Organizational Behavior in Hospital Setting
Organizational Behavior in Hospital Setting
I. Definition
Organizational Behavior (OB) is the study of how people interact within groups. It
encompasses the analysis and understanding of individual and group dynamics, including how
they affect performance, communication, and overall effectiveness within an organization.
In a healthcare setting, Organizational Behavior (OB) refers to the study and application of
how individuals and groups interact within healthcare organizations, such as hospitals, clinics,
and long-term care facilities. It involves understanding and improving the dynamics of these
interactions to enhance and ensure patient safety, patient-centered approaches to care, ethical
behavior among healthcare professionals, and changes to increase patient satisfaction and spur
quality improvements.
Like all businesses, healthcare organizations face numerous challenges in leadership,
organizational hierarchy, decision-making, group dynamics, conflict management, workforce
shortages, and team building. Organizational behavior offers a way to navigate these issues by
gaining a deeper understanding of human behavior. The discipline enables managers and
healthcare professionals to learn the psychological, sociological, and anthropological principles
driving workplace behavior.
As with any large-scale organization, healthcare settings tend to adhere to a hierarchical structure,
and varying levels of authority can contribute to lapses in communication. Professionals in these
settings are often reluctant to report errors or incidents to their superiors and senior colleagues due
to possible negative impacts on their career advancement.
A strong culture has a powerful influence on improving employee contributions, enhancing self-
confidence and commitment, reducing job stress, and improving ethical behavior. This, in turn,
leads to better patient outcomes and overall quality of care.
As a result, healthcare managers are responsible for facilitating the delivery of complex
medical services that must be carefully coordinated by autonomous professionals over whom
the manager has little direct authority – all within an industry system that is facing extreme
financial and policy challenges (Buchbinder, Nancy H. Shanks, 2017).
To achieve organizational behavior goals, the healthcare manager must orchestrate the
collective work of employees and colleagues, so that healthcare can meet many demands.
Managers with organizational behavior skills can unleash the talents of others to help their
organizations thrive in a demanding industry.
1. Team Dynamics
o Interdisciplinary Collaboration: Healthcare involves various professionals (doctors,
nurses, technicians, administrators) working together. Effective teamwork is crucial for
providing comprehensive patient care and improving outcomes.
o Role Clarity and Coordination: Ensuring that all team members understand their roles
and responsibilities helps in coordinating care and minimizing conflicts or overlap.
Process theories, on the other hand, focus on how motivation occurs. These include:
1. Expectancy Theory: This suggests that an individual’s motivation level varies based
on their desire for a specific outcome and their perception of how their performance
will achieve this outcome.
2. Equity Theory: This assumes that individuals are motivated to perform based on their
perception of their inputs (contributions) and outputs (recognition).
3. Satisfaction-Performance Theory: This theory proposes that an individual’s
performance leads to satisfaction, driven by both intrinsic and extrinsic motivators.
o Job Satisfaction: High levels of job satisfaction are linked to lower burnout rates and
higher quality of patient care. Addressing factors such as work-life balance and
professional growth opportunities is crucial. Tenhance job satisfaction, healthcare
managers should:
1. Seek employee opinions and include them in decision-making processes
2. Provide adequate resources and updated equipment
3. Foster open communication and support among staff and supervisors
4. Offer opportunities for professional growth and advancement
o Work-Life Balance: Maintaining a healthy work-life balance has become increasingly
important for healthcare employees. Medical professionals often face long hours, high
stress levels, and demanding workloads, which can negatively impact both their personal
and professional lives. To promote work-life balance, healthcare organizations and
healthcare managers can:
1. Offer flexible work schedules, including remote documenting or telehealth options where
possible
2. Provide on-site childcare facilities
3. Implement comprehensive paid leave policies, differentiating between sick leave,
vacation days, and parental leave
4. Offer employee wellness programs, such as stress management classes or fitness
programs
4. Communication
o Interprofessional Collaboration: It involves a team-based approach to patient care,
resulting in improved outcomes and a better work environment. As healthcare delivery
becomes increasingly complex, coordination among nurses, physicians, pharmacists,
social workers, and other healthcare disciplines has become imperative for enhancing
workplace environments, health systems, and patient care . The benefits of
interprofessional collaboration include:
1. Comprehensive and well-coordinated care
2. More accurate diagnoses and treatment plans
3. Prevention of adverse events
4. Promotion of a culture of safety within healthcare organizations
To facilitate effective interprofessional collaboration, healthcare organizations should
consider implementing clinical communication technology. This technology maintains
constant connectivity among care team members, enabling them to reach out to
physicians, share critical laboratory results, and communicate efficiently through secure
messaging, voice, or video.
o Building Trust: Trust is a fundamental aspect of effective teamwork in healthcare settings.
Building trust among healthcare professionals has a significant impact on patient outcomes
and the overall quality of care provided. To foster trust within healthcare teams, several
strategies can be implemented by healthcare managers:
1. Open communication: Keeping communication channels open allows team members
to understand each other’s roles and responsibilities better.
2. Consistent collaboration: Working together regularly helps build confidence within the
team and facilitates the development of trust over time.
3. Interprofessional education: Exposing healthcare professionals to other disciplines
early in their education can positively influence their perception of teamwork and foster
future collaborative practice.
4. Cultural competence: Developing empathy and cultural awareness among healthcare
providers has become increasingly important, especially for patients from diverse
backgrounds.
5. Shared experiences: Having mutual patients and working together over time helps
build trust among healthcare professionals.
6. Demonstrating reliability: Following through on commitments and being timely in
responses and actions contributes to building trust among team members.
By focusing on these aspects of communication and teamwork, healthcare organizations
can create a more collaborative and effective work environment, ultimately leading to
improved patient care and outcomes.
