Industrial and organizational psychology

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Robert G. Badgett, M.D.[1]

Industrial and organizational psychology is "the branch of applied psychology concerned with the application of psychologic principles and methods to industrial problems including selection and training of workers, working conditions, etc."[1]

Organizational culture and climate

Organizational culture is "beliefs and values shared by all members of the organization. These shared values, which are subject to change, are reflected in the day to day management of the organization"[2]. Components of culture have been described based on anthropology[3][4][5].

Organizational culture affects organizational effectiveness[6] .

Organizational states

Flourishing

Flourishing involves a positive state of psychological or social well-being and positive functioning (not necessarily learning) and addresses life in general rather than just work.[7] However, the concept is variably conceptualized thus making it difficult to study.[8]

Important contributors to flourishing focus on relationships with others at work and are[9]:

  • Giving to others (due to impact on meaningfulness)
  • Task assistance receipt (due to impact on job satisfaction)
  • Friendship (due to positive emotions at work)
  • Personal growth (due to impact on life satisfaction).
Measurement

A six-point scale has been proposed[10][11].

A short scale to measure flourishing has been proposed.[12]

Thriving

Thriving has two components according to factor analysis[13]:

  • Vitality. In this analysis, vitality is very similar to Schaufeli's Vigor subscale of the UWES-9 Engagement scale (see 'Engagement' below)
  • Sense of learning or improvement

A separate body of research has emerged more recently that gives a broader definition to thriving, but does not cite the above research that has used factor analysis to identify core features[14].

Thriving is negatively correlated with burnout[13][15]; however, this benefit may be confined to employees with a high openness to experience[15]

Thriving is fostered among employees whose regulatory focus is promotional by a "employee involvement climate", defined as having employees who "mutually understand that they (a) possess the power to make decisions and act on them, (b) may access and share the informational resources needed to undertake those actions effectively, (c) have opportunities to update their knowledge in order to continually develop their effectiveness, and (d) are rewarded for improving the effectiveness of their work unit and organization"[16].

Measurement

Thriving can be measured[17].

Engagement

Engagement has three dimensions according to factor analysis[18]:

  • Vigor (physical engagement)
  • Dedication (effective engagement)
  • Absorption (cognitive engagement)

Engagement depends on both organizational factors and personnel personality[19]. Inadequate job resources are a cause as found in the job demands-resources model of burnout[20].

Engagement is association with organizational success[21][22], including in health care[23].

Engagement is associated with leadership styles[24].

Measurement

Engagement can be measured by several validated scales[25][26].

Satisfaction

Satisfaction with work is a "pleasurable or positive emotional state resulting from the appraisal of one's job or job experiences”[27].

Burnout

Antecedents

Regarding engagement and job satisfaction, meaningfulness of work strongly correlates[28]

The key antecedent of thriving is proposed to be self-determination, which includes autonomy, competence, and relatedness.[29] This emphasis links thriving to self-determination theory of Deci.[30] Studies have validated autonomy as an antecedent of thriving[31].

How to foster thriving has been reviewed[32][33][34] and includes:

  • Providing decision-making discretion
  • Sharing Information. Using transparency and open book management
  • Minimize incivility at work
  • Provide performance feedback
  • Promote diversity
  • Mastery of tasks. In 1908, the Yerkes-Dodson law[35], and later the concept of 'flow' by Csikszentmihalyi[36], both propose that engagement is strongest when a task is intermediate in difficulty.

Characteristics of individuals

The "Big Five personality traits" are[37][38][39]:

  • Openness to experience
  • Conscientiousness
  • Extraversion
  • Agreeableness
  • Neuroticism

Of these, conscientiousness[40], openness to experience[40][15] and extroversion[40], may affect job performance. The effect may be complicated as open to experience may be positively related to individual and organizational proactivity but negatively related to team and organizational proficiency[39].

Based on a study of players in the National Basketball Association, narcissism reduces team performance[41] .

Openness to experience

Openness to experience affects job performance[40][15].

Personality traits

According to a meta-analysis, " the strongest predictor of engagement (31.10% of the explained variance; ρ = .62), followed by proactive personality (19.60%; ρ = .49), conscientiousness (14.10%; ρ = .39), and extraversion (12.10%; ρ = .40), whereas neuroticism, negative affectivity, agreeableness, and openness to experience were the least important"[42].

