24-Karat or fool’s gold? Consequences of real team and co-acting group membership in healthcare organizations

Although theory on team membership is emerging, limited empirical attention has been paid to the effects of different types of team membership on outcomes. We propose that an important but overlooked distinction is that between membership of real teams and membership of co-acting groups, with the former being characterized by members who report that their teams have shared objectives, and structural interdependence and engage in team reflexivity. We hypothesize that real team membership will be associated with more positive individual- and organizational-level outcomes. These predictions were tested in the English National Health Service, using data from 62,733 respondents from 147 acute hospitals. The results revealed that individuals reporting the characteristics of real team membership, in comparison with those reporting the characteristics of co-acting group membership, witnessed fewer errors and incidents, experienced fewer work related injuries and illness, were less likely to be victims of violence and harassment, and were less likely to intend to leave their current employment. At the organizational level, hospitals with higher proportions of staff reporting the characteristics of real team membership had lower levels of patient mortality and sickness absence. The results suggest the need to clearly delineate real team membership in order to advance scientific understanding of the processes and outcomes of organizational teamwork.

Managing wireless networks in the healthcare sector:emerging experiences of cultural impacts

The existing body of knowledge has generally supported that organizational culture plays a significant role in shaping group identity, work pattern, communication schemes, and interpersonal relations; all of these cultural elements are important organizational factors that shape workplaces and operational routines. In the context of emerging information technology, it has also been suggested that organizational culture could affect IT implementation and management. However, little is known about how emerging information technology shapes organizational culture, which in turn helps reshape the organization as a whole. The purpose of this paper is thus to build empirical understanding of how IT in general and emerging wireless networks in particular reshapes organizational culture. Case studies conducted in two hospitals situated in southwest U.S.A. illustrated that the implementation of wireless networks indeed helped shape and/or reshape organizational culture in the healthcare sector and in turn enhance healthcare organizations’ competitiveness in the marketplace. For IT managers and practitioners in healthcare institutions, effective strategy to plan and manage emerging ITs such as wireless networks will thus have long-term implications on cultivating organizational culture that could eventually reshape workplace and competitiveness.

A multilevel study of the relationships between diversity training, ethnic discrimination and satisfaction in organizations

The prevalence of diversity training has not been matched by empirical research on its effectiveness. Among the most notable gaps are an absence of attention to its impact on discrimination and limited consideration of organizational-level factors. Results from employee surveys across 395 healthcare organizations reveal an effect of the extent of diversity training in organizations on ethnic minorities' experiences of discrimination. In addition, the results demonstrate that the consequences of ethnic discrimination for individuals' job attitudes are influenced by organizational-level phenomenon. These findings highlight the importance of attending to ethnic discrimination as an outcome of diversity training with implications for employee attitudes. © 2010 John Wiley & Sons, Ltd.

How innovation can alleviate negative consequences of demanding work contexts:The influence of climate for innovation on organizational outcomes

This study examines climate for innovation as a method by which negative organizational consequences of demanding work may be lessened. It was expected that a climate for innovation would enable employees to develop coping mechanisms or improved work-related processes which counteract negative consequences of work demands. Extending the job demands-resource model (Karasek, 1979), we predicted and found that among the sample of 22,696 respondents from 131 healthcare organizations, organizational climate for innovation alleviated the negative effects of work demands on organizational performance. Thus, this study informs climate theories and guides practitioners' efforts to support the employees. © 2007 The British Psychological Society.

Staying in nursing:what factors determine whether nurses intend to remain employed?

Aim. To test a model of eight thematic determinants of whether nurses intend to remain in nursing roles. Background. Despite the dramatic increase in the supply of nurses in England over the past decade, a combination of the economic downturn, funding constraints and more generally an ageing nursing population means that healthcare organizations are likely to encounter long-term problems in the recruitment and retention of nursing staff. Design. Survey. Method. Data were collected from a large staff survey conducted in the National Health Service in England between September-December 2009. A multi-level model was tested using MPlus statistical software on a sub-sample of 16,707 nurses drawn from 167 healthcare organizations. Results. Findings were generally supportive of the proposed model. Nurses who reported being psychologically engaged with their jobs reported a lower intention to leave their current job. The perceived availability of developmental opportunities, being able to achieve a good work-life balance and whether nurses' encountered work pressures were also influencing factors on their turnover intentions. However, relationships formed with colleagues and patients displayed comparatively small relationships with turnover intentions. Conclusion. The focus at the local level needs to be on promoting employee engagement by equipping staff with the resources (physical and monetary) and control to enable them to perform their tasks to standards they aspire to and creating a work environment where staff are fully involved in the wider running of their organizations, communicating to staff that patient care is important and the top priority of the organization. © 2012 Blackwell Publishing Ltd.

