Through the Eye of the Beholder: Multiple Perspectives on Quality in Women\u27s Health Care

Quality is an illusive concept with different meanings to different people. Providers often define quality in terms of patient outcomes, professional standards of practice, predetermined criteria used to measure quality, and even subjective opinion. Patients describe quality in terms of the interpersonal aspects of care, how well they were treated, and the responsiveness of the provider to their needs. This qualitative study using a semi-structured interview defined quality from the perspectives of patients, physicians, nurses, and payers associated with a hospital-based women\u27s service line, and how the attributes of quality varied among the multiple groups. The study also described how stakeholders become aware of quality and how they determined a hospital\u27s quality. From the findings of the study, a conceptual framework of quality in women\u27s health was developed

The Effects of Collaboration, Organizational Climate, and Job Stress on Job Satisfaction and Anticipated Turnover in Nursing

The purpose of this study was to examine the effects of collaborative behavior, organizational climate, and job stress on job satisfaction and anticipated turnover in nursing. The path analytic model of anticipated turnover was temporally ordered with all exogenous variables proposed to directly affect job satisfaction and anticipated turnover and indirectly affect anticipated turnover through job satisfaction. Subjects (N = 188) were female Registered Nurses from six hospitals in Southern California. The majority of the respondents were clinical nurses who worked full time on the day shift, although a significant percentage of the sample also worked part-time or perdiem and were assigned to evening, nights, or rotating shifts. The mean age of the sample was 39 years of age with 6 years of seniority in their current position. Collaborative behavior between nurses and physicians and between nurses and managers, organizational climate, and job stress had significant predictive validity with job satisfaction and explained 41% of the variance in job satisfaction. Organizational climate and job stress were the strongest predictors of job satisfaction. Age, nurse-manager collaborative behavior and job satisfaction had predictive validity with anticipated turnover and accounted for 31% of the explained variance in anticipated turnover. Job satisfaction was the strongest predictor of anticipated turnover. A post hoc regression analysis of the dimensions of each exogenous variable with the endogenous variables supported the earlier findings. The post hoc model explained 44% of the variance in job satisfaction and 31% of the variance in anticipated turnover. Post hoc analysis of variance revealed several significant group differences in the study variables. Overall job satisfaction scores between evening and night nurses differed significantly (p ≤ .02) with night nurses reporting higher mean scores than evening nurses. Night nurses also reported the lowest mean scores for anticipated turnover with significant group differences related to the assigned shift reported for anticipated turnover. The current study supported the findings of other researchers related to job satisfaction and anticipated turnover