The influence of hospital department culture on physicians' job satisfaction: an empirical study

Recently, with the development of economy and the innovation of science and technology in society, the competition in the medical market is becoming increasingly fierce, and human resources are becoming more and more important. The maximum development and utilization of human resources has become an important method to improve the core competitiveness of hospitals. With the continuous improvement of hospital management level, the status and importance of hospital culture has become increasingly prominent. Department culture is not only the foundation and key part of hospital culture, but also is a strong embodiment of hospital culture. Effective construction of department cultures, improvement of the job satisfaction of medical staff and promotion of the quality of medical work are of great significance to improve a hospital’s social and economic benefits. In theory, the study of hospital department culture brings a new perspective to the research of traditional hospital human resources. In practice, it provides a new angle for hospital managers to develop higher-level medical staff. Therefore, research necessarily requires the integration of hospital department culture with physicians' job satisfaction. Based on the relevant theories of hospital department cultures and physicians' job satisfaction, this thesis takes Grade-A tertiary hospitals in Hangzhou, China as examples, conceives and designs hospital department culture, designs and tests the measurement subscales of hospital department culture, introduces two mediating variables, namely professional identity and work engagement, and carries out research in the influence mechanism of hospital department culture on physicians' job satisfaction. Through questionnaire surveys and interviews of staff from some Grade-A tertiary hospitals, for instance, the First Affiliated Hospital of Medical College of Zhejiang University of China, model tests and data analysis are carried out for the proposed hypothesis. Finally, the following conclusions are drawn: hospital department culture is composed of material culture, behavior culture, system culture, spiritual culture and innovation culture; hospital department culture can significantly affect work engagement, professional identity and job satisfaction; work engagement plays a significant role in the intermediary relationship between hospital department culture and physicians' job satisfaction, and there is no necessary mediating effect of professional identity on hospital department culture and physicians' job satisfaction.Nos últimos anos, com o avanço da economia e a inovação da tecnologia, a competição no mercado médico se torna cada vez mais renhida e os recursos humanos constituem um recurso cada dia mais importante. Desenvolver e utilizar maximamente os recursos humanos é uma medida crucial para o aumento da competitividade essencial do hospital. A cultura do hospital desempenha um papel relevante no aumento do nível de gestão hospitalar enquanto que a cultural departamental que é considerada como a parte fundamental e importante da cultura do hospital é apresentação e aprofundamento da cultura hospitalar. O reforço da construção da cultura departamental, a elevação da satisfação profissional dos trabalhadores médicos e a promoção da qualidade dos trabalhos médicos se revestem de um significado considerável para aumentar a eficiência socioeconômica do hospital. O estudo sobre a cultura departamental do hospital serve como uma nova perspectiva, na teoria, para os estudos tradicionais relacionados com os recursos humanos do hospital e, por outro lado, na prática, proporciona um novo ângulo para os gestores hospitalares administrarem e desenvolverem profissionais médicos de alto nível. Portanto, é necessário realizar estudos com base na combinação da cultura departamental hospitalar e satisfação profissional dos médicos. Fundamentado na base teórica associada à cultura departamental do hospital e à satisfação dos médicos em relação ao trabalho, este estudo, tomando como exemplo um hospital de excelência da cidade de Hangzhou, China, trata da influência exercida pela cultura do hospital na satisfação profissional dos médicos por meio da construção e concepção da cultura departamental, da elaboração dos parâmetros de avaliação da cultura departamental e da introdução de duas variáveis mediadoras, ou seja, a identidade profissional e a dedicação ao trabalho. Através de questionários e entrevistas realizadas no Hospital Nº 1, afiliado à Faculdade de Medicina da Universidade de Zhejiang, a hipótese foi avaliada em modelos e os dados foram analisados. Foram obtidas as seguintes conclusões: (1) a cultura departamental do hospital é composta por cultura material, cultura acional, cultura institucional, cultura espiritual e cultura inovadora; (2) a cultura departamental exerce grande influência na dedicação ao trabalho, na identificação profissional e na satisfação em relação ao trabalho; (3) a dedicação ao trabalho faz um papel intermediário significativo na correlação entre a cultura departamental e a satisfação no trabalho enquanto a identificação profissional não possui a mesma função na relação entre eles

