No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
New Management Systems and the Ambiguous Nature of Resources: A Qualitative Study about Healthcare Middle Managers
ResearchGate has not been able to resolve any citations for this publication.
Lean production and human work. How should ergonomics react to this new concept of efficiency ? Ergonomists are receiving a growing number of requests directly connected with Lean production. It’s true that there’s nothing really new about just in time methods, kanban, kaisen and so on in the business environment. What is new is the way Lean has burst into the company as a global system, and the uproar caused by the values it encompasses. This points to a major change in the notional referents of companies’ efficiency, impacting work resources and the interpretation of results. The promises of Lean offer companies an opportunity to « change », not just for the « better » (greater agility and flexibility, and faster reaction times) but also for the « good » (emancipation from Taylorism to the point of finding a natural closeness to ergonomics). That last statement raises a number of questions. It was introduced by Lean specialists rather than by ergonomists, and it seems natural therefore that a « disciplinary » response, which does not yet exist, should be provided. There are already several different positions in the field of ergonomics but they cover a very broad spectrum, ranging from those who claim that the Lean is practically equivalent to the end of ergonomics, thereby supporting the correspondence theory, to those who see it as a new form of Taylorism, a new threat to be fought against. On this topical and controversial issue, the authors’ intention is to initiate a dialogue between practitioners and researchers to reach a better understanding of the relative positions of work and of ergonomics.
Lean production has made a comeback in businesses since the mid-2000s, triggering much debate about its impact on working practices. This paper seeks to highlight the manner in which “lean” conceives work. However, neither Ohno, who devised the method and its tools, nor Womack, Jones or Roos, its theoreticians, actually provide us with very much explicit theory. The key idea is to combat waste in the day-to-day operation of workshops. This may lead either to a reassessment of employees’ working conditions or to an obsession with reducing “unproductive” work time by forcing human beings to constantly adapt. This relative uncertainty is all the more important insofar as its implementation outside the automotive sector means that it may be applied in very different productive contexts.
Résumé : Cette communication propose un retour critique sur les analyses sociologiques portant sur les « modèles productifs ». Il existe jusqu'à aujourd'hui plusieurs hypothèses sur le sens et l'ampleur de ces transformations. Le concept de lean production (production au plus juste) contient à notre avis la plus grande pertinence, justement parce qu'il permet de pousse l'analyse sur les causes et les effets le plus possible.
Background
Lean is a set of operating philosophies and methods that help create a maximum value for patients by reducing waste and waits. It emphasizes the consideration of the customer’s needs, employee involvement and continuous improvement. Research on the application and implementation of lean principles in health care has been limited.
Methods
This is a protocol for a systematic review, following the Cochrane Effective Practice and Organisation of Care (EPOC) methodology. The review aims to document, catalogue and synthesize the existing literature on the effects of lean implementation in health care settings especially the potential effects on professional practice and health care outcomes. We have developed a Medline keyword search strategy, and this focused strategy will be translated into other databases. All search strategies will be provided in the review. The method proposed by the Cochrane EPOC group regarding randomized study designs, non-randomised controlled trials controlled before and after studies and interrupted time series will be followed. In addition, we will also include cohort, case–control studies, and relevant non-comparative publications such as case reports. We will categorize and analyse the review findings according to the study design employed, the study quality (low- versus high-quality studies) and the reported types of implementation in the primary studies. We will present the results of studies in a tabular form.
Discussion
Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin the implementation of lean activities in health care settings as defined in this protocol. As a result, the review will provide an evidence base for the effectiveness of lean and implementation methodologies reported in health care.
Systematic review registration
PROSPERO CRD42014008853
Objective
. To address the degree of burnout in nursing managers in hospitals of Western Switzerland, including comparison with medical managers, and its relationship with personal, work-related, and organizational characteristics.
Methods
. Statistical analysis of the scores of the Maslach Burnout Inventory-Human Services Survey from 257 nursing managers who answered a standardized electronic questionnaire.
