Nursing Work Redesign in Response to Managed Care

Hoover, Kim

doi:10.1097/00005110-199811000-00006

Cited by 7 publications

(6 citation statements)

References 32 publications

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“…35,37 Our results show that most respondents experienced job satisfaction. This is consistent with some earlier results, 15,20,23,[27][28][29] but some of the results showed a decrease in job satisfaction. 6,7 The communication of the staff members and the length of the work experience improved job satisfaction.…”

Section: Discussionsupporting

confidence: 93%

“…19 Job satisfaction refers to perceptions and attitudes that staff members have regarding their work. 6,15,19,21,23,[27][28][29] Staff members have been found to appreciate the support they receive from their colleagues. 24,29 However, staff members have expected organizational support and resources 16,17,20,22,23 in order to do their jobs.…”

Section: Work Empowerment During Organizational Changementioning

confidence: 99%

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Work empowerment in multidisciplinary teams during organizational change

Rankinen¹,

Suominen²,

Kuokkanen³

et al. 2009

Int J of Nursing Practice

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Rankinen S, Suominen T, Kuokkanen L, Kukkurainen ML, Doran DI. International Journal of Nursing Practice 2009; 15:403-416 Work empowerment in multidisciplinary teams during organizational change Conducted as part of a project dealing with work empowerment in multidisciplinary teams in a Finnish hospital specializing in providing care and treatment for different rheumatic conditions, this study set out to explore the associations between organizational change factors and perceived work empowerment in a setting where patients with chronic diseases are being cared for by multiprofessional teams. All health-care professionals working at the hospital under investigation were invited to take part in the survey. Data were collected in 2005 with a structured questionnaire consisting of five parts: background variables, organizational change factors, aspects of work empowerment as well as factors promoting and impeding empowerment. Organizational change factors correlated with work empowerment as well as factors promoting and impeding empowerment. There was little agreement by multiprofessional teams that factors relating to organizational change were present in their work setting. Organizational change factors are important in order to be able to meet the demands by facilitating optimal action during organizational changes. The planning and implementing of organizational changes should be performed in cooperation with personnel throughout the organization at all stages. It would be important to address potential difficulties and try to pre-empt any problems from the planning stage.

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Section: Discussionsupporting

confidence: 93%

Section: Work Empowerment During Organizational Changementioning

confidence: 99%

Work empowerment in multidisciplinary teams during organizational change

Rankinen¹,

Suominen²,

Kuokkanen³

et al. 2009

Int J of Nursing Practice

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show abstract

“…gate keeping, utilization control, evidencebased practice protocols, disease management, discharge planning, and changes in clinical support services [44]. In addition, widespread re-structuring transformed the nature of nursing work through reallocation of human resources, including nurse staffing, to maximize nursing time and cost-efficiency [45]. These changes may have reduced slack resources, making the effects of increases in nurse staffing on reducing LOS and mortality ratios more readily discernible.…”

Section: Resultsmentioning

confidence: 99%

The impact of HMO penetration on the relationship between nurse staffing and quality

2005

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While there are a number of studies examining the relationship between nurse staffing and quality, none has examined structural differences in the relationship between nurse staffing and quality contingent upon the level of managed care penetration. We used administrative data, and a dynamic panel data model to examine this relationship in a panel of 422 acute care hospitals from 1990 to 1995. We found that there were significant differences in the relationship between nurse staffing and both mortality and length of stay depending upon the level of HMO penetration in the hospital's market.

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“…Nurses who work in rural hospitals also differ from their urban counterparts in work patterns and commuting behavior (Skillman, Palazzo, Keepnews, & Hart, 2006), both of which have been linked to nurse safety outcomes (Sveinsdóttir, 2006;Trinkoff, Le, Geiger-Brown, Lipscomb, & Lang, in press). Managed care (i.e., HMO) penetration was included because it has provided the impetus for numerous nursing unit re-design efforts like the introduction of professional practice models and changes in nursing skill mix that affect utilization of nursing personnel, staffing adequacy (Hoover, 1998;Mark, Harless, McCue, & Xu, 2004;Mark, Salyer, & Wan, 2003) and, ultimately, safety. Finally, because there is substantial regional variation among hospitals in illness treatment, volume and complexity of procedures performed, and resource consumption (Wennberg & Gittlesohn, 1973;Wennberg, Freeman, & Culp, 1987), we included geographic region as a variable.…”

Section: Organizational Contextmentioning

confidence: 99%