Leadership and organisational outcomes in healthcare

This research examined to what extent and how leadership is related to organisational outcomes in healthcare. Based on the Job Demands-Resource model, a set of hypotheses was developed, which predicted that the effect of leadership on healthcare outcomes would be mediated by job design, employee engagement, work pressure, opportunity for involvement, and work-life balance. The research focused on the National Health Service (NHS) in England, and examined the relationships between senior leadership, first line supervisory leadership and outcomes. Three years of data (2008 – 2010) were gathered from four data sources: the NHS National Staff Survey, the NHS Inpatient Survey, the NHS Electronic Record, and the NHS Information Centre. The data were drawn from 390 healthcare organisations and over 285,000 staff annually for each of the three years. Parallel mediation regressions modelled both cross sectional and longitudinal designs. The findings revealed strong relationships between senior leadership and supervisor support respectively and job design, engagement, opportunity for involvement, and work-life balance, while senior leadership was also associated with work pressure. Except for job design, there were significant relationships between the mediating variables and the outcomes of patient satisfaction, employee job satisfaction, absenteeism, and turnover. Relative importance analysis showed that senior leadership accounted for significantly more variance in relationships with outcomes than supervisor support in the majority of models tested. Results are discussed in relation to theoretical and practical contributions. They suggest that leadership plays a significant role in organisational outcomes in healthcare and that previous research may have underestimated how influential senior leaders may be in relation to these outcomes. Moreover, the research suggests that leaders in healthcare may influence outcomes by the way they manage the work pressure, engagement, opportunity for involvement and work-life balance of those they lead.

An examination of psychological meaningfulness, safety, and availability as the underlying mechanisms linking job features and personal characteristics to work engagement

The present study tested a nomological net of work engagement that was derived from its extant research. Two of the main work engagement models that have been presented and empirically tested in the literature, the JD-R model and Kahn's model, were integrated to test the effects that job features and personal characteristics can have on work engagement through the psychological conditions of meaningfulness, safety, and availability. In this study, safety refers to psychological perceptions of safety and not workplace safety behaviors. The job features that were tested in this model included person-job fit, autonomy, co-worker relations, supervisor support, procedural justice, and interactional justice, while the personal characteristics consisted of self-consciousness, self-efficacy, extraversion, and neuroticism. Thirty-four hypotheses and a conceptual model were tested in order to establish the viability of this nomological net of work engagement in which it was expected that meaningfulness would mediate the relationships between job features and work engagement, safety would mediate the relationships that job features and personal characteristics have with work engagement, and availability (physical, emotional, and cognitive resources) would mediate the relationships that personal characteristics have with work engagement. Furthermore, analyses were run in order to determine the factor structure of work engagement, assess whether or not it exhibits differential validity from organizational commitment and job satisfaction, and confirm that it is positively related to the outcome variable of organizational citizenship behavior (OCB). The final sample consisted of 500 workers from an online labor market who responded to a questionnaire composed of measures of all constructs included in this study. Findings show that work engagement is best represented as a three-factor construct, composed of vigor, dedication and absorption. Furthermore, support was found for the distinction of work engagement from the related constructs of organizational commitment and job satisfaction. With regard to the proposed model, meaningfulness proved to be the strongest predictor of work engagement. Results show that it partially mediates the relationships that all job features have with work engagement. Safety proved to be a partial mediator of the relationships that autonomy, co-worker relations, supervisor support, procedural justice, interactional justice, and self-efficacy have with work engagement, and fully mediate the relationship between neuroticism and work engagement. Findings also show that availability partially mediates the positive relationships that extraversion and self-efficacy have with work engagement, and fully mediates the negative relationship that neuroticism has with work engagement. Finally, a positive relationship was found between work engagement and OCB. Research and organizational implications are discussed.

Work Creativity as a Dimension of Job Performance

To stay competitive, many employers are looking for creative and innovative employees to add value to their organization. However, current models of job performance overlook creative performance as an important criterion to measure in the workplace. The purpose of this dissertation is to conduct two separate but related studies on creative performance that aim to provide support that creative performance should be included in models of job performance, and ultimately included in performance evaluations in organizations. Study 1 is a meta-analysis on the relationship between creative performance and task performance, and the relationship between creative performance and organizational citizenship behavior (OCB). Overall, I found support for a medium to large corrected correlation for both the creative performance-task performance (ρ = .51) and creative performance-OCB (ρ = .49) relationships. Further, I also found that both rating-source and study location were significant moderators. Study 2 is a process model that includes creative performance alongside task performance and OCB as the outcome variables. I test a model in which both individual differences (specifically: conscientiousness, extraversion, proactive personality, and self-efficacy) and job characteristics (autonomy, feedback, and supervisor support) predict creative performance, task performance, and OCB through engagement as a mediator. In a sample of 299 employed individuals, I found that all the individual differences and job characteristics were positively correlated with all three performance criteria. I also looked at these relationships in a multiple regression framework and most of the individual differences and job characteristics still predicted the performance criteria. In the mediation analyses, I found support for engagement as a significant mediator of the individual differences-performance and job characteristics-performance relationships. Taken together, Study 1 and Study 2 support the notion that creative performance should be included in models of job performance. Implications for both researchers and practitioners alike are discussed.

