What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians, nurses and managers looking at Breast Cancer and Acute Myocardial Infarction care in nine countries

Julia Köppen (Corresponding Author), Claudia B. Maier, Reinhard Busse, MUNROS team

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.
Original languageEnglish
Pages (from-to)1118-1125
Number of pages8
JournalHealth Policy
Volume122
Issue number10
Early online date26 Jul 2018
DOIs
Publication statusPublished - Oct 2018

Fingerprint

Nurse Administrators
Myocardial Infarction
Nurses
Breast Neoplasms
Physicians
Health
Health Manpower
Intrinsic Factor
Czech Republic
Salaries and Fringe Benefits
Scotland
Poland
Norway
Turkey
England
Netherlands
Mental Competency
Italy
Observational Studies
Germany

Keywords

  • Motivation
  • Physicians
  • Nurses
  • Personnel Administration
  • Hospital
  • Health workforce
  • New Roles

Cite this

What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians, nurses and managers looking at Breast Cancer and Acute Myocardial Infarction care in nine countries. / Köppen, Julia (Corresponding Author); Maier, Claudia B.; Busse, Reinhard; MUNROS team.

In: Health Policy, Vol. 122, No. 10, 10.2018, p. 1118-1125.

Research output: Contribution to journalArticle

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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.",
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author = "Julia K{\"o}ppen and Maier, {Claudia B.} and Reinhard Busse and {MUNROS team} and Christine Bond and Robert Elliott and Hanne Bruhn and Debbie Mclaggan and Marie Zvonickova and Daniel Hodyc and Hana Svobodov{\'a} and Matthew Sutton and Jonathan Gibson and Anne McBride and Britta Zander and Silvia Coretti and Matteo Ruggeri and {van Exel}, Job and {de Bont}, Antoinette and Marianne Luyendjk and Askildsen, {Jan Erik} and Islam, {Muhammad Kamrul} and Jon Opsahl and Alicja Sobczak and Grazyna Dykowska and Małgorzata Winter and Sabina Ostrowska and Michal Mijal and Seda Basihos and Meryem Dogan and {G{\"u}ldem {\"O}kem}, Z.",
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].",
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T2 - A study among physicians, nurses and managers looking at Breast Cancer and Acute Myocardial Infarction care in nine countries

AU - Köppen, Julia

AU - Maier, Claudia B.

AU - Busse, Reinhard

AU - MUNROS team

AU - Bond, Christine

AU - Elliott, Robert

AU - Bruhn, Hanne

AU - Mclaggan, Debbie

AU - Zvonickova, Marie

AU - Hodyc, Daniel

AU - Svobodová, Hana

AU - Sutton, Matthew

AU - Gibson, Jonathan

AU - McBride, Anne

AU - Zander, Britta

AU - Coretti, Silvia

AU - Ruggeri, Matteo

AU - van Exel, Job

AU - de Bont, Antoinette

AU - Luyendjk, Marianne

AU - Askildsen, Jan Erik

AU - Islam, Muhammad Kamrul

AU - Opsahl, Jon

AU - Sobczak, Alicja

AU - Dykowska, Grazyna

AU - Winter, Małgorzata

AU - Ostrowska, Sabina

AU - Mijal, Michal

AU - Basihos, Seda

AU - Dogan, Meryem

AU - Güldem Ökem, Z.

N1 - 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].

PY - 2018/10

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N2 - 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.

AB - 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.

KW - Motivation

KW - Physicians

KW - Nurses

KW - Personnel Administration

KW - Hospital

KW - Health workforce

KW - New Roles

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DO - 10.1016/j.healthpol.2018.07.018

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VL - 122

SP - 1118

EP - 1125

JO - Health Policy

JF - Health Policy

SN - 0168-8510

IS - 10

ER -