Background. Factors such as the shortage of personnel, hospital closures and mergers, the ageing of the population combined with the evolution of medical technologies have all added pressure to the health care system. These pressures have had an impact on current work environments and health care workers' satisfaction. In light of the evidence on the influence of job satisfaction and retention on the quality of tare and patient safety, interventions are needed to address these issues. / Objective. The objective were to examine the effect of Appreciative Inquiry on: (1) the development of innovative ideas regarding work organization; (2) changes in health care professionals' and particularly nurses' job satisfaction and intent to stay; and, (3) levels of empowerment, social network and perceived organizational support. / Research design. The study used a multiple embedded case study design to access the multifaceted aspects relating to retention and innovation and examine the changes engendered by an AI intervention. / Participants and setting. Two oncology ambulatory clinics constituted the cases; the embedded units were the health care and the management teams (N = 47 and 5) of an adult oncology division in a multi-site university affiliated health care centre in a large Canadian city. / Methods. Multiple sources of evidence were used. They consisted of participant observation, questionnaires providing quantitative and qualitative evidence, interviews, direct observation and documentation. / Results. AI provided a way to involve health care professionals in change processes by creating the opportunity and the conditions that promoted the emergent of innovative ideas. Some of these ideas were implemented during the study period. AI did not result in improved psychological empowerment, perceived organizational support, support network or decreased intent to stay. Job satisfaction decreased over time. Perceptions of organizational support and psychological empowerment were found to influence job satisfaction and intent to stay. / Conclusion. This study makes a contribution to micro-systems examination of change processes and reveals how ideas evolve and are developed in a multidisciplinary context. AI represents a way to tap into the innovative potential of individuals within an organization. The findings suggest that upper and middle management support is required throughout change processes and that multilevel interventions need to be pursued to facilitate the implementation of innovative ideas and subsequently improve work environments.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.103031 |
| Date | January 2007 |
| Creators | Richer, Marie-Claire. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (School of Nursing.) |
| Rights | © Marie-Claire Richer, 2007 |
| Relation | alephsysno: 002598893, proquestno: AAINR32319, Theses scanned by UMI/ProQuest. |
Page generated in 0.0594 seconds