Hospital-based palliative care services aim to streamline medical care for patients with chronic and potentially life-limiting illnesses by focusing on individual patient needs, efficient use of hospital resources, and providing guidance for patients, patients’ families and clinical providers toward making optimal decisions concerning a patient’s care. This study examined the nature of palliative care provision in U.S. hospitals and its impact on selected organizational and patient outcomes, including hospital costs, length of stay, in-hospital mortality, and transfer to hospice. Hospital costs and length of stay are viewed as important economic indicators. Specifically, lower hospital costs may increase a hospital’s profit margin and shorter lengths of stay can enable patient turnover and efficiency of care. Higher rates of hospice transfers and lower in-hospital mortality may be considered positive outcomes from a patient perspective, as the majority of patients prefer to die at home or outside of the hospital setting. Several data sources were utilized to obtain information about patient, hospital, and county characteristics; patterns of hospitals’ palliative care provision; and patients’ hospital costs, length of stay, in-hospital mortality, and transfer to hospice (if a patient survived hospitalization). The study sample consisted of 3,763,339 patients; 348 urban, general, short-term, acute care, non-federal hospitals; and 111 counties located in six states over a 5-year study (2007-2011). Hospital-based palliative care provision was measured by the presence of three palliative care services, including inpatient palliative care consultation services (PAL), inpatient palliative care units (IPAL), and hospice programs (HOSPC). Derived from Institutional Theory, Resource Dependence Theory, and Donabedian’s Structure Process-Outcome framework, 13 hypotheses were tested using a hierarchical (generalized) linear modeling approach. The study findings suggested that hospital size was associated with a higher probability of hospital-based palliative care provision. Conversely, the presence of palliative care services through a hospital’s health system, network, or joint venture was associated with a lower probability of hospital-based palliative care provision. The study findings also indicated that hospitals with an IPAL or HOSPC incurred lower hospital costs, whereas hospitals with PAL incurred higher hospital costs. The presence of PAL, IPAL, and HOSPC was generally associated with a lower probability of in-hospital mortality and transfer to hospice. Finally, the effects of hospital-based palliative care services on length of stay were mixed, and further research is needed to understand this relationship.

The top leader of an organization influences the organizational culture, and the organizational culture influences the leader. Strategic thinking on the part of the leader is a result of organizational culture and/or will impact organizational culture. This qualitative study is a comparative multiple-case study that examines the relationship between leaders and organizational culture and what the leader’s strategic decision-making and organizational changes indicate about the relationship between leadership and organizational culture. The organizational context of private schools is used to better understand the dynamics between leadership and organizational culture. This study uses an interview protocol with CEOs of private schools, a macroculture in the United States, to solicit the leaders’ perspectives on their school’s organizational culture and their perspectives on the specific strategic decisions made by those leaders in the context of that organizational culture. This study focuses on six different schools in Virginia, all approved through accrediting procedures by the Virginia Council for Private Education -- a shared organizational context. Individual focal points for data collection and analysis include individual school websites, published school documents, and required accreditation documents as well as structured interviews with the CEOs of each school. This study examines the cycle of influence that the leader has on the organization through strategic thinking and the influence that the organizational culture has on the leader. Three findings expressed how the leader influences the organizational culture. There were also three findings on how the organizational culture influences the leaders. Two additional findings are on what change indicates about the relationship between the leader and the organizational culture. These findings reveal that a focus on relationships in the school, a willingness to target specific growth for the individual school, and goals that were expressed spiritually as well as academically are key to the leaders. The study also found that the school cultures identified strongly and positively with that of being a family, spiritual focus operationally distinguishes the school cultures, and spiritual identity is also expressed as the relationship the school has to church. Two findings were identified relating to strategic decisions and change; these findings were that evidence of change should be visible and explicit within the organization and organizational change relates directly to focus for growth from the leader. These findings from this study support the conclusions that 1) Christian school leaders have a direct influence on the values and direction of the school’s organizational culture; 2) the Christian school’s organizational identity has a direct influence on the focus of the leader, and 3) changes targeted in Christian schools reflect the focus of the leader on growth. Findings from this research suggest that organizational culture is highly contextualized and as a result strategic thinking and decision-making on the part of the leader are also highly contextualized. Contextualization increases as the leader seeks to grow the organization or to change the organization. Understanding contextualization that exists, and how organizational culture changes as strategic decisions are made by the leader, has implications for further research in effective leadership, effective change, strategic thinking, and growing effective organizational cultures including private and public institutions of higher education and public and private corporate institution.

