Decisional involvement of senior nurse leaders in Canadian acute care hospitals

Wong, Carol; Laschinger, Heather K. Spence; Cummings, Greta G.; Vincent, Leslie; O'Connor, Patty

doi:10.1111/j.1365-2834.2010.01053.x

Cited by 11 publications

(25 citation statements)

References 35 publications

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“…Participation in decision making (PDM) by workers, including all types of nurses, is recognized internationally as an important aspect of effective management in nursing and healthcare [1–5]. Prior researchers, however, have noted deficiencies in the conceptualization of PDM [5, 6].…”

Section: Introductionmentioning

confidence: 99%

“…Prior researchers, however, have noted deficiencies in the conceptualization of PDM [5, 6]. Two factors, little consensus as to its specific meaning [7] and various definitions [8], contribute to inconsistent findings regarding outcomes of participation.…”

Section: Introductionmentioning

confidence: 99%

“…Two factors, little consensus as to its specific meaning [7] and various definitions [8], contribute to inconsistent findings regarding outcomes of participation. These deficiencies may stem from a simplistic view of PDM [4, 5, 9–12], typically measured at the individual level, ignoring systems-level properties.…”

Section: Introductionmentioning

confidence: 99%

“…Emerging properties are generated by local interactions [15] and are particularly important for organizational adaption in complex, chaotic environments, such as the health care environment [16]. Participation emerges as nursing staff and managers of varying expertise and values interact at the local level through a variety of means (e.g., chance encounters, informal meetings, and committee structures) in making formal and informal decisions [5, 11, 12, 17–19]. The purpose of this paper is to (1) describe a measure of PDM as a systems-level property of complex adaptive systems and (2) present empirical evidence of the reliability and validity of the measure using data from two independent studies.…”

Section: Introductionmentioning

confidence: 99%

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Participation in Decision Making as a Property of Complex Adaptive Systems: Developing and Testing a Measure

Anderson

Plowman

Corazzini

et al. 2013

Nursing Research and Practice

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Objectives. To (1) describe participation in decision-making as a systems-level property of complex adaptive systems and (2) present empirical evidence of reliability and validity of a corresponding measure. Method. Study 1 was a mail survey of a single respondent (administrators or directors of nursing) in each of 197 nursing homes. Study 2 was a field study using random, proportionally stratified sampling procedure that included 195 organizations with 3,968 respondents. Analysis. In Study 1, we analyzed the data to reduce the number of scale items and establish initial reliability and validity. In Study 2, we strengthened the psychometric test using a large sample. Results. Results demonstrated validity and reliability of the participation in decision-making instrument (PDMI) while measuring participation of workers in two distinct job categories (RNs and CNAs). We established reliability at the organizational level aggregated items scores. We established validity of the multidimensional properties using convergent and discriminant validity and confirmatory factor analysis. Conclusions. Participation in decision making, when modeled as a systems-level property of organization, has multiple dimensions and is more complex than is being traditionally measured. Managers can use this model to form decision teams that maximize the depth and breadth of expertise needed and to foster connection among them.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Participation in Decision Making as a Property of Complex Adaptive Systems: Developing and Testing a Measure

Anderson

Plowman

Corazzini

et al. 2013

Nursing Research and Practice

View full text Add to dashboard Cite

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“…Disciplinary leaders inspire people and positively influence organizational culture through their expected leadership behavior and practices (19) , especially in this model. These leaders try to engage employees; they …”

Section: Symbolic Framementioning

confidence: 99%

Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital

Bernardes

Cummings

Évora

et al. 2012

Rev. Latino-Am. Enfermagem

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Objective: This study aims to address difficulties reported by the nursing team during the process of changing the management model in a public hospital in Brazil. Methods: This qualitative study used thematic content analysis as proposed by Bardin, and data were analyzed using the theoretical framework of Bolman and Deal. Results: The vertical implementation of Participatory Management contradicted its underlying philosophy and thereby negatively influenced employee acceptance of the change. The decentralized structure of the Participatory Management Model was implemented but shared decision-making was only partially utilized. Despite facilitation of the communication process within the unit, more significant difficulties arose from lack of communication inter-unit. Values and principals need to be shared by teams, however, that will happens only if managers restructure accountabilities changing job descriptions of all team members. Conclusion: Innovative management models that depart from the premise of decentralized decision-making and increased communication encourage accountability, increased motivation and satisfaction, and contribute to improving the quality of care. The contribution of the study is that it describes the complexity of implementing an innovative management model, examines dissent and intentionally acknowledges the difficulties faced by employees in the organization. Enmarcando las dificultades de la aplicación del Modelo de Gestión Participativa en un hospital públicoObjetivo: El estudio tiene como objetivo tratar de las dificultades del equipo de enfermería durante el cambio del modelo de gestión en un hospital público en Brasil. Método: Este estudio cualitativo utilizó el análisis de contenido temático propuesto por Bardin; los datos fueron analizados utilizando el marco teórico de Bolman y Deal. Resultados: La aplicación vertical de la Gestión Participativa, en contradicción con su filosofía, incide negativamente en la aceptación del cambio por los empleados. La estructura descentralizada se llevó a cabo, pero la toma de decisiones compartida se utilizó sólo en parte. Aunque existe facilitación de la comunicación dentro de la unidad, dificultades surgieron de la falta de comunicación inter-unidades.Valores y principios deben ser compartidos por los equipos; esto sólo ocurre si los gerentes reestructurar las responsabilidades y describir las funciones de todos. Conclusión: Modelos innovadores de gestión que tienen como premisa la descentralización de las decisiones y una mayor comunicación fomentan la motivación, la responsabilidad, aumento de la satisfacción, y mejoran la calidad de la atención. La contribución de este estudio se centra en la complejidad de la implementación de una gestión innovadora, el análisis de disenso e intencionadamente en el reconocimiento de dificultades que enfrentan los empleados de la organización. in this context occasionally distance themselves from the care provided to patients. This can work against the nurses' role as professional practitioners who int...

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