IMPORTANCE: Understanding how the electronic health record (EHR) system changes clinician work, productivity, and well-being is critical. Little is known regarding global variation in patterns of ...use. OBJECTIVE: To provide insights into which EHR activities clinicians spend their time doing, the EHR tools they use, the system messages they receive, and the amount of time they spend using the EHR after hours. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed the deidentified metadata of ambulatory care health systems in the US, Canada, Northern Europe, Western Europe, the Middle East, and Oceania from January 1, 2019, to August 31, 2019. All of these organizations used the EHR software from Epic Systems and represented most of Epic Systems’s ambulatory customer base. The sample included all clinicians with scheduled patient appointments, such as physicians and advanced practice practitioners. EXPOSURES: Clinician EHR use was tracked by deidentified and aggregated metadata across a variety of clinical activities. MAIN OUTCOMES AND MEASURES: Descriptive statistics for clinician EHR use included time spent on clinical activities, note documentation (as measured by the percentage of characters in the note generated by automated or manual data entry source), messages received, and time spent after hours. RESULTS: A total of 371 health systems were included in the sample, of which 348 (93.8%) were located in the US and 23 (6.2%) were located in other countries. US clinicians spent more time per day actively using the EHR compared with non-US clinicians (mean time, 90.2 minutes vs 59.1 minutes; P < .001). In addition, US clinicians vs non-US clinicians spent significantly more time performing 4 clinical activities: notes (40.7 minutes vs 30.7 minutes; P < .001), orders (19.5 minutes vs 8.75 minutes; P < .001), in-basket messages (12.5 minutes vs 4.80 minutes; P < .001), and clinical review (17.6 minutes vs 14.8 minutes; P = .01). Clinicians in the US composed more automated note text than their non-US counterparts (77.5% vs 60.8% of note text; P < .001) and received statistically significantly more messages per day (33.8 vs 12.8; P < .001). Furthermore, US clinicians used the EHR for a longer time after hours, logging in 26.5 minutes per day vs 19.5 minutes per day for non-US clinicians (P = .01). The median US clinician spent as much time actively using the EHR per day (90.1 minutes) as a non-US clinician in the 99th percentile of active EHR use time per day (90.7 minutes) in the sample. These results persisted after controlling for organizational characteristics, including structure, type, size, and daily patient volume. CONCLUSIONS AND RELEVANCE: This study found that US clinicians compared with their non-US counterparts spent substantially more time actively using the EHR for a wide range of clinical activities or tasks. This finding suggests that US clinicians have a greater EHR burden that may be associated with nontechnical factors, which policy makers and health system leaders should consider when addressing clinician wellness.
Work recovery research has focused mainly on how after-work break activities help employees replenish their resources and reduce fatigue. Given that employees spend a considerable amount of time at ...work, understanding how they can replenish their resources during the workday is critical. Drawing on ego depletion (Muraven & Baumeister, 2000) and self-determination theory (Deci & Ryan, 1985), we employed multi-source experience sampling methods to test the effects of a critical boundary condition, employee lunch break autonomy, on the relation between lunch break activities and end-of-workday fatigue. Although specific energy-relevant activities had a main effect on end-of-workday fatigue, each of these was moderated by the degree of autonomous choice associated with the break. Specifically, for activities that supported the psychological needs of relatedness and competence (i.e., social and work activities, respectively), as lunch break autonomy increased, effects switched from increasing fatigue to reducing fatigue. To the extent that lunch break activities involved relaxation, however, lunch break autonomy was only important when levels of relaxation were low. We conclude that lunch break autonomy plays a complex and pivotal role in conferring the potential energetic benefits of lunch break activities. Contributions to theory and practice are discussed.
