Hospital quality improvement in context: a multilevel analysis of staff job evaluations
Objective: To investigate how much of the variance in data on nurse evaluation of different aspects of hospital work can be attributed to individual, ward, department and hospital levels, and to discuss the implication of the findings on quality improvement strategies. Design and method: National su...
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| Veröffentlicht in: | Quality & safety in health care 2005-12, Vol.14 (6), p.438-442 |
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| creator | Krogstad, U Hofoss, D Veenstra, M Gulbrandsen, P Hjortdahl, P |
| description | Objective: To investigate how much of the variance in data on nurse evaluation of different aspects of hospital work can be attributed to individual, ward, department and hospital levels, and to discuss the implication of the findings on quality improvement strategies. Design and method: National survey data of work experiences were collected from hospital nurses working at 124 hospital wards in 36 departments in 15 hospitals across Norway during the autumn of 1998. The multilevel structure of the variation of nine indices of job satisfaction was explored by fitting four-level random intercept models (nurse, ward, department and hospital). Results: A total of 2606 nurses (66%) responded. The indices showed varying clustering to organizational units. Intraclass correlations (ICCs) varied from 0.05 to 0.38, representing considerable higher level variation. The ward level was the dominating level for the clustering of nurses’ job aspect evaluations. Conclusion: Multilevel modelling of staff work experiences may identify which improvement goals can be addressed at which organizational level. Improvement efforts should be directed specifically towards each aspect of work and at its most relevant organizational level. Strategies aimed at the micro-organizational level (ward management) rather than the individual level or the macro level (hospital top management) might prove worthwhile. |
| doi_str_mv | 10.1136/qshc.2005.014233 |
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Design and method: National survey data of work experiences were collected from hospital nurses working at 124 hospital wards in 36 departments in 15 hospitals across Norway during the autumn of 1998. The multilevel structure of the variation of nine indices of job satisfaction was explored by fitting four-level random intercept models (nurse, ward, department and hospital). Results: A total of 2606 nurses (66%) responded. The indices showed varying clustering to organizational units. Intraclass correlations (ICCs) varied from 0.05 to 0.38, representing considerable higher level variation. The ward level was the dominating level for the clustering of nurses’ job aspect evaluations. Conclusion: Multilevel modelling of staff work experiences may identify which improvement goals can be addressed at which organizational level. Improvement efforts should be directed specifically towards each aspect of work and at its most relevant organizational level. Strategies aimed at the micro-organizational level (ward management) rather than the individual level or the macro level (hospital top management) might prove worthwhile.</description><identifier>ISSN: 1475-3898</identifier><identifier>EISSN: 1475-3901</identifier><identifier>DOI: 10.1136/qshc.2005.014233</identifier><identifier>PMID: 16326791</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Adult ; Cluster Analysis ; Cooperation ; Data Collection ; Data Interpretation, Statistical ; Departments ; Female ; Health administration ; Hospitals ; Hospitals - standards ; Humans ; Job Satisfaction ; Male ; Middle Aged ; multilevel analysis ; Norway ; Nurses ; Nursing Staff, Hospital ; organization of care ; Original ; Patients ; Professions ; Quality Assurance, Health Care ; quality improvement ; Questionnaires ; Surveys and Questionnaires ; work experiences ; Workloads</subject><ispartof>Quality & safety in health care, 2005-12, Vol.14 (6), p.438-442</ispartof><rights>Copyright 2005 Quality and Safety in Health Care</rights><rights>Copyright: 2005 Copyright 2005 Quality and Safety in Health Care</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b559t-ae2c150622ca54f1550d6e58e6b4c8314093a28f06d5e2e929faadfdc0d8a98a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1744103/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1744103/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16326791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krogstad, U</creatorcontrib><creatorcontrib>Hofoss, D</creatorcontrib><creatorcontrib>Veenstra, M</creatorcontrib><creatorcontrib>Gulbrandsen, P</creatorcontrib><creatorcontrib>Hjortdahl, P</creatorcontrib><title>Hospital quality improvement in context: a multilevel analysis of staff job evaluations</title><title>Quality & safety in health care</title><addtitle>Qual Saf Health Care</addtitle><description>Objective: To investigate how