Showing papers by "Deanne N. Den Hartog published in 2020"

Uncertainty avoidance moderates the relationship between transformational leadership and innovation: A meta-analysis

Abstract: Transformational leadership is commonly assumed to facilitate employee innovation in all cultures. Drawing upon field studies from 17 countries, this meta-analysis revealed that supervisor transformational leadership is positively related to individual- and team-level innovation regardless of national boundaries. However, the relationship trended somewhat more strongly in countries with higher levels of uncertainty avoidance. These findings suggest that employee innovation in most countries can be enhanced by investing in supervisor transformational leadership, but organizations operating in countries with higher levels of uncertainty avoidance may benefit more from this strategy.

Ethical and Passive Leadership and Their Joint Relationships with Burnout via Role Clarity and Role Overload

Abstract: Burnout has important ramifications for employees and organizations and preventing burnout forms an ethical issue for managers. However, the role of the leader and especially the role of ethical aspects of leadership have received relatively little attention in relation to burnout to date. We conducted a survey among employees (N = 386) of a Dutch retail organization, nested in 122 teams with a leader. Our first contribution is that we empirically show the hypothesized opposing relationships of ethical and passive leadership behavior with follower burnout. Furthermore, we examined two job characteristics as mechanisms that link these forms of leadership and burnout. Lastly, we show that the positive relationship of ethical leadership with burnout via role clarity (but not overload) is dependent on the degree of passive leadership the leader is perceived to display. Our results suggest that organizations should promote ethical leadership behaviors and limit passive leadership behaviors by stimulating leaders to be active in their role and use their social influence to promote ethical conduct.

Trauma models to identify major trauma and mortality in the prehospital setting.

Abstract: Background Patients with major trauma might benefit from treatment in a trauma centre, but early identification of major trauma (Injury Severity Score (ISS) over 15) remains difficult. The aim of this study was to undertake an external validation of existing prognostic models for injured patients to assess their ability to predict mortality and major trauma in the prehospital setting. Methods Prognostic models were identified through a systematic literature search up to October 2017. Injured patients transported by Emergency Medical Services to an English hospital from the Trauma Audit and Research Network between 2013 and 2016 were included. Outcome measures were major trauma (ISS over 15) and in-hospital mortality. The performance of the models was assessed in terms of discrimination (concordance index, C-statistic) and net benefit to assess the clinical usefulness. Results A total of 154 476 patients were included to validate six previously proposed prediction models. Discriminative ability ranged from a C-statistic value of 0·602 (95 per cent c.i. 0·596 to 0·608) for the Mechanism, Glasgow Coma Scale, Age and Arterial Pressure model to 0·793 (0·789 to 0·797) for the modified Rapid Emergency Medicine Score (mREMS) in predicting in-hospital mortality (11 882 patients). Major trauma was identified in 52 818 patients, with discrimination from a C-statistic value of 0·589 (0·586 to 0·592) for mREMS to 0·735 (0·733 to 0·737) for the Kampala Trauma Score in predicting major trauma. None of the prediction models met acceptable undertriage and overtriage rates. Conclusion Currently available prehospital trauma models perform reasonably in predicting in-hospital mortality, but are inadequate in identifying patients with major trauma. Future research should focus on which patients would benefit from treatment in a major trauma centre.

The Dutch nationwide trauma registry: The value of capturing all acute trauma admissions

Abstract: Introduction: Twenty years ago the Dutch trauma care system was reformed by the designating 11 level one Regional trauma centres (RTCs) to organise trauma care. The RTCs set up the Dutch National Trauma Registry (DNTR) to evaluate epidemiology, patient distribution, resource use and quality of care. In this study we describe the DNTR, the incidence and main characteristics of Dutch acutely admitted trauma patients, and evaluate the value of including all acute trauma admissions compared to more stringent criteria applied by the national trauma registries of the United Kingdom and Germany. Methods: The DNTR includes all injured patients treated at the ED within 48 hours after trauma and consecutively followed by direct admission, transfers to another hospital or death at the ED. DNTR data on admission years 2007-2018 were extracted to describe the maturation of the registry. Data from 2018 was used to describe the incidence rate and patient characteristics. Inclusion criteria of the Trauma Audit and Research (TARN) and the Deutsche Gesellschaft fur Unfallchirurgie (DGU) were applied on 2018 DNTR data. Results: Since its start in 2007 a total of 865,460 trauma cases have been registered in the DNTR. Hospital participation increased from 64% to 98%. In 2018, a total of 77,529 patients were included, the median age was 64 years, 50% males. Severely injured patients with an ISS≥16, accounted for 6% of all admissions, of which 70% was treated at designated RTCs. Patients with an ISS≤ 15were treated at non-RTCs in 80% of cases. Application of DGU or TARN inclusion criteria, resulted in inclusion of respectively 5% and 32% of the DNTR patients. Particularly children, elderly and patients admitted at non-RTCs are left out. Moreover, 50% of ISS≥16 and 68% of the fatal cases did not meet DGU inclusion criteria Conclusion: The DNTR has evolved into a comprehensive well-structured nationwide population-based trauma register. With 80,000 inclusions annually, the DNTR has become one of the largest trauma databases in Europe The registries strength lies in the broad inclusion criteria which enables studies on the burden of injury and the quality and efficiency of the entire trauma care system, encompassing all trauma‐receiving hospitals.