| Literature DB >> 30804843 |
Anja I Lehmann1, Rebecca Brauchli1, Georg F Bauer1.
Abstract
In taking a goal pursuit perspective into account, the present study examined associations between the context, process and outcome evaluation of an organizational health intervention (OHI) implemented within 29 teams in a hospital setting. In doing so, team climate for innovation as a context factor was measured at baseline (N = 529). Four to six weeks after baseline, N = 250 team representatives participated in a 4-day workshop. During the workshop employees formulated collective goals as action plans to be implemented in the nursing wards. Goal pursuit as a process factor was differentiated into (a) a motivational "goal setting" and (b) a volitional "goal striving" phase. The scale of outcome expectancy (measured after the fourth day of the workshop) was used as an indicator for the goal setting phase. For the operationalization of the goal striving phase, action plans were coded with regard to the proportion of formulated implementation intentions ("if-then plans"). After 6 months, the outcome of the intervention was measured on a retrospective impact scale (N = 385). The results of the multiple regression analysis and of the multilevel analysis show that both team climate and goal pursuit (outcome expectancy and the proportion of if-then plans) were positively related to the perceived impact of the intervention. Furthermore, the results show that the relationship between team climate and the impact of the intervention was mediated by outcome expectancy. The results highlight the contribution of goal theory within context-process-outcome research that leads to a better understanding of when and why OHIs are effective.Entities:
Keywords: context; goal pursuit; healthcare; implementation intentions; lean management; organizational health intervention; process
Year: 2019 PMID: 30804843 PMCID: PMC6370699 DOI: 10.3389/fpsyg.2019.00154
Source DB: PubMed Journal: Front Psychol ISSN: 1664-1078
Topics and contents of the 4-day skills-grades-mix workshops implemented in nursing wards.
| Topics | Contents |
|---|---|
| Day 1: Laying the foundations: Analysis of current value stream | Gemba: analysis of current value stream, analysis of process steps, covered distance, identification of general waste. Analysis of interactions between employees, definition of fields of action, formulation of concrete action plans to be implemented |
| Day 2: Concretion of target process | Presentation and discussion of employee survey results on psychosocial work characteristics, team climate, employee health and work life balance, definition of fields of action, formulation of concrete action plans to be implemented Introduction and planning test run. Introduction to the hospital’s overall lean strategy; lean game. Planning of upcoming implementation of action plans |
| Day 3: Implementation | Developing target skills-grades profiles specific to each ward. Developing or validating checklists. Evaluating first implementations of action plans. Adapting action plans |
| Day 4: Implementation and evaluation | Developing detailed target value stream based on developed skills-grades profiles. Quality audits of project and action plans. Site visit of implemented action plans |
Results of the aggregation analysis and the means, SDs and intercorrelations of the variables.
| Variables | Outcome expectancy | If-then | Participation rate | Workshop participation | RIA (Level 2) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Team climate | 3.54 | 0.32 | 0.17∗∗∗ | 0.79 | 0.97 | 0.329∗ | −0.007 | 0.104 | – | 0.308† |
| Outcome expectancy | 5.59 | 0.61 | 0.25∗∗∗ | 0.65 | 0.91 | – | 0.167 | −0.053 | – | 0.452∗∗ |
| If-then | 0.19 | 0.11 | – | – | – | – | – | 0.031 | – | 0.356∗ |
| Participation rate | 0.18 | 0.06 | – | – | – | – | – | – | – | −0.037 |
| Workshop participation | – | – | – | – | – | – | – | – | – | – |
| RIA (Level 2) | 3.42 | 0.63 | 0.10∗∗∗ | 0.59 | 0.66 | – | – | – | – | – |
| RIA (Level 1) | 3.42 | 1.47 | – | – | – | – | – | – | 0.137∗∗ | – |
FIGURE 1Unstandardized regression coefficients for the relationship between team climate for innovation and the evaluation of the intervention as mediated by goal pursuit (outcome expectancy and if-then plans). H6a and H6b are not illustrated as H2b was not supported by the data. †p < 0.10, ∗p < 0.05 (one-tailed).
Results of the multiple regression analysis.
| Model 1 | Model 2 | Model 3 | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Variable | SE | Beta | SE | Beta | SE | Beta | |||
| Const. | 1.373 | 1.25 | 0.028 | 1.334 | −0.134 | 1.278 | |||
| Team climate | 0.584† | 0.351 | 0.31† | 0.341 | 0.349 | 0.181 | 0.382 | 0.334 | 0.203 |
| Outcome expectancy | 0.394∗ | 0.186 | 0.392∗ | 0.334∗ | 0.181 | 0.333∗ | |||
| If-then | 1.818∗ | 0.985 | 0.314∗ | ||||||
| 0.096 | 0.233 | 0.329 | |||||||
| F for change in | 2.77† | 3.807∗ | 3.916∗ | ||||||
Results of the multilevel analysis.
| Null model | Model 1 | Model 2 | Model 3 | Model 4 | |
|---|---|---|---|---|---|
| Intercept | 3.43 (0.12)∗∗∗ | 3.30 (0.13)∗∗∗ | 3.29 (0.12)∗∗∗ | 3.31 (0.11)∗∗∗ | 3.29 (0.11)∗∗∗ |
| Workshop participation | 0.39 (0.16)∗∗ | 0.39 (0.16)∗∗ | 0.38 (0.16)∗∗ | 0.38 (0.16)∗∗ | |
| Participation rate | −0.30 (1.83) | ||||
| Team climate | 0.58 (0.34)† | 0.31 (0.33) | 0.33 (0.31) | ||
| Outcome expectancy | 0.42 (0.18)∗ | 0.38 (0.17)∗ | |||
| If-then | 1.71 (0.88)∗ | ||||
| Variance within groups | 1.95 (0.15)∗∗∗ | 1.93 (0.14)∗∗∗ | 1.93 (0.14)∗∗∗ | 1.95 (0.15)∗∗∗ | 1.95 (0.15)∗∗∗ |
| Variance between groups | 0.22 (0.10)∗ | 0.22 (0.11)∗ | 0.18 (0.10)† | 0.12 (0.08) | 0.09 (0.07) |
| AIC | 1,381.11 | 1,374.17 | 1,374.66 | 1,351.43 | 1,346.26 |