Team-based working and employee well being:a cross-cultural comparison of United Kingdom and Hong Kong health services

This study examined the impact of team-based working, team structure, and job design on employee well-being (in term of job satisfaction and work stress) in staff working in healthcare organizations in Hong Kong. Cross-cultural differences in the impact of job design, team structure, and employee well-being outcomes between United Kingdom and Hong Kong were also investigated. A group of 197 staff from two Hong Kong hospitals were compared to a sample of 270 UK staff working in National Health Service organizations in the UK. Results showed that team structure and job design were significantly associated with greater employee satisfaction and lower stress for Hong Kong healthcare staff. Culture was also found to moderate the impact of team structure and job design on employee well-being. The findings suggest that although team structure and job design contribute to employee well-being, they have differential impacts across cultures. This provides insights to policy planning on building team-based organizations in the healthcare sector involving multinational collaboration.

New drugs for type 2 diabetes mellitus:what is their place in therapy?

Oral therapy for type 2 diabetes mellitus, when used appropriately, can safely assist patients to achieve glycaemic targets in the short to medium term. However, the progressive nature of type 2 diabetes usually requires a combination of two or more oral agents in the longer term, often as a prelude to insulin therapy. Issues of safety and tolerability, notably weight gain, often limit the optimal application of anti-diabetic drugs such as sulforylureas and thiazolidinediones. Moreover, the impact of different drugs, even within a single class, on the risk of long-term vascular complications has come under scrutiny. For example, recent publication of evidence suggesting potential detrimental effects of rosiglitazone on myocardial events generated a heated debate and led to a reduction in use of this drug. In contrast, current evidence supports the view that pioglitazone has vasculoprotective properties. Both drugs are contraindicated in patients who are at risk of heart failure. An additional recently identified safety concern is an increased risk of fractures, especially in postmenopausal women. Several new drugs with glucose-lowering efficacy that may offer certain advantages have recently become available. These include (i) injectable glucagonlike peptide-1 (GLP-1) receptor agonists and oral dipeptidyl peptidase-4 (DPP-4) inhibitors; (ii) the amylin analogue pramlintide; and (iii) selective cannabinoid receptor-1 (CB1) antagonists. GLP-1 receptor agonists, such as exenatide, stimulate nutrient-induced insulin secretion and reduce inappropriate glucagon secretion while delaying gastric emptying and reducing appetite. These agents offer a low risk of hypoglycaemia combined with sustained weight loss. The DPP-4 inhibitors sitagliptin and vildagliptin are generally weight neutral, with less marked gastrointestinal adverse effects than the GLP-1 receptor agonists. Potential benefits of GLP-1 receptor stimulation on P cell neogenesis are under investigation. Pancreatitis has been reported in exenatide-treated patients. Pramlintide, an injected peptide used in combination with insulin, can reduce insulin dose and bodyweight. The CB1 receptor antagonist rimonabant promotes weight loss and has favourable effects on aspects of the metabolic syndrome, including the hyperglycaemia of type 2 diabetes. However, in 2007 the US FDA declined approval of rimonabant, requiring more data on adverse effects, notably depression. The future of dual peroxisome proliferator-activated receptor-alpha/gamma agonists, or glitazars, is presently uncertain following concerns about their safety. In conclusion, several new classes of drugs have recently become available in some countries that offer new options for treating type 2 diabetes. Beneficial or neutral effects on bodyweight are an attractive feature of the new drugs. However, the higher cost of these agents, coupled with an absence of long-term safety and clinical outcome data, need to be taken into consideration by clinicians and healthcare organizations.

Cultural impact of wireless networks:emerging experiences in the healthcare sector

Culture defines collective behavior and interactions among people in groups. In organizations, it shapes group identity, work pattern, communication schemes, and interpersonal relations. Any change in organizational culture will lead to changes in these elements of organizational factors, and vice versa. From a managerial standpoint, how to cultivate an organizational culture that would enhance these aforementioned elements in organizational workplace should thus be taken into serious consideration. Based on cases studies in two hospitals, this paper investigates how organizational culture is shaped by a particular type of information and communication technology, wireless networks, a topic that is generally overlooked by the mainstream research community, and in turn implicates how such cultural changes in organizations renovate their competitiveness in the marketplace. Lessons learned from these cases provide valuable insights to emerging IT management and culture studies in general and in wireless network management in the healthcare sector in particular.

A strategic case for e-adoption in healthcare supply chains

A growing body of literature suggests that greater benefits of e-business will be obtained when e-business is integrated throughout a supply chain. However, organizations are still cautious in adopting e-business technologies. This paper examines whether a strategic case for e-commerce can be recognised and the factors that influence e-adoption, using e-business development models, a contingency approach and a stakeholder approach. The paper explores the link of e-commerce with strategy and the potential strategic benefits, risks and problems. This paper analysed e-adoption in four diverse healthcare supply chains in the context of the English National Health Service (NHS). The fieldwork showed there is of limited use of e- in supply chains; there are key problems associated with perceived benefits and costs by different actors both within organisations and within the chain. The paper proposes a framework to link the case for e-commerce with the achievement of strategic objectives across three inter-related domains—health, supply and business.