This study increases our understanding of organizational antecedent of bullying among nurses. Workplace bullying among nurses functions as a mediator between the majority of work climate dimensions and outcomes related to job satisfaction and work ability. Strategies to reduce bullying should look at the study finding and specifically job resources and job demands that influence bullying and nurse outcomes.
Purpose
The purpose of this study was to investigate if institutional stress is related to job performance among hospital employees, and if institutional stress is fully or partly mediated by motivational resources with regards to the relation with job performance.
Design/methodology/approach
A self-completion survey was distributed to four public hospitals in Norway, and had a response rate of 40% (N = 9,162). Structural equation modelling was conducted on two groups of hospital employees with (N = 795) and without (N = 8,367) managerial responsibilities.
Findings
Institutional stress was negatively related to job performance for hospital employees without managerial responsibilities. The motivational resources autonomy, competence development and social support partly mediated the relationship between institutional stress and job performance in the group of employees without managerial responsibilities. In the leader group, the motivational resources fully mediated the relationship between institutional stress and job performance. Social support from leaders had a non-significant influence on job performance in both groups.
Research limitations/implications
The main limitation with this study is its cross-sectional design.
Originality/value
The study enables us to extend how work-related stress is related to job performance and the mediating role of the job resources autonomy, competence development and social support. The focus on productivity, and top management’s wish to improve hospital performance, may have unintended consequences, leading to a gap between managerial and clinical worldviews and understanding of goals, policies, values and prioritizing. This can lead to institutional stress. The findings of this study suggest that institutional stress has negative effects on hospital employees’ work motivation and job performance.
Aim
To increase our understanding of challenges in implementing multidisciplinary organisational models in hospitals.
Background
Health‐service policies internationally are pushing for multidisciplinary and patient‐centred organising models but there are challenges involved in moving from profession‐ and discipline‐based organising to the new solutions.
Method
Qualitative case study, interview and document data collected in real time following the implementation process.
Results
It was possible to argue for and against the new department applying either a business‐like logic or a professional logic. The respective logics gave different prescriptions for how a hospital department should be organised.
Conclusion and Implications for Nursing Management
The institutional logics perspective enables managers to understand resistance to new ways of organising work and may be useful in trying to foresee and handle challenges in implementing new organisation models. Managers need to analyse models carefully in terms of which parts may be seen as problematic in their own organisation, and invite all relevant stakeholders into participatory change processes. If the goal is to gather multiple professions and disciplines under one manager in order to increase patient centredness, arrangements must be made for professionals to stay connected to the wider community of practice centred around their specialized knowledge and skills.
This single case study reports on the establishment of a multidisciplinary day care surgery at a Norwegian University Hospital utilising participating action research design principles drawn from sociotechnical theory. Data was collected through mixed methods including stakeholder analysis, document studies, observations of meetings, semi-structured interviews and participating group methods. The senior management at the hospital had decided to implement a department that diverged from organising around professional disciplines, and this decision evoked strong resistance among several professional groups in the first phases of this project. This case follows the implications of the decision to establish a multidisciplinary day care surgery through re-organising location, staff and management structures. The findings suggest that the hospital achieved the vision of creating an efficient multidisciplinary work environment, reducing the culture of tribalism between professions, and creating a work environment with a high degree of knowledge transfer. This case describes how action research can be used to reduce organisational silos and to improve multidisciplinary co-operation.
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