ABSTRACT
Competence and motivation do not necessarily improve or worsen employee performance; even working environment not only might be excessive but also might have less attention. This study aimed ...at exploring the changing role of working competence, motivation and environment to produce business value in achieving the excellent employee performance. This study was conducted at the Regional Planning, Research and Development Board in Tabanan Regency with a population of 80 employees by applying a sampling technique with saturated samples. The findings of this study led the results of increasing competence actually worsened the performance. However, motivation in carrying out work improved the performance due to wholeheartedly working performance and the employees realized about taking part in the work so that it can affect the performance of the organization itself. Meanwhile, good competence here meant the quality of building good working environment as positive and significant as the working motivation. Taking into account, condusive working environment encouraged employee performance in carrying out the work.
Keywords : Work Competence; Motivation; Work Environment; Employee Performance
Despite assumptions that counterproductive work behavior (CWB) leads to detrimental outcomes for organizations, most of the existing CWB research focuses on outcomes for the individual employee. In ...the present study, we clarify fundamental issues regarding unit-level CWB, including its definition and how it is distinct from individual-level CWB. We then use social information-processing (SIP) theory as a lens to articulate our hypotheses regarding the factors associated with unit-level CWB’s emergence (e.g., collective attitudes, human resources practices, leadership) as well as its relationship with unit-level performance (e.g., profit, customer satisfaction). We use meta-analysis (representing 7,110 units and over 391,000 employees) to test our hypotheses. Our results show that unit-level CWB is significantly related to antecedents such as collective job attitudes, the use of strategic human resource management practices (e.g., staffing, training, rewards), and collective perceptions of the work environment (e.g., unit-level fairness perceptions). Moreover, we demonstrate that unit-level CWB is empirically linked to unit-level productivity (ρ = −.23), turnover (ρ = .22), customer satisfaction (ρ = −.26), and profit (ρ = −.31), which verifies the detrimental consequences of CWB at the strategic level. We conclude with a detailed discussion of the theoretical and practical implications of this study as well as a clear plan for future research.
The shifting living and working conditions have profound impacts on the residents' mental health. However, current research in this field has not remarkable investigated.
This study used the China ...Labor-force Dynamic Survey (CLDS) dataset from 2018 and relied on a regression model to examine the effects of the built environment, work environment, and subjective perception on the mental health of Chinese citizens. It also considers the circumstances of both migrants and local residents.
This study revealed significant correlations between mental health and greening space rate, road network density, commuting time, work feelings, community trust, economic satisfaction, and other factors. Additionally, the mental health of local residents was shown to be significantly affected by community security, while it shows no significance in migrants. Furthermore, a significant spatial autocorrelation was found in terms of mental health within the central and eastern regions of China.
The findings of this study offer valuable insights that can be used to facilitate measures aimed at improving the mental health of residents and promoting the development of healthy cities.
Although it has long been recognized that employees' workplace affective commitment can be directed at a variety of foci, theory and research on this multifocal perspective remain underdeveloped, ...possibly due to the lack of a short, yet comprehensive measure. The purpose of the present study was to assess the psychometric properties of a newly developed short (24-item) version of the Workplace Affective Commitment Multidimensional Questionnaire (WACMQ-S), covering affective commitment directed at the organization, supervisor, coworkers, customers, tasks, profession, work, and career. Using two independent samples of English - (N=676, including 648 females) and French - (N=733, including 593 females) speaking healthcare professionals and the newly developed bifactor-ESEM framework, the present study supported the factor validity, composite reliability, test-retest reliability, linguistic invariance, and criterion-related validity (in relation to turnover intentions, in-role performance, and organizational citizenship behaviors) of the WACMQ-S ratings. The results also demonstrated the superiority of a bifactor-ESEM representation of WACMQ-S ratings, confirming the importance of taking into account employees' global levels of commitment to their work life. Finally, the results also proved to be fully generalizable to subsamples of hospital and community healthcare professionals, as well as of nurses and beneficiary attendants.
•Employees' workplace affective commitment can be directed at a variety of foci.•We study the short Workplace Affective Commitment Multidimensional Questionnaire.•We use two samples of English and French speaking healthcare professionals.•The results support a bifactor-ESEM representation, and its linguistic invariance.•The results support the reliability, stability, and criterion-related validity of test scores.
