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The content of the quality improvement work: influencing learning climate, resource adequacy and workload
Umeå University, Faculty of Social Sciences, Department of Psychology.
Umeå University, Faculty of Social Sciences, Department of Psychology.
Umeå University, Faculty of Social Sciences, Department of Psychology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Despite the popularity of Quality Improvement Collaboratives, the evidence of their positive impact is limited. However, awareness of the mechanisms underlying such interventional efforts, as well as of their outcomes, is crucial for HRD professionals. Thus, the general purpose of this study was to examine the relation between process and outcome by addressing two specific aims. The first aim was to explore the content of the quality improvement work and, the second aim was to examine how the content chosen influences employees’ psychosocial work environment. A mixed-methods design was used in this study, including observations and written documentation of the quality improvement work and questionnaires, distributed on two occasions, to136 nursing assistants. Results showed that (1) the content of the quality improvement work differed both in nature and flexibility, even though the same method was used, (2) the perceived learning climate, workload, and resource adequacy were influenced differently by the different contents chosen. This study offers insights into understanding the complexity around such interventions – which might be powerful in some situations and less appropriate in others. Choosing the right method and assuring that the method is implemented is not enough to guarantee the success of the quality improvement work. It is of vital importance that employees have achievable targets in relation to the resources available. Quality improvement should not be achieved at the expense of employees’ psychosocial work environment; otherwise, the improvement process may become counterproductive.

Keyword [en]
quality improvement collaboratives, mixed-methods, content, learning climate, workload, resource adequacy, elderly care
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:umu:diva-68029OAI: oai:DiVA.org:umu-68029DiVA: diva2:615508
Projects
Lärande och kunskap i äldreomsorgen
Available from: 2013-04-10 Created: 2013-04-10 Last updated: 2013-04-12Bibliographically approved
In thesis
1. Intervening with care: creating new infrastructures for learning and increasing quality of elderly care
Open this publication in new window or tab >>Intervening with care: creating new infrastructures for learning and increasing quality of elderly care
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Intervention med omsorg : i syfte att skapa nya infrastrukturer för lärande och öka äldreomsorgens kvalitet
Abstract [en]

Substantial changes in public elderly care in Sweden have been resulting in a standing need of updating staff competence to match the new demands and maintain quality. Since the ability to learn is of importance when confronting changing conditions, organizations in general, as well as the authorities responsible for elderly care, invest large amounts of resources in learning in the workplace. However, the success of such investments depends on the interactions among numerous individual and organizational factors.

This thesis has aimed at increasing our understanding of the process and consequences of the learning intervention Steps for Skills in the context of elderly care, by addressing three specific research aims. The first aim focused on the psychosocial environment as a precondition for learning. The perceived learning climate was addressed in Study 1, and correlations were found between leaders’ and employees’ perceived learning climate and, to some extent, between employees’ perceived learning climate and work group skills.

The second aim focused on the consequences of the intervention for employees in terms of their psychosocial environment and the building of new infrastructures for learning. Changes in perceived learning climate and their relation to the transfer of knowledge were addressed in Study 2. It was found that the intervention had influenced the perceived learning climate differently for different groups. In addition, the use of the new knowledge depended on the learning climate. The consequences for employees were also addressed in Study 3 by examining the relation between process and outcome. Results showed that although the same method was used, the content of the improvement work differed, influencing employees’ perceptions of the learning climate, resource adequacy and workload differently.

The third research aim focused on the consequences of the intervention for elderly by addressing elderly care quality, conceived as autonomy-support. The results from Study 4 identified too many constraining interactions for elderly care to be described as an autonomy-supportive. It is concluded that general quality improvement work does not guarantee increased autonomy-support. All in all, these results show that context and process matter, and also provide information concerning quality improvement through learning interventions.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2013. 69 p.
Keyword
learning intervention, learning climate, skills, knowledge, resource adequacy, workload, quality improvement, autonomy-support, elderly care, Sweden
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-68031 (URN)978-91-7459-604-5 (ISBN)978-91-7459-603-8 (ISBN)
Public defence
2013-05-03, bt102, Beteendevetarhuset, Umeå universitet, Umeå, 10:00 (Swedish)
Opponent
Supervisors
Projects
Lärande och kunskap i äldreomsorg
Available from: 2013-04-12 Created: 2013-04-10 Last updated: 2013-04-12Bibliographically approved

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