Functional diversity and team innovation: A study on the mediating role of social cohesion in primary care teams.

BACKGROUND: Bringing together professionals with different knowledge and skills comes with the opportunity to spur the innovativeness of primary care teams. Nevertheless, empirical evidence shows that it is not self-evident that these innovations are also realized. The social categorization theory suggests that a better understanding of whether these potential team innovations are realized can be obtained by looking at the social cohesion of such teams. PURPOSE: The aim of this study was to study the relationship between functional diversity and team innovation in primary care teams by examining the mediating role of social cohesion. METHODOLOGY: Survey responses and administrative data of 887 primary care professionals and 75 supervisors in 100 primary care teams were analyzed. Structural equation modeling was used to examine a curvilinear mediated relationship among functional diversity and team innovation through social cohesion. RESULTS: The findings show a positive relationship between social cohesion and team innovation as expected. Contrary to the expectations, the relationship between functional diversity and social cohesion is insignificant, and the results show an inverted U-shaped relationship between functional diversity and team innovation instead. CONCLUSIONS: This study reveals an unexpected inverted U-shaped relationship between functional diversity and team innovation. This relationship is not mediated by social cohesion; however, social cohesion is still a significant predictor of team innovation. PRACTICE IMPLICATIONS: Policymakers should be aware of the relevance as well as the complexity of creating social cohesion in functionally diverse primary care teams. As long as it remains unknown how social cohesion is stimulated in functionally diverse teams, it seems best for the team innovation to prevent bringing together too many, but also too few, different functions.

Changes in youth care use after the implementation of community-based support teams: repeated measurement study using registry data and data on team characteristics.

OBJECTIVES: New legislation on youth care in the Netherlands led to the implementation of community-based support teams, providing integrated primary youth care. Important aims of the new Youth Act were more integrated, timely care and less use of intensive forms of care. Our aim was to study changes in youth care use in time and the role of newly introduced community-based support teams herein. SETTING: Register data (2015-2018) on youth of a large city were linked and combined with administrative and aggregated data on team characteristics. PARTICIPANTS: Data on 126 095 youth (0-18 years) were available for analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary, specialised and residential youth care use were the primary outcomes. RESULTS: Generalised estimating equations analyses adjusted for individual characteristics demonstrated that over 4 years, use of primary youth care increased from 2.2% to 8.5% (OR 1.70; 99% CI 1.67 to 1.73), specialised youth care decreased from 7.2% to 6.4% (OR 0.98; 99% CI 0.97 to 1.00) and residential youth care increased slightly (OR 1.04; 99% CI 1.01 to 1.06). Gender, age, family status, migrant background and educational level were all associated with the types of youth care use and also with some trends in time. Likelihood to receive care increased in time for preschool and younger children but did not improve for migrant children.Case load, team size, team turnover, team performance and transformational leadership showed significant associations with different types of youth care use but hardly with trends in time. CONCLUSION: Patterns of youth care use changed towards more locally provided primary youth care, slightly less specialised and slightly more residential youth care. Furthermore, youth care use among younger children increased in time. These trends are partly in line with the trends intended by the Youth Act. Little evidence was found for the role of specific team characteristics on changes in youth care use in time.

Interprofessional teamwork in primary care: the effect of functional heterogeneity on performance and the role of leadership.

This study aimed to unravel the complexity of interprofessional teamwork in primary care teams by testing the relationship between functional heterogeneity and team performance through the mediating role of information elaboration, and the moderating roles of directive leadership and participative leadership. The moderated mediation model was validated using survey data from 1105 professionals and 97 supervisors in 143 Dutch primary care teams. The results confirmed the model and showed a significant negative effect of functional heterogeneity on information elaboration, which in turn had a positive effect on team performance. Both directive and participative leadership moderated the negative effect of functional heterogeneity on information elaboration to the extent that the indirect negative effect of functional heterogeneity on team performance became insignificant under high levels of either directive or participative leadership. The theoretical implications of these findings for the literature on healthcare, team diversity, and leadership, as well as the practical implications for policy makers, educationalists and managers of primary care teams, are discussed.

Towards sustainable local welfare systems: The effects of functional heterogeneity and team autonomy on team processes in Dutch neighbourhood teams.

Nowadays, many European countries delegate health and social care responsibilities from the national level to local authorities. In January 2015, the Netherlands similarly introduced a policy programme authorising municipalities to set their own social welfare policy. A specific feature of this programme is that it stimulates municipalities to implement teams wherein professionals from different disciplines are collectively responsible for a team's decision-making. This suggests that teams ideally have (a) high levels of functional heterogeneity (professionals from different disciplines) and (b) high levels of team autonomy (collective responsibility and decision-making). Based on the policy programme, it can be further assumed that (a) information elaboration, (b) boundary management and (c) team cohesion in teams will improve. In practice, the majority (87%) of Dutch municipalities implemented neighbourhood teams in January 2015. A common feature of these neighbourhood teams is that the various professionals are collectively responsible for all the curative and preventive healthcare, social work and voluntary social support of the citizens in a specific neighbourhood. Nevertheless, the structure and organisation of neighbourhood teams (including the level of functional heterogeneity and team autonomy) vary within and between municipalities. Given this situation, our aim was to examine to what extent functional heterogeneity and team autonomy influence information elaboration, boundary management and team cohesion in neighbourhood teams. We developed six hypotheses based on literature that were then tested on data collected (between May 2016 and January 2017) through an online survey from 1335 professionals in 170 neighbourhood teams. An SEM analysis showed a positive effect of team autonomy on information elaboration, boundary management and team cohesion. Results further showed a negative effect of functional heterogeneity on information elaboration and boundary management. The implications of these findings for practitioners and academics are discussed.