Lemire discusses the challenges faced by medical personnel due to the COVID-19 pandemic and the need to build a better future for family physicians in Canada. She states that two factors ...substantially contribute to burnout in any profession: lack of control of professional and personal demands on our time and energy; and lack of respect from supervisors. In the current context, it is unfortunate that the former affected so many people. Some elements of the pandemic could not be foreseen and others would have benefited from anticipatory planning, funding, and involvement of front-line workers. However, what is completely unacceptable is public criticism of nurses and family physicians by some provincially elected leaders, especially at a time when many are struggling.
Aims and objectives
To conduct an integrative review of the factors associated with why midwives stay in midwifery.
Background
Midwifery retention and attrition are globally acknowledged as an issue. ...However, little is known as to why midwives stay in midwifery as the focus has previously focussed on why they leave.
Design
A structured six‐step integrative review approach was used, and this involved the development of a search strategy, study selection and critical appraisal, data ion and synthesis, interpretation of findings and recommendations for future practice.
Methods
The review was conducted using the databases MEDLINE, CINAHL and PsychInfo. Included studies were in the English language with an unlimited publication date.
Results
Six studies were included in this review: one qualitative, two quantitative and three using mixed methods. Seven themes emerged from synthesisation of the data reported for the six included studies that together help answer the question of why midwives stay in midwifery.
Conclusion
This integrative review has highlighted some important factors that assist in answering the question why midwives stay in midwifery. However, it has also highlighted the need for quality data that reflects the range of contexts in which midwifery is practised.
Relevance to clinical practice
There is an abundance of literature focussing on why midwives leave the profession; however, the gap exists in the reasons why midwives stay. If we can uncover this important detail, then changes within the profession can begin to be implemented, addressing the shortage of midwives issue that has been seen globally for a large number of years.
This book explores how Lean – a global management doctrine – operates and is adopted in the real, corporeal, collective, and affective environments of health and social care services. During Lean ...implementation processes, knowledges, affects, skills, and materialities come together in manifold, complex ways. Based on ethnographic fieldwork, interviews, and observation, and with empirical and theoretical rigour, the book provides an answer to the question of what happens to care work when processes become ‘Leaned’. As in many other fields, the predominantly female health and social care sectors suffer from devaluation in terms of wages and working conditions. The book explores how Lean management is ultimately lived in this gendered context of work and labour. Moreover, the book situates Lean and related management doctrines in the current mutation of capitalism – that is, biocapitalism – in which bios, life itself, becomes the core of value production. The book adds to the corpus of work, organisation, and management studies on Lean that have rarely focused on gender, affect, or sociomateriality. It provides scholars in Social Science, Management, and Gender Studies with a fresh outlook and a cross-disciplinary take on Lean management.
In recent years, research on and the practice of mindfulness have received greater attention in organizational scholarship. Much of the prior work in this area is directed at the workplace outcomes ...of mindfulness interventions in terms of employees' well-being, relationships, and performance. Meanwhile, there is an absence of work that integrates research findings concerning individual and workplace factors that affect workplace mindfulness and determine when and how they influence workplace outcomes. This article reviews current organizational literature concerning potential antecedents of workplace mindfulness as well as mediating mechanisms and boundary conditions of the relationship between workplace mindfulness and workplace outcomes. Based on 32 selected studies, an integrated framework of workplace mindfulness is developed, helping us to summarize the extant scholarship in this area. The framework provides a foundation for an emerging research area and outlines key directions for future research.
•At present, no framework synthesizes knowledge of antecedents, mediators, and moderators related to workplace mindfulness.•An integrative literature review is conducted to develop a comprehensive framework of workplace mindfulness.•The workplace mindfulness framework presents a nomological network of predicting, mediating, and moderating factors.•The integrative literature review outlines key directions for future research.
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