The effects of health transformation program on patient–healthcare personnel communication and interaction in Turkey

The structure of the Turkish healthcare system is being reorganized under Health Transformation Program (HTP) and some serious changes in healthcare system are being carried out. Effective healthcare personnel and patient communication has a significant impact on patients’ health behaviors and health outcomes. The purpose of this study is to examine the effect of communication dimensions and HTP on patient and healthcare personnel communication and interaction. The survey was conducted with simple random sampling to 9,089 patients in Turkey. Exploratory factor analysis showed three dimensions of communication which are in positive and strong relationship: building relationship, process of physical examination and ending communication. Hierarchical multiple regression was performed to measure the effect of communication dimensions and HTP to patient–healthcare personnel communication and interaction. According to the first step, communication dimensions have a statistically significant effect on patient–healthcare personnel communication and interaction. Introduction of HTP to hierarchical multiple regression explained additional meaningful variance in patient–healthcare personnel communication and interaction, after controlling communication dimensions. It is revealed that, HTP has an important role on communication and interaction. This study has a macro approach and it is limited with the patients’ point of view.     

Enhancing hospital supply chain performance: A relational view and empirical test

Improving hospital supply chain performance has become increasingly important as healthcare organizations strive to improve operational efficiency and to reduce cost. In this study, we propose a research model based on a relational view, delineating the factors that influence hospital supply chain performance: trust, knowledge exchange, IT integration between the hospital and its suppliers, and hospital–supplier integration. Testing results of the research model based on data from a sample of 117 supply chain executives from U.S. hospitals show positive direct effects: (1) from trust and from IT integration to knowledge exchange respectively; (2) from knowledge exchange and from IT integration to hospital–supplier integration respectively; and (3) from hospital–supplier integration to hospital supply chain performance. The results also show the following indirect effects: (1) the influences of knowledge exchange and IT integration on hospital supply chain performance are partially and fully mediated by hospital–supplier integration, respectively and (2) the influences of trust and IT integration on hospital–supplier integration are fully and partially mediated by knowledge exchange, respectively. In addition, the results show the following moderating effects: (1) hospital system membership moderates the relationships between IT integration and knowledge exchange and between trust and knowledge exchange; (2) hospital environmental uncertainty moderates the relationship between trust and knowledge exchange; and (3) trust moderates the relationship between knowledge exchange and hospital–supplier integration. Implications of the study findings and directions for future research are discussed.     

Underlining micro socio-psychological mechanisms of buyer-supplier relationships: Implications for inter-organizational learning agility

The nature and patterns of vertical work relationships between buyers and suppliers is a key subject of inquiry in organization and management research. However, the mechanisms conducive to transforming transaction-based relationships into commitment-based relationships remain elusive. Although commitment-based relationships can produce various outcomes, little is known about whether and how these work relationships build and facilitate inter-organizational capabilities and their performance implications. This article presents a theoretical model that clarifies the micro socio-psychological mechanisms by which buyers and suppliers can develop inter-organizational learning agility. By drawing on theoretical insights in the areas of social exchange, micro-foundations, positive work relationships, commitment, and dynamic capabilities, it suggests that three mechanisms – respectful engagement, rich and ongoing communication, and advice seeking and giving – can transition buyer-supplier relations from transactional ties to commitment-based ties. It is argued that relationship commitment is a key to building inter-organizational learning agility by enacting three mechanisms: psychological availability, generativity and reflective reframing. The discussion centers on the fundamentals for developing this stream of research.     