Frontline employees’ innovative service behavior as key to customer loyalty:insights into FLEs’ resource gain spiral

Many service firms require frontline service employees (FLEs) to follow routines and standardized operating procedures during the service encounter, to deliver consistently high service standards. However, to create superior, pleasurable experiences for customers, featuring both helpful services and novel approaches to meeting their needs, firms in various sectors also have begun to encourage FLEs to engage in more innovative service behaviors. This study therefore investigates a new and complementary route to customer loyalty, beyond the conventional service-profit chain, that moves through FLEs' innovative service behavior. Drawing on conservation of resources (COR) theory, this study introduces a resource gain spiral at the service encounter, which runs from FLEs' emotional job engagement to innovative service behavior, and then leads to customer delight and finally customer loyalty. In accordance with COR theory, the proposed model also includes factors that might hinder (customer aggression, underemployment) or foster (colleague support, supervisor support) FLEs' resource gain spiral. A multilevel analysis of a large-scale, dyadic data set that contains responses from both FLEs and customers in multiple industries strongly supports the proposed resource gain spiral as a complementary route to customer loyalty. The positive emotional job engagement-innovative service behavior relationship is undermined by customer aggression and underemployment, as hypothesized. Surprisingly though, and contrary to the hypotheses, colleague and supervisor support do not seem to foster FLEs' resource gain spiral. Instead, colleague support weakens the engagement-innovative service behavior relationship, and supervisor support does not affect it. These results indicate that if FLEs can solicit resources from other sources, they may not need to invest as many of their individual resources. In particular, colleague support even appears to serve as a substitute for FLEs' individual resource investments in the resource gain spiral.

Perceived occupational stress in nurses working in Ireland

Background: This study examines perceived stress and its potential causal factors in nurses. Stress has been seen as a routine and accepted part of the healthcare worker’s role. The lack of research on stress in nurses in Ireland motivated this study. Aims: The aims of this study are to examine the level of stress experienced by nurses working in an Irish teaching hospital, and investigate differences in perceived stress levels by ward area and associations with work characteristics. Method: A cross-sectional study design was employed, with a two-stage cluster sampling process. A self-administered questionnaire was used to collect the data and nurses were investigated across ten different wards using the Nursing Stress Scale and the Demand Control Support Scales. Results: The response rate was 62%. Using outpatients as a reference ward, perceived stress levels were found to be significantly higher in the medical ward, accident and emergency, intensive care unit and paediatric wards (p<0.05). There was no significant difference between the wards with regard to job strain, however, differences did occur with levels of support; the day unit and paediatric ward reporting the lowest level of supervisor support (p<0.01). A significant association was seen between the wards and perceived stress even after adjustment (p<0.05). Conclusion: The findings suggest that perceived stress does vary within different work areas in the same hospital. Work factors, such as demand and support are important with regard to perceived stress. Job control was not found to play an important role.

Os efeitos das perceções de instrumentalização da avaliação de desempenho nas respostas face à organização

Doutoramento em Gestão

Work creativity as a dimension of job performance

To stay competitive, many employers are looking for creative and innovative employees to add value to their organization. However, current models of job performance overlook creative performance as an important criterion to measure in the workplace. The purpose of this dissertation is to conduct two separate but related studies on creative performance that aim to provide support that creative performance should be included in models of job performance, and ultimately included in performance evaluations in organizations. Study 1 is a meta-analysis on the relationship between creative performance and task performance, and the relationship between creative performance and organizational citizenship behavior (OCB). Overall, I found support for a medium to large corrected correlation for both the creative performance-task performance (ρ = .51) and creative performance-OCB (ρ = .49) relationships. Further, I also found that both rating-source and study location were significant moderators. Study 2 is a process model that includes creative performance alongside task performance and OCB as the outcome variables. I test a model in which both individual differences (specifically: conscientiousness, extraversion, proactive personality, and self-efficacy) and job characteristics (autonomy, feedback, and supervisor support) predict creative performance, task performance, and OCB through engagement as a mediator. In a sample of 299 employed individuals, I found that all the individual differences and job characteristics were positively correlated with all three performance criteria. I also looked at these relationships in a multiple regression framework and most of the individual differences and job characteristics still predicted the performance criteria. In the mediation analyses, I found support for engagement as a significant mediator of the individual differences-performance and job characteristics-performance relationships. Taken together, Study 1 and Study 2 support the notion that creative performance should be included in models of job performance. Implications for both researchers and practitioners alike are discussed.^

