Terry H. Wagar

Impact of human resource management practices on nursing home performance.

Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain progressive or high-performance human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more progressive HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain optimal organizational performance.

Turnover and vacancy rates for registered nurses: do local labor market factors matter?

Background: Turnover of nursing staff is a significant issue affecting health care cost, quality, and access. In recent years, a worldwide shortage of skilled nurses has resulted in sharply higher vacancy rates for registered nurses in many health care organizations. Much research has focused on the individual, group, and organizational determinants of turnover. Labor market factors have also been suggested as important contributors to turnover and vacancy rates but have received limited attention by scholars. Purpose: This study proposes and tests a conceptual model showing the relationships of organization-market fit and three local labor market factors with organizational turnover and vacancy rates. Methods: The model is tested using ordinary least squares regression with data collected from 713 Canadian hospitals and nursing homes. Results: Results suggest that, although modest in their impact, labor market and the organization-market fit factors do make significant yet differential contributions to turnover and vacancy rates for registered nurses. Implications: Knowledge of labor market factors can substantially shape an effective campaign to recruit and retain nurses. This is particularly true for employers who are perceived to be employers-of-choice.

Organizational Learning and Continuous Quality Improvement: Examining the Impact on Nursing Home Performance

Interest is growing in learning more about the ability of total quality management and continuous quality improvement (TQM/CQI) initiatives to contribute to the performance of healthcare organizations. A major factor in the successful implementation of TQM/CQI is the seminal contribution of an organizations culture. Many implementation efforts have not succeeded because of a corporate culture that failed to stress broader organizational learning. This may help to explain why some TQM/CQI programs have been unsuccessful in improving healthcare organization performance. Organizational performance variables and organizational learning orientation were assessed in a sample of 181 Canadian long-term care organizations that had implemented a formal TQM/CQI program. Categorical regression analysis shows that, in the absence of a strong corporate culture that stresses organizational learning and employee development, few performance enhancements are reported. The results of the assessment suggest that a TQM/CQI program without the backing of a strong organizational learning culture may be insufficient to achieve augmented organizational performance.

Reducing the Hospital Workforce: What is the Role of Human Resource Management Practices?

n recent years, downsizing has become a ubiquitous phenomenon of organizational life, even though an increasing body of evidence suggests that it may produce few lasting benefits (Heenan 1989; Mentzer 1996). Organizational scholars, in a burgeoning literature focusing on the downsizing process, suggest that downsizing is not merely the reverse of organizational growth and, therefore, requires a unique perspective (Cameron, Sutton, and Whetton 1988). Although downsizing is often stimulated by a change in strategy, a diminution in the availability of critical resources, or declining markets, a decline in performance is not necessarily a precursor (Cameron, Freeman, and Mishra 1993). For instance, organizations may downsize to prune an ineffective bureaucracy, lower overhead costs, hasten decision making, smooth communication, increase entrepreneurship, or improve productivity (Cascio 1993; Tomasko 1987). However, in the long run, achieving any of these benefits may stem mainly from an organizations ability to manage its human capital. The overuse and misuse of downsizing—^in a first response to environmental decline or in the pursuit of short-term, tactical objectives—have been shown to produce lasting deleterious effects on an organizations human resources (ArmstrongStassen 1993; Brockner 1988, 1992; Noer 1993). Nevertheless, how reductions are carried out may play a seminal role in mitigating the dysfunctional human consequences too often associated with organizational retrenchment (Cameron, Freeman, and Mishra 1991). Managing the workforce effectively under conditions of decline and cutback remains a unique and enduring challenge (Feldman and Leana 1994; Gilmore and Hirschhorn 1983). Progressive management of an organizations human resources has long been considered crucial to its effectiveness and, increasingly, a means by which an organization can secure strategic advantage (Lawler 1986; Pfefifer 1994, 1998; Schuler and Jackson 1987). Few researchers have examined the impact that human resource management (HRM) practices associated with higher levels of organizational performance have on an organization experiencing decline or retrenchment. However, this area of research is one of the fields most promising in recent years (Cook and Ferris 1986; Ferris, Schellenberg, and Zammuto 1984). We are only now beginning to understand how such practices afFect performance (Huselid 1995; Sheppeckand Militello 2000; Youndt et al. 1996), yet we know almost nothing about their ability to do so when the organization is undergoing significant change—including labor force displacements. Although the activities and practices identified in the literature as being high performing, high involv-

Is there a relationship between information technology adoption and human resource management

Purpose – The purpose of this paper is to investigate whether the adoption of information technology is associated with human resource management and organizational restructuring.Design/methodology/approach – SMEs in Nova Scotia were visited and complete data from 130 firms were obtained.Findings – The rate of IT adoption varies noticeably among SMEs in Nova Scotia, with less than 10 per cent being high adopters. IT adoption was strongly associated with employer size, organizational restructuring and investment in human resource management.Research limitations/implications – The data are cross‐sectional and the generalizability of the results may be limited. While it was found that HRM and IT were strongly related, it was whether they are associated with higher employer performance was not examined.Practical implications – The results suggest that IT may play a role in enhancing the human resource function.Originality/value – There has been little research exploring the link between HRM and IT adoption, p...