Learning and performance goal orientations

Three goal orientations have been proposed[43]:

  • Learning goal orientation
  • Performance‐prove orientation
  • Performance‐avoid orientation
Regulatory focus

Two regulatory focuses are[44] [16]:

  • Promotion focus is associated with "growth and developmental needs and involves striving for ideals, aspirations, and rewards through accomplishment". Also known has 'head in the clouds'.
  • Prevention focus is associated with "needs for security and safety". Also known as 'feet on the ground'.

regulatory focus can interaction with leadership[45] .

Calling

Calling is defined as[46]:

"A calling is a transcendent summons, experienced as originating beyond the self, to approach a particular life role in a manner oriented toward demonstrating or deriving a sense of purpose or meaningfulness and that holds other-oriented values and goals as primary sources of motivation."

Calling is:

  • Positively association with engagement[47] and well-being[48].
  • Negatively associated with burnout[49].

Characteristics of a job

An organization's mission statement is associated with performance[50].

Empowerment

Perception of empowerment by employees has four dimensions and can be measured with Spreitzer's Measuring Empowerment survey which measures[51]:

  • Meaningfulness or purpose
  • Competence or efficacy
  • Self-determination
    • I am able to make suggestions to improve the work of my team / department.
    • I am involved in deciding on changes introduced that affect my work area / team / department
  • Impact

Other surveys include:

  • AHRQ/SOPS[52]
    • We are encouraged to come up with ideas for more efficient ways to do our work
    • We are involved in making decisions about changes to our work processes
    • We are given opportunities to try out solutions to workflow problems
  • U.K. National Health Survey[53]:
    • I am able to make suggestions to improve the work of my team / department[51].
    • I am involved in deciding on changes introduced that affect my work area / team / department[51].
    • I am able to make improvements happen in my area of work.

Empowerment affects thriving[54].

Moral distress

Moral distress, as operationalized in research studies, is the report by healthcare personnel of participating in the provision of healthcare that the healthcare personnel perceives as inappropriate due to pressure from other health care professionals or administrators of families that the health care professional perceives as inappropriate due to being[55][56]:

  • Unnecessary or futile due to family wishes[57]
  • Suboptimal or insufficient. For example due to lack of funding, coordination, or continuity of care[58].
  • Deceptive. For example, not obtaining consent, not discussing end-of-life care, giving false hope, or not disclosing intravenous medications[58].

Although the use of ‘distress’ in the label suggests a negative emotional state, it’s definition inferred by measurement scales developed and used in research is that moral distress is not a state but rather is the report of participation in events that a reasonable person would interpret as distressing.

Moral distress may also be called moral injury.

Moral distress may be more common in nurses and pharmacists than physicians[59][60][61][57][62][63]. The American Association of Critical-Care Nurses has created a position statement about moral distress, "The 4 A’s to Rise Above Moral Distress."[64]

Scales have been developed to measure moral distress[55][58]

For underlying causes, moral distress negatively correlates with perception of empowerment by healthcare personnel[65].

Moral distress has been studied for correlation with states of workforce wellbeing:

  • Not correlated with engagement[66]
  • Negatively correlated with job satisfaction[59]
  • Positively correlated with burnout[59][60][61]; however, this has not been found in all studies[66][67]. In a separate study, moral distress correlated with the depersonalization component of burnout and just missed correlation with emotional exhaustion[68].
Money, pay, compensation

Financial incentives may help work when the output can be quantified, but may not help "complex, creative jobs."[69] Experiential awards may be better received than financial awards[70]. However, salaries may vary depending on accomplishment and impact[70].

Incentives may lead to knowledge hiding[71]. Organizational cynicism may lead to knowledge hiding[72].

Theory and models of antecedents, indicators, and outcomes

Yerkes-Dodson Law suggestions that the relationship between performance and arousal is bell-shaped so that performance may decrease with excessive arousal. This is similar to work by Csikszentmihaly[73].

The concept of "competence frustration" (versus "flow") suggests a similar bell-shaped relationship between task difficulty and engagement[74]

Self-determination theory

SelfDeterminationTheory.png

Self-determination theory was proposed in the early 1980s.[75] In this theory, autonomy, mastery, and purpose have been validated as components[76][77].

Kahn's theoretical framework

Kahn posed that three key attributes of work are meaningfulness, psychological safety. and availability (availability is related to mastery) [78] and later validated by May[79] .

Culture and Climate

Employee involvement climate, defined as having employees who "mutually understand that they (a) possess the power to make decisions and act on them, (b) may access and share the informational resources needed to undertake those actions effectively, (c) have opportunities to update their knowledge in order to continually develop their effectiveness, and (d) are rewarded for improving the effectiveness of their work unit and organization" is associated with thriving among employees whose regulatory focus is promotional[16].