Factors affecting development of crisis management mechanisms in hospitals

The growing competition among hospitals has almost dissolved hospitals’ absolute dominance over the physician–patient relationship. Many existing systems or regulations governing public organizations are so rigid that outstanding physicians in public hospitals may easily depart or be head hunted by competitors. Therefore, there will be more and starker challenges ahead of public hospitals. Through collection and analysis of a large sample, we attempt to apply a unique data validation method—nonlinear fuzzy neural network model to investigate the research issue. The questionnaire was administered to chairmen or physicians taking administrative positions in Taiwan’s public hospitals. The empirical results are as follows: Uncertainty of the hospital business environment is positively correlated with development of crisis management mechanisms; Operation of crisis management mechanisms is positively correlated with establishment of a medical risk management system; Organizational culture in public hospitals is disadvantageous to operation of crisis management mechanisms.     

Examining transformational leadership,job satisfaction,organizational commitment and organizational trust in Turkish hospitals: public servants versus private sector employees

Leadership, job satisfaction, organizational commitment and trust have become important processes for healthcare management in recent years. One of the contemporary human resource management functions in the organizations involves engaging in leadership development, improving organizational trust and organizational commitment and increasing job satisfaction. Considering the rapidly changing healthcare technology and higher levels of occupational complexity, healthcare organizations are increasingly in need of engaging in leadership development in any given area of expertise to address ever-changing nature of the industry and the delivery of quality of care while remaining cost-effective and competitive. This paper investigates the perceptions of both public servants and private sector employees (outsourcing) on transformational leadership, organizational commitment, organizational trust and job satisfaction in Turkish healthcare industry. Additionally, the paper analyzes the predictability of organizational commitment based on employee – both public servants (physicians, nurses, administrative personnel and other healthcare professionals) and private sector employees (outsourcing) (auxiliary services such as administrative assistants, security personnel, kitchen, laundry and housekeeping employees) – perceptions of transformational leadership, job satisfaction and organizational trust. Using a survey instrument with items adopted from the transformational leadership inventory (TLI) [Podsakoff, P. M., MacKenzie, S. B., Moorman, R. H., & Fetter, R. (1990). Transformational leader behaviors and their effects on followers' trust in leader, satisfaction, and organizational citizenship behaviors. Leadership Quarterly, 1, 107–142], the organizational commitment questionnaire [Meyer, J. P., & Allen, N. J. (1997). Commitment in the workplace: Theory, research, and application. Thousand Oaks, CA: Sage], the organizational trust inventory (OTI) [Cummings, L. L., & Bromiley, P. (1996). The occupational trust inventory (OTI): Development and validation. In R. Kramer & T. Tyler (Eds.), Trust in organizations: Frontiers of Theory and Research (pp. 302–330). Thousand Oaks, CA: Sage] and job satisfaction survey (JSS) [Spector, P. E. (1985). Measurement of human service staff satisfaction: Development of the job satisfaction survey. American Journal of Community Psychology, 13, 693–731], this quantitative study was conducted among 2108 healthcare employees (public servants and private employees) in two large government hospitals in Turkey. The study findings indicate a significant difference between the public servants and private sector employees in terms of their perceptions on two dimensions of transformational leadership (being an appropriate model, providing individualized support), overall transformational leadership and one dimension of job satisfaction (communication). The two dimensions of job satisfaction – operating procedures and communication – as well as organizational trust were the significant predictors of organizational commitment of public servants, whereas the two dimensions of leadership – individualized support and fostering the acceptance – as well as the two dimensions of job satisfaction – promotion and contingent rewards – and organizational trust were the significant regressors of organizational commitment of private sector employees. In addition, there is a significant difference between the predictors of the dimensions of organizational commitment (transformational leadership, job satisfaction and organizational trust) in terms of public servants versus private sector employees. Finally, organizational trust has a significant effect on overall organizational commitment as well as its three dimensions for public servants and private employees.     

