Martina Buljac-Samardzic

Safety culture in long-term care: a cross-sectional analysis of the Safety Attitudes Questionnaire in nursing and residential homes in the Netherlands

Objective The first objective was to investigate if the Safety Attitudes Questionnaire (SAQ) is appropriate to measure the safety attitude of caregivers in nursing and residential homes, and second, to compare safety attitude of these caregivers with available data of caregivers in other settings (ie, inpatients, intensive care unit (ICU) and ambulatory care). Methods Using a cross-sectional survey methodology, we obtained completed SAQ surveys from 521 caregivers (response rate of 53%) working in nine units in nine different nursing and residential homes in The Netherlands. Exploratory factor and Cronbachs alpha measures were used to analyse the psychometric properties of the SAQ. A correlation matrix was performed to study the relationship among the SAQ dimensions. A t test was performed to test significant differences between our sample and the benchmark settings. Results The factor analyses and calculated Cronbachs alphas (α=0.56–0.80) for this sample confirmed the robustness of the SAQ scales. There was a high positive correlation between teamwork climate, job satisfaction, perceptions of management, safety climate and working conditions (r=0.31 to 63), but stress recognition had a negative correlation with each of the other dimensions (r=−0.13 to −0.18). Overall, the scores from the nursing and residential homes differed significantly from the benchmark settings. Conclusions The findings in this study confirmed that the SAQ could also be used in the nursing and residential homes setting. However, stress recognition in nursing and residential homes setting does not seem to be one of the dimensions of the safety attitude construct. Furthermore, Dutch nursing and residential homes have significantly higher scores on most dimensions of the SAQ compared with US inpatient units and comparable scores to ICUs (Dutch and US) and ambulatory services.

Can managers coach their teams too much

Purpose – The relationship between managerial coaching and team performance may be mediated by team reflection because coaching is often thought to lead to reflection, which has been found to lead to improved performance. In contrast, this relationship might be moderated by team reflection, because poorly reflective teams are more likely to depend on coaching than highly reflective teams. The purpose of this paper is to test these rival hypotheses. Design/methodology/approach – The authors employed a longitudinal survey method at two points in time in two long-term care organizations. Team members were asked to rate the level of managerial coaching and team reflection. Team managers were asked to evaluate team performance. Findings – Team reflection turned out to be a moderator and not a mediator in the relationship between managerial coaching and team performance. Only the performance of poorly reflective teams benefits from managerial coaching. Practical implications – Excessive coaching of highly refle...

Who is on the primary care team? Professionals’ perceptions of the conceptualization of teams and the underlying factors: a mixed-methods study

BackgroundDue to the growing prevalence of elderly patients with multi-morbidity living at home, there is an increasing need for primary care professionals from different disciplinary backgrounds to collaborate as primary care teams. However, it is unclear how primary care professionals conceptualize teams and what underlying factors influence their perception of being part of a team. Our research question is: What are primary care professionals’ perceptions of teams and team membership among primary care disciplines and what factors influence their perceptions?MethodsWe conducted a mixed-methods study in the Dutch primary care setting. First, a survey study of 152 professionals representing 12 primary care disciplines was conducted, focusing on their perceptions of which disciplines are part of the team and the degree of relational coordination between professionals from different disciplinary backgrounds. Subsequently, we conducted semi-structured interviews with 32 professionals representing 5 primary care disciplines to gain a deeper understanding of the underlying factors influencing their perceptions and the (mis)alignment between these perceptions.ResultsMisalignments were found between perceptions regarding which disciplines are members of the team and the relational coordination between disciplines. For example, general practitioners were viewed as part of the team by helping assistants, (district) nurses, occupational therapists and geriatric specialized practice nurses, whereas the general practitioners themselves only considered geriatric specialized practice nurses to be part of their team. Professionals perceive multidisciplinary primary care teams as having multiple inner and outer layers. Three factors influence their perception of being part of a team and acting accordingly: a) knowing the people you work with, b) the necessity for knowledge exchange and c) sharing a holistic view of caregiving.ConclusionResearch and practice should take into account the misalignment between primary care professionals’ perceptions of primary care teams, as our study notes variations in the conceptualization of primary care teams. To enhance teamwork between professionals from different disciplinary backgrounds, professionals acknowledge the importance of three underlying conditions: team familiarity, regular and structured knowledge exchange between all professionals involved in the care process and realizing and believing in the added value for patients of working as a team.

The effect of human resource management on performance in hospitals in Sub-Saharan Africa: A systematic literature review

Hospitals in Sub-Saharan Africa (SSA) face major workforce challenges while having to deal with extraordinary high burdens of disease. The effectiveness of human resource management (HRM) is therefore of particular interest for these SSA hospitals. While, in general, the relationship between HRM and hospital performance is extensively investigated, most of the underlying empirical evidence is from western countries and may have limited validity in SSA. Evidence on this relationship for SSA hospitals is scarce and scattered. We present a systematic review of empirical studies investigating the relationship between HRM and performance in SSA hospitals.Following the PRISMA protocol, searching in seven databases (i.e., Embase, MEDLINE, Web of Science, Cochrane, PubMed, CINAHL, Google Scholar) yielded 2252 hits and a total of 111 included studies that represent 19 out of 48 SSA countries.From a HRM perspective, most studies researched HRM bundles that combined practices from motivation-enhancing, skills-enhancing, and empowerment-enhancing domains. Motivation-enhancing practices were most frequently researched, followed by skills-enhancing practices and empowerment-enhancing practices. Few studies focused on single HRM practices (instead of bundles). Training and education were the most researched single practices, followed by task shifting.From a performance perspective, our review reveals that employee outcomes and organizational outcomes are frequently researched, whereas team outcomes and patient outcomes are significantly less researched. Most studies report HRM interventions to have positively impacted performance in one way or another. As researchers have studied a wide variety of (bundled) interventions and outcomes, our analysis does not allow to present a structured set of effective one-to-one relationships between specific HRM interventions and performance measures. Instead, we find that specific outcome improvements can be accomplished by different HRM interventions and conversely that similar HRM interventions are reported to affect different outcome measures.In view of the high burden of disease, our review identified remarkable little evidence on the relationship between HRM and patient outcomes. Moreover, the presented evidence often fails to provide contextual characteristics which are likely to induce variety in the performance effects of HRM interventions. Coordinated research efforts to advance the evidence base are called for.

The different perspectives of patients, informal caregivers and professionals on patient involvement in primary care teams. A qualitative study

Patient involvement in the decision‐making process, especially for chronically ill elderly patients, has become an important element of patient‐centred primary care in many countries, including the Netherlands. This study openly explores different perspectives of patients, informal caregivers and primary care professionals on patient involvement in primary care team interactions.