Bir kamu hastanesinde ISO-9002:1994 Kalite Güvence Yönetimi uygulamasının hasta memnuniyeti ve bazı performans göstergelerine etkisi

The hospitals consuming the 45-75% of the sources set aside for the health services, have come across with the demands for the patient satisfaction, lower costs and higher satisfaction at the beginning of 1990's in Turkey. At the Social Insurance Institution (SSK) hospitals in which there is the most patient unsatisfaction "To Improve the Health Services Quality of SSK ISO-9000 and Continuous Quality Improvement Model" project have been implemented at the beginning of 2000. One of the 32 hospitals at which those studies have been implemented is SSK Kartal Hospital. The subject of our research was the effect of ISO-9000 that started to be implemented on 18.12.2000 according to the Total Quality Management (TQM) principles, on patient satisfaction and some of the performance indicators. The patient staisfaction and the number of the operations increased and laboratory examinations and the medicine consumption amount decreased at SSK Kartal Hospital after the studies of ISO-9000. In these changes the implementation of ISO-9002:1994 Quality Assurance Management was effective, but 3-6 months after documentation of the results, the positive change in some of the indicators decreased and the situation showed a tendency to return back to the previous conditions. Keywords: ISO-9000, quality, quality in hospitals. Ülkemizde kamu hastaneleri arasında en fazla şikayetin ve memnuniyetsizliğin olduğu SSK hastanelerinde 2000 yılında, “SSK Sağlık Hizmetleri Kalitesinin Yükseltilmesi için ISO-9000 ve Sürekli Kalite İyileştirme Modeli” projesi uygulamaya sokulmuştur. Bu çalışmaların  uygulandığı 32 hastaneden birisi de SSK Kartal Hastanesi’dir. Bu hastanede 18.12.2000 tarihinde başlayan ve TKY ilkelerine göre yürütülen ISO-9000 uygulamasının hasta memnuniyeti ve bazı kritik performans göstergelerine etkisi araştırmanın konusunu oluşturmaktadır. Yapılan analizde, SSK Kartal Hastanesi’nde yürütülen ISO-9000 çalışması sonucunda ayaktan tedavi hasta memnuniyetinin ve ameliyat sayısının arttığı, ilaç sarfiyat adedi ile laboratuar tetkik sayılarının da azaldığı, bu değişimlerde de ISO-9002:1994 Kalite Güvence Yönetimi standardının uygulanmasının etkisi olduğu, fakat belgelendirmeden 3-6 ay sonra bazı göstergelerde olumlu değişimin azaldığı ve eski duruma dönüş eğiliminin ortaya çıktığı görülmüştür. Anahtar Kelimeler: ISO-9000, kalite, hastanelerde kalite

Factors affecting managerial roles of Chief Information Officers

Yeni bilgi teknolojilerinin kuruluşlara kazandırabileceği rekabet üstünlüğü, teknoloji kullanımının yaygınlaşması ve kolaylaşması göz önüne alındığında bilgi veya teknolojinin etkin yönetilmesiyle elde edilebilir. Kuruluşların bilişim sistem ve teknolojilerinin yönetiminden, modern örgüt yapılanmalarında Bilişim Sistemleri Üst Düzey Yöneticileri (BSÜDY/Chief Information Officer-CIO) sorumludur. Bilişim Sistemleri Üst Düzey Yöneticisi’nin kaynaklarda geçen rolleri, örgütlerde bilişim teknolojisi ve sistemleri yönetiminin gelişim sürecini göstermesi açısından da önem arz etmektedir. Çeşitli ülkelerde yapılmış çalışmalarda, yöneticinin kişisel özellikleri, örgütteki yeri ve çalıştığı kuruluşun bilişim sistemleri gelişmişlik düzeyi ile rollerinin nasıl etkilendiği araştırılmıştır. Bu çalışmanın amacı da, yazın incelemesindeki modelden yola çıkarak, Bilişim Sistemleri Üst Düzey Yöneticisinin rollerini ve bu rolleri etkileyen faktörleri ortaya koymaktır. Araştırma modeli, Türkiye’de finans, sanayi ve kamu sektörlerinde görev yapan 130 Bilişim Sistemleri Üst Düzey Yöneticisi üzerinde test edilmiştir. Veriler, güncel yazın incelenerek hazırlanan bir soru formu aracılığıyla toplanmıştır. Soru formunda yer alan ifade grupları, önceki çalışmalarda geçerliliği ve güvenilirliği sınanmış ölçekler temel alınarak geliştirilmiştir. Toplanan veriler, betimleyici faktör analizlerinden sonra regresyon analizi yapılarak incelenmiştir. Modelin içerdiği unsurlar arasındaki ilişkiler açığa çıkarılarak daha önce yapılmış çalışmalarla karşılaştırılmış, benzerlikler ve farklılıklar tanımlanmıştır. Anahtar Kelimeler: Bilişim sistemleri, bilişim sistemleri üst düzey yöneticisi, bilişim sistemleri gelişmişlik düzeyi, bilişim sistemleri yönetim öncelikleri.The competitive advantage that new information technologies would bring into companies can be obtained through effective information technologies (IT) management, while technology use becomes more common and easier for all companies. Chief Information Officer (CIO) is in charge of managing information systems (IS) and information technologies (IT) in