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Article
Publication date: 7 July 2021

Lena Ansmann, Vera Vennedey, Hendrik Ansgar Hillen, Stephanie Stock, Ludwig Kuntz, Holger Pfaff, Russell Mannion and Kira Isabel Hower

Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying…

3305

Abstract

Purpose

Healthcare systems are under pressure to improve their performance, while at the same time facing severe resource constraints, particularly workforce shortages. By applying resource-dependency-theory (RDT), we explore how healthcare organizations in different settings perceive pressure arising from uncertain access to resources and examine organizational strategies they deploy to secure resources.

Design/methodology/approach

A cross-sectional survey of key decision-makers in different healthcare settings in the metropolitan area of Cologne, Germany, on perceptions of pressure arising from the environment and respective strategies was conducted. For comparisons between settings radar charts, Kruskal–Wallis test and Fisher–Yates test were applied. Additionally, correlation analyses were conducted.

Findings

A sample of n = 237(13%) key informants participated and reported high pressure caused by bureaucracy, time constraints and recruiting qualified staff. Hospitals, inpatient and outpatient nursing care organizations felt most pressurized. As suggested by RDT, organizations in highly pressurized settings deployed the most vociferous strategies to secure resources, particularly in relation to personnel development.

Originality/value

This study is one of the few studies that focuses on the environment's impact on healthcare organizations across a variety of settings. RDT is a helpful theoretical foundation for understanding the environment's impact on organizational strategies. The substantial variations found between healthcare settings indicate that those settings potentially require specific strategies when seeking to address scarce resources and high demands. The results draw attention to the high level of pressure on healthcare organizations which presumably is passed down to managers, healthcare professionals, patients and relatives.

Details

Journal of Health Organization and Management, vol. 35 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 18 April 2019

Kira Isabel Hower, Holger Pfaff, Christoph Kowalski, Michel Wensing and Lena Ansmann

Measuring attitudes of healthcare providers and managers toward change in health care organizations (HCOs) has been of widespread interest. The purpose of this paper is to…

1511

Abstract

Purpose

Measuring attitudes of healthcare providers and managers toward change in health care organizations (HCOs) has been of widespread interest. The purpose of this paper is to evaluate the psychometric characteristics and usability of an abbreviated German version of the Change Attitude Scale.

Design/methodology/approach

The Change Attitude Scale was used in a survey of healthcare providers and managers in German hospitals after the implementation of a breast cancer center concept. Reliability analysis, confirmatory factor analysis, structural equation modeling and bivariate analysis were conducted.

Findings

Data from 191 key persons in 82 hospitals were analyzed. The item-scale structure produced an acceptable model fit. Convergent validity was shown by significant correlations with measures of individuals’ general opinions of the breast center concept. A non-significant correlation with a scale measuring the hospital’s hierarchical structure of leadership verified discriminant validity. The interaction of key persons’ change attitude and hospitals’ change performance through change culture as a mediator supported the predictive validity.

Research limitations/implications

The study found general support for the validity and usability of a short version of the German Change Attitude Scale.

Practical implications

Since attitudes toward change influence successful implementation, the survey may be used to tailor the design of implementation programs and to create a sustainable culture of high readiness for change.

Originality/value

This is the first study finding that a short instrument can be used to measure attitudes toward change among healthcare providers and managers in HCOs.

Details

Journal of Health Organization and Management, vol. 33 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Available. Open Access. Open Access
Article
Publication date: 31 August 2022

Helge Schnack, Sarah Anna Katharina Uthoff and Lena Ansmann

Like other European countries, Germany is facing regional physician shortages, which have several consequences on patient care. This study analyzes how hospitals perceive…

3286

Abstract

Purpose

Like other European countries, Germany is facing regional physician shortages, which have several consequences on patient care. This study analyzes how hospitals perceive physician shortages and which strategies they adopt to address them. As a theoretical framework, the resource dependency theory is chosen.

Design/methodology/approach

The authors conducted 20 semi-structured expert interviews with human resource officers, human resource directors, and executive directors from hospitals in the northwest of Germany. Hospitals of different ownership types, of varying sizes and from rural and urban locations were included in the sample. The interviews were analyzed by using qualitative content analysis.

Findings

The interviewees reported that human resource departments in hospitals expand their recruiting activities and no longer rely on one single recruiting instrument. In addition, they try to adapt their retaining measures to physicians' needs and offer a broad range of employment benefits (e.g. childcare) to increase attractiveness. The study also reveals that interviewees from small and rural hospitals report more difficulties with attracting new staff and therefore focus on recruiting physicians from abroad.

Practical implications

Since the staffing situation in German hospitals will not change in the short term, the study provides suggestions for hospital managers and health policy decision-makers in dealing with physician shortages.

Originality/value

This study uses the resource dependency theory to explain hospitals' strategies for dealing with healthcare staff shortages for the first time.

Details

Journal of Health Organization and Management, vol. 36 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 28 December 2021

Moritz Ansmann and Markus Seyfried

Quality management has become an integral part of management reforms in public sector organizations. Drawing on a new institutionalist perspective, this study aims to investigate…

576

Abstract

Purpose

Quality management has become an integral part of management reforms in public sector organizations. Drawing on a new institutionalist perspective, this study aims to investigate the relation of management reforms and organizational performance in the context of higher education.

Design/methodology/approach

The authors analyse the interaction between isomorphic conformity in quality management adoption, organizational learning and quality improvement and, in so doing, address the central theoretical question of what effects isomorphic conformity has on organizational performance. Empirically, the study draws on survey data from quality managers at public higher education institutions in Germany. Methodically, it applies confirmatory factor analysis and structural equation modelling.

Findings

The results suggest that mimetic isomorphism is surprisingly compatible with processes of organizational learning, and thus, does not inevitably compromise organizational development.

Originality/value

By presenting these findings, the authors contribute to the controversial theoretical debate concerning the effects of isomorphism and to the ongoing discussion regarding the organizational impact of quality management in higher education.

Details

Quality Assurance in Education, vol. 30 no. 1
Type: Research Article
ISSN: 0968-4883

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