Patient safety is the core goal of medical institutions. The present study focuses on the patient safety culture and staff well-being admit the COVID-19 pandemic. In a large metropolitan hospital group, 337 employees who had participated in the quality improvement interventions completed an anonymous questionnaire of patient safety culture and personal well-being. The multiple regression analyses indicated that managerial role, seniority, female gender and direct contact with a patient were significantly related to the positive attitude on overall or certain dimensions of safety culture. Multivariate analysis also found that dimensions of teamwork climate, safety climate, job satisfaction and stress recognition as patient safety culture predicted staff exhaustion. Finally, comparing with the available institutional historic data in 2018, the COVID group scored higher on the working condition dimension of patient safety culture, but lower on the stress recognition dimension. The COVID group also scored higher on exhaustion. In the post-pandemic era, there seems to be an improvement on certain aspect of the patient safety culture among hospital staff, and the improvement is more prevalent for managers. However, exhaustion is also a poignant problem for all employees. These findings can inform hospital decision-makers in planning and implementing future improvements of patient safety culture and promoting employee well-being and resilience. Our findings also reveal directions for future research.
The present study examines the relationship between patient safety culture and health workers’ well-being. Applying the conservation of resources mechanism, we tested theory-based hypotheses in a large cross-disciplinary sample (N = 3232) from a Taiwanese metropolitan healthcare system. Using the structural equation modeling technique, we found that patient safety culture was negatively related to staff burnout (β = −0.74) and could explain 55% of the total variance. We also found that patient safety culture was positively related to staff work–life balance (β = 0.44) and could explain 19% of the total variance. Furthermore, the above relationships were invariant across groups of diverse staff demography (gender, age, managerial position, and incident reporting) and job characteristics (job role, tenure, and patient contact). Our findings suggest that investing in patient safety culture can be viewed as building an organizational resource, which is beneficial for both improving the care quality and protecting staff well-being. More importantly, the benefits are the same for everyone in the healthcare services.
The aim of this study was to test the flow from long working hours to sickness presenteeism behavior and its outcomes for employees, while integrating intrinsic and extrinsic work value orientations as moderators in the process. We employed a two-wave design with a five-month interval. Data were obtained from 275 employees in Taiwan. The results of latent moderated structural equations (LMS) revealed that long working hours were positively associated with presenteeism, which in turn was negatively related to employees’ well-being and job performance. Furthermore, the negative indirect effect of working long hours on job performance via presenteeism was weaker for those with a higher intrinsic work value orientation. The negative indirect effect of working long hours on well-being via presenteeism was weaker for those with a higher extrinsic work value orientation. We demonstrated that the long-term impact of presenteeism behavior could be understood by viewing work value orientations as resource gains to compensate resource depletion in a demanding work context. This resource dynamism is pivotal to realizing the functional or dysfunctional outcomes of presenteeism behavior. Theoretical and managerial implications of the findings for employees’ well-being and organizational effectiveness are discussed.
This study tested a cross-level moderated mediation model depicting the dynamism of individual resource loss through sickness presenteeism precipitated by long working hours and resource gain from group-level team support and the consequent effect on turnover intention over time. Employing a two-wave survey with 4 months in between, data were obtained from 294 nurses (37 teams) working in 12 hospitals across Taiwan. The hierarchical linear modeling analyses revealed that presenteeism partially mediated the effects of working long hours on later turnover intention. Moreover, group-level team support moderated the presenteeism-turnover linkage. Specifically, the damaging effect of working while ill on heightenedturnover intention was drastically attenuated for those with high team support. Our cross-level moderated mediation model has thus identified team support as a viable resource that can alleviate the damages of working in precarious conditions and help hospitals to retain nurses. We discussed the theoretical and managerial implications of our findings in the context of resource loss and gain, especially when stress and burnout are highly prevalent for the health care professions in the postpandemic era.
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