The role of work climate has been examined in studies based on complexity science[80][81], in order to predict why quality improvement projects succeed[82][83][84] and fail[85].

However, attributes of culture study may not be well based on theory and linked to the above settings.[86]

A reciprocal, beneficial relationship has been proposed between a positive work climate and mission goals[87]. This may be similar the Matthew effect[88].

Interventions to promote positive organizational psychology

Available studies have been reviewed.[89] Studies using appreciative inquiry have been done.[90][91]

Public reporting has been used to try to improve organizational culture.[92][93] Recommendations for how to report have been proposed.[94][95]

Switching to a flatter organizational structure may help[96].

In the U.K. National Health Service, the Boorman report makes 20 recommendations<re>Boorman recommendations. NHS Employers</ref> Subsequent systemic review of interventions incorporating these recommendations has found benefit on the workforce[97].

Leadership

Best practices

In medicine, recommendations for high-performance work systems are available and include[98][99]:

  • Engaging staff
  • Acquiring and developing talent
  • Empowering the frontline
  • Aligning leaders
  • Employee and Organizational outcomes

Surveys to solicit employee feedback

Serial surveying of employee opinion may be effective[100][101]. However, action in response to feedback is needed[102]. Thus, selective action may cause feedback to create a Matthew effect as leaders who are already successful may be disposed to act on the feedback[103].

NHS Staff Surveys

The NHS Staff Surveys have been administered since 2003.

Contents

Workforce states

Burnout is not measured with Maslach's survey[104]. A proxy question for the emotional exhaustion component is available:

  • "During the last 12 months have you felt unwell as a result of work related stress."

Job satisfaction is not measured directly, but a proxy question is available:

  • "I would recommend my organisation as a place to work."

Engagement, using three items from the UWES-9[105], has been measured since 2012:

  • Vigor/vitality: "I look forward to going to work."
  • Dedication: "I am enthusiastic about my job."
  • Absorption: "Time passes quickly when I am working."

Thriving is not available although a validated scale is available[13]. The Staff Surveys has one related question:

  • "The team I work in often meets to discuss the team’s effectiveness."
Leadership tactics

Empowerment, using questions similar to Spreitzer's Measuring Empowerment survey which measures[51]:

  • Meaningfulness or purpose
    • Not directly asked. Related question is "The opportunities I have to use my skills."
  • Competence or efficacy
    • "I am able to do my job to a standard I am personally pleased with."
  • Self-determination
    • "I have a choice in deciding how to do my work."
    • "There are frequent opportunities for me to show initiative in my role."
  • Impact
    • "I am able to make improvements happen in my area of work." and other, similar questions

Complexity leadership theory is partly measured although not using validated items from scales for complexity leadership theory (information gathering and information using)[106][107] and reciprocal learning[108] are available.

  • Generative (information gathering)
    • "Is patient / service user experience feedback collected within your directorate / department?"
    • "I receive regular updates on patient / service user experience feedback in my directorate / department"
  • Administrative (information using)
    • "The team I work in often meets to discuss the team’s effectiveness."
    • "When errors, near misses or incidents are reported, my organisation takes action to ensure that they do not happen again."
    • "Feedback from patients / service users is used to make informed decisions within my directorate / department"
    • "I am confident that my organisation would address my concern" and similar questions

Human resource management

Components of Human Resource Management can be divided[109]:

Technical Human Rource Management

  • Benefits and services
  • Compensation
  • Recruiting and training
  • Safety and health
  • Employee education and training
  • Retirement strategies
  • Employee/industrial relations
  • Social responsibility programs
  • EEO for females, minorities, etc.
  • Management of labor costs
  • Selection testing
  • Performance appraisal
  • Human resource information systems
  • Assessing employee attitudes

Strategic Human Rource Management

  • Teamwork
  • Employee participation and empowerment
  • Workforce planning—flexihitity and deployment
  • Workforce productivity and quality of output
  • Management and executive development
  • Succession and development planning for managers
  • Advance issue identification/strategic studies
  • Employee and manager communications
  • Work/family programs'*

High-Performance Work Practices (HPWP)

HPWPs are human resource practices that[110][111][98]:

  • "increase employees’ knowledge, skills, and abilities (KSAs)"
  • "empower employees to leverage their KSAs for organizational benefit"
  • "increase their motivation to do so"

The following early study of HPWP have been found to affect employee outcomes (turnover and productivity) and measures of corporate financial performance[109]

Employee skills and organizational structures

  • What is the proportion of the workforce who are included in a formal information sharing program (e.g.. a newsletter)?
  • What is the proportion of the workforce whose job has been subjected to a formal job analysis?
  • What proportion of non-entry level jobs have been filled from within in recent years?
  • What is the proportion of the workforce who are administered attitude surveys on a regular basis?
  • What is the proportion of the workforce who participate in Quality of Work Life (QWL) programs, Quality Circles (QC). and/or labor-management participation teams?
  • What is the proportion of the workforce who have access to company incentive plans, profit-sharing plans, and/or gain-sharing plans?
  • What is the average number of hours of training received by a typical employee over the last 12 months?
  • What is the proportion of the workforce who have access to a formal grievance procedure and/or complaint resolution system?
  • What proportion of the workforce is administered an employment tesi prior to hiring?