Job evaluation model of major public hospitals in China

The current economic climate has contributed to an increasingly competitive environment among organizations. In order to ensure competitive advantage, they must be able to promote high levels of professional performance. This research is part of this theme and aims to analyze how the job characteristics, professional knowledge, skills, competencies, training and work engagement influence the job evaluation and, consequently, the performance of employees of six public hospitals, China. The sample consists of 546 subjects aged between 21 and 58 years (M = 37.9; SD = 8.73), with the majority being females (55.5%). For the collection of data, such scales were used as the Job Diagnostic Survey (JDS), the Knowledge, Skills, Abilities, and Other Personal Characteristics Scale (KSAOS), the Competencies and Training Scale (CTS) and the Utrecht Work Engagement Scale (UWES). The results obtained show that the job characteristics, the professional knowledge, the skills, the training and the work engagement influence the job evaluation. It was also found that the male respondents, those belonging to the older age group, those with higher academic qualifications and those with higher positions present higher average performance in all dimensions under study. It was also possible to verify that Autonomy is the JDS variable with greater effect on the Job evaluation and the bigger the Autonomy, Skill variety and Feedback given to the employees, the more positive their perception of Job evaluation. Data analysis also reveals that KSAO moderate the relations between job characteristics and job evaluation and the dimension with the most effect on Job evaluation is Professional Ethics and Health Law. On the other hand, the higher the competencies and professional training in the area of Organization and finance, the greater the Job evaluation. Finally, it was verified that Vigor is the only variable with significant effect on Job evaluation. It is hoped that these results may inspire further research that contributes to a better understanding of these relationships; and at the practical level, it is intended to alert the justified investment by the organizations in the implementation of a performance evaluation model. Taking into account the current competitiveness at the organizational level, it is considered that the analysis of the relationships between these dimensions is crucial to an organization. In this way, this project is intended to build a new process of performance evaluation in public hospitals in China, based on the competencies identified for each job.Atualmente, o clima económico contribuiu para um ambiente cada vez mais competitivo entre as organizações e para garantir a vantagem competitiva, as organizações devem ser capazes de promover altos níveis de desempenho profissional. Esta investigação insere-se nesta temática e tem como objetivo estudar como as características da função, o conhecimento profissional, as habilidades, as competências e o envolvimento no trabalho influenciam a avaliação do trabalho e, consequentemente, o desempenho dos funcionários de seis hospitais públicos . China. A amostra é composta por 546 sujeitos com idades compreendidas entre os 21 e os 58 anos (M = 37.9; DP = 8.73), sendo a maioria do sexo feminino (55.5%). Os dados foram recolhidos através das seguintes escalas: Job Diagnostic Survey (JDS), Escala de Conhecimento, Habilidades, Aptidões e Outras Escalas Pessoais (KSAOS), Escala de Competências e Formação (CTS) e Escala de Envolvimento no Trabalho de Utrecht ( UWES). Os resultados obtidos mostram que as características da função, o conhecimento profissional, as habilidades, a formação e o envolvimento no trabalho influenciam a avaliação do trabalho. Constatou-se também que os entrevistados do sexo masculino, os que pertencem à faixa etária mais avançada, os que possuem maior qualificação académica e que ocupam posições hierárquicas mais elevadas, apresentam um desempenho médio superior em todas as dimensões em estudo. Também foi possível verificar que a Autonomia é a variável do JDS com maior efeito na avaliação do trabalho e que quanto maior é a Autonomia, a variedade de competências e o feedback dado aos funcionários, mais positiva é a sua perceção da avaliação do trabalho. A análise dos dados também revelou que o KSAO modera a relação existente entre as características da função e a avaliação do trabalho e que a variável com maior efeito na avaliação do trabalho é a Ética Profissional e a Lei da Saúde. Por outro lado, quanto maiores são as competências e a formação profissional na área de Organização e Finanças, melhor é a avaliação do trabalho. Por último, verificou-se que o Vigor é a única dimensão do envolvimento no trabalho com efeito significativo na avaliação do mesmo. Espera-se que esses resultados possam inspirar pesquisas futuras e que possam contribuir para uma melhor compreensão dessas relações; a nível prático pretende-se alertar os gestores para a implementação de um modelo de avaliação de desempenho. Considerando a atual competitividade a nível organizacional, considera-se que a análise da relação entre estas dimensões é crucial para qualquer organização. Esta investigação pretende assim construir um novo processo de avaliação do trabalho nos hospitais públicos na China, com base nas competências identificadas para cada função

Relationships among work-family conflict, organizational silence, peer support, and turnover intention of second child nurses in China

