Managers shaping the service triangle: Navigating resident and worker interests through work design in nursing homes

Managers play a key role in shaping the service triangle and navigating stakeholder interests within this. In healthcare, labor shortages are prompting consideration of the consequences of care delivery for service users and staff. Here we consider how senior nursing home managers tasked with balancing resident and worker interests manage tensions using work design. Findings identify a five-cluster typology, reflecting variations in how managers from twenty Flemish nursing homes operationalize the same resident-centred care model. Managers purposively shape a different service triangle in each operationalization, variously prioritizing benefits for residents, seeking the golden mean or attempting to suppress tensions

Activering van werklozen in België en Nederland

status: publishe

Managers shaping the service triangle: Navigating resident and worker interests through work design in nursing homes

Managers play a key role in shaping the service triangle and navigating stakeholder interests within this. In health care, labor shortages are prompting consideration of the consequences of care delivery for service users and staff. Here, the authors consider how senior nursing home managers tasked with balancing resident and worker interests manage tensions using work design. The findings identify a five-cluster typology, reflecting variations in how managers from 20 Flemish nursing homes operationalize the same resident-centered care model. Managers purposively shape a different service triangle in each operationalization, variously prioritizing benefits for residents, seeking the golden mean, or attempting to suppress tensions.status: Published onlin

Continu verbeteren in een Vlaams woonzorgcentrum: ook beter voor zorgverleners?

Continu verbeteren (CVB) van werkprocessen maakt vanaf het begin van de 21e eeuw opmars in de zorg. Tot hiertoe bleef onduidelijk welke gevolgen dit heeft voor de kwaliteit van de arbeid bij zorgverleners. In dit artikel wordt de kwaliteit van de arbeid onderzocht in De Vierde Wand, een Vlaams woonzorgcentrum waar men CVB sinds begin 2015 toepast. Een kwantitatieve vergelijking met ‘conventionele’ woonzorgcentra toont dat de zorgverleners in De Vierde Wand lagere werkeisen, meer regelmogelijkheden en een verhoogde bevlogenheid rapporteren. Aan de hand van kwalitatieve data schrijven we dit verschil in belangrijke mate toe aan CVB. Hoewel continu verbeteren in dit woonzorgcentrum positief uitpakt voor de kwaliteit van de arbeid, komen in dit artikel ook enkele concrete verbeterpunten voor het toepassen van CVB in dit woonzorgcentrum naar voren.status: publishe

Continu verbeteren in een Vlaams woonzorgcentrum: ook beter voor zorgverleners?

Continu verbeteren (CVB) van werkprocessen maakt vanaf het begin van de 21e eeuw opmars in de zorg. Tot hiertoe bleef onduidelijk welke gevolgen dit heeft voor de kwaliteit van de arbeid bij zorgverleners. In dit artikel wordt de kwaliteit van de arbeid onderzocht in De Vierde Wand, een Vlaams woonzorgcentrum waar men CVB sinds begin 2015 toepast. Een kwantitatieve vergelijking met ‘conventionele’ woonzorgcentra toont dat de zorgverleners in De Vierde Wand lagere werkeisen, meer regelmogelijkheden en een verhoogde bevlogenheid rapporteren. Aan de hand van kwalitatieve data schrijven we dit verschil in belangrijke mate toe aan CVB. Hoewel continu verbeteren in dit woonzorgcentrum positief uitpakt voor de kwaliteit van de arbeid, komen in dit artikel ook enkele concrete verbeterpunten voor het toepassen van CVB in dit woonzorgcentrum naar voren

Putting a band-aid on a wooden leg: A sociotechnical view on the success of decentralisation attempts to increase job autonomy

Purpose: Decentralisation attempts that aim to increase job autonomy do not always succeed. This paper aims to study to what extent the tendency to maintain existing operational task divisions is an important explanation for this lack of success. Research design: 456 employees in 25 organisations participated in a cross-sectional intervention study. Each employee filled out a questionnaire on job autonomy both before and after the decentralisation process, in which all organisations shifted regulatory, preparatory and supportive tasks to the lowest organisational level. Findings: This study found small, but significant, effects of decentralisation attempts on job autonomy. The size of the effect, however, depended on the way in which the operational tasks were divided. Simultaneously, larger effects were found for organisations which decentralised tasks and changed the way operational tasks were divided. Both findings reached the conclusion that although decentralisation attempts seemed important for increasing job autonomy, the way in which the operational tasks were divided, and even changed, was at least as important for a successful decentralisation process. Originality: After decades of research on modern sociotechnical theory, this study is the first to show that decentralisation attempts do not merely increase job autonomy. The effect of such attempts depend on the way in which operational tasks are divided in organisations.status: publishe

Structure Please; Continuous Improvement and Employee Consequences in a Dynamic Task Environment

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Structure Please; Continuous Improvement and Employee Consequences in a Dynamic Task Environment

Whilst continuous improvement (CI) programs have had an enduring appeal for several decades, their sustainability has been a concern for almost as long. Sustaining a CI program requires permanent support of all its stakeholders, particularly of the most important ones—employees. Some authors argue that continuous improvement programs are beneficial for employee wellbeing, while others contest this. We contribute to the small empirical basis for such claims by presenting results from research among care workers in Flemish nursing homes. Questionnaires from 553 care workers in a nursing home applying continuous improvement and in a reference group of nine comparable homes were analyzed to study differences in job demands, job resources, burnout risk, and work engagement. In addition, we have drawn on interviews, site visits, and other qualitative data to assess the extent to which the differences found may be attributed to the CI program used. Overall, the care workers in the nursing home with the CI program evaluated their jobs as better than their colleagues in the reference group. These differences are at least partly caused by the continuous improvement program. We argue that the main effect is that over time, daily work processes become more structured. The work pressure decreases as work becomes less hectic

Evidence of Workplace Innovation from Organisational and Economic Studies

status: publishe