the modern organizational structure. The roles of chief information officer cited in the information systems management literature are very important as those roles also refer to the development stage of information systems/ information technologies management. First generation information systems managers were identified as data processing managers. Parallel to technological advancements the role of information systems managers evolved and second generation managers became design and implementation of information systems as well. Third generation managers became part of senior management in the organizations ands the last generation managers were identified as chief information officers and started to involve in strategic decision making processes. Several research studies on chief information officer roles were conducted in different countries by analyzing chief information officer?s personal characteristics, position in the organization and information technologies maturity level of the organization. Researchers found that internal factors related to information technologies management plays more important role than any other factor. Thus, internal effectiveness and similar concepts are prioritized and the managerial roles that focus on improvements in these concepts re-applied more than those related to strategic decisions and external roles. The aim of this study is to introduce chief information officer roles and the factors that affect chief information officer roles in Turkey by using the model cited in the literature. The research model was adapted from the model used by Gottschalk (2002) and tested on 130 chief information officers from finance, industry, and government sectors in Turkey. Research data was collected with a questionnaire prepared upon comprehensive literature review. The expression patterns of the questionnaire were based on the previous studies, in which their validity and reliability were already approved. The questionnaire consisted four sections: Personal characteristics and organizational factors, managerial roles scale adapted for chief information officers by Grover et al. (1993), technical roles scale by Computer Sciences Corporation (1996) and information systems maturity scale developed by Brancheau et al. (1996). The collected data was examined with the explanatory factor analysis followed by regression analyses. The relationships among the elements in the model were clearly stated and also compared with previous studies. Thus, the similarities and differences were described. The research findings indicated no significant relationship among personal characteristics of chief information officers and roles they prefer while fulfilling their tasks and responsibilities. Among organizational factors, the hierarchical level difference with chief information officer or other highest managerial position had significant impact on one of the roles. Other organizational factors did not affect the roles of chief information officers. These results indicate that personal and organizational factors do not have significant impact on managerial roles of chief information officers in Turkey and they are not fully able to contribute to the business processes by utilizing their personal differences. The impact of information systems maturity level was more significant comparing to personal and organizational factors. The main indicators of which role a chief information officer would assume were found to be information technologies efficiency level followed by information technologies maturity level and information technologies responsibility level. The high impact of information technologies related factors indicates that internal issues such as efficient management of information systems, roles and responsibilities remains priority for chief information officers. This situation also implies that organizations are currently overwhelmed with those internal factors and they could not fully utilize these systems as a part of strategic management decisions. Efficient use of information systems is a prerequisite for benefiting from their features as a competitive advantage factor. However, organizations are still struggling to achieve higher efficiency levels and contributions of information systems related decisions to strategic management of the organizations remains at lower levels. This finding is also supported by current participation of chief information officers to strategic decision making processes and committees. The result findings identified the chief information officer roles and the factors affecting these roles in Turkey. Analysis of results indicated that chief information officer roles and strategic importance of chief information officer position need to be emphasized more in modern organizations in Turkey. Keywords: Information systems, information technologies, information management, Chief Information Officer (CIO), information system maturity, chief information officer roles

