Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Social capital in healthcare: A resource for sustainable engagement in organizational improvement work
KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.ORCID iD: 0000-0002-8457-679X
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Social capital, work engagement, working conditions, and leadership are concepts that have been studied previously, but there is lack of knowledge about what processes promote sustainable organizational improvement work in hospitals, and specifically, what leads healthcare professionals to engage in clinical developments.

The overall aim of this thesis is to increase knowledge of how social capital and engagement contribute to sustainable organizational improvement work in hospitals and how social capital and engagement are created during organizational improvement work. Data were collected by a questionnaire at three times over a period of two years at five hospitals and all studies are quantitative.

The results show that improved working conditions and employees’ attitudes to engagement in improvement work are associated with and have importance for healthcare professionals’ work engagement and clinical engagement in improving care processes (Study I). Job demands, social capital, and other job resources are associated with healthcare professionals’ intention to leave their jobs, whereas high levels of social capital are associated with low levels of intention to leave (Study II). Increased social capital predicted healthcare professionals’ job satisfaction, work engagement, and engagement in patient safety (Study III). Leadership is shown to be important for healthcare professionals’ social capital, and levels of leadership quality correlate with levels of social capital over time (Study IV).

In conclusion, social capital, increased job resources, and decreased job demands are important conditions for healthcare professionals’ engagement in organizational improvement work. To develop social capital, leadership quality is an important precondition. Social capital can be regarded as a resource for sustainable organizational improvement work in healthcare, because of its importance for healthcare professionals’ engagement, job satisfaction, and intention to leave.

Abstract [sv]

Socialt kapital, arbetsengagemang, arbetsförhållanden och ledarskap är begrepp som har studerats tidigare men det saknas kunskap om vilka processer som främjar hållbar verksamhetsutveckling i sjukhus, specifikt vad får hälso- och sjukvårdspersonal att engagera sig i kliniskt utvecklingsarbete.

 

Det övergripande syftet med den här avhandlingen är att öka kunskapen om hur socialt kapital och engagemang bidrar till verksamhetsutveckling och hur socialt kapital och engagemang skapas under pågående verksamhetsutveckling. I Studie I var syftet att identifiera dimensioner av engagemang bland hälso- och sjukvårdspersonal och att undersöka hur dessa är relaterade till arbetsförhållanden under pågående utveckling av vårdprocesser. I Studie II var syftet att analysera samband mellan arbetsförhållanden och socialt kapital i relation till vårdpersonalens intention att sluta sitt arbete och att undersöka om socialt kapital modererar förhållandet mellan arbetskrav och intention att sluta sitt arbete. Den tredje studien (III) syftade till att undersöka vikten av socialt kapital för arbetstillfredsställelse, arbetsengagemang och engagemang i kliniskt utvecklingsarbete bland hälso- och sjukvårdspersonal. Studie IV syftade till att utforska om och vilka ledarskapskvalitéter som har inverkan på socialt kapital över tid bland anställda i hälso- och sjukvården.

 

Det empiriska materialet bygger på data från ett forskningsprogram som inkluderar tre forskningsprojekt. Data samlades in via enkät vid tre tillfällen över en period av två år och samtliga studier är kvantitativa. Studierna är baserade på en sjukhuskohort från fem sjukhus. I Studie II analyserades tvärsnittsdata. I studierna I, III och IV analyserades longitudinella data.

 

Resultaten visade att förbättrade arbetsförhållanden och anställdas attityd till engagemang var associerade till och var viktiga för hälso- och sjukvårdspersonals arbetsengagemang och kliniska engagemang i utveckling av vårdprocesser (Studie I). Arbetskrav, socialt kapital och andra arbetsresurser är associerade till hälso- och sjukvårdspersonals intention att sluta sitt arbete samt att hög nivå av socialt kapital är associerat till låg nivå av intention att sluta sitt arbete (Studie II). Ökat socialt kapital visade sig predicera hälso- och sjukvårdspersonals arbetstillfredsställelse, arbetsengagemang och engagemang i patientsäkerhet (Studie III). Ledarskap var viktigt för hälso- och sjukvårdspersonals sociala kapital och nivåer av ledarskapskvalitét korrelerade med nivåer av socialt kapital över tid (Studie IV).

