Health care management review
-
Health Care Manage Rev · Oct 2007
Comparative StudyCountry of origin and racio-ethnicity: are there differences in perceived organizational cultural competency and job satisfaction among nursing assistants in long-term care?
Long-term care facilities nationwide are finding it difficult to train and retain sufficient numbers of nursing assistants, resulting in a dire staffing situation. Researchers, managers, and practitioners alike have been trying to determine the correlates of job satisfaction to address this increasingly untenable situation. One factor that has received little empirical attention in the long-term care literature is cultural competence. Cultural competence is defined as a set of skills, attitudes, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations. ⋯ Developing and maintaining organizational cultural competency and employee autonomy are important managerial strategies for increasing job satisfaction and improving staff retention. Toward this end, creating a comfortable work environment for employees of different races/cultures is an integral part of the process. Managerial recommendations are discussed.
-
Health Care Manage Rev · Oct 2007
Transformational change in health care systems: an organizational model.
The Institute of Medicine's 2001 report Crossing the Quality Chasm argued for fundamental redesign of the U.S. health care system. Six years later, many health care organizations have embraced the report's goals, but few have succeeded in making the substantial transformations needed to achieve those aims. ⋯ The conceptual model holds promise for guiding health care organizations in their efforts to pursue the Institute of Medicine aims of fundamental system redesign to achieve dramatically improved patient care.
-
Health Care Manage Rev · Oct 2007
A study of the effects of innovative and efficient practices on the performance of hospice care organizations.
Due to changes in social norms, funding initiatives, and other environmental factors, the business of hospice care has significantly evolved over the past 40 years. There has been an influx of for-profit firms, increased consolidation, and significant funding changes. We have witnessed a growth in utilization rates, an increase in insurance coverage, and improved governmental funding. Hospice care organizations have responded to these pressures by pursuing more efficient and innovative business practices. ⋯ It appears that incorporating innovative practices is positively related to quality of care. Although cost containment may be necessary for continued survival, efficiency improvement efforts do not seem to lead to improved quality of care.
-
Despite the growing pervasiveness of team-based job designs in health care organizations, there is a degree of uncertainty and ambiguity about the process through which teams affect outcomes. ⋯ Although adopting team-based job designs is an important first step, attention must also be paid to the context and atmosphere of such teams. Better outcomes will be achieved when team members perceive a supportive team atmosphere and an empowering team context with clear and jointly developed goals, an appropriate mix of skills and expertise, and rewards linked to team performance.