An Examination of Psychological Meaningfulness, Safety, and Availability as the Underlying Mechanisms linking Job Features and Personal Characteristics to Work Engagement

The present study tested a nomological net of work engagement that was derived from its extant research. Two of the main work engagement models that have been presented and empirically tested in the literature, the JD-R model and Kahn’s model, were integrated to test the effects that job features and personal characteristics can have on work engagement through the psychological conditions of meaningfulness, safety, and availability. In this study, safety refers to psychological perceptions of safety and not workplace safety behaviors. The job features that were tested in this model included person-job fit, autonomy, co-worker relations, supervisor support, procedural justice, and interactional justice, while the personal characteristics consisted of self-consciousness, self-efficacy, extraversion, and neuroticism. Thirty-four hypotheses and a conceptual model were tested in order to establish the viability of this nomological net of work engagement in which it was expected that meaningfulness would mediate the relationships between job features and work engagement, safety would mediate the relationships that job features and personal characteristics have with work engagement, and availability (physical, emotional, and cognitive resources) would mediate the relationships that personal characteristics have with work engagement. Furthermore, analyses were run in order to determine the factor structure of work engagement, assess whether or not it exhibits differential validity from organizational commitment and job satisfaction, and confirm that it is positively related to the outcome variable of organizational citizenship behavior (OCB). The final sample consisted of 500 workers from an online labor market who responded to a questionnaire composed of measures of all constructs included in this study. Findings show that work engagement is best represented as a three-factor construct, composed of vigor, dedication and absorption. Furthermore, support was found for the distinction of work engagement from the related constructs of organizational commitment and job satisfaction. With regard to the proposed model, meaningfulness proved to be the strongest predictor of work engagement. Results show that it partially mediates the relationships that all job features have with work engagement. Safety proved to be a partial mediator of the relationships that autonomy, co-worker relations, supervisor support, procedural justice, interactional justice, and self-efficacy have with work engagement, and fully mediate the relationship between neuroticism and work engagement. Findings also show that availability partially mediates the positive relationships that extraversion and self-efficacy have with work engagement, and fully mediates the negative relationship that neuroticism has with work engagement. Finally, a positive relationship was found between work engagement and OCB. Research and organizational implications are discussed.

The Support Role in Clinical Supervision of Nursing Students: Determinant in the Development of Emotional Skills

The problematic situation faced by clients, associated to the processes of health and disease, is expressed through emotions that nursing students have to deal with in the course of care and their formative experiences in clinical teaching. Students have learning needs not only to manage emotions in the context of customer care, but also in terms of their own internal world, emotional conflicts, emotional stress and burn-out. With the present literature review, we intend to explore existing evidence regarding the ways in which the nurse supervisor's support towards nursing students potentiates the development of their competences for the performance of emotional labour. These skills prove to be the key in the ability to manage the emotionally intense situations of care practice and the support function of the nursing supervisor contributes to the development of such competences.

The antecedents to participation in learning activities among support staff at a college in Ontario