Hospital choices in times of cutback: the role of organizational culture

Organizational scholars and practitioners alike have long recognized the role of corporate culture in shaping the strategic and operational choices that organizations pursue. It is the responsibility of those who plan for change to select approaches that are compatible with the enduring elements of the organization’s dominant culture. A large sample of Canadian hospitals were surveyed to assess how organizational culture impacts the choices that organizations make in managing fiscal cutbacks. Results suggest that approaches and strategies used by Canadian hospitals in managing the change are variably influenced by CEO perceptions of the prevailing corporate culture.

Sustaining a service quality initiative in the midst of downsizing - Can it be done?

Abstract This study examined employees perceptions of the factors associated with a service quality initiative during and following organizational downsizing. The participants were employees of a large Canadian federal government department that began implementing a service quality initiative in 1995 and then reduced its workforce by 20% between 1996 and 1997. One hundred employees were interviewed in 1996 and 275 employees completed a questionnaire in 1997 and 14 months later in 1998. Overall, survivors perceived that the downsizing had an adverse effect on the departments quality initiative. Factors during the downsizing that were associated with greater perceived support for the quality initiative, service quality, teamwork and quality improvement efforts following the downsizing were job level (management), greater initial commitment to the quality initiative, lower perceived negative downsizing effect on the quality initiative, higher perceived organizational morale, and higher trust in the organization and organizational commitment. Initial commitment to the quality initiative was an especially important predictor of how remaining employees perceived the quality initiative following the downsizing. Respondents reported a significant increase in service quality and teamwork following the downsizing period suggesting that these key features of a quality program may be only temporarily affected by organizational downsizing.

Downsizing and Organizational Restructuring: What Is the Impact on Hospital Performance?

Abstract In recent years, hospitals have radically restructured their operations while significantly downsizing their workforces. To date, little is known about the combined effect of these change processes on organizational functioning. There have been few large‐scale studies investigating how hospitals have performed when both organizational restructuring and downsizing are used concurrently. The research reported here sets out to separate and isolate the independent and combined effect of organizational restructuring and downsizing on hospital performance. In particular, it aims to address the following question: Do hospitals which undergo significant organizational restructuring while maintaining their workforce complement perform any better than hospitals that institute significant restructuring while heavily downsizing, and any better than hospitals which heavily downsize but undertake little or no organizational restructuring? Categorical regression analysis results from a sample of 285 Canadian acute care hospitals suggest that organizational restructuring and downsizing have differential impacts on organizational performance. Hospitals which undertook significant organizational restructuring while heavily downsizing were perceived to perform better than hospitals that heavily downsized but conducted little or no organizational restructuring, but performed worse than hospitals that undertook significant restructuring while maintaining their workforce complement. However, when the method of conducting the change management process was controlled for, these performance differences were reduced or eliminated.

Managing the workforce reduction: hospital CEO perceptions of organizational dysfunction.

EXECUTIVE SUMMARY Over the past few years many nations have undertaken activities aimed at restructuring and reengineering their health system as a means of achieving greater cost effectiveness and consumer responsiveness. Most efforts at reforming healthcare delivery have been accompanied by the downsizing of healthcare organizations. Organizations that are undergoing decline or significant workforce contractions are widely believed to experience a number of negative or dysfunctional attributes as a consequence of reductions in, or redeployments of, their labor force. For organizations undergoing planned workforce reductions, much speculation has been made in an attempt to identify a set of “best practices” that have the potential to mitigate the dysfunctional consequences associated with large permanent reductions in the workforce. This article explores the relationships among workforcereduction practices and perceptions of organizational dysfunction in a large sample of Canadian hospitals. Results of the analysis suggest that the application of certain “progressive” workforce‐reduction practices preceding, during, and subsequent to the downsizing process may play an important role in mitigating some of these dysfunctional organizational consequences. This research provides some evidence to suggest that how a workforce reduction is carried out may have a greater effect on organizational effectiveness than either the magnitude or severity of the overall workforce reduction.

Reducing the workforce: examining its consequences in health care organizations

In recent years, health care in Canada as elsewhere has witnessed unprecedented restructuring and reorganization. Concurrent with the massive restructuring of health care systems, many health care organizations have dramatically downsized their workforces by shedding jobs and people. It is generally assumed that forced workforce reductions can have significant deleterious consequences on organizations. This study examines the impact of workforce reduction on perceptions of organizational performance in a large sample of Canadian health care organizations.