Changes in Transformational Leadership and Empirical Quality Outcomes in a Finnish Hospital over a Two-Year Period: A Longitudinal Study

This paper describes the changes in transformational leadership and quality outcomes that occurred between 2008 and 2011 in a Finnish university hospital that is aiming to meet the Magnet standards. Measurements were conducted in 2008-2009 and subsequently in 2010-2011 by surveying nursing staff and patients. Nursing staff were surveyed using web-based surveys to collect data on transformational leadership (n1=499, n2=498) and patient safety culture (n1=234, n2=512) and using both postal and web-based surveys to gather information on job satisfaction (n1=1176, n2=779). Questionnaires were used to collect data on care satisfaction from patients (n1=678, n2=867). Transformational leadership was measured using the 54-item TLS, job satisfaction with the 37-item KUHJSS, patient safety culture with the 42-item HSPSC, and patient satisfaction using the 42-item RHCS questionnaire. Transformational leadership, which was the weakest area, was at the same level between the two measurement occasions. Job satisfaction scores increased between 2008 and 2010, although they were generally excellent in 2008. The scores for nonpunitive responses to errors and events reported were also higher in the 2010-2011 surveys. The highest empirical outcome scores related to patient satisfaction. The project and the development initiatives undertaken since 2008 seem to have had positive effects on empirical quality outcomes

The Job Satisfaction of Finnish Nursing Staff: The Development of a Job Satisfaction Scale and Survey Results

This paper describes the development of the Kuopio University Hospital Job Satisfaction Scale (KUHJSS) and the results of the survey. The scale was developed through a systematic literature review, and its validity and reliability were assessed using several psychometric properties including expert evaluation (n=5), a pilot survey (n=172), and exploratory factor analysis. The final version of KUHJSS included 37 items. A large sample psychometric evaluation was made by nursing staff (n=2708). The exploratory factor analysis revealed seven factors with modest internal consistency (0.64–0.92). The staff reported relatively high job satisfaction. The greatest satisfaction was derived from motivating factors associated with the work; the least, from the job's demands. Respondents who considered their working units to provide an excellent quality of care reported the highest job satisfaction in every subarea (P<.0001). The KUHJSS proved to be a reliable and valid tool for measuring job satisfaction in hospital care