Influence of high performance work systems on employee subjective well-being and job burnout: empirical evidence from the Chinese healthcare sector

Over the last two decades, high performance work systems (HPWSs) research has been dominated by examining the effects of these systems on firm performance. Research on the impact of HPWSs on employees has been marginalised. This study examines the impact of HPWSs on two psychological outcomes for employees, namely, subjective well-being (SWB) and workplace burnout, by utilising data collected from 1488 physicians and nurses in 25 Chinese hospitals. It also examines the moderating effects of employees' organisational based self-esteem (OBSE), as an individual intervention and physician–nurse relationships, as an organisational intervention, on the relationship between HPWSs and employee outcomes. HPWS is found to increase employees' SWB and decrease burnout. Such well-being-enhancing and burnout-relieving effects are stronger when employees have high OBSE. The positive effect of HPWS on SWB is also stronger when there is a collaborative relationship among employees in an organisation. The major contribution of this study is to unpack the ‘black box’ of how HPWS influences employee well-being in the Chinese healthcare sector context.     

The impact of consumer health information on the demand for health services

This paper empirically examines whether consumers use health information, from non-physician information sources, as a substitute or complement for health services – namely for physician visits and emergency room (ER) visits. An indicator of patient trust in physicians is developed and used as a proxy for potential unobserved heterogeneity that may drive both consumers’ propensity to seek information and to use physician services. The results, after correcting for sample selection bias and controlling for unobserved heterogeneity, concur with the literature, that consumer health information increases the likelihood of visiting a physician as well as the frequency of visits on average. However, low-trust consumers tend to substitute self-care through consumer health information for physician services. Further, better-informed consumers make significantly fewer ER visits suggesting that information may be improving efficiency in the market.     

Comparing the impact of leader–member exchange,psychological empowerment and affective commitment upon Australian public and private sector nurses: implications for retention

This study uses Leader–Member Exchange (LMX) theory to test the associations between the supervisor–subordinate relationship, psychological empowerment and affective commitment amongst 1283 nurses working in Australian public and private hospitals. Both qualitative and quantitative data were collected, analysed and presented. The findings show that the quality of LMX is more important in public sector nursing contexts than in the private sector with regard to the relationship between empowerment and affective commitment. Furthermore, the relationship between empowerment and affective commitment is stronger for nurses in public sector organisations with low-quality LMX than for nurses in public sector organisations with high-quality LMX. As empowerment and affective commitment are both predictors of staff retention, the findings can assist in developing targeted current and future retention strategies for healthcare management.     

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.     

Employment security and employee organizational citizenship behavior: does an ‘iron rice bowl’ make a difference?

Empirical evidence linking employment security to organizational citizenship behavior (OCB) is equivocal. Limited research has considered the effect of employment status. Using data from 217 subordinate–supervisor dyads in a large state-owned enterprise in China as basis, our research found significant association between overall perceived employment security and employee OCB. However, this relationship may vary depending on employment status. Further analysis suggested a curvilinear relationship for permanent employees with an ‘iron rice bowl’ (lifetime employment) and a linear relationship for contractual employees without an ‘iron rice bowl’. Our study contributes to a thorough understanding of the relationship between employment security and positive behaviors in terms of OCB by integrating the literature on social exchange, psychological contract, and proactive behavior.     

Posting,quoting, and replying: a comparison of methodological approaches to measure communication ties in web forums

Active involvement in discussion-based communities is nowadays a firm part of people’s online activities. The measurement of communication ties and networks between contributors to such domains is thus becoming a relevant research question in social sciences. However, especially in web forums, very often almost no direct relational information exists that would indicate the presence of communication ties among contributors. In contrast with the reply-to structure of Usenet newsgroup or mailing list conversations that contain explicit relational information created by the contributors, some web forums only enable participants to add new posts to threads or to quote preceding posts in threads. When discussions emerge, it is difficult to identify who is replying to whom. Drawing on the social network studies dealing with the conversational patterns in Usenet and web forums, this paper presents an alternative approach to identifying the ties between authors of posts. Several assumptions are discussed, and different measures are developed and empirically evaluated. The findings provide a starting point for the development of a standardized methodology for studying social networks in online communities where only limited direct information about communication ties is available.     

