Hospital & health services administration
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Hosp Health Serv Adm · Jan 1997
Organizational citizenship behavior among hospital employees: a multidimensional analysis involving job satisfaction and organizational commitment.
As hospitals continue to face intense pressure to control operating costs, many have resorted to staff reductions and other redesign efforts. The remaining employees are frequently asked to do more with less. ⋯ Usefulness analyses indicated that satisfaction with coworkers and affective commitment were the two most important predictors of one dimension of citizenship behavior, as each construct contributed unique variance in the dependent variable. Implications for future research and practice are provided.
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Hosp Health Serv Adm · Jan 1996
ReviewBusiness as usual? Changes in health care's workforce and organization of work.
Major changes are occurring in the health care workforce and organization of work. Such changes include, for example, a shift in workforce composition from specialists to generalists in medical care, as well as a shift from autonomous work performance to work performed in teams. ⋯ It identifies patterns of change and examines their causes. Further, we raise questions about the implications of these changes for practice and research in the health care field.
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Hosp Health Serv Adm · Jan 1996
Multicenter StudyKeys to patient satisfaction in the emergency department: results of a multiple facility study.
Patient satisfaction is a significant issue for emergency departments. The special nature of the emergency encounter calls for a sound understanding of the factors that influence patient satisfaction. ⋯ We find that demographic variables such as age and sex do not significantly influence the decision to recommend. Nursing/staff items, physician issues, and waiting time are the key factors that drive satisfaction with emergency departments.
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Hosp Health Serv Adm · Jan 1994
"How much do you get paid if I volunteer?" Suggested institutional policy on reward, consent, and research.
Pharmaceutical companies often ask practicing physicians to conduct phase IV or postmarketing research on new drugs. Companies pay physicians to enroll their patients and report dosage and side-effect information. ⋯ Improving investigators' financial status while increasing medical risks to phase IV subjects is ethically unsound, especially if subjects are unaware of investigators' rewards. We suggest a model policy and guidelines that affirm subjects' need for informed consent, investigators' need for recognition and support, and institutions' need to protect patients from undisclosed risk and relations.
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This article suggests that the community hospital can be an important key to health reform at the local level; that community benefit guidelines are acceptable to hospitals and community leaders in a 49-site national demonstration program; and that these guidelines can prove useful for communities in moving toward health reform. Types of community involvement by hospitals are categorized, and examples of each type are developed. Community benefit programs can be a promising approach to effectively respond at the local level to the problems of poor health status, lack of access to care, and increasing health care costs. Addressing financing of care without attention to changes in the delivery system will not lead to effective health reform.