Emerging Occupational and Organizational Forms in Health Service Delivery
This workshop features two studies of emerging occupational and organizational forms in health service delivery.
Emergent Health-Care Occupations and Quality of Life: A Cross-Country Study
Marta Elvira, Ph.D.
Visiting Professor, IESE Business School, University of Navarra, Spain
This project aims to understand the structuring of emergent occupational and organizational forms in health care services. Employment growth in health related fields leads labor markets today. For example, the U.S. Bureau of Labor Statistics reports that the Education and Health Services sector of the economy will experience the largest increase in job growth both in absolute terms and in percentage growth within a single sector. This growth results from a well-known economic and demographic phenomenon affecting mostly Europe and North America, namely the increasing demand for healthcare and social assistance because of an aging population and longer life expectancy.
These social changes imply more than just a growing need for management of the expanding provision of health care and social services. They also mean profound transformations in the institutional and social settings where care is given. This project aims to contribute to recent research concerning the effect of these changes on the emergence of new occupations and the need for multidisciplinary work approaches in caring for the aged. In addition, there is little research in understanding the human capital programs to accompany skill development in these jobs. Because these trends encompass large geographical regions (Europe and USA) and involve different disciplines such as health management, labor relations and sociology of work, the starting point is to research different systems such as those in USA, UK, Sweden, Italy and Spain.
Overall, this project aims to achieve: (a) an understanding of health caregivers’ jobs and the design of a corresponding educational program to effectively deliver quality care; (b) an adequate definition of healthy elderly quality of life (QOL), departing from the multiple conceptualizations currently used in research; and (c) a theoretical framework to help categorize the growing number and type of organizations and occupations in the care sector.
A by-product of the study will be to identify similarities as well as differences in the understanding of care giving due to variations in health care systems across the involved countries (e.g., socialized vs. privatized medicine). The findings will help put national idiosyncrasies in their larger context and understand cross-national patterns in health care work.
The Role of Middle Managers in Managing Performance in Hospitals: An International Perspective
Greg Bamber, Ph.D.
Professor and Director of Research, Monash University, Melbourne, Australia
Many studies have examined various aspects of human resource management in an attempt to reconcile the impact of human resource management on organisational and employee performance. Much HRM research has focused on high performance HR (HPHRM). Supporters and critics infer that there is a link between HPHRM and organisational performance, but the extent of that link and any causal relationship is controversial. In much of the literature there has not been an effective concentration on what happens between the "policy" and organisational performance – the "black box" of HPHRM systems.
This paper discusses pilot case studies of two hospitals in Australia where, using qualitative methods, we delve into the black box. We find that ward managers have a large capacity to determine good and bad HRM practices through their line-manager responsibilities with front-line staff. Ward managers can have a significant impact on intention to quit and levels of discretionary effort. Ward managers have the capacity to elicit personal commitment from staff, the outcome of which can be lower levels of staff turnover and better performance. However, hospital executives have tended to neglect these middle managers, particularly with regard to developing their skills and competencies.