Satisfaction with a performance appraisal system and affecting factors

İşe yerleştirme, performans değerleme, ücretlendirme, eğitim ve motivasyon insan kaynakları yönetiminin temel unsurlarıdır. Bunlar arasında performans değerleme, diğer insan kaynakları sistemlerinin kurulmasında üstlendiği yardımcı rol nedeniyle, önem derecesinde en ön planda yer almaktadır. Ayrıca değerleme sayesinde çalışanların verimliliği belirlenir ve sürekli gelişim planlarıyla bireylerin desteklenmesi ve geliştirilmesi sağlanır. Sonuç olarak performans değerleme bir organizasyonun insan kaynaklarının verimliliğini arttırmada temel bir gerekliliktir. Çalışanların organizasyona karşı tutum ve tepkileri, uygulamalı psikoloji dalında en çok araştırılan konu başlıklarından biri olmuştur. Benzer olarak araştırmacı ve uygulamacılar tarafından yoğun bir şekilde araştırılan bir diğer konu da performans değerlemedir. Çalışanların performans değerleme süreci hakkındaki tutumları ve tepkileri, performans değerleme sisteminin faydası değerlendirilirken göz önünde bulundurulması gereken en önemli kriterlerden biridir. Bu çalışmada, konuyla ilgili yazın incelenmiş ve bu doğrultuda çalışanların performans değerleme sistemi memnuniyetlerini etkileyebilecek algı ve tutumlar belirlenmiştir. Teorik beklentiler doğrultusunda oluşturulan araştırma hipotezleri, kamunun sahipliğini yaptığı özel bir işletmede sınanmıştır. Veriler, güncel yazın incelenerek, özgün olarak hazırlanan bir soru formu aracılığıyla toplanmıştır. Soru formunda yer alan ifade grupları, önceki çalışmalarda geçerliliği ve güvenilirliği sınanmış ölçekler temel alınarak geliştirilmiştir. Toplanan veriler, yapılan betimleyici faktör analizlerinden sonra regresyon analizi yapılarak incelenmiştir. Elde edilen bulgular doğrultusunda, memnuniyetle ilişkili unsurlar açığa çıkarılmıştır. Araştırma sonuçları, daha önceden yapılmış çalışmalarla karşılaştırılarak oluşan farklılıklar yorumlanmıştır. Anahtar Kelimeler: Performans değerleme sistemi, algı ve tutum, etkinlik, memnuniyet.Employee selection, performance appraisal, compensation, training, and motivation are the major topics of the human resources management. Among these topics, performance appraisal is the most important one because of the supportive role in forming the other systems. Furthermore, an appraisal is helpful determining effectiveness of the employees, which concludes with the continuous improvement, and support plans of the individuals. Finally, a performance appraisal is a basic necessity to increase the effectiveness of the human resources of an organization. One of the most researched topics of the applied psychology branch is the attitudes and reactions of the employees towards the organization. Research about job satisfaction and the organizational commitment is the main axis of the issue. Another frequently researched topic is the "performance appraisal". The attitudes and the reactions of the employees about the process are one of the most important criteria while evaluating the usefulness of performance appraisal systems. In the last decade, there has been an increase in the number of studies, which have investigated the characteristics of performance appraisal systems. These studies have used questionnaires to assess individuals' reactions to various aspects of the appraisal system. In this research, literature regarding the opinions of employees' has been reviewed, and the perceptions and attitudes that might affect employees' satisfaction level of performance appraisal have been determined. Research hypothesis that was formed on the basis of the theoretical expectations have been tested in a private sector organization which is owned by government. All the data were collected with a questionnaire which was prepared genuinely after reviewing the contemporary literature. The expression patterns of the questionnaire were based on the previous studies in which their validity and the reliability were already approved. The collected data were examined with the regression analysis technique after the descriptive factor analysis. Based on the findings of the analysis, the relationships which forms the satisfaction construct were revealed. As a result of the research, it is observed that, a two-sided interaction exists between the satisfaction and effectiveness variables. This observation points out