Abstract
Background Many European countries experience health workforce skill-mix challenges due to demographic changes, multimorbidity and medical technology. Yet, there is limited cross-country research in hospitals.
Methods Cross sectional, observational study on staff role changes and contributing factors in nine European countries. Survey of physicians, nurses and managers (n = 1,524) in 112 hospitals treating patients with breast cancer or acute myocardial infarction. Group differences were analysed across country clusters (skill-mix reform countries [England, Scotland and the Netherlands] vs. no reform countries [Czech Republic, Germany, Italy, Norway, Poland and Turkey]) and stratified by physicians, nurses and managers, using Chi-squared, Mann-Whitney U and Kruskal Wallis tests.
Results Nurses in countries with major skill-mix reforms reported more frequently being motivated to undertake a new role (66.5%) and having the opportunity to do so (52.4%), compared to nurses in countries with no or minor reforms (39.2%; 24.8%; p < .001 each). Physicians and nurses considered intrinsic motivating factors (personal satisfaction, use of qualifications) more motivating than extrinsic factors (salary, career opportunities). Reported barriers were workforce shortages, facilitators were professional and management support. Managers’ recruitment decisions on choice of staff were mainly influenced by skills, competences and experience of staff.
Conclusion Managers need to know the motivational factors of their employees and enabling versus hindering factors within their organisations to govern change effectively.
Methods Cross sectional, observational study on staff role changes and contributing factors in nine European countries. Survey of physicians, nurses and managers (n = 1,524) in 112 hospitals treating patients with breast cancer or acute myocardial infarction. Group differences were analysed across country clusters (skill-mix reform countries [England, Scotland and the Netherlands] vs. no reform countries [Czech Republic, Germany, Italy, Norway, Poland and Turkey]) and stratified by physicians, nurses and managers, using Chi-squared, Mann-Whitney U and Kruskal Wallis tests.
Results Nurses in countries with major skill-mix reforms reported more frequently being motivated to undertake a new role (66.5%) and having the opportunity to do so (52.4%), compared to nurses in countries with no or minor reforms (39.2%; 24.8%; p < .001 each). Physicians and nurses considered intrinsic motivating factors (personal satisfaction, use of qualifications) more motivating than extrinsic factors (salary, career opportunities). Reported barriers were workforce shortages, facilitators were professional and management support. Managers’ recruitment decisions on choice of staff were mainly influenced by skills, competences and experience of staff.
Conclusion Managers need to know the motivational factors of their employees and enabling versus hindering factors within their organisations to govern change effectively.
| Original language | English |
|---|---|
| Pages (from-to) | 1118-1125 |
| Number of pages | 8 |
| Journal | Health Policy |
| Volume | 122 |
| Issue number | 10 |
| Early online date | 26 Jul 2018 |
| DOIs | |
| Publication status | Published - Oct 2018 |
Bibliographical note
We thank all those who supported and guided this work both within the MUNROS research project team and external partners and advisory board members. In particular, we acknowledge and highly appreciate the valuable support provided by Christine Bond, and Robert Elliott, the MUNROS Co-Principal Investigators. We acknowledge group authorship of the MUNROS collaboration group and thank all MUNROS researchers and project partners for their constructive collaboration during the research.Funding
This work was supported by the European Union under the European Community’s Seventh Framework Programme (FP7 HEALTH-2012-INNOVATION-1) [grant agreement number HEALTH-F3-2012-305467EC, 2012].
Keywords
- Motivation
- Physicians
- Nurses
- Personnel Administration
- Hospital
- Health workforce
- New Roles
Access to Document
- Accepted Manuscript
© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/