Les tendances de la participation à la formation des adultes au Canada n’ont pas évolué depuis des décennies, malgré les nouvelles influences économiques qui ont stimulé l’augmentation et la diversification permanente de la formation des employés et malgré les initiatives plus nombreuses en faveur de l’apprentissage des employés en milieu de travail. Il est donc nécessaire de ne plus se contenter d’étudier les prédicteurs de la formation déjà connus dans les profils des employés et des employeurs. Il est, en revanche, indispensable d’étudier les antécédents de la participation des employés à la formation, y compris les aspects et les étapes du processus qui la précède. Cette étude porte sur les antécédents de la participation des employés aux formations dans un important collège communautaire urbain en Ontario. Afin de préparer le recueil des données, un cadre théorique a été élaboré à partir du concept d’expression de la demande. Ce cadre implique l’existence d’un processus qui comporte plusieurs étapes, au cours desquelles plusieurs intervenants interagissent et dont la formation est susceptible d’être le résultat. Les résultats de l’enquête sur le profil d’apprentissage ont permis de conclure que le comportement des employés et de l’employeur est conforme aux modèles de prédicteurs existants et que les taux et les types de participation étaient similaires aux tendances nationales et internationales. L’analyse des entrevues d’un groupe d’employés atypiques, de leurs superviseurs, ainsi que de représentants du collège et du syndicat, a révélé d’importants thèmes clés : l’expression de la demande n’est pas structurée et elle est communiquée par plusieurs canaux, en excluant parfois les superviseurs. De plus, la place de l’auto évaluation est importante, ainsi que la phase de prise de décision. Ces thèmes ont souligné l’interaction de plusieurs intervenants dans le processus d’expression de la demande d’apprentissage et pendant la prise de décision. L’examen des attentes de chacun de ces intervenants au cours de ce processus nous a permis de découvrir un désir tacite chez les superviseurs et les employés, à savoir que la conversation soit à l’initiative de « l’autre ». Ces thèmes clés ont été ensuite abordés dans une discussion qui a révélé une discordance entre le profil de l’employeur et les profils des employés. Celle-ci se prête à la correction par l’employeur de son profil institutionnel pour l’harmoniser avec le profil dispositionnel des employés et optimiser ainsi vraisemblablement son offre de formation. Ils doivent, pour cela, appliquer un processus plus systématique et plus structuré, doté de meilleurs outils. La discussion a porté finalement sur les effets des motivations économiques sur la participation des employés et a permis de conclure que, bien que les employés ne semblent pas se méfier de l’offre de formation de l’employeur et que celle ci ne semble pas non plus les décourager, des questions de pouvoir sont bel et bien en jeu. Elles se sont principalement manifestées pendant le processus de prise de décision et, à cet égard, les superviseurs comme les employés reconnaissent qu’un processus plus structuré serait bénéfique, puisqu’il atténuerait les problèmes d’asymétrie et d’ambiguïté. Les constatations de cette étude sont pertinentes pour le secteur de la formation des adultes et de la formation en milieu de travail et, plus particulièrement, pour la méthodologie de recherche. Nous avons constaté l’avantage d’une méthodologie à deux volets, à l’écoute de l’employeur et des employés, afin de mieux comprendre la relation entre l’offre de formation et la participation à la formation. La définition des antécédents de la participation sous la forme d’un processus dans lequel plusieurs intervenants remplissent plusieurs rôles a permis de créer un modèle plus détaillé qui servira à la recherche future. Ce dernier a démontré qu’il est indispensable de reconnaître que la prise de décision constitue une étape à part entière, située entre l’expression de la demande et la participation à la formation. Ces constatations ont également révélé qu’il est véritablement indispensable que le secteur de la formation des adultes continue à traiter les questions reliées à la reconnaissance de la formation informelle. Ces conclusions et la discussion sur les constatations clés nous ont inspiré des recommandations à appliquer pour modifier les retombées du processus précédant la participation des employés à la formation. La majorité de ces recommandations ont trait à l’infrastructure de ce processus et ciblent donc principalement l’employeur. Certaines recommandations sont cependant destinées aux syndicats, aux superviseurs et aux employés qui peuvent aider l’employeur à remplir son rôle et favoriser la participation efficace de tous à ce processus. Les recommandations qui précédent impliquent que ce sont les antécédents de la formation qui gagneraient à être plus structurés et non la formation elle même. La structuration de l’infrastructure de l’apprentissage présente cependant des risques à elle seule. En liaison avec ce phénomène, une étude spécifique des effets de la nature, de la qualité et de l’asymétrie de la relation superviseur employé sur la participation des employés à la formation serait bénéfique. Mots clés : formation en entreprise, formation professionnelle continue, antécédents à la participation, employés de soutien

Cooperative task support for the control room

The National Grid Company plc. owns and operates the electricity transmission network in England and Wales, the day to day running of the network being carried out by teams of engineers within the national control room. The task of monitoring and operating the transmission network involves the transfer of large amounts of data and a high degree of cooperation between these engineers. The purpose of the research detailed in this paper is to investigate the use of interfacing techniques within the control room scenario, in particular, the development of an agent based architecture for the support of cooperative tasks. The proposed architecture revolves around the use of interface and user supervisor agents. Primarily, these agents are responsible for the flow of information to and from individual users and user groups. The agents are also responsible for tackling the synchronisation and control issues arising during the completion of cooperative tasks. In this paper a novel approach to human computer interaction (HCI) for power systems incorporating an embedded agent infrastructure is presented. The agent architectures used to form the base of the cooperative task support system are discussed, as is the nature of the support system and tasks it is intended to support.

