Self-Control Matters: Examining Indirect Use of Hospital Information Systems and its Control Mechanisms

Indirect use of hospital information systems (HIS), denoting the designated physicians’ indirect interaction with HIS through delegating HIT-related tasks to others, has become a popular phenomenon in hospitals. Indirect use frees physicians from busy work and helps them achieve improved productivity, however, agency theory and organization literature alert that the consequences of indirect use may departure from physicians’ expectation due to agency problems. To resolve such challenges, prior work places great emphasis on formal control and social control. Considering the nature of hospital setting, this study proposes that agent’s self-control could also be a prominent control mechanism. To obtain a comprehensive understanding, this study builds a research model to depict the impacts of the three control mechanisms and their interplays on indirect use performance. Proposed methodology and preliminary findings are also discussed in this study, which aims to provide insights about how to perform indirect use efficiently and effectively

The Indirect Effects of Participative and Abusive Supervisions on Talent Development through Clinical Learning Environment

This chapter aims to examine the indirect effect of clinical learning environment in the relationship between supervisory styles (participative and abusive supervisions) and talent development in the healthcare setting. A questionnaire-based survey was implemented to collect the data. The data was collected from 355 junior doctors in six Malaysian public hospitals. The partial least squares based structural equation modeling (PLS-SEM) was used to test the hypotheses. The main findings are: (1) clinical learning environment has a strong positive indirect effect on the participative supervision-talent development link. This reveals that a conducive clinical learning environment that allows empowerment leads to talent development and (2) clinical learning environment has a strong negative indirect effect on the abusive supervision-talent development link. This implies that junior doctors who feel abused have reduced capacity to work and participate in the learning environment which consequently affects their talent development. The result of this study is consistent with theoretical propositions that clinical learning environment indirectly affects the relationship between participative supervision-talent development and abusive supervision-talent development. This study contributes to the clinical learning environment literature by providing empirical support towards identifying clinical learning environment as the underlying mechanism that accounts for the participative supervision-talent development and abusive supervision-talent development relationships

Understanding power in relation to voice and silence on patient safety among surgical professionals in Ghanaian teaching hospitals

Employee voice is essential in positive work outcomes and harm prevention. However, there is a dearth of research on how power influences voice and silence in organisations (e.g Morrison et al., 2015). This study aims at understanding the implication of upward and interdisciplinary power relationships on voice and silence among Healthcare Professionals (HCPs) on patient safety in surgery. Sixty-seven (67) interviews and policy documents were analysed from two teaching hospitals in Ghana. The study found that formal power inequality is often reinforced by sociocultural authority. This enables superiors to take unilateral decisions and disregard inputs of team members resulting in preventable harm as well as apathy and silence on patient safety. Likewise, authority gradient creates a psychological barrier in hierarchy and undermine voice at interpersonal and broad surgical levels. The unequal power relationships coupled with lack of organisational support exposes those who speak up to risk. Beyond these, military authority often reinforces power or overrides healthcare authority and undermine voice in the military hospital. In terms of interdisciplinary power relationships, doctors’ authority often undermines nurses’ voice and compel them to undertake perceived harmful practices. However, a sense of equal interdisciplinary power relationship between surgeons and anaesthesiologists give rise to power struggles that promote voice in their respective speciality but undermine voice across speciality. Finally, HCPs adopt ingenious voice strategies to avoid appearing offensive and enhance receptivity to voice. Although sociocultural values generally reinforce formal power and silence, these equally provide unique interpersonal access that occasionally permeates power barriers for effective voice. Findings imply the need to empower HCPs, especially nurses, and shift surgical responsibility from individuals such as surgeons to teams as a way of mitigating unequal power and promoting a sense of involvement to encourage voice. Surgery may also consider ‘transdisciplinary approach’ as a creative solution to interdisciplinary power challenges to voice. Further implications for management and practice are presented in the conclusion of the study

What lies beneath? The role of informal and hidden networks in the management of crises

Crisis management research traditionally focuses on the role of formal communication networks in the escalation and management of organisational crises. Here, we consider instead informal and unobservable networks. The paper explores how hidden informal exchanges can impact upon organisational decision-making and performance, particularly around inter-agency working, as knowledge distributed across organisations and shared between organisations is often shared through informal means and not captured effectively through the formal decision-making processes. Early warnings and weak signals about potential risks and crises are therefore often missed. We consider the implications of these dynamics in terms of crisis avoidance and crisis management

A theoretical model for the application of Web 2.0 in e-Government

Government organisations in many countries have started embracing modern technologies such as second generation web (Web 2.0) in an attempt to maximize on the benefits of these technologies as well as keeping up with the current trend. Nevertheless, the advancement and the adoption of these of technologies is in its initial stages in the public sector. Therefore, the research problem is that the literature surrounding the application of Web 2.0 is still highly tentative and exploratory. In particular, there is a lack of research exploring the application of Web 2.0 technologies in the context of local e-Government. This study aims to address this research problem by presenting a comprehensive decision-making tool to aid the effective application of Web 2.0 technologies amongst local government authorities (LGAs). In doing so, resulting in the development of a theoretical model that is underpinned by information systems evaluation criteria and impact factors of Web 2.0 from an internal organizational perspective. By addressing the research problem, this study will make a significant contribution to the normative literature by providing new insights of Web 2.0 technologies within the public sector. This will be of specific relevance to scholars, policy makers, LGAs and practitioners who are interested in the adoption of Web 2.0 technologies in an e-Government context. This paper presents the proposed theoretical model and is largely devoted to an explanation on the development of the model

Direct and Indirect Use of Information Systems in Organizations: An Empirical Investigation of System Usage in a Public Hospital

A user’s interaction with an Information System (IS) could transpire in two ways: direct and indirect. While most prior literature examines the direct interaction between a user and the system, few have examined and differentiated between direct and indirect use. In this study, we anchor on the theory of psychological attachment to study the effects of various external social factors on direct-usage and indirect-usage of an organizational IS. Survey results from 102 physicians in a public hospital reveal that punishment and informational influence are significantly related to direct-usage of the Electronic Medical Record System (EMRS) by physicians. Punishment and image are significantly associated with indirect-usage of EMRS

An impact model to understand and improve work-life balance in early-career researchers in radiation oncology.

Purpose The COVID-19 pandemic had a substantial effect on mental health and work productivity of early-career researchers working in Radiation Oncology (RO). However, the underlying mechanisms of these effects are unclear. The aim of the current qualitative study was therefore to achieve a better understanding of how these effects arose and could be managed in the future. Methods This study was conducted jointly by RO and qualitative health researchers. Data was collected in four online Focus Groups with 6-11 RO researchers (total N = 31) working in Europe. The transcripts were analysed through a qualitative cross-impact analysis. Results Causal relations were identified between seventeen variables that depict the impact of disrupted working conditions. Mental health and work productivity were indeed the most important affected variables, but relations between variables towards these impacts were complex. Relations could either be positive or negative and direct or indirect, leading to a cascade of interrelated events which are highly personal and could change over time. We developed the model 'impact of disrupted working conditions' depicting the identified variables and their relations, to allow more individual assessment and personalised solutions. Conclusion The impacts of disrupted working conditions on RO researchers varied due to the complexity of interrelated variables. Consequently, collective actions are not sufficient, and a more personal approach is needed. Our impact model is recommended to help guide conversations and reflections with the aim of improving work/life balance. The participants showed high levels of personal responsibility towards their own mental health and work productivity. Although being an individual issue, a collective responsibility in developing such approaches is key due to the dependency on organizational variables

Scoping review of intergenerational learning methods for developing digital competence and their outcomes

Due to the rapid digitalization of healthcare, it is important to strengthen professionals’ digital competence, particularly to support older professionals to stay in work until retirement age. People of different ages have different digital competencies. Younger generations are ‘digital natives’ who have learned to use digital devices fluently from a young age, while older generations have had to learn to use them in adulthood. The increasing number of new technologies causes in some cases stress, especially for more older healthcare workers. Intergenerational learning methods for developing digital competence may offer a way to narrow digital competence gaps in healthcare. The aim of this scoping review was to identify current evidence regarding intergenerational learning methods for developing digital competence, and their outcomes. The results can be used to help develop methods for intergenerational digital competence development and improve healthcare professionals’ digital competence. A scoping review was conducted across four databases (Scopus, CINAHL, Web of Science, ProQuest) without time limits. The search produced 2905 references, of which 23 studies are included in the review. Thematic analysis was used to analyze these studies’ results. The results showed that a key method for intergenerational digital competence development is reverse mentoring, where a less experienced person serves as a mentor to a more experienced one. Intergenerational digital competence development methods can be done one-on-one or in groups, in classes or on digital platforms. The outcomes of these methods illustrated that they promote mutual learning, increase the digital competence of older adults and the work life skills of young mentors, and narrow the gap between generations. Using such methods, it is possible to make better use of each generation’s expertise. Intergenerational learning could suggest ways of narrowing the digital gap and enhancing intergenerational communication. Healthcare could benefit from implementing intergenerational learning methods for developing digital competence, increasing the digital competence of healthcare professionals, and narrowing the gap between generations

An impact model to understand and improve work-life balance in early-career researchers in radiation oncology

Purpose: The COVID-19 pandemic had a substantial effect on mental health and work productivity of early-career researchers working in Radiation Oncology (RO). However, the underlying mechanisms of these effects are unclear. The aim of the current qualitative study was therefore to achieve a better understanding of how these effects arose and could be managed in the future.Methods: This study was conducted jointly by RO and qualitative health researchers. Data was collected in four online Focus Groups with 6-11 RO researchers (total N = 31) working in Europe. The transcripts were analysed through a qualitative cross-impact analysis.Results: Causal relations were identified between seventeen variables that depict the impact of disrupted working conditions. Mental health and work productivity were indeed the most important affected variables, but relations between variables towards these impacts were complex. Relations could either be positive or negative and direct or indirect, leading to a cascade of interrelated events which are highly personal and could change over time. We developed the model 'impact of disrupted working conditions' depicting the identified variables and their re-lations, to allow more individual assessment and personalised solutions.Conclusion: The impacts of disrupted working conditions on RO researchers varied due to the complexity of interrelated variables. Consequently, collective actions are not sufficient, and a more personal approach is needed. Our impact model is recommended to help guide conversations and reflections with the aim of improving work/life balance. The participants showed high levels of personal responsibility towards their own mental health and work productivity. Although being an individual issue, a collective responsibility in devel-oping such approaches is key due to the dependency on organizational variables

Evidence synthesis on the occurrence, causes, consequences, prevention and management of bullying and harassment behaviours to inform decision making in the NHS

Background Workplace bullying is a persistent problem in the NHS with negative implications for individuals, teams, and organisations. Bullying is a complex phenomenon and there is a lack of evidence on the best approaches to manage the problem. Aims Research questions What is known about the occurrence, causes, consequences and management of bullying and inappropriate behaviour in the workplace? Objectives Summarise the reported prevalence of workplace bullying and inappropriate behaviour. Summarise the empirical evidence on the causes and consequences of workplace bullying and inappropriate behaviour. Describe any theoretical explanations of the causes and consequences of workplace bullying and inappropriate behaviour. Synthesise evidence on the preventative and management interventions that address workplace bullying interventions and inappropriate behaviour. Methods To fulfil a realist synthesis approach the study was designed across four interrelated component parts: Part 1: A narrative review of the prevalence, causes and consequences of workplace bullying Part 2: A systematic literature search and realist review of workplace bullying interventions Part 3: Consultation with international bullying experts and practitioners Part 4: Identification of case studies and examples of good practic