much of the variance in data on nurse evaluation of different aspects of hospital work can be attributed to individual, ward, department and hospital levels, and to discuss the implication of the findings on quality improvement strategies. Design and method: National survey data of work experiences were collected from hospital nurses working at 124 hospital wards in 36 departments in 15 hospitals across Norway during the autumn of 1998. The multilevel structure of the variation of nine indices of job satisfaction was explored by fitting four-level random intercept models (nurse, ward, department and hospital). Results: A total of 2606 nurses (66%) responded. The indices showed varying clustering to organizational units. Intraclass correlations (ICCs) varied from 0.05 to 0.38, representing considerable higher level variation. The ward level was the dominating level for the clustering of nurses’ job aspect evaluations. Conclusion: Multilevel modelling of staff work experiences may identify which improvement goals can be addressed at which organizational level. Improvement efforts should be directed specifically towards each aspect of work and at its most relevant organizational level. 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Hofoss, D ; Veenstra, M ; Gulbrandsen, P ; Hjortdahl, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b559t-ae2c150622ca54f1550d6e58e6b4c8314093a28f06d5e2e929faadfdc0d8a98a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Cluster Analysis</topic><topic>Cooperation</topic><topic>Data Collection</topic><topic>Data Interpretation, Statistical</topic><topic>Departments</topic><topic>Female</topic><topic>Health administration</topic><topic>Hospitals</topic><topic>Hospitals - standards</topic><topic>Humans</topic><topic>Job Satisfaction</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multilevel analysis</topic><topic>Norway</topic><topic>Nurses</topic><topic>Nursing Staff, Hospital</topic><topic>organization of care</topic><topic>Original</topic><topic>Patients</topic><topic>Professions</topic><topic>Quality Assurance, Health Care</topic><topic>quality improvement</topic><topic>Questionnaires</topic><topic>Surveys and Questionnaires</topic><topic>work experiences</topic><topic>Workloads</topic><toplevel>online_resources</toplevel><creatorcontrib>Krogstad, U</creatorcontrib><creatorcontrib>Hofoss, D</creatorcontrib><creatorcontrib>Veenstra, M</creatorcontrib><creatorcontrib>Gulbrandsen, P</creatorcontrib><creatorcontrib>Hjortdahl, P</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Quality & safety in health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krogstad, U</au><au>Hofoss, D</au><au>Veenstra, M</au><au>Gulbrandsen, P</au><au>Hjortdahl, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hospital quality improvement in context: a multilevel analysis of staff job evaluations</atitle><jtitle>Quality & safety in health care</jtitle><addtitle>Qual Saf Health Care</addtitle><date>2005-12</date><risdate>2005</risdate><volume>14</volume><issue>6</issue><spage>438</spage><epage>442</epage><pages>438-442</pages><issn>1475-3898</issn><eissn>1475-3901</eissn><abstract>Objective: To investigate how much of the variance in data on nurse evaluation of different aspects of hospital work can be attributed to individual, ward, department and hospital levels, and to discuss the implication of the findings on quality improvement strategies. Design and method: National survey data of work experiences were collected from hospital nurses working at 124 hospital wards in 36 departments in 15 hospitals across Norway during the autumn of 1998. The multilevel structure of the variation of nine indices of job satisfaction was explored by fitting four-level random intercept models (nurse, ward, department and hospital). Results: A total of 2606 nurses (66%) responded. The indices showed varying clustering to organizational units. Intraclass correlations (ICCs) varied from 0.05 to 0.38, representing considerable higher level variation. The ward level was the dominating level for the clustering of nurses’ job aspect evaluations. Conclusion: Multilevel modelling of staff work experiences may identify which improvement goals can be addressed at which organizational level. Improvement efforts should be directed specifically towards each aspect of work and at its most relevant organizational level. 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| subjects | Adult Cluster Analysis Cooperation Data Collection Data Interpretation, Statistical Departments Female Health administration Hospitals Hospitals - standards Humans Job Satisfaction Male Middle Aged multilevel analysis Norway Nurses Nursing Staff, Hospital organization of care Original Patients Professions Quality Assurance, Health Care quality improvement Questionnaires Surveys and Questionnaires work experiences Workloads |
| title | Hospital quality improvement in context: a multilevel analysis of staff job evaluations |
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