Jennifer Craft Morgan

The quality of healthcare jobs: can intrinsic rewards compensate for low extrinsic rewards?

Frontline healthcare worker jobs are among the fastest growing occupations in the USA. While many of these are ‘bad jobs’ with low pay and few benefits, the intrinsic nature of frontline work can also be very rewarding. This article examines the influence of extrinsic job characteristics (e.g. wages and benefits) versus intrinsic characteristics (e.g. meaningful tasks) on job satisfaction and intent to stay with one’s current employer. This article uses a mixed-methods approach, drawing on survey data collected from frontline workers and organizations in a variety of healthcare settings, as well as interview and focus group data from frontline workers to contextualize and interpret the findings in the multi-level models. The results indicate that both intrinsic and extrinsic characteristics are significant predictors of job satisfaction, but only extrinsic characteristics help explain intent to stay with the employer.

A Configurational Approach to the Relationship between High‐Performance Work Practices and Frontline Health Care Worker Outcomes

OBJECTIVE To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care. METHODS Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis. PRINCIPAL FINDINGS Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers. CONCLUSIONS High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices.

Development and testing of the Satisfaction in Nursing Scale.

Background:Because work satisfaction of nurses is related negatively to turnover and related positively to performance, it is essential that it be assessed accurately and meaningfully. The most commonly used scales for assessment of satisfaction were developed at least 30 years ago and are not consistent with the concerns of todays nurses. Objectives:The objectives of this study were to develop and test a new work satisfaction measure, the Satisfaction in Nursing Scale (SINS). Methods:On the basis of qualitative interviews with 20 nurses, 115 distinct items pertaining to work satisfaction as a nurse were identified. After assessment for content validity, 113 items remained. A total of 787 participants were used for the initial analyses of the SINS. Data from an additional 366 participants were used to confirm the factor structure and to assess the convergent validity of the SINS further. Results:Exploratory factor analysis yielded a scale with 59 items on four factors, accounting for 41% of the variance in scores. Reliability estimates for the SINS factors range from.81 to.94. All four factors were confirmed using Structural Equation Modeling (SEM), with an additional 4 items removed. The SINS factors correlated moderately with a measure of organizational commitment (r =.40-.62). Moderate correlations were also found between the SINS and the counterpart factors of the Hinshaw and Atwood Work Satisfaction Scale. Discussion:The SINS is a sound work satisfaction instrument. Next steps include further construct validity assessment and exploration of the use of the SINS in other clinical settings.

Strengthening the Long-Term Care Workforce: The Influence of the WIN A STEP UP Workplace Intervention on the Turnover of Direct Care Workers

Given high rates of turnover among direct care workers in long-term care settings, it is important to identify factors affecting organizational-level turnover rates. In this study, the authors examine the impact of a workforce intervention program (Workforce Improvement for Nursing Assistants: Supporting Training, Education, and Payment for Upgrading Performance [WIN A STEP UP]) on turnover rates of direct care workers in nursing homes. Using data collected yearly between 2002 and 2006 from 405 nursing homes in North Carolina, the authors employ random effects modeling to predict a dichotomous outcome of “above-average” versus “below-average” turnover. Results indicate that nursing homes participating in the WIN A STEP UP program are 15% more likely to have below-average turnover than are nonparticipating nursing homes. Organizational factors such as ownership type and Medicaid participation also influenced turnover, whereas labor market factors had no independent effects. The results suggest that workforce development projects that increase the training of direct care workers and provide associated rewards show some potential to lower turnover rates of the direct care workforce.

Fostering Supportive Learning Environments in Long-Term Care: The Case of WIN A STEP UP

Abstract The education of direct care workers (DCWs) is key to improving job quality and the quality of care in long-term care (LTC). This paper describes the successful integration of a supervisory training program into a continuing education intervention (WIN A STEP UP) for DCWs, identifies the factors that appear to influence the integration of the learning into practice, and discusses the implications for educators. The WIN A STEP UP program achieved its strongest results when the DCW curriculum was paired with Coaching Supervision. Attention to pre-training, training and post-training conditions is necessary to successfully integrate learning into practice in LTC.