that an inefficient fraction of the integrated system may cause unsatisfactory feelings among the employees. Due to the obtained results, the satisfaction level of the appraisal is having parallel motives with the major aims of the projected targets of the system, which is the main effectiveness indicator of the entire system. "Justice Perception" is one of the major elements which is influential on the entire perception of the satisfaction issue. On the previous researches, it has been declared that the satisfaction level about the appraisal is directly related with the "Justice Perception" of the employers. The findings of the research, verifies the relation between the two dimensins of justice which are, procedural and distributional justice and the satisfaction figures. This result shows that any lack of justice in the appraisal systems is likely to decrease the satisfaction levels of the employees. In the previous studies, it has been indicated that the knowledge of the appraisees about the appraisal system is related with their satisfaction levels. In the realized research findings, it was seen that this relation was related with the "Personal System Knowledge" perception of the appraisee which is a sub-factor of  "Perceived System Knowledge". Personal knowledge perception is a variable figure, which shows the knowledge of the related individual, regarding the concept of the appraisal system. A different sub-factor of this structure is the "General Knowledge Perception Variable" which shows the knowledge level of the appraisees about the appraisal system. This result also proves the importance of the correct "Appraisal Definition" which needs to be explained to the appraisees. The more the appraisees learn about the appraisal system, the higher appraisal satisfaction levels are reached by the appraisees. There are several limitations of the present study which should be noted. Since this study focused on a single appraisal system in one organization, generalizations regarding the results are somewhat limited. Additional research is needed which replicates the present findings using other appraisal systems in other organizations. This would provide additional evidence for understanding the characteristics of effective appraisal systems, which are acceptable to both managers and employees.  Keywords: Performance appraisal systems, perceptions and attitudes, effectiveness, satisfaction

Affective components of organizational commitment: A comprehensive structural equations model in a public sector organization

Örgütsel bağlılık, yazında bugüne dek çok araştırılmasına rağmen hem bağlam duyarlılığı hem de belirleyicileri ve sonuçları açısından karmaşıklığı nedeniyle hala ilgi toplayan bir araştırma başlığıdır. Çalışmamızın amacı, örgütsel bağlılığın duygusal bileşenlerinin belirleyicilerinden sayılan “iş tatmini” ve “genel yaşam tatmini” gibi faktörler ve sonucu sayılabilecek “örgütsel performans algısı” ve “ayrılma niyeti” gibi diğer faktörlerle eş anlı etkileşimini bir model çerçevesinde sınamaktır. Öncelikle yazın incelemesinden duygu tabanlı örgütsel bağlılığın belirleyicileri ve sonuçları sentezlenerek bir kuramsal model geliştirilmiş, geliştirilen bu modeldeki nedensellik ilişkileri önsavlara dönüştürülmüştür. Bu kuramsal modelin tamamını ve faktörler arası etkileşimleri eş anlı olarak test edebilmek için yapısal denklem modelleme yönteminden faydalanılmış ve AMOS 4.0 yazılım programı kullanılarak test modelleri geliştirilmiştir. Geliştirilen modeller bir kamu kuruluşunda çalışan 752 memur personelden soru formu yoluyla toplanan veriler üzerinde sınanmıştır. Kuramsal modelde duygusal tabanlı örgütsel bağlılık için öngörülen kompozit faktör yapısı veri setine tam uymayınca iki faktörlü çözüme geçilmiş, elde edilen iki faktör “duygusal aidiyet” ve “sadakat” olarak adlandırılmıştır. Çift faktörlü yapı belirleyicilik ve sonuçlar açısından test amaçlı yapısal denklem modellerine dahil edildiğinde bulgular bazı önsavları tamamen, bazılarını kısmen desteklemiş, bazılarını ise hiç desteklememiştir. “İş tatmini”, “duygusal aidiyet” ve “sadakat” arasındaki ilişkilerin yön ve şiddeti konusunda bu kavramlar arasındaki yoğun çoklu bağlantılar nedeniyle berrak bir değerlendirme yapmak zorlaşmıştır. Buna rağmen denilebilir ki “iş tatmini” genel olarak “duygusal aidiyet” ve “sadakat”i, bu ikisinin iş tatminini belirleme düzeyinden çok daha fazla belirliyor görünümdedir. İşinden tatmin olan bir kamu çalışanı özellikle örgüte karşı duygusal aidiyet geliştirmekte ve bu duygusal aidiyet sadakate yol açmaktadır. Ayrıca, yazındaki bulgulara benzer şekilde sadakatin ayrılma niyetini azalttığı, iş tatmininin ise