打破国家医疗服务体系中的不平等复制循环:高级管理团队行动的重要性(SMTA)

IF 2.7 3区 管理学 Q2 INDUSTRIAL RELATIONS & LABOR
Wen Wang, Roger Seifert, Matthew Bamber
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引用次数: 0

摘要

目的本研究探讨了英国国家医疗服务体系(NHS)中以关键绩效指标(KPIs)为中心的管理方式如何打破少数族裔医务工作者所面临的不平等再生产循环。该研究通过信号理论的视角来实现这一目的。设计/方法/途径从英国国家医疗服务系统(NHS)年度员工调查中编制了 2018-2020 年三年的面板数据,涵盖 207 家医院,并与相关行政记录进行了匹配。结构方程模型用于在组织层面检验提出的假设。研究结果调节中介模型揭示了管理者和同事持续的种族歧视会不利于少数民族医务工作者的职业发展,这反过来又强化和复制了他们之间的经济和健康不平等。更重要的是,我们展示了高级管理团队就员工反馈意见采取行动(SMTA)这一集体协议如何打破这一恶性循环。研究局限/意义虽然我们的研究侧重于非营利性医疗保健领域,但它为扩展拟议模型以了解组织不平等现象以及如何解决这一问题提供了重要机会。社会意义本文揭示了为什么提供公共服务以减少社会不平等的组织的宗旨会在其商业化运作过程中被弱化,更重要的是,如何通过管理实践来体现其根本宗旨。原创性/价值本研究通过解读不平等的再生产过程,以及更重要的是,如何打破这种恶性循环,为解决非营利部门以 KPI 为中心的管理所带来的意外后果之一提供了一条前进的道路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Breaking the inequality reproduction circle in the NHS: the importance of senior management team's actions (SMTA)

Purpose

This study examines potential ways to break the inequality reproduction circle faced by ethnic minority health workers and sustained by key performance indicators (KPIs)-centred management in the National Health Service (NHS) in England. It does so through the lens of signalling theory.

Design/methodology/approach

Three years panel data for 2018–2020 covering 207 hospitals was compiled from the annual NHS staff survey and matched with relevant administrative records. Structural equation modelling was used to test the proposed hypotheses at the organisational level.

Findings

The moderated mediating model reveals that persistent racial discrimination by managers and coworkers can disadvantage the career progression of ethnic minority health workers, which in turn reinforces and reproduces economic and health inequalities among them. More importantly, we show how the collective agreement that the senior management team acts (SMTA) on staff feedback can break this vicious circle.

Research limitations/implications

While our research focuses on the not-for-profit health care sector, it opens important opportunities to extend the proposed model to understand organisational inequality and how to address it.

Practical implications

Perceived SMTA can send strong signals to reduce deep-rooted discrimination (race, gender, age, etc.) through resource allocations and instrumental functions. This is also a way to address the current staff burnout and shortage issues in the healthcare sector.

Social implications

This article reveals why the purpose of organisations that provide public service to reduce social inequality was comprised during their business-like operations and more importantly, how to reflect their foundational purpose through management practice.

Originality/value

This study offers a way forward to resolve one of the unintended consequences of KPI-centred management in the not-for-profit sector through unpacking the process of inequality reproduction and, more importantly, how it is possible to break this vicious circle.

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来源期刊
Employee Relations
Employee Relations Multiple-
CiteScore
6.50
自引率
8.80%
发文量
69
期刊介绍: ■Communication, participation and involvement ■Developments in collective bargaining ■Equal opportunities ■Health and safety ■HRM ■Industrial relations and employment protection law ■Industrial relations management and reform ■Organizational change and people ■Personnel and recruitment ■Quality of working life
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