 

Slutsatsen är att socialt kapital, ökade arbetsresurser och minskade arbetskrav är viktiga förutsättningar för hälso- och sjukvårdspersonals engagemang i verksamhetsutveckling. För att utveckla socialt kapital är ledarskapskvalitét en viktig förutsättning. Genom det sociala kapitalets betydelse för hälso- och sjukvårdspersonals engagemang, arbetstillfredsställelse och intention att sluta sitt arbete kan det sociala kapitalet betraktas som en resurs för hållbar verksamhetsutveckling i sjukvården.

Place, publisher, year, edition, pages
Stockholm: Kungliga Tekniska högskolan, 2017. , p. 68
Series
TRITA-STH : report, ISSN 1653-3836 ; 2017:8
Keywords [en]
Healthcare, social capital, engagement, leadership, sustainability
Keywords [sv]
Sjukvård, socialt kapital, engagemang, ledarskap, hållbarhet
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Technology and Health
Identifiers
URN: urn:nbn:se:kth:diva-212301ISBN: 978-91-7729-463-4 (print)OAI: oai:DiVA.org:kth-212301DiVA, id: diva2:1136583
Public defence
2017-09-29, T1, Emmy Rappesalen, Hälsovägen 11 C, Huddinge, 13:00 (Swedish)
Opponent
Supervisors
Funder
AFA Insurance, 120321Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0376Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-00484
Note

QC 20170830

Available from: 2017-08-30 Created: 2017-08-28 Last updated: 2017-08-30Bibliographically approved
List of papers
1. Health care clinicians' engagement in organizational redesign of care processes: Health care clinicians' engagement in organizational redesign of care processes
Open this publication in new window or tab >>Health care clinicians' engagement in organizational redesign of care processes: Health care clinicians' engagement in organizational redesign of care processes
Show others...
2018 (English)In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 68, p. 249-257Article in journal (Refereed) Published
Abstract [en]

The Swedish health care system is reorienting towards horizontal organization for care processes. A main challenge is to engage health care clinicians in the process. The aim of this study was to assess engagement (i.e. attitudes and beliefs, the cognitive state and clinical engagement behaviour) among health care clinicians, and to investigate how engagement was related to work resources and demands during organizational redesign. A cohort study was conducted, using a questionnaire distributed to clinicians at five hospitals working with care process improvement approaches, two of them having implemented Lean production. The results show that kinds of engagement are interlinked and contribute to clinical engagement behaviour in quality of care and patient safety. Increased work resources have importance for engagements in organizational improvements, especially in top-down implementations. An extended work engagement model during organizational improvements in health care was supported. The model contributes to knowledge about how and when clinicians are mobilized to engage in organizational changes.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Work engagement, Lean production, Health care workers
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-213372 (URN)10.1016/j.apergo.2017.12.001 (DOI)000426224900028 ()29409641 (PubMedID)2-s2.0-85038032216 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0376AFA Insurance, 120321
Note

QC 20170830

Available from: 2017-08-30 Created: 2017-08-30 Last updated: 2018-03-28Bibliographically approved
2. Intention to leave among health care professionals: The importance of working conditions and social capital
Open this publication in new window or tab >>Intention to leave among health care professionals: The importance of working conditions and social capital
2017 (English)In: Journal of Hospital Administration, ISSN 1927-6990, E-ISSN 1927-7008, Vol. 6, no 3, p. 58-66Article in journal (Refereed) Published
Abstract [en]

Hospitals in Sweden are redesigning their care processes to increase efficiency. However, related to these changes, there is a risk of increased staff intention to leave and turnover due to increased workload and work pace. The literature on work engagement and job demands and resources suggests that specific job resources can buffer negative effects; i.e., intention to leave because of job demands. Social capital is suggested to have the potential to be a resource associated with staff intention to leave. The aim of this study was to investigate the associations between social capital and intention to leave and to test if social capital  moderates the relationship between job demands and intention to leave. A sample of five hospitals working under conditions of improvements of care processes were studied using a questionnaire administered to the healthcare clinicians (n = 849). High levels of social capital were associated with low levels of intention to leave. However, the moderating effect of social capital was not confirmed. Intention to leave among occupational groups was influenced differently by social capital, other job resources, and job demands.