This empirical study is based on a survey among Chinese nurses. Nurses in 216 secondary and tertiary level hospitals were selected using convenience sampling method, and 3,974 valid questionnaires were obtained. Four scales were adopted: Work-Family Conflict Scale, Organizational Silence Scale, Peer Support Scale and Turnover Intention Scale. IBM SPSS Statistics and AMOS were used. The results showed that the work-family conflict, organizational silence and peer support of Chinese nurses were all at medium to high levels. Nurses without children had lower levels of work-family conflict than nurses with a child or children; nurses with one child had lower levels of work-family conflict than nurses with two or more children; compared with nurses without children, nurses with a child or children had lower levels of turnover intention; work-family conflict positively influenced turnover intention; peer support negatively influenced organizational silence and turnover intention; organizational silence positively influenced turnover intention. Work-family conflict and peer support had both direct and indirect effects on turnover intention; organizational silence had a direct effect on turnover intention; and peer support and organizational silence mediated the relationship between work-family conflict and turnover intention. This study explored the formulation of motivational management strategies. The factors influencing nurses' turnover intention and the relationships among them were discussed. The results showed that the number of children influences nurses' work-family conflict, organizational silence, peer support, and turnover intention. This study provides insights for nursing managers to improve nursing management models and health policies.Este estudo é baseado num questionário junto de enfermeiras chinesas, com recurso a amostragem por conveniência. Foram selecionadas enfermeiras de 216 hospitais chineses e validados 3974 questionários. Utilizaram-se quatro escalas para medir as dimensões "conflito trabalho-família", "silêncio organizacional", "apoio dos pares" e "intenção de saída". A análise estatística foi feita com IBM SPSS Statistics e AMOS. Os resultados mostram níveis médios a altos nas dimensões conflito trabalho-família, silêncio organizacional e apoio dos pares. As enfermeiras sem filhos apresentaram níveis mais baixos de conflito trabalho-família do que aquelas que têm filhos. Por outro lado, as enfermeiras com um único filho demonstraram níveis mais baixos de conflito trabalho-família do que as que têm dois ou mais filhos. No que se refere à variável intenção de saída as enfermeiras com uma ou mais crianças mostraram níveis mais baixos de intenção de saída, enquanto que o conflito trabalho-família influenciou positivamente essa intenção. O apoio dos pares influenciou negativamente o silêncio organizacional e a intenção de saída; o silêncio organizacional influenciou positivamente a intenção de saída. O conflito entre trabalho e família e o apoio de pares tiveram efeitos diretos e indiretos na intenção de saída; o silêncio organizacional teve um efeito direto na intenção de saída; o apoio dos pares e o silêncio organizacional mediaram a relação entre o conflito trabalho-família e a intenção de saída. Este estudo explorou a formulação de estratégias de gestão motivacional. A autora discutiu os fatores que influenciam a intenção de saída das enfermeiras, e sua inter-relação. Os resultados mostram que o número de crianças influencia o conflito trabalho-família, o silêncio organizacional, o apoio dos pares e a intenção de saída. Este estudo fornece insights para os gestores de enfermagem com vista à melhoria dos modelos de gestão de enfermagem e das políticas de saúde

Dynamic capabilities and performance improvement of private hospitals in China on the basis of resource-based theory: A case study of Foshan Chancheng Central Hospital (FCCH)

Based on the resource based view, and by applying a dynamic capabilities theory, this thesis explains and illustrates how enterprises adapt to the changing environments, identify and discover opportunities and threats. The effective coordination and integration of internal and external resources enable enterprises to form a long lasting and rapid resource model that can make enterprises to be adaptive to the changes in external environment, create more value with resources, and thus bring unique dynamic capabilities to enterprises to have sustainable competitive advantages. Dynamic capabilities can transform the old knowledge of enterprises to new knowledge or create new knowledge adapted to the new environment within the enterprise, thus changing the original capability structure of the enterprise and making the enterprise step forward. Dynamic capabilities are effective means for enterprises to obtain sustainable competitive advantage, which can only be obtained by the possession of dynamic capabilities. Taking the reform, development, strategy implementation and resource integration practice of Foshan Chancheng Hospital as an example, the research has important enlightenment significance for Chinese private hospitals to explore effective integration of internal and external resources and how to build their dynamic capabilities to improve competitive advantages and obtain good performance.Com base numa visão baseada em recursos, na teoria das capacidades dinâmicas, esta Tese pretende mostrar como as empresas se adaptam a ambientes em mudança, identificando oportunidades e ameaças no ambiente e reconstro em recursos internos e externos. A coordenação e integração eficazes de recursos internos e externos permitem que as empresas formem uma configuração de recursos rápida e duradoura que pode fazer com que as empresas se adaptem às mudanças no ambiente exter no, criem mais valor com os recursos e, assim, tragam capacidades dinâmicas exclusivas dando aso a vantagens competitivas sustentáveis. Capacidades dinâmicas podem transformar o conhecimento antigo das empresas em novo conhecimento ou criar novos conhecime ntos adaptados ao novo ambiente dentro da empresa, mudando assim a estrutura de capacidade original da empresa e fazendo a empresa dar um passo à frente. Capacidades dinâmicas são meios eficazes para as empresas obterem vantagem competitiva sustentável, qu e só pode ser obtida pela posse de capacidades dinâmicas. Tomando o desenvolvimento, a implementação da estratégia e a prática de integração de recursos do Hospital Foshan Chancheng como exemplo, a Tese discute ainda as formas fundamentais para os hospitai s privados chineses integrarem efetivamente recursos internos e externos, construindo assim capacidades dinâmicas para sustentar vantagens competitivas