Situation assessment through multi-modal sensing of dynamic environments to support cognitive robot control

Awareness of emerging situations in a dynamic operational environment of a robotic assistive device is an essential capability of such a cognitive system, based on its effective and efficient assessment of the prevailing situation. This allows the system to interact with the environment in a sensible (semi)autonomous / pro-active manner without the need for frequent interventions from a supervisor. In this paper, we report a novel generic Situation Assessment Architecture for robotic systems directly assisting humans as developed in the CORBYS project. This paper presents the overall architecture for situation assessment and its application in proof-of-concept Demonstrators as developed and validated within the CORBYS project. These include a robotic human follower and a mobile gait rehabilitation robotic system. We present an overview of the structure and functionality of the Situation Assessment Architecture for robotic systems with results and observations as collected from initial validation on the two CORBYS Demonstrators.

A efetividade de grupos de pais para o tratamento de problemas internalizantes e o papel do comportamento do supervisor na formação de terapeutas analítico-comportamentais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Bem-estar no trabalho : os aspectos do suporte do supervisor e estilos de liderança

Bem-estar no trabalho, percepção de suporte do supervisor e estilos de liderança são temas que vêm despertando atenção crescente nos últimos tempos, de diversos pesquisadores no campo de estudos do comportamento organizacional. O objetivo desta pesquisa foi investigar o impacto da percepção do suporte do supervisor e dos estilos de liderança no bem-estar no trabalho. O construto bem-estar no trabalho no presente estudo foi representado por duas dimensões: satisfação no trabalho e comprometimento organizacional afetivo. A amostra foi composta por 200 trabalhadores que atuavam em empresas privadas e públicas, situadas no Estado de São Paulo, sendo 110 mulheres e 90 homens, distribuídos entre solteiros e casados. O instrumento de coleta de dados foi um questionário composto por quatro escalas que mediram as variáveis: percepção de suporte do supervisor, estilos de lideranças, satisfação no trabalho e comprometimento organizacional afetivo. Para a análise dos dados utilizou-se um programa estatístico. Foram calculadas estatísticas descritivas das variáveis do estudo (médias, desvios-padrão e correlações bivariadas) e modelos de regressão multivariada para se investigar os impactos causados por percepção do suporte do supervisor e por estilos de liderança sobre bem-estar no trabalho, representado por vínculos com o trabalho (satisfação no trabalho) e com a organização (comprometimento organizacional afetivo). Os resultados deste estudo, revelaram maiores impactos do suporte do supervisor do que de estilos de liderança sobre bem-estar no trabalho. Ao final, algumas considerações e recomendações serão feitas destacando-se a importância do bem-estar no trabalho sobre a saúde dos trabalhadores e das organizações.

Bem-estar no trabalho : os aspectos do suporte do supervisor e estilos de liderança

Bem-estar no trabalho, percepção de suporte do supervisor e estilos de liderança são temas que vêm despertando atenção crescente nos últimos tempos, de diversos pesquisadores no campo de estudos do comportamento organizacional. O objetivo desta pesquisa foi investigar o impacto da percepção do suporte do supervisor e dos estilos de liderança no bem-estar no trabalho. O construto bem-estar no trabalho no presente estudo foi representado por duas dimensões: satisfação no trabalho e comprometimento organizacional afetivo. A amostra foi composta por 200 trabalhadores que atuavam em empresas privadas e públicas, situadas no Estado de São Paulo, sendo 110 mulheres e 90 homens, distribuídos entre solteiros e casados. O instrumento de coleta de dados foi um questionário composto por quatro escalas que mediram as variáveis: percepção de suporte do supervisor, estilos de lideranças, satisfação no trabalho e comprometimento organizacional afetivo. Para a análise dos dados utilizou-se um programa estatístico. Foram calculadas estatísticas descritivas das variáveis do estudo (médias, desvios-padrão e correlações bivariadas) e modelos de regressão multivariada para se investigar os impactos causados por percepção do suporte do supervisor e por estilos de liderança sobre bem-estar no trabalho, representado por vínculos com o trabalho (satisfação no trabalho) e com a organização (comprometimento organizacional afetivo). Os resultados deste estudo, revelaram maiores impactos do suporte do supervisor do que de estilos de liderança sobre bem-estar no trabalho. Ao final, algumas considerações e recomendações serão feitas destacando-se a importância do bem-estar no trabalho sobre a saúde dos trabalhadores e das organizações.