Digital Theses Archive


Tesi etd-09212021-173905

Type of thesis
Performance Management in Nursing from the inside and out: how professional behaviour, job satisfaction and patient experience impact organizational dynamics.
Scientific disciplinary sector
Istituto di Management - MANAGEMENT
relatore Prof.ssa VAINIERI, MILENA
Presidente Prof.ssa NUTI, SABINA
Membro Prof. Pier Luigi Lopalco
Membro Prof. BELLE', NICOLA
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Exam session start date
This thesis is part of a research activity carried out within the Institute of Management and its focus is the analysis on Performance Management in Nursing from the point of view of different stakeholders. The latter are in different positions with respect to health organizations: patients have an external point of view that generates perceptions and experience measures (PREMs), and nurses with an internal point of view that generates measures on their job satisfaction, intention to leave, willingness to recommend their workplace, amongst the most important ones (Organizational Climate Survey). The interest in the nursing staff derives from the fact that they are, worldwide, making an important contribution for the functioning of healthcare systems both in terms of number of professionals and proximity to patients in all care settings. <br>The global landscape is influenced by factors like the shortage of healthcare workers and the difficulties in their retaining, the parallel rise in healthcare demand and the dramatic and unpredictable changes imposed by the pandemic. It requires a thorough analysis on the levers that can be detected and used to inform managers and policy makers for them to make effective and punctual decisions and policies that can boost personnel’s retention and satisfaction to deliver to patients the assistance and care they ask for, with the characteristics that they deem necessary and worthy of their expectations.<br> To fill literature gaps there are three research questions to be addressed: (i) are inclusiveness and openness to innovation factors that enhance nursing job satisfaction and willingness to recommend their workplace? (ii) do defaults and reminders affect the propensity of nurses and other healthcare professionals to implement guidelines, to provide a safer care and meet patient needs? (iii) can healthcare service provision models affect patient experience?<br>This last point, (i.e., the study of the nursing care delivery organization models), was the departure point of a long way journey into the real-world data generated in Tuscany Region, that served the aim of being an experimental ground for the research to deploy its tools and formulate hypothesis and conclusions. To illustrate the direction followed, four interconnected articles are presented, which aim is to explore the real-world data, merging different data sources, to identify levers that can be used to enhance good management practices and fitted policies. Organizational healthcare models indicate to professionals the direction to follow to achieve clinical objectives, being built on the purpose of match the way nursing assistance is provided with the necessity of meeting patient needs.<br>Innovation-prone work environments and inclusiveness (i.e., reassurance after a failure from colleagues and peers) bolster both nurses’ job satisfaction and willingness to recommend, bur a special attention has to be given to the “baby boom” generation that still involved in care as seniority is a variable to consider when designing policies and interventions, especially for what concerns the acceptance and the use of technology. the use of the right type of nudges can produce desirable effects on nurses’ compliance to international clinical guidelines and to standard precautions: the use of visual reminders may represent a solid way of tackling public management issues with cost-effective and easy interventions. Pure theoretical models seem not to exist. Mixing features of different models into a hybrid seems more effective in meeting users’ expectations. Healthcare services’ users appreciate service delivery characteristics identified with the experience of being taken care of. <br>These findings can inform decision makers on the way to arrive to trigger a virtuous circle that leads to the provision of a safer and more valuable treatment for patients, which will have a positive effect on patient’s opinions on the experiences of hospitalization and on the healthcare system in general. <br><br>