The landscape industry in the United States suffers higher turnover among middle management positions. Upper management does not know why this is occurring and currently has no strategy to deal with it. The purpose of this study was to investigate the reasons for high turnover among middle managers and explore the ways to reduce turnover. Reducing turnover may help with the stability of the landscape industry and increase employee retention. Conceptual framework for this study included Maslow's hierarchy of needs, Herzberg's two factor theory, situational theory, and contingency theory. This qualitative exploratory case study addressed the reasons for high turnover of middle managers and the strategies that might prevent high turnover in landscape industry. Three cases were selected, and each case included a sample of 5 middle managers in addition to publicly available company archival information. Middle managers were interviewed using semi-structured interviews. Archival data were used to achieve data saturation. Thematic analysis reviled the following results. The findings indicate that middle managers typically perceive that stress to sell and loss of contracts cause turnover. By creating strategies to reduce stress and manage contract loss, upper management may reduce turnover. The implications for social change include increased viability of landscape companies, which could result in decreased unemployment and increased quality of life for middle managers within the industry.

Escalation of commitment is an individual's persistent behavior at sustaining commitment to an original decision or course of action. Although researchers have found that personality impacts escalation of commitment behavior, this study addressed a gap in escalation of commitment behavior regarding personality in higher education, which has consistently been ignored. Building on the self-justification theory, this study was an investigation of (a) whether perceived self-efficacy and dispositional optimism individually predicted escalation of commitment behavior; and (b) whether perceived self-efficacy and dispositional optimism jointly predicted escalation of commitment behavior after controlling for age, gender, ethnicity, socioeconomic status, and tenure. Hierarchical regression was performed using a sample of 76 participants from a community college in Minnesota. Results suggested that only perceived self-efficacy will predict leaders' escalation of commitment behavior and not dispositional optimism. The result of this study has implications for positive social change by aiding effective leadership decision making, enabling better screening and recruiting process, and allowing organizations to develop specific training and intervention programs that will help educational leaders utilize their positive attributes appropriately.

Small- to medium-size enterprises (SMEs) play a vital role in a dynamic economy through job creation, poverty alleviation, and socioeconomic development in developed and developing countries. The purpose of this multiple case study was to explore how SME leaders in Lagos, Nigeria, adopted information and communication technology (ICT) as a business strategy to increase profitability and compete globally. Organizational leaders have adopted ICT so that their organizations can become more efficient, effective, innovative, and globally competitive. This study involved 4 SMEs that had successfully implemented ICT. The participants included 5 SME leaders from each of the SMEs. The data collection method included in-person semistructured interviews of participants and review of existing company data. Data were analyzed using inductive data analysis, which included member checking to ensure trustworthiness of interpretations and occurred until theoretical saturation had occurred. The technology acceptance model (TAM), which specifies the relationship between perceived usefulness, perceived ease of use, attitude toward computer use, and intention to use technology, was applied as a framework to explain the Nigerian SME's ICT adoption strategies. Four major themes emerged from the data analysis: ICT adoption factors, ICT roles and benefits, role of government, and SME success factors. The findings of this study may help SME leaders and government leaders address many of the factors inhibiting the adoption of ICT in SMEs. The findings of this study may positively affect social change by ensuring that SMEs are successful and able to create jobs, which in turn may help to alleviate poverty and promote socioeconomic development through adoption of ICT.

Ethical breaches in many organizations can be traced to failures in ethical leadership, which undermine trust. If a leader's ethical behavior in their private life and settings is perceived as influencing workplace ethics, it may in turn affect organizational trust levels and the development of trust. A quantitative study based on the social learning and moral theory was conducted to determine whether a difference exists between a leader's self-perceptions of their ethical behaviors inside and outside of the workplace, and whether it affects their perceived personal trustworthiness. Participants' (N = 94) scores on work and nonwork versions of the ethical leadership scale were compared using a paired-samples t test, which determined no significant differences in their ethical behaviors inside and outside of the workplace. Then multiple regression analyses were conducted, which indicated that the model containing both independent variables regarding ethical behavior inside and outside the workplace significantly predicted changes in the dependent variable personal trustworthiness: F (7, 86) = 6.025, p < .001. The model explained 27% of the variance in personal trustworthiness. The model also significantly predicted changes in scores related to propensity to trust; F (10, 83) = 3.692, p < .001. The model explained 23% of the variance in propensity to trust. This research will aid leaders in understanding more about the perception of their own ethics and how this plays into the cultivation of trust. It also has implications that may influence leadership among all types of work environs, including government organizations and industry.