Impact of CEO-board social ties on accounting conservatism: Internal control quality as a mediator

The paper aims to explore the association between CEO-board social ties and accounting conservatism. We found there is a negative relationship between CEO-board social ties and accounting conservatism. It implies that more CEO-board social ties reduce board’s monitoring function and encourage CEO’s tendency to adopt less conservative principles for their own personal gains. We also found the mediating effect of the quality of internal control system between CEO-board ties and accounting conservatism. This piece of finding further implies that the internal control system decided by the board could be the means via which CEO realizes less conservative principles. Contributions, limitations, and implications to corporate governance as well as security exchange commission are also discussed.     

HRM and knowledge-transfer: a micro analysis in a Middle Eastern emerging market

This is a study surrounding the interplay between Human Resource Management (HRM) and knowledge transfer within an emerging institutional petro-state. It seeks to link HRM and knowledge transfer through individual-level mechanisms in response to the recent calls for more research on micro-foundations. Our findings provide empirical evidence for HRM-related factors influencing knowledge exchange in a sample of 815 employees in the national context of the UAE. We found that individual-level perceptions and extrinsic motivation have a positive impact on knowledge exchange; however, we found evidence to suggest only an indirect effect of individual perceptions of organisational commitment to knowledge exchange, via individual intrinsic motivation and social interaction. Unlike some existing accounts from the Western world, individual perceptions of organisational commitment to knowledge sharing had no direct positive impact on knowledge exchange – an issue that may be ascribed to the distinct institutional setting of the UAE. This paper adds to the existing literature on HRM and knowledge exchange by bringing to bear new evidence from a Middle Eastern emerging market setting – an area thus far relatively neglected in the literature.     

The processes of social capital and employee creativity: empirical evidence from intraorganizational networks

The aim of this paper is to extend and elaborate social capital approaches to organizational creativity by identifying different mechanisms that employees can deploy to promote the development of social capital through social interaction, relationship quality and network ties. The findings, based on data from a sample of 382 employees across different areas of expertise and countries in a multinational manufacturing firm, indicate that relationship quality and network ties play a mediating role between social interaction and organizational creativity. The findings of this study contribute to the development of a conceptual theoretical model for explaining the interrelationships among three mechanisms of social capital and organizational creativity performance.     

Changing Organizational Forms and the Employment Relationship

This paper draws upon new research in the UK into the relationship between changing organizational forms and the reshaping of work in order to consider the changing nature of the employment relationship. The development of more complex organizational forms – such as cross organization networking, partnerships, alliances, use of external agencies for core as well as peripheral activities, multi‐employer sites and the blurring of public/private sector divide – has implications for both the legal and the socially constituted nature of the employment relationship. The notion of a clearly defined employer–employee relationship becomes difficult to uphold under conditions where employees are working in project teams or on‐site beside employees from other organizations, where responsibilities for performance and for health and safety are not clearly defined, or involve more than one organization. This blurring of the relationship affects not only legal responsibilities, grievance and disciplinary issues and the extent of transparency and equity in employment conditions, but also the definition, constitution and implementation of the employment contract defined in psychological and social terms. Do employees perceive their responsibilities at work to lie with the direct employer or with the wider enterprise or network organization? And do these perceptions affect, for example, how work is managed and carried out and how far learning and incremental knowledge at work is integrated in the development of the production or service process? So far the investigation of both conflicts and complementarities in the workplace have focused primarily on the dynamic interactions between the single employer and that organization’s employees. The development of simultaneously more fragmented and more networked organizational forms raises new issues of how to understand potential conflicts and contradictions around the ‘employer’ dimension to the employment relationship in addition to more widely recognized conflicts located on the employer–employee axis.     