Employee motivation

  • What is the proportion of the workforce whose performance appraisals are used to determine their compensation?
  • What proportion of the workforce receives formal performance appraisals?
  • Which of the following promotion decision rules do you use most often? (a) merit or performance rating alone; (b) seniority only if merit is equal; (c) seniority among employees who meet a minimum merit requirement; (d) seniority.
  • For the five positions that your firm hires most frequently, how many qualified applicants do you have per position (on average)?

Assessing employee attitudes (AHRQ)

High-Performance Work Practices have been more recently proposed by the United States [Agency for Healthcare Research and Quality] (AHRQ)[112][98]. These include:

Subsystem #1: Engaging Staff

  • Conveying mission and vision
  • Information sharing
  • Employee involvement in decision-making. Defined by the AHRQ as " Practices supporting employees' ability to influence the “decisions that matter” through mechanisms such as quality circles, process project teams, management/town hall meetings, and/or suggestion systems." "2007). Employee surveying and visibly acting on survey results also fit into this practice category."[98]
  • Performance-contingent compensation

Subsystem #2: Acquiring and Developing Talent

  • Rigorous recruiting
  • Selective hiring
  • Extensive training
  • Career development

Subsystem #3: Empowering the Frontline. Defined by the AHRQ as "These practices most directly affect the ability and motivation of frontline staff, clinicians in particular, to influence the quality and safety their care team provides."

  • Employment security
  • Reduced status distinctions
  • Teams/decentralized decisionmaking

Subsystem #4: Aligning Leaders. Defined by the AHRQ as "These practices influence the capabilities of the organization's leadership in running and evolving the organization as a whole."

  • Management training linked to organizational needs. Defined by the AHRQ as "Practices involving the alignment of leadership development resources with the strategic direction of the organization. Examples include use of core competency models and/or incorporation of goals to guide training, assessment, and feedback programs."
  • Succession planning
  • Performance-contingent compensation

A meta-analysis in 2006 has shown the effectiveness of HPWPs for five dimensions of organizational performance measures: [111]:

  • productivity
  • retention
  • accounting returns
  • growth
  • market returns

High-Performance Management System (IHI)

More recently, the Institute for Healthcare Improvement (IHI) developed the High-Performance Management System (HPMS)[113][114]. Key components are:

Primary Driver P1: Drive Quality Control

  • S1: Standardization: Processes exist to help define and disseminate standard work (what to do and how to do it).
  • S2: Accountability: A process is in place to review execution of standard work.
  • S3: Visual Management: Process performance information is continuously available to synchronize staff attention and guide current activities.
  • S4: Problem Solving: Methods are available for surfacing and addressing problems that are solvable at the front line, and for developing improvement capability.
  • S5: Escalation: Frontline staff scope issues and escalate those that require management action to resolve.
  • S6: Integration: Goals, standard work, and QI project aims are integrated across organizational levels and coordinated among units and departments.

Primary Driver P2: Manage Quality Improvement

  • S7: Prioritization: Processes are established to help prioritize frontline improvement projects based on organizational goals.
  • S8: Assimilation: Improvement projects are integrated into daily work.
  • S9: Implementation: Frontline teams have support to move from QI back to QC, integrating the results of QI projects into standard processes.

Primary Driver P3: Establish a Culture of High-Performance Management

  • S10: Policy
  • S11: Feedback
  • S12: Transparency
  • S13: Trust

The IHI HPMS does not well map to antecedents of workforce engagement[78][115]:

  • Membership and safety

( Availability and mastery

  • Meaningfulness
  • Autonomy or self-determination

Harmful practices

Pay for performance can reduce mental health of employees[116].

Overworked managers may treat employees unfairly[117]. Daily performance appraisal may be harmful[118].

Organizational decision making and conflict resolution

Organizational decision making is "the process by which decisions are made in an institution or other organization". [119]

Consensus

Group members may overestimate the degree of consensus[120]. This may be due to difficulty in inferring the opinion of a teammember.

