Identifying the Dimensions and Components of Quality Improvement of Education and Rural Health Workers’ Performance in Hormozgan, Iran

Background: Education focuses on strengthening the performance of employees while improvement prepares them for other positions in the organization. Objectives: The present study aimed to identify the dimensions and components of quality improvement of education and rural health workers in Hormozgan, Iran. Methods: The current applied-descriptive study reviewed education and improvement of rural healthcare workers (called “behvarz” in Persian) based on document study and Delphi methods. To this end, 10 researchers in the fields of rural healthcare workers, health experts, and skilled rural health workers were asked to participate. The sampling was based on the snowball method; the data were obtained and refined through the fuzzy Delphi method. Results: The results showed that the experts had an appreciable inclination for the design and implementation of education in the first phase with a mean of 0.8538, followed by social, cultural, and professional improvement with a mean of 0.8396. Also, among other dimensions, the highest level of education agreement was 0.840. In the second phase, the design and implementation component of education with a mean of 0.84 was in the first place. For the improvement component, the social, cultural, and professional improvement yielded a mean of 0.8521. Conclusions: The impact of both education and improvement on people’s general health should be highlighted more than ever. However, theoretical and practical deep study of qualitative education toward improving and promoting the health system is required.

How does job mobility relate to work commitment among rural healthcare workers? a cross-sectional study in western China

Background Rural healthcare workers (RHWs) are the core of the rural health system. The antecedents of turnover of RHWs have been well studied, but little is known about the consequences of job mobilities among RWHs. This study aimed to identify the association between job mobility and the work commitment of RHWs in China. Methods Based on a three-stage random sampling method, a cross-sectional survey was conducted in 11 western provinces in China. A total of 3783 RHWs, consisting of 2245 doctors and 1538 nurses, were included in our study. Confirmatory factor analysis, Pearson’s chi-squared test, one-way ANOVA, linear regression analysis, and binary logistic regression analysis were performed for data analyses. Results 46.3% of RHWs reported the experience of job mobility in the past. Work commitment of RHWs was not very high; specifically, the mean scores of pride in, concern for, and dedication to work were 3.54, 3.81, and 3.61 (out of a maximum of 5), respectively, and 29.9% presented turnover intent. RHWs’ overall experience of job mobility in the past was significantly associated with an increased odds of having the turnover intent. With respect to the last job mobilities of RHWs, the last job changes that occurred in the last 3 years, especially these lateral (i.e., job changes between two healthcare institutions at the same hierarchical level) and upward (i.e., job changes from a healthcare institution at a lower hierarchical level to current institution) mobilities, were significantly associated with a high level of work commitment (i.e., pride in, concern for, and dedication to work) among RHWs. However, the lateral mobilities in the last four to 5 years and the downward mobilities (i.e., job changes from a healthcare institution at a higher hierarchical level to current institution) 6 years ago or more significantly increased the odds of having turnover intent among RHWs, and RHWs whose last job changes were other mobilities (i.e., job changes from a non-healthcare institution to a healthcare institution) in the last four to 5 years reported had a significantly low level of pride in and concern for work and an increased odds of having the turnover intent. Conclusions The study suggests that the overall experience of job mobility in the past is a threat to RHWs’ work commitment to their current healthcare institutions. The honeymoon-hangover pattern exists in the association between a single job change and RHWs’ work commitment. Managers of rural healthcare institutions should pay more attention to these RHWs with the experience of job mobility to enhance their work commitment.

How can rural community-engaged health services planning achieve sustainable healthcare system changes?

ObjectivesThe objectives of the Rural Site Visit Project (SV Project) were to develop a successful model for engaging all 201 communities in rural British Columbia, Canada, build relationships and gather data about community healthcare issues to help modify existing rural healthcare programs and inform government rural healthcare policy.DesignAn adapted version of Boelen’s health partnership model was used to identify each community’s Health Care Partners: health providers, academics, policy makers, health managers, community representatives and linked sectors. Qualitative data were gathered using a semistructured interview guide. Major themes were identified through content analysis, and this information was fed back to government and interviewees in reports every 6 months.SettingThe 107 communities visited thus far have healthcare services that range from hospitals with surgical programs to remote communities with no medical services at all. The majority have access to local primary care.ParticipantsParticipants were recruited from the Health Care Partner groups identified above using purposeful and snowball sampling.Primary and secondary outcome measuresA successful process was developed to engage rural communities in identifying their healthcare priorities, while simultaneously building and strengthening relationships. The qualitative data were analysed from 185 meetings in 80 communities and shared with policy makers at governmental and community levels.Results36 themes have been identified and three overarching themes that interconnect all the interviews, namely Relationships, Autonomy and Change Over Time, are discussed.ConclusionThe SV Project appears to be unique in that it is physician led, prioritises relationships, engages all of the healthcare partners singly and jointly in each community, is ongoing, provides feedback to both the policy makers and all interviewees on a 6-monthly basis and, by virtue of its large scope, has the ability to produce interim reports that have helped inform system change.

Rewards and employee creativity among rural healthcare employees: the mediating role of organizational support for innovation and the moderating impact of supervisory support

Purpose This paper aims to explore the mediating effect of organizational support for innovation and moderating impact of supervisory support on how rewards shape employee creativity among rural healthcare employees, a group with few resources and considerable expectations. Design/methodology/approach Using a regression-based moderated path analysis, the authors tested the hypotheses with healthcare employee survey data from a large Southern rural hospital in the USA. Findings The empirical results suggest organizational support for innovation mediates the influence of rewards on employee creativity. In addition, the indirect effect of rewards on employee creativity via organizational support for innovation is moderated by supervisory support, such that the indirect effect is more pronounced at high levels of supervisory support than at low levels of supervisory support. Originality/value This study contributes to the organizational support and creativity literature by exploring the indirect relations of rewards on employee creativity through organizational support for innovation, and the moderating role of supervisory support in such relations.