Productivity and turnover in PCPs: The role of staff participation in decision-making

Dorothy Y. Hung, Thomas G. Rundall, Deborah Cohen, Alfred F. Tallia, Benjamin F. Crabtree

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. Methods: This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Results: Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. CONCLUSION:: Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.

Original languageEnglish (US)
Pages (from-to)946-951
Number of pages6
JournalMedical Care
Volume44
Issue number10
DOIs
StatePublished - Oct 2006
Externally publishedYes

Fingerprint

turnover
Primary Health Care
Decision Making
productivity
staff
Efficiency
decision making
participation
Information Dissemination
Job Satisfaction
Quality Improvement
Cross-Sectional Studies
Regression Analysis
work satisfaction
organizational structure
Research
regression analysis
employee
commitment
examination

Keywords

  • Healthcare organization
  • Participation in decision-making
  • Primary care practice
  • Productivity
  • Turnover

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Productivity and turnover in PCPs : The role of staff participation in decision-making. / Hung, Dorothy Y.; Rundall, Thomas G.; Cohen, Deborah; Tallia, Alfred F.; Crabtree, Benjamin F.

In: Medical Care, Vol. 44, No. 10, 10.2006, p. 946-951.

Research output: Contribution to journalArticle

Hung, Dorothy Y. ; Rundall, Thomas G. ; Cohen, Deborah ; Tallia, Alfred F. ; Crabtree, Benjamin F. / Productivity and turnover in PCPs : The role of staff participation in decision-making. In: Medical Care. 2006 ; Vol. 44, No. 10. pp. 946-951.
@article{ac3818c346374284a209dcd8dedc1c89,
title = "Productivity and turnover in PCPs: The role of staff participation in decision-making",
abstract = "Background: Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. Methods: This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Results: Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. CONCLUSION:: Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.",
keywords = "Healthcare organization, Participation in decision-making, Primary care practice, Productivity, Turnover",
author = "Hung, {Dorothy Y.} and Rundall, {Thomas G.} and Deborah Cohen and Tallia, {Alfred F.} and Crabtree, {Benjamin F.}",
year = "2006",
month = "10",
doi = "10.1097/01.mlr.0000220828.43049.32",
language = "English (US)",
volume = "44",
pages = "946--951",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Productivity and turnover in PCPs

T2 - The role of staff participation in decision-making

AU - Hung, Dorothy Y.

AU - Rundall, Thomas G.

AU - Cohen, Deborah

AU - Tallia, Alfred F.

AU - Crabtree, Benjamin F.

PY - 2006/10

Y1 - 2006/10

N2 - Background: Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. Methods: This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Results: Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. CONCLUSION:: Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.

AB - Background: Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. Methods: This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Results: Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. CONCLUSION:: Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.

KW - Healthcare organization

KW - Participation in decision-making

KW - Primary care practice

KW - Productivity

KW - Turnover

UR - http://www.scopus.com/inward/record.url?scp=33748991445&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748991445&partnerID=8YFLogxK

U2 - 10.1097/01.mlr.0000220828.43049.32

DO - 10.1097/01.mlr.0000220828.43049.32

M3 - Article

C2 - 17001266

AN - SCOPUS:33748991445

VL - 44

SP - 946

EP - 951

JO - Medical Care

JF - Medical Care

SN - 0025-7079

IS - 10

ER -