and actions for improving occupational safety. We build on safety climate literature and theory on behavioral integrity to better understand the relationship between the leader's behavioral integrity regarding safety and work-related injuries. In a time-lagged study of 658 nurses, we find that behavioral integrity for high safety values is positively associated with greater reporting of fewer and less severe occupational injuries. The effects of behavioral integrity regarding safety can be better understood through the mediating mechanisms of safety compliance and psychological safety toward one's supervisor. We discuss the implications of our findings for future research on safety climate.

Workforce implications of injury among home health workers: evidence from the National Home Health Aide Survey.

PURPOSE OF STUDY: The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH) Organization of Work and Occupational Safety and Health framework is used to examine (a) relationships between injuries and work outcomes as reported by home health aides (HHAs) and (b) the likely efficacy of employee training and supervisor support in reducing worker risk for injury. DESIGN AND METHODS: Data for this analysis were drawn from the 2007 National Home Health Aide Survey, a nationally representative survey. Ordinary least squares regression and multinomial logistic regression were used to examine relationships between worker injury and (a) worker outcomes and (b) organizational outcomes and to examine ratings of training and supervisory support relative to risk of injury. RESULTS: Injured aides had lower job satisfaction, higher turnover intent, and poor employment and care quality perceptions. HHA perceptions of poor training and poor supervisory support were significantly related to higher risk for workplace injuries. IMPLICATIONS: The current study suggests that workplace training has an important role in helping reduce direct care worker injuries, thereby decreasing organizational expenses related to injury, such as workers' compensation, sick time, and turnover. The NIOSH Organization of Work and Occupational Safety and Health framework offers a mechanism by which occupational health and safety interventions may be derived to reduce incidents of injury.

Behavioral integrity for safety, priority of safety, psychological safety, and patient safety: a team-level study.

This article clarifies how leader behavioral integrity for safety helps solve follower's double bind between adhering to safety protocols and speaking up about mistakes against protocols. Path modeling of survey data in 54 nursing teams showed that head nurse behavioral integrity for safety positively relates to both team priority of safety and psychological safety. In turn, team priority of safety and team psychological safety were, respectively, negatively and positively related with the number of treatment errors that were reported to head nurses. We further demonstrated an interaction effect between team priority of safety and psychological safety on reported errors such that the relationship between team priority of safety and the number of errors was stronger for higher levels of team psychological safety. Finally, we showed that both team priority of safety and team psychological safety mediated the relationship between leader behavioral integrity for safety and reported treatment errors. These results suggest that although adhering to safety protocols and admitting mistakes against those protocols show opposite relations to reported treatment errors, both are important to improving patient safety and both are fostered by leaders who walk their safety talk.