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医院重组与医生工作满意度:一项实证研究。

Hospital restructuring and physician job satisfaction: an empirical study.

作者信息

Mascia Daniele, Morandi Federica, Cicchetti Americo

机构信息

Catholic University of the Sacred Heart, Department of Public Health, Rome, Italy.

Catholic University of the Sacred Heart, Department of Management, Rome, Italy.

出版信息

Health Policy. 2014 Feb;114(2-3):118-27. doi: 10.1016/j.healthpol.2013.11.001. Epub 2013 Nov 16.

Abstract

The adoption of clinical directorates through the internal reconfiguration of hospital organizations has been one of the most widespread restructuring interventions in many Western European countries. Despite its extensive adoption, a lack of knowledge remains on the analysis of how this reorganization affects professionals' job satisfaction. This paper contributes to the debate on clinical directorates by exploring how the structural characteristics of newly adopted organizational models influence physician's job satisfaction. More than 300 physicians in 18 clinical directorates in the Italian National Health Service were surveyed regarding their overall job satisfaction following the introduction of departmental arrangements. Survey results were then linked to another survey that classified newly adopted models according to the criteria used to merge hospital wards into directorates, by recognizing "Process-integration", "Specialty-integration" and "Mixed-integration" types of directorates. Our findings show that structural aspects of change significantly influenced overall job satisfaction, and that a physician's openness to experience moderated the adoption and implementation of new clinical directorates. Specifically, results demonstrate that physicians with high openness to experience scores were more receptive to the positive impacts of change on overall job satisfaction. Implications for how these findings may facilitate organizational shifts within hospital settings are discussed.

摘要

通过医院组织内部重新配置采用临床科室管理模式,已成为许多西欧国家最为普遍的重组干预措施之一。尽管该模式被广泛采用,但对于这种重组如何影响专业人员的工作满意度,仍缺乏相关分析。本文通过探讨新采用的组织模式的结构特征如何影响医生的工作满意度,为有关临床科室管理模式的辩论做出了贡献。针对意大利国家医疗服务体系中18个临床科室的300多名医生,就部门安排实施后的总体工作满意度进行了调查。然后,将调查结果与另一项调查相关联,该调查根据用于将医院病房合并为科室的标准,将新采用的模式分为“流程整合型”、“专科整合型”和“混合整合型”科室。我们的研究结果表明,变革的结构方面显著影响总体工作满意度,并且医生对新体验的开放性调节了新临床科室管理模式的采用和实施。具体而言,结果表明,对新体验开放性得分高的医生更容易接受变革对总体工作满意度的积极影响。本文还讨论了这些研究结果如何促进医院环境中的组织变革。

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