Job Stability and Wage Progression Patterns among Early TANF Leavers

This article reports on first-year employment experiences of a randomly selected sample of 213 Illinois TANF leavers. Aggregate employment levels were 70 percent at exit, and leavers typically generated earnings from a single full-time job. However, employment often was unstable, so that only about one-fourth of leavers had the same job both at exit and when interviewed 10-11 months later. Employment instability resulted from the marginal or temporary nature of many jobs, as well as employment barriers such as health problems and lack of day care. Average wage levels easily exceeded the minimum wage and grew during the first year after exit, but nonetheless often were insufficient to provide incomes above the poverty level. The findings underscore the need to develop post-employment service strategies that assist persons in accessing work-related benefits such as child care and Medicaid, as well as improved income support strategies such as expansion of the Earned Income Tax Credit

A realist evaluation of the management of a well- performing regional hospital in Ghana

<p>Abstract</p> <p>Background</p> <p>Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study.</p> <p>Methods</p> <p>We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews.</p> <p>Results</p> <p>We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment.</p> <p>Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development.</p> <p>Conclusion</p> <p>This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers.</p