Place, publisher, year, edition, pages
Sciedupress, 2017
Keywords
Social capital, Intention to leave, Job demands, Job resources, Organizational improvement
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-212310 (URN)10.5430/jha.v6n3p58 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-00484
Note

QC 20170829

Available from: 2017-08-18 Created: 2017-08-18 Last updated: 2017-08-29Bibliographically approved
3. Social capital among healthcare professionals: A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements
Open this publication in new window or tab >>Social capital among healthcare professionals: A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements
2016 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 53, p. 116-125Article in journal (Refereed) Published
Abstract [en]

Background: Social capital can be an important resource to facilitate the needed improvements in quality of care and efficiency in hospitals. Objectives: To assess the importance of social capital (recognition, vertical trust, horizontal trust and reciprocity) for job satisfaction, work engagement and engagement in clinical improvements. Design: A prospective cohort design was used. Settings: Intensive care units and emergency, surgical and medical units at five Swedish hospitals with ongoing development of their processes of care. Participants: Healthcare professionals (physicians, registered nurses, assistant nurses) at five Swedish midsize hospitals. Methods: The participants answered a questionnaire at two occasions, NN = 1602 at baseline and NN = 1548 at one-year follow-up. Mean hospital response rate was 53% at baseline and 59% at follow-up. Univariate, multivariate and logistic regression analyses were performed, and the prospective analysis was based on 477 respondents. Results: Social capital was associated with healthcare professionals' general work engagement and job satisfaction. Analysis showed positive associations between all measured aspects of social capital and engagement in clinical improvements of patient safety and quality of care. The prospective analysis showed that increased social capital predicted increased job satisfaction, work engagement and engagement in clinical improvements of patient safety. Conclusion: Social capital is strongly related to job satisfaction and active engagement with clinical improvements. The findings contribute to a deeper knowledge of social capital as a predictive factor that influences patient safety and health among healthcare staff.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Clinical improvement, Healthcare, Job satisfaction, Patient safety, Quality of care, Social capital, Work engagement
National Category
Health Sciences
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-180315 (URN)10.1016/j.ijnurstu.2015.07.012 (DOI)000366873100012 ()26315780 (PubMedID)2-s2.0-84955377066 (Scopus ID)
Funder
AFA Insurance
Note

QC 20150201

Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2017-12-01Bibliographically approved
4. Leadership quality: a factor important for social capital in healthcare organizations
Open this publication in new window or tab >>Leadership quality: a factor important for social capital in healthcare organizations
Show others...
2017 (English)In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 31, no 2, p. 175-191Article in journal (Refereed) Published
Abstract [en]

Purpose - The purpose of this paper is to investigate the relation between leadership and social capital and what qualities of leadership are important for social capital among employees in hospital settings over time. Design/methodology/approach - A cohort of employees in hospitals answered a questionnaire at three occasions. Five small (approx. 100-bed) or mid-sized (approx. 500-bed) hospitals were included. The response rate was 54 percent at baseline (n = 865), 59 percent at one-year follow-up (n = 908) and 67 percent at two-year follow-up (n = 632). Findings - Repeated measures over time showed differences between groups in levels of social capital with respect to levels of leadership quality. Relation-oriented leadership had the strongest association with social capital. There was evidence that leadership was associated with social capital over time and that different kinds of leadership qualities were associated with social capital. Research limitations/implications - This study conducted and analyzed quantitative data, and therefore, there is no knowledge of managers' or employees' own perceptions in this study. However, it would be interesting to compare managers' decreased and increased leadership quality and how such differences affect social capital over time. Practical implications - The findings feature the possibility for healthcare leaders to build high quality leadership as an important resource for social capital, by using different leadership orientations under different circumstances. Originality/value - The paper showed that leadership was an important factor for building social capital and that different leadership qualities have different importance with respect to certain circumstances.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2017
Keywords
Leadership, Healthcare, Social capital, Cohort, Leadership quality
National Category
Health Sciences
Identifiers
urn:nbn:se:kth:diva-210525 (URN)10.1108/JHOM-12-2016-0246 (DOI)000402934800004 ()28482768 (PubMedID)2-s2.0-85019143580 (Scopus ID)
Funder
AFA Insurance, 120321
Note

QC 20170604

Available from: 2017-07-04 Created: 2017-07-04 Last updated: 2017-08-28Bibliographically approved

Open Access in DiVA

fulltext(844 kB)378 downloads
File information
File name FULLTEXT01.pdfFile size 844 kBChecksum SHA-512
6caeb511074ec418e6fe662d911e7bc5d629e5924c8ea5d8e15a2251d3bb9e420eabf06251d661ea7f19cf3937289813ec5357aebcb92fc2b95e23ff4cbdcdf2
Type fulltextMimetype application/pdf

Authority records BETA

Strömgren, Marcus

Search in DiVA

By author/editor
Strömgren, Marcus
By organisation
Ergonomics
Production Engineering, Human Work Science and Ergonomics

Search outside of DiVA

GoogleGoogle Scholar
Total: 378 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 1762 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf