Health Care Management Review最新文献

{"title":"Burned out and thinking of quitting: A moderated-mediation model of frontline health care workers and occupational stigma during COVID-19.","authors":"Jessica A Peck, Tracy H Porter, Candice Vander Weerdt, Greta L Polites","doi":"10.1097/HMR.0000000000000458","DOIUrl":"10.1097/HMR.0000000000000458","url":null,"abstract":"<p><strong>Background: </strong>Work burnout and job turnover intentions pose challenges for health care workers. An understudied area of impact is COVID-19 occupational stigma consciousness or the awareness that one's occupation has been stigmatized because of proximity and exposure to COVID-19.</p><p><strong>Purposes: </strong>Using job demands-resources theory, we examine the impact of COVID-19 occupational stigma consciousness, a novel job demand, on work burnout and job turnover intentions and the effectiveness of common job resources to buffer these effects among nurses in the United States.</p><p><strong>Methodology/approach: </strong>We surveyed frontline nurses working in the United States during the COVID-19 pandemic ( N = 282). We used structural equation modeling to examine the impact of COVID-19 occupational stigma consciousness on job turnover intentions and the mediating role of work burnout. Perceived supervisor support and supportive work climate were examined as job resources.</p><p><strong>Results: </strong>COVID-19 occupational stigma consciousness was significantly related to work burnout, and work burnout fully mediated the relationship between COVID-19 occupational stigma consciousness and job turnover intentions. Perceived supervisor support was related to reduced job turnover intentions and reduced work burnout. However, supportive work climate and perceived supervisor support did not moderate the impact of COVID-19 occupational stigma consciousness on work burnout.</p><p><strong>Conclusions: </strong>This study found support for the negative impact of a novel job demand, COVID-19 occupational stigma consciousness, on nurses in the workplace. Social support resources that are effective in other contexts for reducing the harmful effects of job demands were not effective at reducing occupational stigma among nurses during COVID-19.</p><p><strong>Practice implications: </strong>As pandemics increase in frequency, organizations and managers should understand the effects of disease-related stigma consciousness on employees and focus on implementing job resources that can mitigate the effects of such stigma.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"12-21"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Band-aids and firewalls: A resource-based view of ransomware attack vulnerability in health care organizations.","authors":"Mahdieh Zare Bidoki, Michele L Heath, Geoffrey A Silvera","doi":"10.1097/HMR.0000000000000463","DOIUrl":"10.1097/HMR.0000000000000463","url":null,"abstract":"<p><strong>Background: </strong>In the advance of the digital health technology, health care organizations (HCOs) are tasked with balancing technological advances with rising incidence of cyber threats. Despite the importance of robust Information Technology (IT) infrastructure, HCOs may be underinvesting in cybersecurity, prioritizing system integration and other operational needs.</p><p><strong>Purposes: </strong>This study examines the threat of health information breaches and ransomware attacks via resource-based view of the firm by examining the role of HCO resources in breaches.</p><p><strong>Methodology/approach: </strong>A multivariate logistic regression analysis of a nationally representative sample of HCOs ( N = 2,262) was executed on data provided by the Office for Civil Rights (2019-2024) and the American Hospital Association (2019).</p><p><strong>Results: </strong>The study finds mixed evidence that resource availability influences the likelihood of a breach and ransomware attack. HCO centralization and teaching status were more likely to report both breach and ransomware attack, whereas HCO size relates to a significant reduction. The study finds no support for the effectiveness of IT risk mitigation capacity.</p><p><strong>Conclusion: </strong>The findings show that the incidence of breaches and ransomware attacks relates to HCO resource availability. Although the study finds no evidence that IT risk-mitigation capacity (IT staffing and expenditures) reduced the likelihood of breach or ransomware, this may be driven by the infrequency of these events.</p><p><strong>Practical implications: </strong>HCOs' understanding of their risk profile is limited, and there is a need for greater transparency in the incidence of ransomware attacks, in particular. There is a need for further examination of IT strategy and operations in an increasingly digital health care environment.