Background Several technological innovations have been introduced in healthcare over the years, and their implementation proved crucial in addressing challenges of modern health. Healthcare workers have frequently been called upon to become familiar with technological innovations that pervade every aspect of their profession, changing their working schedule, habits, and daily actions. Purpose An in-depth analysis of the paths towards the acceptance and use of technology may facilitate the crafting and adoption of specific personnel policies taking into consideration definite levers, which appear to be different in relation to the age of nurses. Approach The strength of this study is the application of UTAUT model to analyse the acceptance of innovations by nurses in technology-intensive healthcare contexts. Multidimensional Item Response Theory is applied to identify the main dimensions characterizing the UTAUT model. Paths are tested through two stage regression models and validated using a SEM covariance analysis. Results The age is a moderator for the social influence: social influence, or peer opinion, matters more for young nurse. Conclusion The use of MIRT to identify the most important items for each construct of UTAUT model and an in-depth path analysis helps to identify which factors should be considered a leverage to foster nurses’ acceptance and intention to use new technologies (o technology-intensive devices). Practical implications Young nurses may benefit from the structuring of shifts with the most passionate colleagues (thus exploiting the social influence), the participation in ad hoc training courses (thus exploiting the facilitating conditions), while other nurses could benefit from policies that rely on the stressing of the perception of their expectations or the downsizing of their expectancy of the effort in using new technologies.

PurposeUser experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.Design/methodology/approach65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.FindingsPatients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.Research limitations/implicationsDifferent features referring to different nursing models make the difference in producing an excellent user experience with the service.Practical implicationsThese findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.Originality/valueThis is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.Highlights This is one of the first studies on the relationship between provision models of nursing care and patient experience.Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

This paper addresses the evaluation of nursing quality and safety beyond nursing tasks in specific healthcare settings and sets it in a context that conveys the sense of complexity and multifaceted nature of the contribution that nursing makes to the whole system. The paper describes research conducted in Tuscany during 2019 involving regional managers and heads of nursing departments. This research has led to the development of an integrated evaluation framework through focus groups and consensus process with the latter, which includes Performance Organizational climate data, Patient-Reported Experience Measures (PREMs), and Patient-Reported Outcome Measures (PROMs). This integrated framework aims at both making sense of extant measures as key performance indicators shared among different professionals while recognizing the important role of nursing care by adding specific measures and can be seen as a tool that boosts the sense of “teamness” in healthcare.

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Background Nurses’ perception towards job satisfaction and willingness to recommend their workplace are relevant to a number of areas including the quality of nursing care delivery. Hence, an increasing number of scholars seek to understand the factors that influence these two concepts. Yet, inclusiveness and openness to innovation are under-investigated. Purpose The paper focuses on the relative importance that factors like propensity towards innovation, working conditions and inclusion have on nurses’ job satisfaction and their willingness to recommend their workplace. Methods A large sample of nurses was extracted from the organizational climate survey carried out in all healthcare authorities of nine Italian Regions through the years 2016–2018. Descriptive and multilevel regressions were carried out to investigate the factors that influence nurses’ job satisfaction and their willingness to recommend the hospital in which they work in, analysing both overall and in specific age classes. Results When recommending a workplace, nurses tend to recommend units showing higher propensity to innovate (OR 2.83), while the most important factor related to job satisfaction is the encouragement after a failure (OR 2.23). Inclusiveness is a key factor for both job satisfaction and willingness to recommend, whilst innovation prone organizations appear to be the most attractive for nurses. The levers mix is slightly different among the age classes. Findings identify the levers to be used in order to attract nurse workforce and increase nurses’ job satisfaction. These levers are partially different for young and senior nurses.

Barchielli, Chiara 2020 The designing of an evaluation and monitoring system of the primary care services reorganization in Tuscany through the process of implementation of the "family and community nurse" (FCN) care model: the case

The concept of job satisfaction positively correlates with many areas investigated by the organizational climate. We focused on nurses’ perception towards job satisfaction, as it is relevant regarding nursing care delivery’s quality, which is directly linked to patients’ safety. Additionally, we provide a measure of the relative importance that each investigated factor has on nurses’ job satisfaction and their willingness to recommend the organization they work in to other professionals. A validated census survey was administered in eight different Italian Regions. A total of 35.156 observations were the object of different analysis preformed using STATA. The questions/statements were Likert scaled from 1 to 5 and were compared to the exposure one “I am satisfied with my work in my structure/unit”. The research population has an average age of 47 years (females 80.36% ,men are 19.64%) and men are more satisfied than women with their work. There are various factors that impact the area of “job satisfaction” with different importance (all statistically significant): feeling of encouragement to react after the experience of a failure (OR 2.23), empowerment over quality job results (OR 1.68), sustainable work pace (OR 1.47), firm’s propensity towards innovation (OR 1.36), and experience discomfort while working (OR 1.05). Other factors impacted the area “I would recommend to a colleague to work in my firm” with different importance (all statistically significant). These factors include: firm’s propensity towards innovation (OR 2.84), feeling of encouragement to react after the experience of a failure (OR 1.43), sustainable work pace (OR 1.32), empowerment over quality job results (OR 1.31), experience discomfort while working (OR 1.02). The two most important levers, innovation and inclusion can be beneficial to improve workforce experience and care delivery. Managerial implications: data can show which levers to use in order to achieve the most desired goals. Key messages nurses’ perception towards job satisfaction is relevant regarding nursing care delivery’s quality, which is directly linked to patients’ safety. Innovation and inclusion can be beneficial to improve workforce experience and care delivery.

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