Burnout is a serious work related syndrome that is a result of exposure to chronic work stress. In addition to the consequences of burnout on the individual, the symptoms of burnout can adversely affect the organization, the clients the individual works with and the individual's close family and friends. The literature has focused on the history of burnout and the level of burnout experienced by various high stress occupations; however there has not been extensive research into the role personality traits play in burnout. The main research question of this study was to identify personality traits that are more susceptible to burnout among correctional workers. This research utilized the survey research method by having participants voluntarily complete a demographics form, the Maslach Burnout Inventory for Human Service Workers, and the Big Five Inventory. Data was collected through an online questionnaire (N=169). Data was analyzed by correlation analysis and two step multiple regression using demographics and the individual components of burnout. The results suggested that individuals possessing the personality trait Neuroticism experienced high levels of Emotional Exhaustion and Depersonalization. The results also suggested that the length of years employed had no relationship to burnout. The study found that years worked, type of work and marital status on their own did not have any relationship with burnout; however when coupled with personality traits. The findings also showed that Neuroticism was the only personality trait that was associated with all three dimensions of burnout. These findings can assist organizations with identifying individuals in the field of corrections who may be predisposed to burnout and allow for early intervention. As a result, the interventions can lead to social change where individuals can be healthier, happier, more fulfilled and better able to protect and service the clients, the organization and the public.

Currently there is a high rate of registered nurse (RN) turnover due in part to bullying and harassment among peers; which fosters lower quality nursing care, jeopardizes patient safety, and increases healthcare costs. The purpose of this quantitative nonexperimental study was to examine the relationship between inpatient nurses' individual self-esteem and reported bullying and harassment with their intent to leave their job. Two theories were used to provide structure to this work: cognitive experimental self theory and oppressed group theory. Data were collected using the Negative Acts Questionnaire, the Rosenberg Self-Esteem Scale, and the Turnover Intentions Measure. All RNs in a Midwestern state were emailed an invitation link to the instruments housed on SurveyMonkey. Only those respondents who claimed to be inpatient RNs were included in the study (n = 770). The three research questions asked about bullying and harassment among inpatient RNs, about the self-esteem of RNs who experienced bullying and harassment and those who have not, and if those RNs who experienced bullying and harassments intended to leave their jobs. With a 2.1% response rate, results indicated that there was a relationship among RNs and bullying and harassment, the self-esteem of RNs who did not experience bullying and harassment was higher than those who did experience bullying and harassment, and there was a positive relationship between RNs experiencing bullying and harassment and their intent to leave their jobs. This research suggests that if bullying and harassment patterns among RNs are identified sooner, RN turnover can be reduced, patient care quality and safety can be improved, and U.S. healthcare costs can decrease.

Industry and research have shown that, in addition to the knowledge, skills, and abilities of individuals, other factors play an influential role in the efficiency of a team. The research questions for this study examined the influence of functional characteristics, defined as the cognitive and evaluative processes such as intentions, emotions, planning, and perception that influence decisions, on team outcomes and the time it takes to complete a task. Using a quantitative, experimental research design, the research questions were grounded in personality systems interactions as the theoretical framework. Analysis of variance was applied to evaluate the hypotheses with an independent measure used to analyze 114 student participant responses to an online assessment and a team task. Results of a test of between-subjects effect identified their functional characteristic levels. Findings displayed statistical significance with main effect for (a) action orientation and (b) the time it takes to complete an assigned task, F(2, 57) = 3.24, p = 0.047. These findings could serve to decrease organizational costs such as those associated with human resource selection processes, team training, or team performance outcomes. The findings support positive social change by increasing social and behavioral psychologists' understanding of human-to-human behavioral interactions and the influence of functional characteristics on organizational teams.

Research on the glass ceiling shows that women may encounter obstacles in their pursuit of high-level management positions. The purpose of this quantitative study was to test the explanatory style theoretical framework by examining relationships between women's glass ceiling beliefs, career advancement satisfaction, and quit intention and to determine whether satisfaction with career advancement opportunities mediated the relationship between glass ceilings beliefs and quit intention. Data were collected from 179 working women in the public or private sector and women who exited the public or private sector job market within the past 5 years via Web-based surveys. Glass ceiling beliefs were assessed using the Career Pathways Survey (CPS), career advancement satisfaction was assessed using the Career Satisfaction Measure, and quit intention was assessed using the Intention to Quit Scale and data were analyzed using multiple regression and correlational statistical techniques. Findings indicated significant relationships between the principal variables. Results also showed that career advancement satisfaction had a significant mediating effect on denial, resilience, and acceptance glass ceiling beliefs and quit intention. Findings may be used to help women understand how their glass ceiling beliefs and career satisfaction drivers influence their reaction to workplace events and may be used by employers to implement proactive retention strategies.