Carol Borrill

The link between the management of employees and patient mortality in acute hospitals

The relationship between human resource management practices and organizational performance (including quality of care in health-care organizations) is an important topic in the organizational sciences but little research has been conducted examining this relationship in hospital settings. Human resource (HR) directors from sixty-one acute hospitals in England (Hospital Trusts) completed questionnaires or interviews exploring HR practices and procedures. The interviews probed for information about the extensiveness and sophistication of appraisal for employees, the extent and sophistication of training for employees and the percentage of staff working in teams. Data on patient mortality were also gathered. The findings revealed strong associations between HR practices and patient mortality generally. The extent and sophistication of appraisal in the hospitals was particularly strongly related, but there were links too with the sophistication of training for staff, and also with the percentages of staff working in teams.

Leadership behavior and subordinate well-being

The authors used a longitudinal design to investigate the relation between leadership behavior and the well-being of subordinates. Well-being is conceptualized as peoples feelings about themselves and the settings in which they live and work. Staff members (N = 562) of 2 Community Trusts participated 4 times in a 14-month period. Five models were formulated to answer 2 questions: What is the most likely direction of the relation between leadership and well-being, and what is the time frame of this relation? The model with the best fit suggested that leadership behavior and subordinate responses are linked in a feedback loop. Leadership behavior at Time 1 influenced leadership behavior at Time 4. Subordinate well-being at Time 2 synchronously influenced leadership behavior at Time 2. Leadership behavior at Time 4 synchronously influenced subordinate well-being at Time 4.

Getting the most out of multidisciplinary teams: A multi‐sample study of team innovation in health care

Driven by the assumption that multidisciplinarity contributes positively to team outcomes teams are often deliberately staffed such that they comprise multiple disciplines. However, the diversity literature suggests that multidisciplinarity may not always benefit a team. This study departs from the notion of a linear, positive effect of multidisciplinarity and tests its contingency on the quality of team processes. It was assumed that multidisciplinarity only contributes to team outcomes if the quality of team processes is high. This hypothesis was tested in two independent samples of health care workers (N = 66 and N = 95 teams), using team innovation as the outcome variable. Results support the hypothesis for the quality of innovation, rather than the number of innovations introduced by the teams.

Fatigue in the workforce of national health service trusts: Levels of symptomatology and links with minor psychiatric disorder, demographic, occupational and work role factors

The aims of this study were: (1) to obtain a systematic estimate of the levels of fatigue in representative samples of the major occupational groups of health care workers; (2) to examine the relationship between fatigue and mental health as a function of occupational and work role factors; and (3) to test the proposition that fatigue arises from a combination of poor mental health and high job stress. Questionnaire data from 7720 NHS Trust staff was used. Higher levels of fatigue were reported among health care workers in comparison with general population figures. Highest levels of general fatigue, the subjective sensation of tiredness, were experienced by doctors (especially women doctors), professions allied to medicine and managers. Highest levels of fatigability, the onset of symptoms after exertion, were experienced by ancillary and nursing staff. Both general fatigue and fatigability were associated with high levels of psychological distress. Support was also found for the proposition that fatigue arises from a combination of poor mental health and high work demands.

Psychological morbidity and job satisfaction in hospital consultants and junior house officers: multicentre, cross sectional survey

Junior house officers have traditionally been the most distressed doctors in the health service.1 Recently, however, there have been reports of significant psychological morbidity in senior doctors such as hospital consultants.2Previous studies found that levels of distress decrease with increasing medical seniority.3 Much of the organisational burden of recent hospital reform has fallen on consultants, while junior doctors continue to have their hours of work reduced. We investigated whether these changes had affected the relation between medical seniority, psychological morbidity, and job satisfaction. View this table: Comparison of job satisfaction, work demands, job autonomy, and general health questionnaire scores for consultants and house officers. Scores on 16 items of job satisfaction are also listed. In all cases higher scores indicate more favourable outcomes except for 12 item version of general health questionnaire (GHQ) and work demands scale where higher scores indicate greater psychological morbidity and increased work demands respectively. …

Strain as a moderator of the relationship between work characteristics and work attitudes.