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"54-65"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does hospital consolidation promote quality?: Organizational and strategic issues.","authors":"Lawton R Burns, Alejandra Benitez, Michael Sielski, Mark V Pauly","doi":"10.1097/HMR.0000000000000460","DOIUrl":"10.1097/HMR.0000000000000460","url":null,"abstract":"<p><strong>Issue: </strong>Two of the most important healthcare management topics studied over the past 37 years are hospital consolidation and quality. The specifics of consolidation's impact on quality are buried in a \"black box\" of organizational changes that typically follow consolidation. Academic researchers, both inside and outside health care, question the quality benefits. The paper discusses why quality benefits are not often observed.</p><p><strong>Critical theoretical analysis: </strong>Strategy and management theory are ambivalent about consolidation's impact on quality (i.e., suggest both positive and negative effects). Such ambivalence is evident in a two-stage conceptual model of how consolidation might impact quality. Consolidation is accompanied by strategic initiatives and organizational changes that can involve quality-promoting investments but may also harm quality.</p><p><strong>Insight/advance: </strong>The paper documents the ambivalent effects of consolidation on quality, which repeatedly manifest themselves in theory, a conceptual model, and several literature reviews. One explanation for the mixed results are methodological issues that hamper model estimation; another explanation is the two-stage conceptual model. In the first stage, hospitals consolidate to pursue organizational changes and strategic goals, some of which may target quality. In the second stage, such changes can exert quality impacts, but not necessarily. Most research focuses on the second stage rather than the first; research on the first is more indirect.</p><p><strong>Practice implications: </strong>Hospital executives and researchers should not assume that consolidation will yield quality improvements. Executives often espouse quality improvement as a goal of consolidation but may or may not invest in quality improvement initiatives. Even when they do, such initiatives may not lead to higher quality.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"2-11"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The contingent effects of hospitals' campaign contributions on Medicaid expansion after the Affordable Care Act.","authors":"Colby D Green, Douglas A Schuler, Carson D Cannon, Richard B Scoresby","doi":"10.1097/HMR.0000000000000459","DOIUrl":"10.1097/HMR.0000000000000459","url":null,"abstract":"<p><strong>Background: </strong>This paper examines the campaign contributions made by hospitals and their employees to state legislators in the years following the Affordable Care Act, during the period in which hospitals sought Medicaid expansion in all 50 states.</p><p><strong>Purpose: </strong>The purpose of this research was to identify the institutional characteristics in which campaign contributions are an effective management tool for obtaining favorable policy.</p><p><strong>Methods: </strong>In this study, we combined archival data from the Kaiser Commission on Medicaid and the Uninsured, the National Institute on Money in State Politics, the National Conference of State Legislatures, and the U.S. Census Bureau from 2010 to 2015. The analysis uses a two-stage residual inclusion Cox proportional hazards model to estimate the conditional effects of hospitals' state-level campaign contributions on the hazard of Medicaid expansion.</p><p><strong>Results: </strong>In this analysis, it has been demonstrated that campaign contributions increased the likelihood of Medicaid expansion in states with large legislative districts but decreased the likelihood of Medicaid expansion in states in which a single political party controls the executive and legislative branches. This research concludes that the effectiveness of campaign contributions is contingent on characteristics of local legislative institutions.</p><p><strong>Practice implications: </strong>Our findings encourage health care administrators to assess the institutional environment before engaging in political activities. Dollars contributed to campaigns in states with large legislative districts are likely to be effective, whereas dollars spent in states with unified governments are likely the least effective. In these latter contexts, health care administrators are encouraged to seek alternative methods of policy influence.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"32-42"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why should I do it? Examining the dual impact of illegitimate tasks on employee outcomes.","authors":"Eram Fatima Siddiqui, Dheeraj Sharma, Koustab Ghosh","doi":"10.1097/HMR.0000000000000461","DOIUrl":"10.1097/HMR.0000000000000461","url":null,"abstract":"<p><strong>Background: </strong>Illegitimate tasks are work assignments perceived as unreasonable or unnecessary. Such tasks fall outside the boundaries of duties considered appropriate for a given professional role. Illegitimate tasks are a widespread issue in the health care sector. Literature has largely emphasized the negative outcomes of illegitimate tasks. However, we suggest that the consequences of illegitimate tasks might not always be uniformly negative but could be paradoxical, depending upon the appraisal mechanisms.