Results
. Nursing managers showed a low degree of burnout, which was similar to that of medical managers. Most of them had a low level of emotional exhaustion and a low level of depersonalization, while personal accomplishment was contrasted. Only 2.3% had a high degree of burnout. These findings challenge the hypothesis of high stress being associated with high burnout, as nursing managers can be supposed to have a highly demanding job due to their intermediary position within the hospital hierarchy. Variations of burnout by personal, work-related, and organizational characteristics mainly concerned emotional exhaustion.
Conclusion
. Though nursing managers face a highly demanding job, they may benefit from resources (including coping strategies and empowerment) which help counterbalance job stress. Unequal distribution of resources may play a central role when facing burnout.
Psychology has increasingly turned to the study of psychosocial resources in the examination of well-being. How resources are being studied and resource models that have been proffered are considered, and an attempt is made to examine elements that bridge across models. As resource models span health, community, cognitive, and clinical psychology, the question is raised of whether there is overuse of the resource metaphor or whether there exists some underlying principles that can be gleaned and incorporated to advance research. The contribution of resources for understanding multicultural and pan-historical adaptation in the face of challenge is considered. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In this article, we develop and meta-analytically test the relationship between job demands and resources and burnout, engagement, and safety outcomes in the workplace. In a meta-analysis of 203 independent samples (N = 186,440), we found support for a health impairment process and for a motivational process as mechanisms through which job demands and resources relate to safety outcomes. In particular, we found that job demands such as risks and hazards and complexity impair employees' health and positively relate to burnout. Likewise, we found support for job resources such as knowledge, autonomy, and a supportive environment motivating employees and positively relating to engagement. Job demands were found to hinder an employee with a negative relationship to engagement, whereas job resources were found to negatively relate to burnout. Finally, we found that burnout was negatively related to working safely but that engagement motivated employees and was positively related to working safely. Across industries, risks and hazards was the most consistent job demand and a supportive environment was the most consistent job resource in terms of explaining variance in burnout, engagement, and safety outcomes. The type of job demand that explained the most variance differed by industry, whereas a supportive environment remained consistent in explaining the most variance in all industries.
This study of 805 Finnish teachers working in elementary, secondary, and vocational schools tested 2 interaction hypotheses. On the basis of the job demands–resources model, the authors predicted that job resources act as buffers and diminish the negative relationship between pupil misbehavior and work engagement. In addition, using conservation of resources theory, the authors hypothesized that job resources particularly influence work engagement when teachers are confronted with high levels of pupil misconduct. In line with these hypotheses, moderated structural equation modeling analyses resulted in 14 out of 18 possible 2-way interaction effects. In particular, supervisor support, innovativeness, appreciation, and organizational climate were important job resources that helped teachers cope with demanding interactions with students.
The job demands–resources (JD-R) model proposes that working conditions can be categorized into 2 broad categories, job demands and job resources, that are differentially related to specific outcomes. A series of LISREL analyses using self-reports as well as observer ratings of the working conditions provided strong evidence for the JD-R model: Job demands are primarily related to the exhaustion component of burnout, whereas (lack of) job resources are primarily related to disengagement. Highly similar patterns were observed in each of 3 occupational groups: human services, industry, and transport (total N = 374). In addition, results confirmed the 2-factor structure (exhaustion and disengagement) of a new burnout instrument—the Oldenburg Burnout Inventory—and suggested that this structure is essentially invariant across occupational groups.
The Job Demands-Resources model (JD-R model) became highly popular among researchers. The current version of the model proposes that high job demands lead to strain and health impairment (the health impairment process), and that high resources lead to increased motivation and higher productivity (the motivational process). This chapter reviews the assumptions and development of the JD-R model and presents an overview of important findings obtained with the model. Although these findings largely support the model's assumptions, there are still several important unresolved issues regarding the JD-R, including the model's epistemological status, the definition of and distinction between demands and resources, the incorporation of personal resources, the distinction between the health impairment and the motivational processes, the issue of reciprocal causation, and the model's applicability beyond the individual level. The chapter concludes with an agenda for future research and a brief discussion of the practical application of the model. © 2014 Springer Science+Business Media Dordrecht. All rights are reserved.