örgütsel performans algısını arttırdığı gözlemlenmiştir. Anahtar Kelimeler: Örgütsel bağlılık, iş tatmini, ayrılma niyeti, yapısal denklem modelleri.Organizational commitment construct has attained widespread attention from the organizational scholars during the last three decades. Yet, its close relations to other organizational attitudes and behaviors have rendered its causal identification quite complicated. Besides, many recent studies have indicated that the concept might reveal different characteristics in different contexts. Thus, this study attempts to identify and explain the affective component of organizational commitment with regard to a set of correlated organizational attitudes in a Turkish public sector organization. In order to achieve a reliable and causally robust analysis only the affective component of organizational commitment was analyzed. A thorough literature survey was performed to synthesize a theoretical model about the causal linkages of the construct. According to this survey, one of the most important correlates of organizational commitment is job satisfaction and organizational performance. Therefore, job satisfaction and perceived organizational performance was included in the model with two-way causal paths. Life satisfaction was found to be strongly correlated to job satisfaction and thus integrated to the theoretical model. The last construct included in the model was intent-to-leave. Five testable hypotheses were constituted to test the causal paths between the main constructs of the model. As method, we designed self-administrative questionnaires to measure these organizational attitudes. Questionnaire items were developed based on reliable scales for each construct but adapted to the Turkish and public sector domain. We ran a pilot sample and rechecked validity and reliability of our measures. Then we proceeded to apply our questionnaire to the whole civil servant population of a public sector organization. The total of returned questionnaires were 752 (approx. 90% of population), and due to missing values we ended up with 704 usable observations. Before testing our hypothesis, we started to examine the reliability and validity of our constructs. We used Exploratory Factor Analysis (EFA) method and Cronbach's Alpha for testing construct reliability. EFA did not load on a composite factor for affective organizational commitment scale but supported a two-factor solution. Since this was not expected, a confirmatory factor analysis was run to verify this solution. We found considerable support for a two-factor solution of affective organizational commitment construct, which we named "affective belongingness" and "loyalty" respectively. Having confirmed our measures, as a next step, the theoretical model was moved to AMOS 4.0 program to test the whole model simultaneously. Structural Equations Modeling (SEM) technique enables testing of multiple latent (unobserved) constructs and their interactions, using simultaneous structural equations derived from observed variables. Using SEM, we tested our theoretical model but due to the complex two-way interactions between key constructs, two test models were needed to account for all hypothesized relations. The first test model's overall fit, determined by  2 and GFI, was deemed acceptable, but some of the causal paths were observed as insignificant. The second test model fitted poorly to the data and again some paths were found to have insignificant scores. An optimum model with all paths significant and a good overall fit was produced and designated. Test models using SEM revealed that job satisfaction determined affective belongingness and by being emotionally attached to their organizations, public sector civil servants became more loyal. On the other hand, as predicted, loyal civil servants became less inclined to leave their organization. Yet, there were no statistically significant causal relations between affective based commitment and perceived organizational performance. However, test models indicated that the more satisfied the employees became the more inclined they were to rate their organization as performing well. Also, job satisfaction was found to determine life satisfaction more, even though the reverse is also statistically true. Thus, we conclude that job satisfaction has become even more critical a factor for public organizations to create loyal and emotionally charged employees. To increase satisfaction not just tangible categories such as pay system count but also good administrative capabilities matter. Keywords: Organizational commitment, job satisfaction structural equations model, intent-to-leave