</p><p><strong>Purposes: </strong>Using the lens of the transactional model of stress and coping, we suggest that when individuals appraise illegitimate tasks as challenges, it is associated with positive outcomes like employee resilience. However, if they appraise illegitimate tasks as hindrances, it is associated with negative outcomes like the intention to quit.</p><p><strong>Method: </strong>The study was conducted using a time-lagged survey of 207 nurses in the health care sector in India, where illegitimate tasks are highly prominent.</p><p><strong>Results: </strong>Illegitimate tasks were positively associated with challenge and hindrance appraisals. The appraisal mechanisms mediated the relationship between illegitimate tasks and employee outcomes (employee resilience and intention to quit). Individuals with higher calling orientation were less likely to perceive illegitimate tasks as hindrances.</p><p><strong>Practice implications: </strong>Organizations should ensure that illegitimate tasks are appraised as challenges rather than hindrances through workload and stress management techniques.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"43-53"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A tri-theory-driven approach to engaging team members in quality improvement.","authors":"Heather D Martin, Reid M Eagleson, Carletta F Dobbins, Allyson G Hall, Frederick van Pelt","doi":"10.1097/HMR.0000000000000452","DOIUrl":"10.1097/HMR.0000000000000452","url":null,"abstract":"<p><strong>Issue: </strong>Conventional quality improvement methodologies are often deployed in silos using a narrow, predefined scope, bypassing opportunities to leverage frontline team member input and expertise. Existing frameworks acknowledge the importance of interprofessional team engagement but often overemphasize quantitative improvements while underappreciating their employees' emotional distress attributable to working in dysfunctional systems. Insufficient attention to frontline insights and employee emotional states can result in marginal improvement outcomes with limited sustainability.</p><p><strong>Critical theoretical analysis: </strong>We describe three leading theories of quality improvement, namely, participatory management theory, systems theory, and peer support principles, and discuss their individual limitations as a way to motivate an integrative approach to include frontline health care workers in problem solving and process improvement. We demonstrate how these theories may be combined into a tri-theory methodology to promote sustainable change initiatives that are selected and implemented by these workers.</p><p><strong>Theoretical implications: </strong>Using a real-world application of the tri-theory methodology in an academic medical center, the interprofessional team was able to successfully implement accountable care teams within the organization.</p><p><strong>Practice implications: </strong>Integrating systems and participatory management theories with peer support principles provides an empowering approach for creating conditions that mitigate burnout, nurture trusting relationships, and enable the team's emotional stress to be leveraged in identifying the critical improvement areas.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"296-304"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging expertise in interorganizational teaming: Exploring the intertwined roles of goal awareness and expertise awareness.","authors":"Esther Sackett, Anna T Mayo","doi":"10.1097/HMR.0000000000000456","DOIUrl":"10.1097/HMR.0000000000000456","url":null,"abstract":"<p><strong>Background: </strong>Past work on interorganizational health care alliances suggests that the effectiveness of these collaborations hinges on members both pooling expertise toward the collaboration's joint goal and leveraging expertise for their own independent goals. Yet, prior research on knowledge transfer does not explain how opportunities for such leveraging are recognized.</p><p><strong>Purposes: </strong>The aim of this research was to better understand the mechanisms through which members of interorganizational collaborations can uncover where there is expertise that could be leveraged toward their independent goals.</p><p><strong>Methodology/approach: </strong>We conducted a multisource qualitative study of a successful interorganizational health care alliance. We inductively analyzed 21 semistructured interviews with representatives from the alliance's 10 member centers and triangulated our findings using 7 years of archival data.</p><p><strong>Results: </strong>We discover that the expertise needed for leveraging toward independent goals is often not pertinent to the alliance's joint goal, such that members must attend to others' independent goals and related expertise to uncover something that could be leveraged toward their own independent goals. Our findings point to the role of membership stability and interpersonal relationships in facilitating expertise leveraging.</p><p><strong>Conclusion: </strong>We highlight the critical role of membership stability in enabling the relationships that foster knowledge transfer and point to several mechanisms that can mitigate the challenges that accompany fluid participation in interorganizational collaborations.