Motivation: The motivation of this overview is to present the state of the art of Job Demands–Resources (JD–R) model whilst integrating the various contributions to the special issue.
Research purpose: To provide an overview of the JD–R model, which incorporates many possible working conditions and focuses on both negative and positive indicators of employee well-being. Moreover, the studies of the special issue were introduced.
Research design: Qualitative and quantitative studies on the JD–R model were reviewed to enlighten the health and motivational processes suggested by the model.
Main findings: Next to the confirmation of the two suggested processes of the JD–R model, the studies of the special issue showed that the model can be used to predict work-place bullying, incidences of upper respiratory track infection, work-based identity, and early retirement intentions. Moreover, whilst psychological safety climate could be considered as a hypothetical precursor of job demands and resources, compassion satisfaction moderated the health process of the model.
Contribution/value-add: The findings of previous studies and the studies of the special issue were integrated in the JD–R model that can be used to predict well-being and performance at work. New avenues for future research were suggested.
Practical/managerial implications: The JD–R model is a framework that can be used for organisations to improve employee health and motivation, whilst simultaneously improving various organisational outcomes.
aim . . . is to identify and describe a particular aspect of illness behaviors in the elderly / what do elderly persons do when they recognize illness / what is this phenomenon of illness behavior / what is important here / what is going on here / interested in questions of meaning and culture that call for constructivist inquiry / the field research style is their choice for meeting the analysis objectives of identification and qualitative description (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This paper examines the relationship between workload, burnout and somatization in nurses. The respondents consisted of 1363 nurses employed in hospitals, which were undergoing extensive restructuring. Results of structural equation analyses showed that workload was positively related to emotional exhaustion. Emotional exhaustion led to cynicism and somatization, and cynicism was negatively related to nurses' professional efficacy. Implications of the results for nursing practice are discussed. Copyright © 2001 John Wiley & Sons, Ltd.
Conservation of Resources (COR) theory predicts that resource loss is the principal ingredient in the stress process. Resource gain, in turn, is depicted as of increasing importance in the context of loss. Because resources are also used to prevent resource loss, at each stage of the stress process people are increasingly vulnerable to negative stress sequelae, that if ongoing result in rapid and impactful loss spirals. COR theory is seen as an alternative to appraisal-based stress theories because it relies more centrally on the objective and culturally construed nature of the environment in determining the stress process, rather than the individual’s personal construel. COR theory has been successfully employed in predicting a range of stress outcomes in organisational settings, health contexts, following traumatic stress, and in the face of everyday stressors. Recent advances in understanding the biological, cognitive, and social bases of stress responding are seen as consistent with the original formulation of COR theory, but call for envisioning of COR theory and the stress process within a more collectivist backdrop than was first posited. The role of both resource losses and gains in predicting positive stress outcomes is also considered. Finally, the limitations and applications of COR theory are discussed.
We constructed a model of workplace psychosocial safety climate (PSC) to explain the origins of job demands and resources, worker psychological health, and employee engagement. PSC refers to policies, practices, and procedures for the protection of worker psychological health and safety. Using the job demands–resources framework, we hypothesized that PSC as an upstream organizational resource influenced largely by senior management, would precede the work context (i.e., job demands and resources) and would in turn predict psychological health and work engagement via mediation and moderation pathways. We operationalized PSC at the school level and tested meso-mediational models using two-level (longitudinal) hierarchical linear modelling in a sample of Australian education workers (N = 209–288). Data were repeated measures separated by 12 months, nested within 18 schools. PSC predicted change in individual psychological health problems (psychological distress, emotional exhaustion) through its relationship with individual job demands (work pressure and emotional demands). PSC moderated the relationship between emotional demands and emotional exhaustion. PSC predicted change in employee engagement, through its relationship with skill discretion. The results show that the PSC construct is a key upstream component of work stress theory and a logical intervention site for work stress intervention.