Social capital configuration, legal bonds and performance in buyer-supplier relationships

Academics have increasingly recognized the benefits derived from social networks embedded within companies’ buyer-supplier relationships. However, prior research has only examined the influence of social capital elements on performance, either individually or in part. We propose an integrative model examining the relationships among relational, structural and cognitive dimensions of social capital, and between these dimensions and the cost and innovation performance of the firm. A sample of 163 buyer-supplier relationships is used to test the model. Regression results indicate that the relational dimension of social capital fully or partially mediates the effect of the cognitive dimension on performance, and partially mediates the link between the structural dimension, operationalized as social interaction ties, and innovation performance. Further, high levels of legal bonds were found to moderate the relationship between the relational dimension of social capital and performance outcomes. Implications for theory and managers are discussed.     

Design of financial incentives and payment schemes in healthcare systems: A review

In this paper, we review the existing studies on the design of financial incentives and payment mechanisms for healthcare service providers, which have been published in the literature of operations research & management science. We classify these studies in two ways: first, by the care provider focused on: physicians or hospitals; and next, by categorizing payment/incentive schemes as retrospective or prospective models under each care provider group. The problem setting, including the geographic background and research methodology, are briefly discussed for each paper, as are the findings with regard to accessibility, quality, efficiency, and the facilitation of integration and collaboration, if reported. We also provide a detailed discussion of potential research problems that would offer promising avenues for future study.     

Communication channels,innovation tasks and NPD project outcomes in innovation-driven horizontal networks

Inter-organizational collaborations and horizontal networks are increasingly playing a pivotal role in innovations and new product development among firms. In this study, we investigate the link between the innovation task analyzability and the richness of communications channels used in network arrangements and the link between task analyzability and ties and project development time. We investigated the links based on the data collected from 372 respondents representing ninety three different innovation-driven horizontal networks. The results of structural equation modeling reveal a negative link from task analyzability to communication channel richness and a positive link from communication channel richness to ties. Communication channel richness was found to partially mediate the influence that task analyzability has on both NPD project outcomes of ties and development time. The implications of our results for theory and practice are discussed.     

Old flames never die – the role of binding social ties for corporate entrepreneurship in family firms

This paper investigates the role of social ties and family embeddedness for corporate entrepreneurship in family firms. Family firms are mostly characterized by close and often inseparable ties between the dominant family coalition and the firm and offer specific resources within a context of both rational as well as non-rational factors that influence entrepreneurial strategies. We empirically test (n =?181) the relationship between binding social ties and innovation, strategic renewal, and corporate venturing. Our findings indicate a strong significance for networks and close and stable relationships both to inside the firm and the outside in decision making for corporate venturing and innovation. In contrast, the results for strategic renewal show no relevance of strong social ties. We link up with the debate on the role of owners as an important stakeholder group.

     

Physician and hospital funding options in a public system with decreasing resources

Methods of physician and hospital reimbursement have been the subject of many debates over the years. Structuring a method of payment for physicians under a publicly funded system is particularly difficult when considered in relation to methods of hospital funding. In this paper, we present a mathematical model that simulates physician and hospital behaviour in a publicly funded health care system under a variety of funding scenarios. The model assumes both doctors and hospitals are constrained profit satisficers. Given this assumption, and a reduction in funding to the institution, the model searches for a resource allocation that will achieve target incomes for both decision-making groups through changes to case mix and/or reductions in the fixed or variable costs of production.Results indicate that when physicians are funded on a fee-for-service basis, the hospital funding method in place may have little impact on resource allocation following a budget reduction. When physicians are funded via salary, conflict between the two groups is reduced, but under supply is more likely to occur. These results raise important questions regarding the type of hospital funding model that should be in place.Unlike earlier approaches, our model jointly simulates the behaviour of both hospitals and health care providers. By including both actors, it provides a mechanism for investigating the interaction between physicians and hospitals under a variety of funding scenarios. Given that hospital-physician systems respond to funding reductions by reducing the fixed costs of production or by decreasing the variable costs of production, the model can be used to identify a range of alternative case mix, case cost, and cost-sharing scenarios.