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Psychosocial Work Environment and Prediction of Quality of Care Indicators in One Canadian Health Center

Authors

  • Maxime Paquet PhD,

    Corresponding author
    • Co-principal investigator, Research and Intervention Center for Healthy Organizations, McGill University Health Center, Montreal, Quebec, Canada
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  • François Courcy PhD,

    1. Associate Professor, Department of Psychology, University of Sherbrooke, Sherbrooke, Quebec, Canada
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  • Mélanie Lavoie-Tremblay RN, PhD,

    1. Assistant Professor, McGill University School of Nursing, Montreal, Quebec, Canada, Researcher at the Fernand Seguin Research Center of Hopital Louis-H Lafontaine, Montreal, Quebec, Canada, FRSQ Career award Junior I
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  • Serge Gagnon PhD,

    1. Principal Investigator and Associate Director, Research and Intervention Center for Healthy Organizations, McGill University Health Center, Montreal, Quebec, Canada
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  • Stéphanie Maillet DPs (cand.)

    1. Research Assistant, Research and Intervention Center for Healthy Organizations, McGill University Health Center, Montreal, Quebec, Canada
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Address correspondence to Dr. Maxime Paquet, McGill University Health Center—Research and Intervention Center for Healthy Workplaces, 3550 Chemin Côte-des-Neiges, Montreal, Quebec H3H 1V4, Canada; maxime.paquet@muhc.mcgill.ca

ABSTRACT

Background

Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators.

Question

What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality.

Methods

The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses.

Results

The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance.

Conclusions

This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay.

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