On the other hand, in a non-randomized study that did not account for baseline conflicts, voting was associated with dissatisfaction[121]. It may be likely that these teams chose to vote because of diversity of perspectives whereas teams that choose consensus had more baseline homogeneity. In addition, post-decision voice was not clearly used.

After voting on organizational procedures, postdecisional voice by the minority group can reduce negative impact on perceptions of fairness and task commitment by employees in the voting minority. [122] In the study by Hunton, postdecisional voice was solicited by asking voters "their thoughts and feelings" about the options debated. Participants were also told that their postdecisional voice was "noninstrumental" and would not change the choice[122].

Delphi technique

A Delphi technique may be more effective.[123]

The Delphi technique involves[124]:

  1. Identifying a research problem
  2. Completing a literature search
  3. Developing a questionnaire of statements
  4. Conducting anonymous iterative mail or e-mail questionnaire rounds
  5. Providing individual and/or group feedback between rounds
  6. Summarizing the findings

A modified Delphi had been developed by the RAND Corporation.[125][126]

The technique can vary regarding anonymity of participants and the number of iterations or rounds.

The Delphi Technique can be conducted online either asynchronously via email[127] or synchronously using a software such as ExpertLens.[128][129]

Organizational change and innovation

A survey for Practice adaptive reserve may[130] or many not[131] predict successful organizational change. Practive adaptive reserve is negatively associated with burnout[132][131]

Many studies have examined how to promote organizational change via patient-centered medical home in primary care by large projects such as the VA PACT[133][134][135] and the American Academy of Family Physician[136]. These methods have been systematically reviewed.

Innovation

Two types:

  • Internal - adopting and adapting. Various issues affect knowledge sharing within an organization[137][138][139]. Recommendations to promote knowledge sharing are[139]:
    • "Design work in a way that encourages sharing and promotes the right type of motivation. Give stimulating work that uses brain cells and give people autonomy. Don’t overload people (which creates time pressure). Be careful when creating too many 'dependencies' between workers as it can also create pressure."
    • "Create a cooperative culture. Do not create competition through individual incentives or through labelling [sic] people as winners versus losers or publicly comparing them (for example, what messages do performance appraisals send?)."
    • "Act as a role model and share your knowledge with others. Show you trust others to make good use of the knowledge you share with them. Also make sure you use the knowledge they share with you competently and with integrity."
  • External - development

Scales to measure:

  • Team Climate Inventory (TCI) has five scales: vision, participative safety, support for innovation, task orientation, interaction frequency[140]
  • Hurley has five dimensions: Innovativeness, Participative Decision-Making, Power Sharing, Support and Collaboration, Learning and Development[141]
  • Sisodiya developed a scale based on responses by managers[142]

External - incorporating external information

  • My organization actively seeks out external sources of knowledge and technology (e.g., published research, regional and national meetings, professional societies, external colleagues) when developing new ideas[143]

Appreciative inquiry

Appreciative inquiry was developed in 1987 by Cooperrider and Srivastva[144]

Positive deviance

A positive deviance approach has been recommended to identify and disseminate best organizational practices[145][146] [147]Early description of this method was[145]:

  • "Develop case definitions"
  • "Identify four to six people who have achieved an unexpected good outcome despite high risk"
  • "Interview and observe these people to discover uncommon behaviours or enabling factors that could explain the good outcome"
  • "Analyse the findings to confirm that the behaviours are uncommon and accessible to those who need to adopt them"
  • "Design behaviour change activities to encourage community adoption of the new behaviours"
  • "Monitor implementation and evaluate the results"

Identifying deviances

Ideally, positive deviants should be identified by blinded comparison to control groups[146], yet this is infrequently done[147] and instead deviants are informally identified by reputation[99][148].

Various statistical approaches are used to identify the true deviants[149][150]. Inadequate sample may hinder identifying deviants[151]. Regression to the mean may confound identifying postive deviances and the assessment of improvement[152].

Not all QI measures may be appropriate[153].

Positive deviance may include grounded theory, ethnography methods, guided conversations/interviews, and focus groups[154].

Interventions using positive deviants

Reports of successful use have been published[155] Specific examples include:

Measuring

Overall measurement of learning and improvement can be measured with[17]:

  • "I see myself continually improving"
  • "I continue to learn more as time goes by"

Internal innovation due to reciprocal learning

  • "I am frequently taught new things by other people I work with"[108]

External innovation due to environmental scanning.

  • "the number of memberships in professional associations"[169]

Organizations

See also

References

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