Scott C. Moore

Civility, Respect, Engagement in the Workforce (CREW): Nationwide Organization Development Intervention at Veterans Health Administration

This article presents a description and preliminary evaluation of a nationwide initiative by the Veterans Health Administration (VHA) called Civility, Respect, and Engagement in the Workforce (CREW). The goal of CREW is to increase workplace civility as assessed by employee ratings of interpersonal climate in workgroups. Once endorsed by the VHA leadership and adopted by the leaders of particular VHA hospitals, CREW was conducted by local facility coordinators who were trained and supported by the VHA National Center for Organization Development. This article explains the conceptual and operational background of CREW and the approach used to implement the initiative, presents results from two CREW administrations with a total of 23 sites, and reports significant preintervention to postintervention changes in civility at intervention sites as compared to no significant changes at comparison sites within each administration. It discusses these findings in the conceptual (theoretical) and operational (intervention evaluation) context of interventions targeting civility.

Development of a short-form Learning Organization Survey: the LOS-27.

Despite urgent need for innovation, adaptation, and change in health care, few tools enable researchers or practitioners to assess the extent to which health care facilities perform as learning organizations or the effects of initiatives that require learning. This study’s objective was to develop and test a short-form Learning Organization Survey to fill this gap. The authors applied exploratory factor analysis and confirmatory factor analysis to data from Veterans Health Administration personnel to derive a short-form survey and then conducted further confirmatory factor analysis and factor invariance testing on additional Veterans Health Administration data to evaluate the short form. Results suggest that a 27-item, 7-factor survey (2 environmental factors, 1 on leadership, and 4 on concrete learning processes and practices) reliably measures key features of organizational learning, allowing researchers to evaluate theoretical propositions about organizational learning, its antecedents, and outcomes and enabling managers to assess and enhance organizations’ learning capabilities and performance.

Employee age and tenure within organizations: relationship to workplace satisfaction and workplace climate perceptions.

This study estimated the relative influence of age/generation and tenure on job satisfaction and workplace climate perceptions. Data from the 2004, 2008, and 2012 Veterans Health Administration All Employee Survey (sample sizes >100 000) were examined in general linear models, with demographic characteristics simultaneously included as independent variables. Ten dependent variables represented a broad range of employee attitudes. Age/generation and tenure effects were compared through partial &eegr;2 (95% confidence interval), P value of F statistic, and overall model R2. Demographic variables taken together were only weakly related to employee attitudes, accounting for less than 10% of the variance. Consistently across survey years, for all dependent variables, age and age-squared had very weak to no effects, whereas tenure and tenure-squared had meaningfully greater partial &eegr;2 values. Except for 1 independent variable in 1 year, none of the partial &eegr;2 confidence intervals for age and age-squared overlapped those of tenure and tenure-squared. Much has been made in the popular and professional press of the importance of generational differences in workplace attitudes. Empirical studies have been contradictory and therefore inconclusive. The findings reported here suggest that age/generational differences might not influence employee perceptions to the extent that human resource and management practitioners have been led to believe.

Predictors of Job Satisfaction and Turnover Intention in VHA Mental Health Employees: A Comparison Between Psychiatrists, Psychologists, Social Workers, and Mental Health Nurses

This exploratory study compared job satisfaction and turnover intention among psychiatrists, psychologists, social workers, and mental health nurses in the Veterans Health Administration, focusing on four predictors: civility, procedural justice, autonomy, and psychological safety. A sample of 11,726 VHA mental health employees was used. Results of the structural equation modeling showed that, for all occupations, civility, procedural justice, and autonomy predicted job satisfaction, which in turn predicted turnover intention. Psychological safety directly predicted turnover intention, a unique finding to this study. There were, however, no differences in the predictors across occupations. Implications and directions for future research are discussed.

Team Process Variation Across Diabetes Quality of Care Trajectories

Conceptual frameworks in health care do not address mechanisms whereby teamwork processes affect quality of care. We seek to fill this gap by applying a framework of teamwork processes to compare different patterns of primary care performance over time. We thematically analyzed 114 primary care staff interviews across 17 primary care clinics. We purposefully selected clinics using diabetes quality of care over 3 years using four categories: consistently high, improving, worsening, and consistently low. Analyses compared participant responses within and between performance categories. Differences were observed among performance categories for action processes (monitoring progress and coordination), transition processes (goal specification and strategy formulation), and interpersonal processes (conflict management and affect management). Analyses also revealed emergent concepts related to psychological and organizational context that were reported to affect team processes. This study is a first step toward a comprehensive model of how teamwork processes might affect quality of care.