Economic-Social Interaction during China’s Transition

I discuss the nature of the economic reforms in China during the last quarter of a century in the context of a typology of economic systems, emphasizing the interaction between economic and social mechanisms. I also consider China’s options for further reforms. I focus on economic reforms that make the growth path less resource demanding and social reforms that enhance income security and improve education and health care for disadvantaged population groups.China; Transition Economies; Social Insurance; Human Services

Environmental Disasters and Individuals’ Emergency Preparedness:

Environmental disasters are becoming more frequent. These disasters not only include the most common natural disasters, but also include man-made disasters, such as public health, accident disasters, etc., which have caused greater damage to human society and cities. Because of the limitations of a single government-led model in emergency response, the emergency preparedness of communities, families and individuals are more important. In particular, the emergency preparedness psychology and behavior of individuals directly determine whether or not they can effectively protect themselves and their families in the first time of disaster. This Special Issue focuses on environmental disasters and individuals’ emergency preparedness in the perspective of psychology and behavior

A study on funding for elder care in China

Today, the rapid growth of aged populations is a pressing issue across the globe. In China, longevity risk is also associated with complex social issues consequent on birth control policies in the 1980s, raising the demand for elder care services in recent years. However, the relatively high cost of elder care services creates financial burdens not only for elderly people themselves, but also for their children. While increasing retirement incomes, the Chinese Government has also promoted new forms of social elder care, introducing market mechanisms into public nursing institutions, to increase financial resources for elder care provision. This thesis analyses these new funding models for elder care, examining supply and demand side factors that shape their effectiveness within a theoretical framework of New Public Management (NPM) and social investment. First, case studies are used to compare funding policies in four types of nursing institutions in and around Wuhan, Hubei Province, to evaluate different Public and Private Partnership (PPP) funding arrangements and their consequent influence on the performance of the nursing institutions. Second, Data Envelopment Analysis (DEA) is employed to calculate and compare the elder care services index in urban and rural areas. The outcomes provide insightful and useful guidance to identify probable problems within the elder care funding system. The results reveal that investment is more efficient when dedicated to financing the incomes of the elderly rather than to the construction of elder care institutions. The conclusions propose the feasibility of public long-term care insurance (LTCI) in China, as an appropriate approach to improve elderly people’s retirement income and thus their ability to purchase long-term care (LTC) in the future

The role of mediation in solving medical disputes in China

BACKGROUND Medical litigation represents a growing cost to healthcare systems. Mediation, arbitration, and other alternative dispute resolution (ADR) methods are increasingly used to help solve the disputes and improve healthcare satisfaction. In China, the increasing number of medical disputes has contributed to concern for the safety of physicians and mistrust between physician and patients resulting in ADR processes being established in several provinces in recent years. Our aim was to describe and explain the impact of this new mediation process in the Chinese healthcare system. METHODS Our study investigated mediation practices in China using case-level data from 5614 mediation records in Guangdong Province between 2013 and 2015. We investigated how the resolution success as well as the compensations are associated with the case characteristics using regression analysis. RESULTS Among the cases analyzed, 1995 (41%) were solved with agreement through mediation, 1030 were closed by reconciliation, 559 were closed by referring to court and 1017 cases were withdrawn after mediation. Five hundred five Yinao cases were solved with the help of mediators on the spot. We find that mediation solved about 90% of medical disputes under present mechanisms, while more police support is needed to cope with Yinao. The average compensation of mediation is CNY60,200 and average length of mediation is 87 days. Longer time taken to reach resolution and more money claimed by patients are associated with lower resolution success rate (p < 0.01) and higher compensation levels (p < 0.01). CONCLUSION Our results show the performance of mediation mechanisms in China to help solve medical disputes. ADR plays a role in reducing the need for initiating litigation and may ultimately increase satisfaction with the healthcare system