Motivationseffekte bei den Mitarbeitern durch die Krankenhaus-Kultur

Developing a culture of safety is a core element of many efforts to improve patient safety and care quality. This systematic review identifies and assesses interventions used to promote safety culture or climate in acute care settings. The authors searched MEDLINE, CINAHL, PsycINFO, Cochrane, and EMBASE to identify relevant English-language studies published from January 2000 to October 2012. They selected studies that targeted health care workers practicing in inpatient settings and included data about change in patient safety culture or climate after a targeted intervention. Two raters independently screened 3679 abstracts (which yielded 33 eligible studies in 35 articles), extracted study data, and rated study quality and strength of evidence. Eight studies included executive walk rounds or interdisciplinary rounds; 8 evaluated multicomponent, unit-based interventions; and 20 included team training or communication initiatives. Twenty-nine studies reported some improvement in safety culture or patient outcomes, but measured outcomes were highly heterogeneous. Strength of evidence was low, and most studies were pre-post evaluations of low to moderate quality. Within these limits, evidence suggests that interventions can improve perceptions of safety culture and potentially reduce patient harm.

This study meta-analytically examined extensive literature associated with work commitment. The primary purposes were to (a) cumulate correlations among dimensions of work commitment to see which were intercorrelated and (b) determine impact of work commitment dimensions and subdimensions on specific outcome variables (job satisfaction, job performance, turnover intentions, and turnover). Results were cumulated across 997 articles. The positive manifold of correlations suggests the presence of a common psychological construct underlying different commitment forms, with the exception of calculative, continuance, and union commitment. Most of the 94 meta-analyzed correlations were small, suggesting that concept redundancy is not a major concern. Meta-analyses of the correlations of 24 commitment constructs with 4 outcome variables suggest that different commitment forms have similar patterns of correlations with outcome variables.

We apply Quinn and Rohrbaugh's (1983) competing values framework (CVF) as an organizing taxonomy to meta-analytically test hypotheses about the relationship between 3 culture types and 3 major indices of organizational effectiveness (employee attitudes, operational performance [i.e., innovation and product and service quality], and financial performance). The paper also tests theoretical suppositions undergirding the CVF by investigating the framework's nomological validity and proposed internal structure (i.e., interrelationships among culture types). Results based on data from 84 empirical studies with 94 independent samples indicate that clan, adhocracy, and market cultures are differentially and positively associated with the effectiveness criteria, though not always as hypothesized. The findings provide mixed support for the CVF's nomological validity and fail to support aspects of the CVF's proposed internal structure. We propose an alternative theoretical approach to the CVF and delineate directions for future research.