Introduction Several studies have investigated the mediating role of overall justice (OJ) in the relationships between specific dimensions of justice and employee attitudes. However, prior research has neglected to examine OJ during the process of organizational change, as suggested in fairness heuristic theory (FHT). Objective This study aims to replicate the results of previous studies and expand them by examining, in two contexts of organizational change implementation, the mediating role of OJ in the relationships between procedural, interpersonal, and informational justice (PJ, ITJ, and IFJ, respectively) and employee attitudes (job satisfaction, turnover intentions, and organizational commitment). Methodology We surveyed 537 employees experiencing a company reorganization (Study 1) and 188 employees experiencing a merger (Study 2). Results Each dimension of justice is related to OJ, which in turn is associated to employee attitudes. Furthermore, bootstrap results indicated that OJ mediates the effects of PJ, ITJ, and IFJ on job satisfaction and turnover intentions (in both studies), and on affective, normative, and continuance commitment (in Study 2). Conclusion Our findings show the importance of fairness during organizational change. Treating employees fairly in times of change is crucial for managers.

Justice and employees’ attitudes during organizational change: The mediating role of overall justice

Les recentes reformes du systeme de sante ont induit des imperatifs paradoxaux : faire mieux avec moins. La situation cree une insatisfaction generale des conditions de travail de la part des soignants, poussant un grand nombre a vouloir abandonner leur profession. Dans une demarche de fidelisation du personnel, le management et la culture organisationnelle ne sont pas negligeables. Le concept de l'hopital attractif, avec ses principes de decentralisation du pouvoir et son management participatif, apporte des solutions partielles a cette problematique. En effet, la litterature sur le sujet recommande que les etablissements de sante soutiennent mieux leurs managers dans leur capacite d'accompagner les equipes a travers une culture favorisant l'empowerment. Mais les principes du modele Magnet et la thematique specifique de « l'empowerment structurel » sont-ils adaptes a la culture des hopitaux en France ? Cet article pose la question de l'application de ce principe fondamental des hopitaux magnetiques dans la culture hospitaliere francaise. L'objectif est d'inciter une reflexion autour du sujet et de proposer que le corps infirmier s'approprie la thematique de la qualite de vie au travail, a l'instar de l'accreditation Magnet aux Etats-Unis.

Is the structural empowerment of “magnet” hospitals conceivable in France? [L’empowerment structurel des hôpitaux « magnétiques » est-il concevable en France ?]

Abstract Aim The aim of this study is to assess the effect of a systemic intervention on the evolution of empowering leadership and emotional exhaustion in a university hospital sub‐centre compared to a control sub‐centre, both being part of a large French university hospital complex. Background Empowering leadership is a promising strategy for developing hospital team engagement and performance. However, the bureaucratic functioning of large hospitals, characterized by a managerial culture of control and a stratified organization, can be a barrier to empowering leadership. Methods The intervention included empowering leadership training, direct field experimentation of empowering leadership and coaching, involving all the sub‐centre hierarchical levels for 12 months. Data were collected before and after the intervention. A total of 441 and 310 participants were, respectively, included in the intervention and control sub‐centres. Results Empowering leadership was decreased, and emotional exhaustion was increased in the control sub‐centre, while the scores remained stable in the intervention sub‐centre. The increased emotional exhaustion in the control sub‐centre could partially be explained by the change in empowering leadership. Conclusion In a context of decreased empowering leadership and increased emotional exhaustion, the intervention had a protective effect. Implications for the design of future interventions were discussed. Implications for Nursing Management This study unequivocally showed the benefit of transforming hospital management towards empowering leadership, to prevent increased emotional exhaustion. Registration number This study is registered on ClinicalTrials.gov on 4 July 2019 (NCT04010773).

Impact of empowering leadership on emotional exhaustion: A controlled interventional study in a large French university hospital complex

Paving the way to reduce work-stress in rehabilitation nurses: Promising results from a pilot study.

Work stress (WS) is a set of harmful physical and emotional reactions that occur when the demands coming from work are not adequate to the skills, resources, or needs of the worker. This causes physical, mental, psychological, or social suffering and dysfunction, which can lead to burnout syndrome.The aim of this study is to evaluate WS in the healthcare professions, evaluating the effectiveness of a professional stress prevention program to promote a reduction in WS.Thirty-three healthcare professionals of the Multiple Sclerosis (MS) rehab ward of the IRCCS Neurolesi (Messina, Italy) were enrolled in this study. The professional stress prevention program was based on group support activities, as well as individual support.At baseline, we found a high burnout risk in physiotherapists, physicians, and other healthcare professionals. At the end of the meetings, we found a normalization in WS, with a higher sense of personal realization in all of the health-professions, and a greater use of functional coping strategies.The occupational stress-reducing intervention in healthcare teams can promote a reduction of stress and anxiety, encouraging more functional coping strategies to face work difficulties. 

Improving Healthcare Professional Psychological Well-being in Neurorehabilitation: An Exploratory Study Focusing on Work Stress.

Empowerment of hospital workers is known as a key factor of organizational performance and occupational health. Nevertheless, empowering workers remains a real challenge. As in many traditional organizations, hospitals follow a bureaucratic model defined by a managerial culture of control and a stratified organization, which at once weaken professionals’ mastery of their work and hinder their commitment and performance. Based on the existing literature this protocol describes a new managerial and organizational transformation program as well as the study design of its effect on worker empowerment in a large French public hospital. The project is funded by the French Ministry of Health for a total of 498,180 €. This study is a randomized controlled trial conducted in a French university hospital complex (CHU). The CHU comprises 12 sub-centers (SC) with about 20 care units and 1000 employees each. Randomization is performed at SC level. The intervention lasts 12 months and combines accompaniment of healthcare teams, frontline managers and SC directors to empower first-line professionals in the experimental SC. Quantitative outcome measurements are collected over 2 years during mandatory check-ups in the occupational medicine department. The primary outcomes are structural and psychological empowerment, motivational processes, managerial practices, working conditions, health and performance. Mixed linear modeling is the primary data analysis strategy. The protocol was approved by the CHU health ethics committee. The results of the analysis of the intervention effects will be reported in a series of scientific articles. The results will contribute to reflection on prevention and management policies, and to the development of Workplace Quality-of-Life. If the intervention is a success, the system will warrant replication in other SCs and in other health facilities. The study was retrospectively registered at ClinicalTrials.gov on July 4, 2019 (NCT04010773).

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Impact at two years of an intervention on empowerment among medical care teams: study protocol of a randomised controlled trial in a large French university hospital.

Johan Lesot

Papers

Impact at two years of an intervention on empowerment among medical care teams: study protocol of a randomised controlled trial in a large French university hospital.