Susan ayers cambridge handbook of psychology he

feedback about the quality of care from line staff and sometimes
also from patients. CQI procedures embody the principles that
quality management should be a systematic and integral part
of everyday healthcare work, be focused on patient-centred
practice and encompass information about ongoing care and
outcomes.
In one controlled trial, nurse managers were paired with
nurse consultants in problem-solving leadership development
meetings. On units in which nurse managers participated more
fully in the intervention, staff reported greater increases in
co-worker cohesion and clarity and less alienation from work than
did staff on units in which nurse managers participated less (Weir
et al., 1997).
In another relevant project, a CQI process was used to evaluate
clinical supervision and its effect on the quality of care. CQI was
implemented on five medical wards with team supervision
supported by ongoing self-appraisal of work and systematic feedback
from patients. After the intervention, staff monitored their
work more carefully and the quality of care and patient satisfaction
improved (Hyrkas & Lehti, 2003). Overall, studies in this
area show that staff involvement in decision-making and team problem-solving
can improve the work climate, reduce job stressors and
promote better individual and organizational outcomes.
REFERENCES
Aiken, L.H., Clarke, S.P. & Sloane, D.M.
(2002a). Hospital staffing, organization, and
quality of care: cross-national findings.
International Journal for Quality in
Health Care, 14, 5–13.
Aiken, L.H., Clarke, S.P., Sloane, D.M.,
Sochalski, J. & Silber, J.H. (2002b).
Hospital nurse staffing and patient
mortality, nurse burnout, and job
dissatisfaction. Journal of the
American Medical Association, 288,
1987–93.
Aolen, L.H., Sloane, D.M., Lake, E.T.,
Sochalski, J. & Weber, A.L. (1999).
Organization and outcomes of inpatient
AIDS care. Medical Care, 37, 760–72.
Avallone, A. & Gibbon, B. (1998). Nurses’
perceptions of their work environment in
a Nursing Development Unit. Journal of
Advanced Nursing, 27, 1193–201.
Belicki, K. & Woolcot, R. (1996). Employee
and patient-designed study of burnout
and job satisfaction in a chronic care
hospital. Employee Assistance Quarterly,
12, 37–45.
Clarke, S.P., Rockett, J.L., Sloane, D.M. &
Aiken, L.H. (2002a). Organizational
climate, staffing, and safety equipment
as predictors of needlestick injuries
and near-misses in hospital nurses.
American Journal of Infection Control,
30, 207–16.
Clarke, S.P., Sloane, D.M. & Aiken, L.H.
(2002b). Effects of hospital staffing and
Future directions
Work stressors are likely to continue to intensify as healthcare staff
encounter more acutely ill patients; cost containment efforts and
competition; new medical technologies and associated ethical
dilemmas; and performance monitoring and quality improvement
programmes that demand ever greater accountability and perfection.
To cope with these changes, healthcare staff members need
to be empowered; that is, to be involved in the development of
responsive organizations in which they can participate actively in
improving the workplace and healthcare services. Such an approach
can enhance the work climate and contribute to better staff
performance and patient outcomes.
Acknowledgements
organizational climate on needlestick
injuries to nurses. American Journal of
Public Health, 92, 1115–19.
Davidson, G. & Elliot, B.V. (1997).
Teambuilding in a rural mental
health center: a case study.
Organization Development Journal, 15,
27–33.
Garman, A.N., Corrigan, P.W. & Morris, S.
(2002). Staff burnout and patient
satisfaction: evidence of relationships at
the care unit level. Journal of Occupational
Health Psychology, 7, 235–41.
Hemingway, M.A. & Smith, C.S. (1999).
Organizational climate and occupational
stressors as predictors of withdrawal
behaviours and injuries in nurses. Journal
of Occupational and Organizational
Psychology, 72, 285–99.
Hipwell, A.A., Tyler, P.A. & Wilson, C.M.
(1989). Sources of stress and dissatisfaction
among nurses in four hospital
environments. British Journal of Medical
Psychology, 62, 71–9.
Hyrkas, K. & Lehti, K. (2003). Continuous
quality improvement through team
supervision supported by continuous
self-monitoring of work and systematic
patient feedback. Journal of Nursing
Management, 11, 177–88.
Laschinger, H.K.S., Finegan, J., Shamian, J.
& Wilk, P. (2004). A longitudinal
analysis of the impact of workplace
empowerment on work satisfaction.
Preparation of this manuscript was supported by the Department of
Veterans Affairs Health Services Research and Development Service
research funds and by NIAAA Grant AA12718. The views expressed
here are the authors’ and do not necessarily represent the views of
the Department of Veterans Affairs.
Journal of Organizational Behavior,
25, 527–45.
Leiter, M.P., Harvie, P. & Frizzell, C. (1998).
The correspondence of patient satisfaction
and nurse burnout. Social Science and
Medicine, 47, 1611–17.
Moos, R. (1994). Work environment scale
manual. Palo Alto, CA: Consulting
Psychologists Press.
Moos, R. & Moos, B. (1998). The staff
workplace and the quality and
outcome of substance abuse
treatment. Journal of Studies on Alcohol,
59, 43–51.
Morrison, E.F. (1998). The culture of
caregiving and aggression in psychiatric
settings. Archives of Psychiatric Nursing,
12, 21–31.
Schaefer, J. & Moos, R. (1996). Effects of
work stressors and work climate on
long-term care staff’s job morale and
functioning. Research in Nursing and
Health, 19, 63–73.
Shinn, M., Morch, H., Robinson, P.E. &
Neuner, R.A. (1993). Individual,
group, and agency strategies for
coping with job stressors in
residential child care programs.
Journal of Community and Applied
Social Psychology, 3, 313–24.
Thomas, L.H. (1992). Qualified
nurse and nursing auxiliary perceptions
of their work environment in
primary, team, and functional
Healthcare work environments 443