5. Conflict Resolution:
o Managing Conflicts: Conflicts may arise between staff members or between staff and
patients. Effective conflict resolution strategies are important to maintain a harmonious
work environment and high-quality patient care. Some common sources of conflict in
healthcare settings include:
1. Staff conflicts regarding workload distribution and shift preferences
2. Interdisciplinary disagreements about treatment plans and responsibilities
3. Ethical disputes on topics such as end-of-life care and patient autonomy
4. Communication breakdowns resulting in misunderstandings
To address conflicts effectively, healthcare professionals should:
1. Foster open communication
2. Mediate and negotiate
3. Identify underlying issues
4. Encourage empathy
5. Seek compromise
6. Provide guidance and coaching
7. Encourage professional behavior
8. Follow established policies and procedures
9. Document issues and provide follow-up
o Support Systems: Providing support mechanisms, such as counseling and mediation,
helps address conflicts and reduces workplace stress.
6. Change Management
o Implementing Change: Healthcare settings often undergo changes in protocols,
technologies, and regulations. Understanding how to manage these changes effectively is
crucial to maintaining operational efficiency and staff morale.
o Managing Resistance: Helping staff understand and adapt to changes reduces resistance
and improves the implementation of new practices.
o Effective change management strategies include:
1. Integrating change discussions into existing meetings to make it a natural part of
leaders’ work.
2. Focusing on the employee experience to build desire for important changes and
address retention issues.
3. Engaging employees in shaping the direction of changes that impact their daily work.
4. Taking an enterprise focus to understand how various changes intersect and impact the
organization as a whole.
5. Leveraging key influencers as change champions to help busy managers fulfill their
roles during change.
6. Building change capabilities throughout the organization through an effective enterprise
change management (ECM) strategy.
B. Measuring Performance
Performance measurement has an impact on improving healthcare quality, efficiency, and
outcomes. Healthcare organizations use various metrics to evaluate their performance and
identify areas for improvement. Some essential healthcare performance measures include:
1. Length of stay
2. Readmission rates
3. Patient satisfaction (HCAHPS scores)
4. Mortality rates
5. Bed utilization rate
6. Hospital incidents
7. Average cost per discharge
8. Operating margin
These measures help healthcare institutions analyze data, identify gaps in care, recognize
above-standard performance, and monitor changes in quality of care over time. Performance
measurement initiatives typically involve the active participation of physicians and hospital
staff to ensure the measures are meaningful and the data is accurate.
A. Patient Satisfaction
Patient satisfaction has a significant influence on clinical outcomes and healthcare
performance. Studies have shown a positive relationship between organizational culture and
customer satisfaction. For instance, Greenslade and Jimmieson found that organizational
climate for service predicted performance, which, in turn, predicted patient satisfaction.
Additionally, Tzeng et al. described the strength of organizational culture as the extent to
which staff view the organization as having clear communication of directions and values,
which was positively correlated with job satisfaction and patient satisfaction.
Empowering leadership has a substantial impact on patient satisfaction, with 17 out of 19
patient satisfaction items showing correlation coefficients of medium effect size or larger.
Employee engagement and psychological safety/trust also demonstrated strong correlations
with patient satisfaction measures. These findings highlight the importance of organizational
factors in shaping patient experiences and outcomes.
B. Patient Safety
Patient safety has become a national priority since the publication of the Institute of
Medicine’s seminal report, “To Err is Human: Building a Safer Health Care System.” The
report emphasized the pivotal role of system failures and the benefits of a strong safety
culture in preventing medical errors. It also highlighted the interconnectedness of patient and
worker safety, noting that hazards to healthcare workers due to lapses in infection control,
fatigue, or faulty equipment may result in injury or illness not only to workers but also to
patients.
Several studies have found organizational factors to be the most significant predictor of safe
work behaviors. Compliance with standard precautions increased when workers felt that their
institution had a strong commitment to safety and when institutions targeted interventions at
improving organizational support for employee health and safety. The Centers for Disease
Control and Prevention’s Healthcare Infection Control Practices Advisory Committee has
noted that organizational characteristics, including safety culture, influence healthcare
personnel adherence to recommended infection control practices.
C. Patient Engagement
Patient engagement has become increasingly important in healthcare, driven by increased
consumerism and the COVID-19 pandemic. Providers must remain educated and focused on
patient engagement preferences, including increased transparency during care, the use of
technology, and post-discharge communication. Patient-centered practices have resulted in
improved outcomes as they evolve to meet consumer expectations.
Research has shown that patients with lower engagement levels, as measured by the Patient
Activation Measure (PAM), are more likely to experience major medication errors, emergency
department visits, and unplanned readmissions. Furthermore, patients with the lowest
engagement rates showed total costs of care that were 8% higher in the first year and 21%
higher in the next year compared to patients with high engagement scores.
XIII. Conclusion
Organizational Behavior (OB) in hospital settings is pivotal for optimizing both patient care and
staff performance. By examining how individuals and groups interact within the complex
environment of healthcare, OB provides valuable insights into enhancing team dynamics,
leadership effectiveness, communication, and overall organizational culture.
In hospitals, where teamwork is essential and the stakes are high, understanding OB helps
address critical challenges such as managing diverse teams, facilitating effective
communication, and navigating hierarchical structures. Implementing OB principles can lead to
improved patient outcomes through better-coordinated care and more engaged healthcare
professionals. It also aids in mitigating conflicts, managing change, and fostering a positive work
environment.
Ultimately, the application of OB in hospitals ensures that organizational practices are aligned
with both the needs of patients and the well-being of staff. By focusing on these aspects,
healthcare organizations can create a more supportive and efficient workplace, leading to
enhanced quality of care, greater job satisfaction, and a more resilient and adaptive
organization.
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