Examining relationships between director leadership practices and manager worklife and burnout

Managers are subject to high stress and burnout in their demanding roles, so addressing their worklife and level of burnout is important to retain leadership in healthcare organizations. The purpose of this study was to examine the relationship between the observed leadership style of directors and the worklife and burnout of healthcare managers. A secondary analysis of data from 176 leaders in five different managerial cohorts within a provincial cancer agency was conducted using multiple regression and MANCOVA analysis. The study used data collected from the Worklife Improvement and Leadership Development study in 2006, the Kouzes and Posner Leadership Practices Inventory, the Maslach Burnout Inventory, and the Areas of Worklife Survey. Findings indicate the importance of transformational leadership styles to empower managers. Directors may improve the worklife of managers by using transformational leadership practices to address the amount of control and appropriateness of rewards to positively influence the job satisfaction of managers.     

Implementation of accounting reforms

Abstract

Innovations in financial and accounting techniques represent a fundamental aspect of the reforms undergone by public administrations in recent decades. The article presents the results of a survey, conducted on 237 local governments, whose purpose is to assess the implementation of accounting reforms in Italy, aimed at introducing accruals reporting in the traditional budgetary accounting system to enhance accountability and transparency in the overall modernization process. The analysis shows that the importance of cash- and commitment-based accounting in the overall system is overwhelming, whereas the marginality of the ‘new’ accrual-based reporting is evident. In the opinions of preparers, accruals accounting is not seen as a useful tool and the link with internal needs and managerial control systems is absent. Is the time ripe for a new reform?     

Judicial Efficiency and Immigrant Entrepreneurs

Extensive research exists on the individual determinants of being an immigrant entrepreneur, concerning both social environment and human capital. However, the role of the judiciary has not been investigated yet. Analyzing more than 160,000 new micro enterprises owned by immigrants, our paper aims to fill this gap by focusing on the relation between justice and immigrant entrepreneurship. Results show that judicial efficiency is one of the determinants of self‐employment, although some differences among immigrant groups are identified. Therefore, the study confirms the key role of judicial enforcement in promoting not only growth but also the integration of these new citizens.     

ACCOUNTING REFORMS: DETERMINANTS OF LOCAL GOVERNMENTS' CHOICES

The introduction of accrual accounting in Italian Local Governments has been mandated in a way that permits, and in fact encourages, a merely formal compliance. Local Governments must produce accrual‐based financial statements, but double‐entry bookkeeping is not mandatory, nor may traditional budgetary accounting be abandoned. Why, then, should they bother to introduce an integrated system of budgetary and accrual accounting? In this paper, we empirically investigate the determinants of Local Government's choices of accounting innovation. According to our results, ‘rational’ elements such as complexity, types of activities performed, presence of surpluses, and access to capital markets are seemingly unhelpful in explaining why a Local Government decides to introduce accrual accounting. What counts are ‘institutional’ and cultural explanations, such as the perceptions of CFOs and the North‐South divide.     

“But we can't go back”

In 2004, a provincial cancer agency in Canada developed and implemented a provincewide Leadership Development Initiative (LDI) to enhance organizational leadership and relationships. Research using a quasi‐experimental survey design determined whether LDI implementation influenced the emotional health and leadership practices of LDI participants. An ethnographic approach (18 focus groups and 13 individual interviews) explored participants' perceptions of the LDI. This article presents qualitative findings that contribute to understanding the statistically significant findings of increasing levels of cynicism, emotional exhaustion, and burnout for most LDI participants. The LDI was regarded as a critical strategy for helping leaders grow and cope with change and help in changing organizational leadership culture to be more collaborative and inclusive. However, an organizational history of short‐lived, flavor‐of‐the‐month development initiatives and growing skepticism and disengagement by leaders represented in the themes of Catch‐22 and “there is no going back” contributes to understanding why these quantitative measures increased. Few studies have explored the hypothesis that real organizational development happens through a series of planned stages. In this study, leaders experienced escalating frustration because change was not seen to occur fast enough in “others” and reported that this was necessary before they would alter their own behavior. Leadership development programs in general need to reflect the reality that it takes considerable time, patience, and effort to effect fundamental change in leadership culture.     

The influence of authentic leadership behaviors on trust and work outcomes of health care staff

A key element of a healthy work environment is trust: trust between staff and their leaders. Authentic leadership is proposed as the core of effective leadership needed to build trust because of its clear focus on the positive role modeling of honesty, integrity, and high ethical standards in the development of leader‐follower relationships. A model linking authentic leadership behaviors with trust in management, perceptions of supportive groups and work outcomes (including voice or speaking‐up behavior, self‐rated job performance, and burnout) using secondary analysis procedures was examined. The hypothesized model was tested using structural equation modeling in two samples of health care employees from a western Canadian cancer care agency: clinical care providers including nurses, pharmacists, physicians, and other professionals (N = 147) and nonclinical employees including administrative, support, and research staff (N = 188). Findings suggest that supportive leader behavior and trust in management are necessary for staff to be willing to voice concerns and offer suggestions to improve the workplace and patient care.     

The impact of nurse staffing on hospital costs and patient length of stay: a systematic review

Research examining the relationships between nurse staffing, hospital costs, and length of stay is varied using a range of methods and definitions. This lack of coherence in definitions and measurement tools for cost and length of stay makes it difficult to conclude with certainty the results of nurse staffing on hospital cost and length of stay. However, the evidence reflected that significant reductions in cost and length of stay may be possible with higher ratios of nursing personnel in hospital settings. Sufficient numbers of RNs may prevent patient adverse events that cause patients to stay longer than necessary. Patient costs were also reduced with greater RN staffing as RNs have higher knowledge and skill levels to provide more effective nursing care as well as reduce patient resource consumption. Hospital administrators are encouraged to use higher ratios of RNs to non-licensed personnel to achieve their objectives of quality patient outcomes and cost containment.     

VISION AND PRACTICE OF E-GOVERNMENT: AN EMPIRICAL STUDY

With the internet expanding rapidly in the 1990s, most of the reform agendas of Western countries embedded information technologies in their vision for change (Heeks, 1999; and Holmes, 2001). Existing studies into the diffusion of e-government has mainly centred on the USA and exposed a limited diffusion of digital delivery systems. This paper focuses on e-government by way of the adoption and use of ICT and internet for the delivery of information and services and explores the extent to which local governments endorse the e-government agenda by looking at the strategies and policies of municipalities and their actual use of e-government for the delivery of services and information. The paper utilizes data from a survey conducted during the winter of 2005-2006, addressed to the Chief Information Officers at Italian MUs with a population greater than 40,000. The results show that despite a certain degree of endorsement in terms of strategies for e-government, the use of e-government for the delivery of services is still quite limited.