The three-year “Healthy Hospital” project was designed to increase participatory decision making, thereby decreasing job stress and increasing job satisfaction. Evaluation methods included employee surveys, focus groups and key informant interviews. Overall stress levels, job satisfaction and self-esteem generally improved. The diverse types of evaluation converge on a conclusion that the project achieved modest but significant gains throughout the organization. Lessons for future research and applications are discussed.
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References
1.
BestJABurkeBEWalshRGMulcheyRD. Healthy Hospital: A demonstration project to improve nursing worklife. Dimensions in Health Services1991; 68(4): 27–29.
2.
VilleneuveM. Research in progress: Worklife concerns of Ontario nurses. Review: Quarterly Newsletter of the Quality of Nursing Work life Unit1993; 3(4): 1–2.
3.
Canadian Nurses Association/Canadian Healthcare Association.Nurse retention and quality of life: A national perspective. Ottawa: The Associations; 1990.
4.
FrisinaAMurrayMAAirdC. What do nurses want?: A review of job satisfaction and job turnover literature. Toronto: Hospital Council of Metropolitan Toronto; 1998.
5.
KramerM. The magnet hospitals: Excellence revisited. Journal of Nursing Administration1990; 20(9): 35–44.
6.
KramerMSchmalenbergC. Magnet hospitals: Part I — institutions of excellence. Journal of Nursing Administration1988a; 18(1): 13–24.
7.
KramerMSchmalenbergC. Magnet hospitals: Part II — institutions of excellence. Journal of Nursing Administration1988c; 18(2): 13–19.
8.
MurrayMASmithSD. Nursing morale in Toronto: An analysis of career, job, and hospital satisfaction among hospital staff nurses. Toronto: Hospital Council of Metropolitan Toronto; 1988.
9.
AntonovskyA. Health, stress, and coping. San Francisco: Jossey-Bass; 1979.
10.
KarasekRTheorellT. Healthy work: Stress, productivity, and the reconstruction of working life. New York: Basic Books; 1990.
11.
IsraelB. Social networks and social support: Implications for natural helper and community level interventions. Health Education Quarterly1985; 12: 66–80.
12.
PetersTJWatermanRHJr. In search of excellence. New York: Harper & Row; 1982.
13.
CohenSSymeS, editors. Social support and health. Orlando (FL): Academic; 1985.
14.
MinklerM. Improving health through community organization. In: GlantzKLewisFMRimerBK, editors. Health behavior and health education: Theory, research, and practice. San Francisco: Jossey-Bass; 1990.
15.
WallersteinNBernsteinE. Empowerment education: Freire's ideas adapted to health education. Health Education Quarterly1988; 15: 379–394.
16.
Glass Ceiling Commission.Good for business: Making full use of the nation's human capital. Washington (DC): U.S. Government Printing Office; 1995.
17.
HemingwayMASmithCS. Organizational climate, occupational stressors, and withdrawal behavior in nurses. Paper presented at Work, Stress, and Health '95: Creating Healthier Workplaces Conference; September 14–16; Washington, D.C.
18.
LandyFQuickJCKaslS. Work, stress, and well-being. International Journal of Stress Management1994; 1: 33–73.
19.
MacLennanBW. Stressor reduction: An organizational alternative to individual stress management. In: QuickJCMurphyLRHurrellJJ, editors. Stress and well-being at work. Washington (DC): American Psychological Association; 1992.
20.
RosenRFlowerJ. The leaner, healthier company. Healthcare Forum Journal1992 May-June.
21.
MichelaJLLukaszewskiMPAllegranteJP. Organizational climate and work stress: A general framework applied to inner-city schools. In: SauterSLMurphyLR, editors. Organizational risk factors for job stress. Washington (DC): American Psychological Association; 1995.
22.
Hospital Employees Union members include housekeeping, licensed practical nurses, biomedical electronics technicians, dietary and clerical workers, open heart perfusionists, etc. Health Services Association members include social work, physio and occupational therapy, dietitians, X-ray and medical laboratory technologists, etc.
23.
O'Brien-PallasLBaumannA. Quality of nursing work life issues — a unifying framework. Canadian Journal of Nursing Administration1992; 5: 12–16.
PierceJLGardnerDGCummingsLLDunhamRB. Organization-based self-esteem: Construct definition, measurement, and validation. Academy of Management Journal1989; 32(3): 622–648.
27.
Note that the scales have various ranges, so means of scales and subscales are not all directly comparable. Some are based on four-point scale items, some on five-point scales and some on seven-point scales. The Job Stress subscale scores range from 1 (Strongly Disagree) to 4 (Strongly Agree), with higher scores meaning greater job control and personal support, but also greater job demand and hazard; the midpoint is 3. The Job Satisfaction subscale scores range from 1 (Very Dissatisfied) to 5 (Very Satisfied), with higher scores meaning greater satisfaction; the midpoint is 3. The Organizational Climate subscale scores range from a minimum of 1 (Poor) to a maximum of 9 (Excellent), with higher scores being positive; the midpoint is 5. The Organization-Based Self-Esteem (OBSE) scores range from 1 (Strongly Disagree) to 7 (Strongly Agree), with higher scores meaning greater self-esteem; the midpoint is 4. The midpoints can be used as an indicator of positive or negative attitudes about job stress, job satisfaction, organizational climate, and work self-esteem. Means above the midpoints are positive, means below the midpoints are negative.
28.
Centre for Labour and Management Studies.Organizational practices and the changing employment relationship. Proceedings of the Canadian Workplace Research Network/Centre for Labour and Management Studies Inaugural Conference; 1996 Oct 18–19; Vancouver. In press.
29.
KotterJP. Leading change: Why transformation efforts fail. Harvard Business Review1995 March-April; 59–67.
