Organizational trust, employee commitment and job satisfaction in Turkish hospitals: implications for public policy and health.

BACKGROUND: Understanding relationships between factors that can affect organizational outcomes such as organizational trust, employee commitment and job satisfaction is important to foster healthy work conditions in organizations. AIMS: This study aimed to determine the perception of Turkish physicians about organizational trust, employee commitment and job satisfaction and determine the relationships between them. METHODS: A questionnaire was developed based on three standard survey instruments and given to 1679 doctors in four training and research hospitals in Istanbul, Turkey, in 2013. The Pearson correlation coefficient was calculated and regression analyses were conducted. RESULTS: A total of 304 doctors completed the survey (18.1% response rate). Most were males (57%), over 30 years old (62%) and specialists (82%). A strong positive correlation was found among the study variables (P ≤ 0.001). Regression analyses indicated that organizational trust was a significant predictor of job satisfaction and commitment. CONCLUSIONS: Policy-makers need to consider implementing interventions in the health care system to improve the working conditions of current and future doctors in Turkey, in order to attract and retain them and prevent health care labour force losses.

Perceptions of physicians about knowledge sharing barriers in Turkish health care system.

This study was based on knowledge sharing barriers about attitudes of physicians in Turkish health care system. The present study aims to determine whether the knowledge sharing barriers about attitudes of physicians vary depending on gender, position, departments at hospitals, and hospital ownership status. This study was planned and conducted on physicians at one public hospital, one university hospital, and one private hospital in Turkey. 209 physicians were reached for data collection. The study was conducted in June-September 2014. The questionnaire (developed by A. Riege, (J. Knowl. Manag. 9(3):18-35, 2005)), five point Likert-type scale including 39 items having the potential of the physicians' knowledge- sharing attitudes and behaviors, was used in the study for data collection. Descriptive statistics, reliability analysis, student t test and ANOVA were used for data analysis. According to results of this study, there was medium level of knowledge sharing barriers within hospitals. In general, physicians had perceptions about the lowest level individual barriers, intermediate level organizational barriers and the highest level technological barriers perceptions, respectively. This study revealed that some knowledge sharing barriers about attitudes of physicians were significantly difference according to hospital ownership status, gender, position and departments. Most evidence medical decisions and evidence based practice depend on experience and knowledge of existing options and knowledge sharing in health care organizations. Physicians are knowledge and information-intensive and principal professional group in health care context.

Nurses' views on electronic medical records (EMR) in Turkey: an analysis according to use, quality and user satisfaction.

Electronic medical records are generally used by nurses in hospitals. However, studies investigating views on and evaluations of electronic medical records by nurses are limited in Turkey and in other countries around the world. Thus, in this study, nurses' views on electronic medical record systems will be investigated in terms of use, quality and user satisfaction. Our goal was to investigate the views on electronic medical records used by nurses working at hospital clinics (inpatient care units). Moreover, in this study, we will examine whether there are relationships among the use, quality and user satisfaction of electronic medical records. This study is composed of field research conducted using questionnaires. To prepare the data-measuring instrument, the literature on electronic medical records was reviewed. In addition, during the pilot run of the questionnaire, some revisions were made to the measuring instrument to account for the views of nurse managers in the field. The questionnaire consists of 35 items: 12 items for use, 12 items for quality and 11 items for user satisfaction. A Likert scale type was used in this questionnaire. Responses for usage and quality were assigned a value of 1-5 ('never/almost never/not at all' to 'always/almost always') for each item. Responses for user satisfaction were assigned a value of 1-5 ('not at all', to 'very great') for each item. The study was planned and conducted on nurses working at inpatient care units at one public university hospital, one Turkish Ministry of Health hospital and one private hospital in Kocaeli. A sampling technique was not used because we aimed to conduct the questionnaire among all nurses. At the end of this study, the questionnaire had been conducted on 200 nurses. We found that the average score for the nurses' satisfaction with electronic medical records was 3.28, the average score for using electronic medical records was 1.96, and the average score for the quality of electronic medical records was 3.16. We also determined that there are significant relationships among the use, quality and user satisfaction of electronic medical records. This study revealed that there are significant differences among the mean quality scores for the EMR systems in the Ministry of health hospital, the university hospital and the private hospital. Interestingly, 59.0% of all participants in this study felt that EMR systems were not well integrated into their workflow. In addition, half of all respondents had not been trained in using EMR systems.

The factors affecting length of stay of the patients undergoing appendectomy surgery in a military teaching hospital.

The principal objectives of this study were to identify the main predictors of the length of postoperative hospital stay for patients undergoing appendectomy in a military training hospital in Turkey, to examine the effects of each significant predictor, and to justify to hospital health care managers the reasons why an increase in effective use of hospital utilization resources is needed and so important. This study gives the results of a 2-year retrospective study conducted at Gulhane Military Medical Academy between January 2003 and January 2005. The medical files of 417 patients undergoing appendectomy during this 2-year period were reviewed. A number of demographic and clinical patient characteristics were examined to determine their significance in lengthening the post-operative and total hospital stay. After taking all demographic and clinical patient characteristics into account, it was determined that those patients who were temporary or short-term service members and whose medical complications were more severe were more likely to stay in the hospital for longer periods. Despite its limitations, the study reveals that factors affecting variations in resource utilization can be minimized by following very simple administrative procedures. Furthermore, the results could increase awareness among hospital managers of the significant factors involved for health care providers in modifying their behavior concerning resource utilization decisions.