Public understanding of cigarette smoke constituents: three US surveys

Introduction The Tobacco Control Act requires public disclosure of information about toxic constituents in cigarette smoke. To inform these efforts, we studied public understanding of cigarette smoke constituents. Methods We conducted phone surveys with national probability samples of adolescents (n=1125) and adults (n=5014) and an internet survey with a convenience sample of adults (n=4137), all in the USA. We assessed understanding of cigarette smoke constituents in general and of 24 specific constituents. Results Respondents commonly and incorrectly believed that harmful chemicals in cigarette smoke mostly originate in additives introduced by cigarette manufacturers (43–72%). Almost all participants had heard that nicotine is in cigarette smoke, and many had also heard about carbon monoxide, ammonia, arsenic and formaldehyde. Less than one-quarter had heard of most other listed constituents being in cigarette smoke. Constituents most likely to discourage respondents from wanting to smoke were ammonia, arsenic, formaldehyde, hydrogen cyanide, lead and uranium. Respondents more often reported being discouraged by constituents that they had heard are in cigarette smoke (all p<0.05). Constituents with names that started with a number or ended in ‘ene’ or ‘ine’ were less likely to discourage people from wanting to smoke (all p<0.05). Discussion Many people were unaware that burning the cigarette is the primary source of toxic constituents in cigarette smoke. Constituents that may most discourage cigarette smoking have familiar names, like arsenic and formaldehyde and do not start with a number or end in ene/ine. Our findings may help campaign designers develop constituent messages that discourage smoking.

How people think about the chemicals in cigarette smoke: a systematic review

Laws and treaties compel countries to inform the public about harmful chemicals (constituents) in cigarette smoke. To encourage relevant research by behavioral scientists, we provide a primer on cigarette smoke toxicology and summarize research on how the public thinks about cigarette smoke chemicals. We systematically searched PubMed in July 2016 and reviewed citations from included articles. Four central findings emerged across 46 articles that met inclusion criteria. First, people were familiar with very few chemicals in cigarette smoke. Second, people knew little about cigarette additives, assumed harmful chemicals are added during manufacturing, and perceived cigarettes without additives to be less harmful. Third, people wanted more information about constituents. Finally, well-presented chemical information increased knowledge and awareness and may change behavior. This research area is in urgent need of behavioral science. Future research should investigate whether educating the public about these chemicals increases risk perceptions and quitting.

Where are they now? Results of a career survey of library and information science graduates

This paper provides an overview of Workforce Issues in Library and Information Science 1 (WILIS 1), a large scale retrospective career study of graduates of all library and information science (LIS) programs in North Carolina from 1964–2007. The interdisciplinary research team used a multiple methods approach to data collection consisting of a survey of LIS graduates, a survey of administrators of LIS programs, and key informant interviews. This article presents an overview of the study design and methods followed by key results from the survey of graduates. The specific research goals of WILIS 1 were: (1) to gain a comprehensive understanding of the educational, workplace, career, and retention issues facing LIS graduates; (2) to investigate the way in which LIS programs track their graduates and use these data for educational and workforce planning; (3) to explore possibilities for a career tracking model that could be used by all LIS programs in the future; and (4) to disseminate the study results in a manner that would facilitate LIS workforce planning. WILIS 1 has now been joined by a second study known as WILIS 2, which is further developing the alumni tracking model that all LIS programs can potentially use.

Documenting Diversity among Working LIS Graduates

The purpose of this article is to document the demographic characteristics of the library and information science (LIS) workforce and to discuss the implications of these findings for education and workforce planning. Workforce Issues in Library and Information Science 1 (WILIS 1) is a collaborative research partnership of the University of North Carolina Chapel Hill School of Information and Library Science and the University of North Carolina Institute on Aging, funded by the Institute of Museum and Library Services through its Librarians for the 21st Century Program. Workforce Issues in Library and Information Science 1 (WILIS 1) is a comprehensive study of the career patterns of graduates of LIS programs in North Carolina since 1964. This article examines data from 1,903 working LIS graduate respondents. The results of this study suggest that the LIS workforce is predominantly female, underrepresented in terms of race/ethnic minorities, and consists of slightly older workers than the workforce overall. Comparisons of earnings reveal a substantial wage gap between the males and females in the sample (men earn more). We also find significant race, sex, and gender differences in factors that motivated respondents to enter an LIS program and qualities of jobs that respondents find desirable. Based on these findings, we suggest the following strategies to increasing diversity: (1) focus efforts on recruiting race/ethnic minorities to the LIS profession; (2) structure LIS jobs to accommodate the needs of women workers; and (3) plan for and accommodate the large segment of older and retiring workers.

Library and information services: impact on patient care quality

PURPOSE The purpose of this paper is to explore library and information service impact on patient care quality. DESIGN/METHODOLOGY/APPROACH A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. FINDINGS Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching librarys web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. ORIGINALITY/VALUE Electronic collections and services provided by the library and the librarian contribute to patient care quality.