Explication and testing of the structural component of a transtheoretical organization model

2.50
Hdl Handle:
http://hdl.handle.net/10755/150413
Type:
Presentation
Title:
Explication and testing of the structural component of a transtheoretical organization model
Abstract:
Explication and testing of the structural component of a transtheoretical organization model
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Brewer, Barbara
P.I. Institution Name:University of Arizona
Specific Aims: To explicate and test an organization model derived from the synthesis of three organization design theories/frameworks commonly employed in the nursing literature, technostructural theory (Perrow, 1967), structural contingency theory (Lawrence and Lorsch, 1967), and sociotechnical systems theory (Pasmore, 1988). Rationale/Background: Research within healthcare systems has looked at environmental structure as being a prime determinant of outcomes. The problem with this research has been that structure has been traditionally defined as a bureaucratic type of structure, which is not consistent with the modern world. Therefore, the purpose of this research is to redefine the conceptualization and measurement of structure to be more consistent with a team-based context and to then test those measures within the acute care setting. Theoretical Framework: The transtheoretical organization model consists of four stages. The first stage, environment, contains elements of the organization’s technical and social environments. The first stage will not be tested in this research. The second stage, structure, reflects a team-based context and contains elements consistent with self-managing work teams. The third stage, integration, contains elements representing intrateam processes such as coordination and cooperation. The final stage, goals, contains patient safety and organizational efficiency measures. The model contains two moderators, organizational context, representing the hospital culture external to the workgroup and work technology, which represents the task type. Methods: Sample and Setting. The sample will consist of 20 medical-surgical units. The setting will be the acute care general hospital. Subjects will consist of staff employed on the sampled units. Subjects will include representatives of other disciplines who routinely provide services to patients on the sampled units. Measures: Group Task Design (Cohen, Ledford, & Spreitzer, 1996), Hospital Culture (Quinn & Kimberly, 1984), Relational Coordination (Gittell et al., 2000), Conflict (Rahim, 1983), Flexibility (Campion, Medsker, & Higgs, 1993), Shirking (Campion, Medsker, & Higgs, 1993), Task Type (Stewart & Barrick, 2000). Outcomes: Patient Safety: Nosocomial Urinary Tract Infection Rate, Patient Falls with Injury Rate. Resource Use: Length of Stay, and Patient Care Unit Direct Labor and Supply Expense. Analysis: Analysis will be performed at both the individual and patient care unit (group) levels. Individual level analysis will consist of evaluation of reliability and construct validity of all measures. Confirmatory Factor Analysis will be performed to estimate hypothesized relationships of items to their latent variables. Individual level data will be aggregated using the criteria recommended by Verran, Gerber, & Milton (1995) to assess validity of the individual level data as a representation of the group or patient care unit. Bivariate relationships among group means will be assessed with Pearson Product Moment techniques. Path analysis will be performed to assess structural relationships specified in the Transtheoretical Organization Model. Results: It is anticipated that the model being tested in this research will provide early evidence of team-based patient care unit and hospital characteristics associated with patient safety and efficient resource use.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleExplication and testing of the structural component of a transtheoretical organization modelen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150413-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Explication and testing of the structural component of a transtheoretical organization model</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Brewer, Barbara</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Arizona</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bbrewer@nursing.arizona.edu</td></tr><tr><td colspan="2" class="item-abstract">Specific Aims: To explicate and test an organization model derived from the synthesis of three organization design theories/frameworks commonly employed in the nursing literature, technostructural theory (Perrow, 1967), structural contingency theory (Lawrence and Lorsch, 1967), and sociotechnical systems theory (Pasmore, 1988). Rationale/Background: Research within healthcare systems has looked at environmental structure as being a prime determinant of outcomes. The problem with this research has been that structure has been traditionally defined as a bureaucratic type of structure, which is not consistent with the modern world. Therefore, the purpose of this research is to redefine the conceptualization and measurement of structure to be more consistent with a team-based context and to then test those measures within the acute care setting. Theoretical Framework: The transtheoretical organization model consists of four stages. The first stage, environment, contains elements of the organization&rsquo;s technical and social environments. The first stage will not be tested in this research. The second stage, structure, reflects a team-based context and contains elements consistent with self-managing work teams. The third stage, integration, contains elements representing intrateam processes such as coordination and cooperation. The final stage, goals, contains patient safety and organizational efficiency measures. The model contains two moderators, organizational context, representing the hospital culture external to the workgroup and work technology, which represents the task type. Methods: Sample and Setting. The sample will consist of 20 medical-surgical units. The setting will be the acute care general hospital. Subjects will consist of staff employed on the sampled units. Subjects will include representatives of other disciplines who routinely provide services to patients on the sampled units. Measures: Group Task Design (Cohen, Ledford, &amp; Spreitzer, 1996), Hospital Culture (Quinn &amp; Kimberly, 1984), Relational Coordination (Gittell et al., 2000), Conflict (Rahim, 1983), Flexibility (Campion, Medsker, &amp; Higgs, 1993), Shirking (Campion, Medsker, &amp; Higgs, 1993), Task Type (Stewart &amp; Barrick, 2000). Outcomes: Patient Safety: Nosocomial Urinary Tract Infection Rate, Patient Falls with Injury Rate. Resource Use: Length of Stay, and Patient Care Unit Direct Labor and Supply Expense. Analysis: Analysis will be performed at both the individual and patient care unit (group) levels. Individual level analysis will consist of evaluation of reliability and construct validity of all measures. Confirmatory Factor Analysis will be performed to estimate hypothesized relationships of items to their latent variables. Individual level data will be aggregated using the criteria recommended by Verran, Gerber, &amp; Milton (1995) to assess validity of the individual level data as a representation of the group or patient care unit. Bivariate relationships among group means will be assessed with Pearson Product Moment techniques. Path analysis will be performed to assess structural relationships specified in the Transtheoretical Organization Model. Results: It is anticipated that the model being tested in this research will provide early evidence of team-based patient care unit and hospital characteristics associated with patient safety and efficient resource use. </td></tr></table>en_GB
dc.date.available2011-10-26T10:23:53Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:23:53Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.