Speaking up about workplace safety: An experimental study on safety leadership

In this study, we test whether dierent types of safety leadership styles predict dierent employees\u2019 change-oriented discretionary communications about safety (i.e., safety voice) after controlling for proactive personality disposition to improve organizational sustainability. Building upon a multidimensional model of safety voice, which attempts to conceptualize dierent ways in which employees make suggestions about safety procedures, we developed four realistic scenarios in which we manipulated the supervisor\u2019s safety leadership style, including: (1) transformational safety leadership, (2) transactional safety leadership, (3) passive safety leadership, and (4) control group (i.e., no leadership at all). We randomly assigned 103 participants to two of four scenarios and measured four facets of safety voice and proactive personality dispositions. The findings showed that after controlling for the respondents\u2019 proactive personality, transformative safety leadership predicted promotive safety voice, transactional safety leadership predicted preventive safety voice, and passive safety leadership predicted hostile safety voice. These findings have a number of implications for our understanding of safety leadership and employees\u2019 safety communications

La didattica a distanza nell’Italia diseguale. Criticità e differenze territoriali durante la prima ondata Covid-19

none4noLe misure intraprese dal governo italiano per il contenimento della prima ondata Covid-19 hanno avuto importanti ricadute sul mondo della scuola. Il diffuso ricorso alla didattica a distanza (DAD), pur avendo permesso un certo grado di continuità didattica in una situazione emergenziale, è stato accompagnato da numerose criticità che si sono innestate sulle condizioni di vulnerabilità preesistenti. Considerando le importanti disuguaglianze territoriali che caratterizzano il contesto nazionale, questo lavoro approfondisce alcuni impatti dell’implementazione emergenziale della DAD tra le regioni italiane. L’articolo fornisce misura delle relazioni tra alcuni elementi di divario territoriale e una serie di criticità – tra cui i livelli di partecipazione e le problematiche di apprendimento degli studenti, le principali difficoltà riscontrate dagli insegnanti e il loro grado di soddisfazione – che sono state rilevate attraverso una web-survey somministrata a un campione di oltre 3.000 insegnanti.openBazzoli, Nico; Barberis, Eduardo; Carbone, Domenico; Dagnes, JoselleBazzoli, Nico; Barberis, Eduardo; Carbone, Domenico; Dagnes, Josell

Changes in the Health Care Safety Net 1992–2003: Disparities in Access for Uninsured Persons in Florida

A patchwork of services is available to the US uninsured through the healthcare safety net (SN). During 1996–2003, some SN hospitals (SNHs) closed or converted ownership from public or non-profit to for-profit status. However, around this time the number of community health centers (CHCs) grew due to new federal funding. This paper examines the impact of these two countervailing SN events on access to care for the uninsured. Hospital admissions for ambulatory care sensitive conditions (ACSCs) relative to marker conditions were used as our access measure. We examined 35,730 discharges for uninsured adults treated in Florida hospitals in the years 1992 or 2003. A generalized estimating equation model was used to assess differential access effects for racial and ethnic groups. We found that in communities with CHC openings but no SNH contractions, uninsured black and white individuals experienced deteriorations in access over time but the Hispanic uninsured did not. However, in communities where SNHs closed or converted, access deteriorations occurred for all three racial and ethnic groups. Thus, the potentially beneficial effects of CHC expansions on access to primary care for the uninsured Hispanic population in Florida appeared to be offset if contractions in the hospital safety net were present

The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis prevention services in substance use disorders treatment clinics: a case study

<p>Abstract</p> <p>Background</p> <p>The Organizational Readiness to Change Assessment (ORCA) is a measure of organizational readiness for implementing practice change in healthcare settings that is organized based on the core elements and sub-elements of the Promoting Action on Research Implementation in Health Services (PARIHS) framework. General support for the reliability and factor structure of the ORCA has been reported. However, no published study has examined the utility of the ORCA in a clinical setting. The purpose of the current study was to examine the relationship between baseline ORCA scores and implementation of hepatitis prevention services in substance use disorders (SUD) clinics.</p> <p>Methods</p> <p>Nine clinic teams from Veterans Health Administration SUD clinics across the United States participated in a six-month training program to promote evidence-based practices for hepatitis prevention. A representative from each team completed the ORCA evidence and context subscales at baseline.</p> <p>Results</p> <p>Eight of nine clinics reported implementation of at least one new hepatitis prevention practice after completing the six-month training program. Clinic teams were categorized by level of implementation-high (n = 4) versus low (n = 5)-based on how many hepatitis prevention practices were integrated into their clinics after completing the training program. High implementation teams had significantly higher scores on the patient experience and leadership culture subscales of the ORCA compared to low implementation teams. While not reaching significance in this small sample, high implementation clinics also had higher scores on the research, clinical experience, staff culture, leadership behavior, and measurement subscales as compared to low implementation clinics.</p> <p>Conclusions</p> <p>The results of this study suggest that the ORCA was able to measure differences in organizational factors at baseline between clinics that reported high and low implementation of practice recommendations at follow-up. This supports the use of the ORCA to describe factors related to implementing practice recommendations in clinical settings. Future research utilizing larger sample sizes will be essential to support these preliminary findings.</p

The relationship between safety net activities and hospital financial performance

<p>Abstract</p> <p>Background</p> <p>During the 1990's hospitals in the U.S were faced with cost containment charges, which may have disproportionately impacted hospitals that serve poor patients. The purposes of this paper are to study the impact of safety net activities on total profit margins and operating expenditures, and to trace these relationships over the 1990s for all U.S urban hospitals, controlling for hospital and market characteristics.</p> <p>Methods</p> <p>The primary data source used for this analysis is the Annual Survey of Hospitals from the American Hospital Association and Medicare Hospital Cost Reports for years 1990-1999. Ordinary least square, hospital fixed effects, and two-stage least square analyses were performed for years 1990-1999. Logged total profit margin and operating expenditure were the dependent variables. The safety net activities are the socioeconomic status of the population in the hospital serving area, and Medicaid intensity. In some specifications, we also included uncompensated care burden.</p> <p>Results</p> <p>We found little evidence of negative effects of safety net activities on total margin. However, hospitals serving a low socioeconomic population had lower expenditure raising concerns for the quality of the services provided.</p> <p>Conclusions</p> <p>Despite potentially negative policy and market changes during the 1990s, safety net activities do not appear to have imperiled the survival of hospitals. There may, however, be concerns about the long-term quality of the services for hospitals serving low socioeconomic population.</p