The Effects of Leadership and Job Autonomy on Vitality: Survey and Experimental Evidence.

Vitality refers to the experience of having energy available to one's self. Vital employees are full of positive energy when they work, and feel mentally and physically strong. Such employees often show higher job performance and lower stress than their less vital colleagues. Despite the importance of vitality, few public administration studies have studied vitality. More generally, by focusing on vitality, we aim to bring a "positive psychology" perspective into the domain of public administration. We analyze whether two important job characteristics (leader's task communication and job autonomy) affect vitality. We use a multi-method design. A large-scale survey (N = 1,502) shows that leader's task communication and job autonomy are positively related to vitality. A lab experiment (N = 102) replicated these findings, showing cause-and-effect relationships. In conclusion, public organizations can potentially increase employee vitality (a) by increased task communication from leaders and (b) by providing employees with greater job autonomy.

Work-Family Conflict Among Employees and the Self-Employed Across Europe.

This article examines the level of work-family conflict of self-employed persons, a changing but neglected group in work-life research, compared to employees in Europe. Differences between the two groups are explained by looking at job demands and resources. The inclusion of work-family state support makes it possible to examine differences between countries. Multilevel analysis has been applied to data from the European Social Survey (ESS 2010). The results show that job demands and resources operate differently for employees and the self-employed. The relationship between employment type and WFC is mediated mainly by job demands such as working hours, working at short notice, job insecurity and supervisory work. The results also reveal variation across countries that cannot be explained by state support, signalling the need for a more complete understanding of WFC from a cross-national perspective.

Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations.

BACKGROUND: In recent years, the high prevalence of mental health problems among health care workers has given rise to great concern. The academic literature suggests that employees' perceptions of their work environment can play a role in explaining mental health outcomes. PURPOSES: We conducted a systematic review of the literature in order to answer the following two research questions: (1) how does organizational climate relate to mental health outcomes among employees working in health care organizations and (2) which organizational climate dimension is most strongly related to mental health outcomes among employees working in health care organizations? METHODOLOGY/APPROACH: Four search strategies plus inclusion and quality assessment criteria were applied to identify and select eligible studies. As a result, 21 studies were included in the review. Data were extracted from the studies to create a findings database. The contents of the studies were analyzed and categorized according to common characteristics. FINDINGS: Perceptions of a good organizational climate were significantly associated with positive employee mental health outcomes such as lower levels of burnout, depression, and anxiety. More specifically, our findings indicate that group relationships between coworkers are very important in explaining the mental health of health care workers. There is also evidence that aspects of leadership and supervision affect mental health outcomes. Relationships between communication, or participation, and mental health outcomes were less clear. PRACTICAL IMPLICATIONS: If health care organizations want to address mental health issues among their staff, our findings suggest that organizations will benefit from incorporating organizational climate factors in their health and safety policies. Stimulating a supportive atmosphere among coworkers and developing relationship-oriented leadership styles would seem to be steps in the right direction.

HRM and its effect on employee, organizational and financial outcomes in health care organizations.

BACKGROUND: One of the main goals of Human Resource Management (HRM) is to increase the performance of organizations. However, few studies have explicitly addressed the multidimensional character of performance and linked HR practices to various outcome dimensions. This study therefore adds to the literature by relating HR practices to three outcome dimensions: financial, organizational and employee (HR) outcomes. Furthermore, we will analyze how HR practices influence these outcome dimensions, focusing on the mediating role of job satisfaction. METHODS: This study uses a unique dataset, based on the 'ActiZ Benchmark in Healthcare', a benchmark study conducted in Dutch home care, nursing care and care homes. Data from autumn 2010 to autumn 2011 were analyzed. In total, 162 organizations participated during this period (approximately 35% of all Dutch care organizations). Employee data were collected using a questionnaire (61,061 individuals, response rate 42%). Clients were surveyed using the Client Quality Index for long-term care, via stratified sampling. Financial outcomes were collected using annual reports. SEM analyses were conducted to test the hypotheses. RESULTS: It was found that HR practices are - directly or indirectly - linked to all three outcomes. The use of HR practices is related to improved financial outcomes (measure: net margin), organizational outcomes (measure: client satisfaction) and HR outcomes (measure: sickness absence). The impact of HR practices on HR outcomes and organizational outcomes proved substantially larger than their impact on financial outcomes. Furthermore, with respect to HR and organizational outcomes, the hypotheses concerning the full mediating effect of job satisfaction are confirmed. This is in line with the view that employee attitudes are an important element in the 'black box' between HRM and performance. CONCLUSION: The results underscore the importance of HRM in the health care sector, especially for HR and organizational outcomes. Further analyses of HRM in the health care sector will prove to be a productive endeavor for both scholars and HR managers.