Acute pain therapy in German hospitals as competitive factor : Do competition, ownership and case severity influence the practice of acute pain therapy?

BACKGROUND Due to the implementation of the diagnosis-related groups (DRG) system, the competitive pressure on German hospitals increased. In this context it has been shown that acute pain management offers economic benefits for hospitals. The aim of this study was to analyze the impact of the competitive situation, the ownership and the economic resources required on structures and processes for acute pain management. MATERIAL AND METHODS A standardized questionnaire on structures and processes of acute pain management was mailed to the 885 directors of German departments of anesthesiology listed as members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin). RESULTS For most hospitals a strong regional competition existed; however, this parameter affected neither the implementation of structures nor the recommended treatment processes for pain therapy. In contrast, a clear preference for hospitals in private ownership to use the benchmarking tool QUIPS (quality improvement in postoperative pain therapy) was found. These hospitals also presented information on coping with the management of pain in the corporate clinic mission statement more often and published information about the quality of acute pain management in the quality reports more frequently. No differences were found between hospitals with different forms of ownership in the implementation of acute pain services, quality circles, expert standard pain management and the implementation of recommended processes. Hospitals with a higher case mix index (CMI) had a certified acute pain management more often. The corporate mission statement of these hospitals also contained information on how to cope with pain, presentation of the quality of pain management in the quality report, implementation of quality circles and the implementation of the expert standard pain management more frequently. There were no differences in the frequency of using the benchmarking tool QUIPS or the implementation of recommended treatment processes with respect to the CMI. CONCLUSION In this survey no effect of the competitive situation of hospitals on acute pain management could be demonstrated. Private ownership and a higher CMI were more often associated with structures of acute pain management which were publicly accessible in terms of hospital marketing.

Disturbances of agency and ownership in schizophrenia: An auditory verbal event related potentials study

A ‘sense of self’ is essentially the ability to distinguish between self-generated and external stimuli. It consists of at least two very basic senses: a sense of agency and a sense of ownership. Disturbances seem to provide a basic deficit in many psychiatric diseases. The aim of our study was to manipulate those qualities separately in 28 patients with schizophrenia (14 auditory hallucinators and 14 non-hallucinators) and 28 healthy controls (HC) and to investigate the effects on the topographies and the power of the event-related potential (ERP). We performed a 76-channel EEG while the participants performed the task as in our previous paper. We computed ERPs and difference maps for the conditions and compared the amount of agency and ownership between the HC and the patients. Furthermore, we compared the global field power and the topographies of these effects. Our data showed effects of agency and ownership in the healthy controls and the hallucinator group and to a lesser degree in the non-hallucinator group. We found a reduction of the N100 during the presence of agency, and a bilateral temporal negativity related to the presence of ownership. For the agency effects, we found significant differences between HC and the patients. Contrary to the expectations, our findings were more pronounced in non-hallucinators, suggesting a more profoundly disturbed sense of agency compared to hallucinators. A contemporary increase of global field power in both patient groups indicates a compensatory recruitment of other mechanisms not normally associated with the processing of agency and ownership.

Turning Agents into Psychological Principals: Aligning Interests of Non-Owners Through Psychological Ownership

Principals who delegate tasks to agents face the perennial challenge of overcoming agency problems. We investigate whether feelings of ownership among senior managers in the absence of formal ownership can align agents' interests with those of principals, thus turning agents into psychological principals. Using a moderated mediation model, we find that psychological ownership is positively related to company performance through the mediating effect of individual-level entrepreneurial behaviour. We also find that the effect of psychological ownership on individual-level entrepreneurial behaviour and, ultimately, company performance is weaker for high levels of monitoring compared to low levels. These findings offer important contributions to agency, psychological ownership, and entrepreneurship literatures.

Affective Commitment and Job Satisfaction among Non-family Employees: Investigating the Roles of Justice Perceptions and Psychological Ownership

Due to numerous characteristics often attributed to family firms, they constitute a unique context for non-family employees’ justice perceptions. These are linked to non-family employees’ pro-organizational attitudes and behaviors, which are essential for family firms’ success. Even though scholarly interest in non-family employees’ justice perceptions has increased, more research is still needed, also because the mechanism connecting justice perceptions and favorable outcomes is not fully understood yet. We address this gap by explicitly investigating non-family employees’ justice perceptions and by introducing psychological ownership as a mediator in the relationships between justice perceptions (distributive and procedural) and common work attitudes (affective commitment and job satisfaction). Our analysis of a sample of 310 non-family employees from Germany and German-speaking Switzerland reveals that psychological ownership mediates the relationships between distributive justice and affective commitment as well as job satisfaction. This represents valuable contributions to family business research, organizational justice and psychological ownership literature, and to practice.

Psychological Ownership of Employees as a Mediator in the Justice - Affective Commitment Relationship

Numerous scholars have accumulated evidence on the positive effects that employees’ organizational justice perceptions exert on work-related outcomes such as affective commitment. However, research still lacks understanding of the underlying mechanisms connecting the two constructs. In this article we aim to narrow this gap by examining the concept of psychological ownership as a possible mediator between organizational justice perceptions and affective commitment. Investigating a sample of 619 employees, we find distributive justice to be positively related to psychological ownership, and observe psychological ownership as a full mediator of the distributive justice and affective commitment relationship. These insights offer a new explanation in understanding the justice-commitment connection, contributing to both organizational justice and psychological ownership literature and opening up ways for promising future research.

The Committed and the Happy: Exploring the Effects of Justice and Ownership Perceptions among Non-family Employees

A main challenge that family businesses face is fostering non-family employees' val-ue-creating attitudes, such as affective commitment and job satisfaction. While justice perceptions have been identified as being critical in the creation of these outcomes, the process how they actually evolve is less clear, especially in family firms. We address this gap by introducing psychological ownership as a mediator in the relationships between justice perceptions (distributive and procedural) and common work attitudes (affective commitment and job satisfaction). Our analysis of a sample of 310 non-family employees from family firms in German-speaking Switzerland and Germany reveals that psychological ownership mediates the relationships between distributive justice and affective commitment as well as job satisfaction. This leads to valuable contributions to family business research, organizational justice and psychological ownership literatures, and to practice.

Family Influence and Psychological Ownership: The Mediating Effects of Control

The concept of psychological ownership (PO) has been increasingly researched in the last years. However, knowledge about the emergence of PO is still scarce. So far, no study has investigated the development of PO in the context of family firms. We aim to investigate the emergence of PO in that context by drawing on the family´s influence on the business as a decisive factor. We thereby elaborate on the effect of family influence on PO, mediated by non-family managers´ perceived control over the company.

Psychological Ownership of Employees as a Mediator in the Justice - Affective Commitment Relationship

Numerous scholars have accumulated evidence on the positive effects that employees' organizational justice perceptions exert on work-related outcomes such as affective commitment. However, research still lacks understanding of the underlying mechanisms connecting the two constructs. In this article we aim to narrow this gap by examining the concept of psychological ownership as a possible mediator between organizational justice perceptions and affective commitment. Investigating a sample of 619 employees, we find distributive justice to be positively related to psychological ownership, and observe psychological ownership as a full mediator of the distributive justice and affective commitment relationship. These insights offer a new explanation in understanding the justice-commitment connection, contributing to both organizational justice and psychological ownership literature and opening up ways for promising future research