This diary study investigated whether and how supervisors' leadership style influences followers' daily work engagement. On the basis of leadership theories and the job demands–resources model, we predicted that a transformational leadership style enhances employees' work engagement through the mediation of self-efficacy and optimism, on a day-to-day basis. Forty-two employees first filled in a general questionnaire, and then a diary survey over five consecutive workdays. The results of multilevel analyses offered partial support for our hypotheses. Daily transformational leadership related positively to employees' daily engagement, and day-levels of optimism fully mediated this relationship. However, daily self-efficacy did not act as a mediator. These findings expand theory and previous research by illuminating the role of transformational leaders in fostering employee work engagement.
It is now well recognized that employees can develop multiple work-relevant commitments, and that commitment itself is a multidimensional construct. Unfortunately, there remains considerable disagreement, both within and across work commitment literatures (e.g., organizational, occupational, union), about what commitment is, its dimensionality, how it develops, and how it affects behavior. We argue that commitment should have a “core essence” regardless of the context in which it is studied, and that it should therefore be possible to develop a general model of workplace commitment. We propose such a model based on the propositions that commitment (a) is a force that binds an individual to a course of action of relevance to a target and (b) can be accompanied by different mind-sets that play a role in shaping behavior. We demonstrate how this model helps to explain existing research findings and can serve as a guide for future research and for the management of workplace commitments.
In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.
American hospitals have undergone three waves of organizational restructuring in the past two decades. These changes have had direct effects on a key set of employees--nurses. A review of the relevant literature to identify the ways in which hospital restructuring affects the work of registered nurses focuses on three important structural characteristics of nursing work: nurses' work roles, workload, and control of work. The review concludes that the impact of restructuring on each of the characteristics affects nurses' satisfaction with their work and may also affect the quality of patient care. While much of the policy debate around restructuring focuses on the extent to which reductions in nurse staffing levels affects quality of care, it is important to examine not only changes in nurse staffing levels, but changes in the work performed by registered nurses, as well.
L'ergonome et les débats sur la performance de l'entreprise. Actes des 16èmes Journées de Bordeaux sur la pratique de l'ergonomie
- F Daniellou
Daniellou F (2009) L'ergonome et les débats sur la performance de l'entreprise. Actes des 16èmes Journées de
Bordeaux sur la pratique de l'ergonomie, Bordeaux.
Die Theorie der Ressourcenerhaltung und das multiaxiale Copingmodell -eine innovative Stresstheorie
- S E Hobfoll
- P Buchwald
Hobfoll SE, Buchwald P (2004) Die Theorie der Ressourcenerhaltung und das multiaxiale Copingmodell -eine innovative Stresstheorie. Stress gemeinsam bewältigen, Göttingen, 11-26.
Psychologie du travail. Modèles, concepts et méthodes
- M Bruchon-Schweitzer
Bruchon-Schweitzer M (2002) Psychologie du travail.
Modèles, concepts et méthodes. Dunod, Paris.
Lean Management: outils, méthodes, retours d'expériences
- C Hohmann
Hohmann C (2012) Lean Management: outils, méthodes,
retours d'expériences. Paris.
Medical heads and head nurses between managerialism and professionalism: a necessary double-bind? In: Winston TN, Handbook on burnout and sleep deprivation: risk factors, management strategies and impact on performance and behavior
- V Haberey-Knuessi
- J L Heeb
Haberey-Knuessi V, Heeb JL (2015) Medical heads and head
nurses between managerialism and professionalism: a necessary double-bind? In: Winston TN, Handbook on burnout and
sleep deprivation: risk factors, management strategies and
impact on performance and behavior. Nova, New York.
Méthodologie de la recherche qualitative
- H Dumez
Dumez H (2013) Méthodologie de la recherche qualitative,
Paris.
Travail d'organisation du lean manufacturing et santé: à la source des risques. Perspectives interdisciplinaires sur le travail et la santé
- S Bruère
S Bruère (2012) Travail d'organisation du lean manufacturing et santé: à la source des risques. Perspectives interdisciplinaires sur le travail et la santé 14: 1-24.
Salariés, le lean tisse sa toile et vous entoure
- P Rouzaud
Rouzaud P (2011) Salariés, le lean tisse sa toile et vous
entoure. L Harmattan, Paris.