</p><p><strong>Practice implications: </strong>Practices that foster stability and the development of interpersonal relationships within interorganizational collaborations may enhance knowledge transfer. When representative stability cannot be preserved, intraorganizational handoffs may be useful for mitigating information loss. Furthermore, systems to keep track of expertise and goals (e.g., dashboards, repositories, routines) could also prove useful in fostering knowledge leveraging.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"327-336"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing the newest member of our editorial team.","authors":"Larry R Hearld, Cheryl Rathert, Jennifer L Hefner","doi":"10.1097/HMR.0000000000000454","DOIUrl":"10.1097/HMR.0000000000000454","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"261"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining team creativity in primary care.","authors":"Yuna S H Lee, Nancy LaVine, Yulia Kogan, Lusine Poghosyan","doi":"10.1097/HMR.0000000000000455","DOIUrl":"10.1097/HMR.0000000000000455","url":null,"abstract":"<p><strong>Background: </strong>Primary care teams are essential to high-quality patient-centered care but face persistent challenges. In other industries, team creativity is well-studied and is gaining traction in health care, particularly in primary care, where it may foster innovation and improvement.</p><p><strong>Purposes: </strong>The aim of this study was to adapt and refine the concept of team creativity for primary care, using management literature to develop a context-specific framework.</p><p><strong>Methodology/approach: </strong>A three-stage empirical design was used. First, team creativity dimensions were identified through a review and thematic analysis of management literature. Second, a panel of 15 primary care experts adapted these dimensions for primary care. Third, a survey of 648 primary care team members in a large health system was followed by exploratory factor analysis to identify core dimensions.</p><p><strong>Results: </strong>Five dimensions of primary care team creativity emerged: team orientation to creativity, team creative processes, job-required creativity, team creative outputs, and leveraging team creativity.</p><p><strong>Conclusion: </strong>Team creativity can be conceptualized and measured in primary care.</p><p><strong>Practice implications: </strong>Primary care teams can apply these five dimensions to generate creative ideas in daily work. Managers can support this by allocating resources, implementing supportive practices, and recognizing creative contributions.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"315-326"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"This stuff matters\": Rural health care leaders and meaningfulness at work.","authors":"Matthew J DePuccio, Alison Coates, Bill Auxier, Erin E Sullivan","doi":"10.1097/HMR.0000000000000457","DOIUrl":"10.1097/HMR.0000000000000457","url":null,"abstract":"<p><strong>Background: </strong>Rural health care leaders face unique stressors and opportunities that shape their experience of meaningfulness at work. Understanding how these leaders derive meaningfulness from their work is critical to fostering well-being and facilitating positive work outcomes.</p><p><strong>Purposes: </strong>We examined how rural health care leaders find meaning in their work and identified the workplace factors that contribute to or undermine their experiences of meaningfulness.</p><p><strong>Methodology/approach: </strong>We conducted 30 semistructured interviews with rural health care leaders to understand the factors contributing to health care leaders' stress and burnout and what they believed could minimize workplace stressors. Interviews were one-on-one, recorded, transcribed, and deidentified before being inductively coded. Three rounds of inductive coding yielded a data structure depicting the first-order concepts, second-order themes, and aggregate dimensions that help explain participants' experiences of meaningfulness at work.</p><p><strong>Results: </strong>Our analysis revealed three broader dimensions related to health care leaders' experiences of meaningfulness at work: relational fulfillment, work impact reinforcement, and strains on meaningfulness. Specifically, health care leaders' experiences of meaningful work were positively shaped by their relationships and impact with employees, patients, and the community and negatively influenced by feeling unappreciated and organizational constraints.</p><p><strong>Practice implications: </strong>Our research identifies opportunities for organizations and boards of directors to foster rural health care leaders' meaningfulness at work by adopting intentional approaches to developing high-quality connections that can offer support, build trust, and make leaders feel valued. Through these efforts, leaders could strengthen their relationships at work and enhance their capabilities to serve better the employees, patients, and communities who benefit from their work.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"50 4","pages":"262-270"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}