Research on the psychological effects of work characteristics has investigated their relationships with both work attitudes and psychological strain, with the latter 2 variables being treated as alternative or joint dependent variables. The focus of this article is to propose that strain moderates the relationship between perceptions of work characteristics and work attitudes. The proposition is tested on a maximum sample of 9,327 health care employees by using moderated multiple regression followed by subgroup comparisons. The results strongly support the moderating effect, showing that as strain increases, the strength of the relationship between perceptions of work characteristics and work attitudes decreases.

New parents at work: Jobs, families and the psychological contract

Abstract Interviews with seven women and six men who had recently returned to work after becoming first-time parents were carried out to examine experiences of the policies, practices and attitudes of their employers towards new parents, and to assess how far they felt able to discuss their circumstances and changed expectations with their managers. Findings pointed to considerable differences in the attitudes of employers to the men and women. Almost all the women had changed to part-time work, but arranging this had not been easy and some had found it difficult to come to terms with a difference in status. Many of the respondents had reservations about discussing their positions and altered expectations with their managers, and it seemed unlikely that mutually beneficial psychological contracts could be negotiated without changes in organisational cultures and policies. The findings have implications for our understanding of organisational careers and for career-planning interventions in organisations.

Psychometric properties of the Community Mental Health Team effectiveness questionnaire (CMHTEQ)

The Community Mental Health Team effectiveness questionnaire (CMHTEQ) is a 27-item measure of Community Mental Health Team (CMHT) effectiveness for completion by team members. It was constructed following a stakeholder conference representing the following constituencies: clinicians, users and carers, mental health researchers, policy makers and managers. We present a psychometric analysis of the CMHTEQ, based on the responses of 1450 (response rate: 75%)CMHT staff of a sample of 113 CMHTs recruited from all Trusts providing community mental health care across four English NHS Regions. Three factors emerged from an exploratory analysis of 50% of the data, upheld by a confirmatory analysis of the remaining data: meeting external requirements; internal team processes; evidence and feedback. Factor scales exhibited acceptable internal reliabilities. The CMHTEQ meets the need for a measure of the effectiveness of CMHTs, as perceived by their members, for use in research studies of the environment and effectiv...The Community Mental Health Team effectiveness questionnaire (CMHTEQ) is a 27-item measure of Community Mental Health Team (CMHT) effectiveness for completion by team members. It was constructed following a stakeholder conference representing the following constituencies: clinicians, users and carers, mental health researchers, policy makers and managers. We present a psychometric analysis of the CMHTEQ, based on the responses of 1450 (response rate: 75%)CMHT staff of a sample of 113 CMHTs recruited from all Trusts providing community mental health care across four English NHS Regions. Three factors emerged from an exploratory analysis of 50% of the data, upheld by a confirmatory analysis of the remaining data: meeting external requirements; internal team processes; evidence and feedback. Factor scales exhibited acceptable internal reliabilities. The CMHTEQ meets the need for a measure of the effectiveness of CMHTs, as perceived by their members, for use in research studies of the environment and effectiveness of mental health care, and by service managers or CMHTs seeking to monitor or track performance change over time.

The Psychology of Effective Teamworking

Teams have become the building blocks of organizations (Lawler, Mohrman and Ledford, 1992). As organizations grow in size and become structurally more complex, groups of people are needed who work together in coordinated ways to achieve objectives that contribute to the overall aims, effectiveness and competitiveness of the organization. Team working provides the flexibility needed to respond effectively, appropriately and more quickly than competitors to the constantly changing demands in the organization’s environment, and provides a mechanism for bringing together the range of expertise, skills and knowledge required to complete complex work tasks.