Ma Shaozhuang, Xu Xuehu, Trigo Virginia, Ramalho Nelson J C
Instituto Universitario de Lisboa (ISCTE-IUL) , Business Research Unit (UNIDE-IUL), Lisbon, Portugal.
Third Affiliated Hospital of Guangzhou Medical University , Guangzhou, China.
J Health Organ Manag. 2017 Mar 20;31(1):110-124. doi: 10.1108/JHOM-09-2016-0165.
Purpose The purpose of this paper is twofold: first, to develop and test theory on how commitment human resource (HR) practices affect hospital professionals' job satisfaction that motivates them to generate desirable patient care and subsequently improve doctor-patient relationships (DPR) and second, to examine how commitment HR practices influence hospital managers and clinicians in different ways. Design/methodology/approach Using a cross-sectional survey, the authors collected data from 508 clinicians and hospital managers from 33 tertiary public hospitals in China. Structural equation model was employed to test the relationships of the variables in the study. Findings Commitment HR practices positively affect the job satisfaction of the healthcare professionals surveyed and a positive relationship is perceived between job satisfaction and DPR. Overall, the model shows a reversal on the strongest path linking job satisfaction and DPR whereby managers' main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic satisfaction only. Practical implications DPR might be improved by applying commitment HR practices to increase healthcare professional's intrinsic and extrinsic satisfaction. In addition, while recognizing the importance of compensation and benefits to address the underpayment issue of Chinese healthcare professionals, empowerment and autonomy in work, and the use of subjects' expertise and skills may serve as stronger motivators for clinicians rather than hard economic incentives in achieving DPR improvements. Originality/value This study contributes to the small but growing body of research on human resource management (HRM) in the healthcare sector with new evidence supporting the link between commitment HR practice and work attitudes, as well as work attitudes and patient care from the perspective of clinicians and hospital managers. This study represents an initial attempt to examine the associations among commitment HR practices, job satisfaction and DPR in the Chinese healthcare sector. The findings provide evidence to support the value of commitment HR practices in Chinese hospital context, and demonstrate the importance of effective HRM in improving both hospital managers and clinicians' work attitudes.
目的 本文目的有两个：其一，构建并检验关于承诺型人力资源（HR）实践如何影响医院专业人员的工作满意度，进而促使他们提供理想的患者护理并改善医患关系（DPR）的理论；其二，考察承诺型HR实践如何以不同方式影响医院管理人员和临床医生。 设计/方法/途径 通过横断面调查，作者从中国33家三级公立医院的508名临床医生和医院管理人员那里收集了数据。采用结构方程模型来检验研究中各变量之间的关系。 发现 承诺型HR实践对所调查的医疗保健专业人员的工作满意度有积极影响，并且工作满意度与医患关系之间存在正相关关系。总体而言，该模型显示在连接工作满意度和医患关系的最强路径上出现了反转，即管理人员的主要关联是通过外在工作满意度起作用，而对于临床医生而言，仅通过内在满意度起作用。 实际意义 应用承诺型HR实践以提高医疗保健专业人员的内在和外在满意度，可能会改善医患关系。此外，在认识到薪酬和福利对于解决中国医疗保健专业人员薪酬过低问题的重要性的同时，工作中的授权和自主权以及对专业人员专业知识和技能的运用，可能比硬性经济激励措施更能激励临床医生实现医患关系的改善。 原创性/价值 本研究为医疗保健领域中关于人力资源管理（HRM）的虽小但不断增长的研究做出了贡献，提供了新的证据支持承诺型HR实践与工作态度之间的联系，以及从临床医生和医院管理人员的角度看工作态度与患者护理之间的联系。本研究是在中国医疗保健领域检验承诺型HR实践、工作满意度和医患关系之间关联的初步尝试。研究结果为支持承诺型HR实践在中国医院背景下的价值提供了证据，并证明了有效人力资源管理在改善医院管理人员和临床医生工作态度方面的重要性。
