Impact of productivity on cross-training configurations and optimal staffing decisions in hospitals

Gnanlet, Adelina; Gilland, Wendell G.

doi:10.1016/j.ejor.2014.03.033

Cited by 32 publications

(21 citation statements)

References 40 publications

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“…Lean theory, concretely Manos and Vincent (2012), believes that one of the greatest advantages that an organization can have is its own flexibility, which is also shared by Brusco and Johns (1998), and the ability to adapt to new situations and avoid bottlenecking. The lean thinking theory provides these characteristics to an organization by means of the cross-training tool as both Manos and Vincent (2012) together with Gnanlet and Gilland (2014) state. Furthermore, Tyagi et al (2015) stated in their research that cross-training helps a team member to perform a wide range of activities enhancing flexibility and greater idea generation capabilities.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

How does the employee cross-training lean tool affect the knowledge transfer in product development processes?

Stanica

Peydro

2016

VJIKMS

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Purpose This paper aims to study the challenge of transferring knowledge among product development processes of an research and development department and other departments of the organization. To have a more concise focus on this broad field and having a lean perspective, this paper aims to analyse and identify how the cross-training employee lean tool affects the knowledge transfer processes in the previously mentioned departments. Design/methodology/approach This paper bases its research on a valid theoretical framework which is built to develop an explorative perspective that allows the authors to create and interpret the data collected from the companies through interviews. The paper uses a qualitative perspective by using the expertise of the companies not only to validate and draw conclusions from the studied theoretical framework but also to look beyond it. Findings The companies agree that the implementation of the cross-training employee lean tool will have a positive effect on the knowledge transfer processes in the organizations. Other important advantages that are detected are that this lean tool broadens the knowledge and the competences of employees, and that it helps the company to manage the tacit knowledge. However, some unexpected drawbacks such as the lack of metrics for measuring the knowledge transfer and the strictness of this lean tool were also found. Originality/value No previous research exists that analyses the effect of cross-training lean tool in knowledge transfer processes. This paper identifies such a gap in the literature and is used as the starting point to motivate the use of this tool to improve knowledge transfer processes due to the positive effects of it.

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Section: Theoretical Frameworkmentioning

confidence: 99%

How does the employee cross-training lean tool affect the knowledge transfer in product development processes?

Stanica

Peydro

2016

VJIKMS

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“…First, the healthcare sector constitutes a substantial component of many economies (e.g., 17.9% of the US GDP; Martin et al , 2018). Moreover, healthcare organizations constitute a critical context where compelling arguments exist in favor of the flexible assignment of personnel (Abrams and Berge, 2010; Gnanlet and Gilland, 2014; Manelski et al , 2013) as well as against it, because of its predicted detrimental effects on patient outcomes (e.g., Aiken et al , 2007; Bae et al , 2010).…”

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confidence: 99%

The impact of the use of employee functional flexibility on patient safety

Salvador

Gnanlet

McDermott

2020

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PurposeThe purpose of this study is to examine the effect of the use of unit-level functional flexibility on one particular patient outcome, unit-acquired pressure ulcers, and the potential moderating influences of coworker support and workload.Design/methodology/approachThis study uses an archival approach, examining data from 68 hospital units.FindingsThe results indicate that a unit's higher use of functionally flexible nurses in one-quarter was associated with a higher number of pressure ulcers among the unit's patients the following quarter. This detrimental effect was significantly diminished when coworker support within the unit was high. Unit-level nurse workload did not have any moderating influence.Research limitations/implicationsOne of the scholarly contributions of this study is that it links greater use of functionally flexible employees to a negative patient safety outcome at the unit level. As most of the variables used in the study were archival measures, future research could examine the replicability of these findings using other indicators and measures.Practical implicationsBeyond healthcare settings, the results prompt managers in industries where there has been growing use of functional flexibility (e.g., banking) to think about the associated unintended negative consequences. That said, the results also point to coworker instrumental support as a means by which to mitigate negative outcomes.Originality/valueAlthough functional flexibility has been shown to positively correlate with a number of organizational performance indicators, this is one of the very few studies that has examined its negative consequences, particularly on patient safety.

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“…Further, studies have shown that nursing overtime is not only caused by patient acuity but by the available workforce (off-duty nurses, bedside nurses planned for work, etc.). 35 Consequently, overtime is influenced by numerous factors and not only unit occupancy and patient acuity.…”

Section: Discussionmentioning

confidence: 99%

Association of Nursing Overtime, Nurse Staffing, and Unit Occupancy with Health Care–Associated Infections in the NICU

et al. 2017

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This study aims to assess the association of nursing overtime, nurse staffing, and unit occupancy with health care-associated infections (HCAIs) in the neonatal intensive care unit (NICU). A 2-year retrospective cohort study was conducted for 2,236 infants admitted in a Canadian tertiary care, 51-bed NICU. Daily administrative data were obtained from the database "Logibec" and combined to the patient outcomes database. Median values for the nursing overtime hours/total hours worked ratio, the available to recommended nurse staffing ratio, and the unit occupancy rate over 3-day periods before HCAI were compared with days that did not precede infections. Adjusted odds ratios (aOR) that control for the latter factors and unit risk factors were also computed. A total of 122 (5%) infants developed a HCAI. The odds of having HCAI were higher on days that were preceded by a high nursing overtime ratio (aOR, 1.70; 95% confidence interval [95% CI], 1.05-2.75, quartile [Q]4 vs. Q1). High unit occupancy rates were not associated with increased odds of infection (aOR, 0.85; 95% CI, 0.47-1.51, Q4 vs. Q1) nor were higher available/recommended nurse ratios (aOR, 1.16; 95% CI, 0.67-1.99, Q4 vs. Q1). Nursing overtime is associated with higher odds of HCAI in the NICU.

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Impact of productivity on cross-training configurations and optimal staffing decisions in hospitals

Cited by 32 publications

References 40 publications

How does the employee cross-training lean tool affect the knowledge transfer in product development processes?

How does the employee cross-training lean tool affect the knowledge transfer in product development processes?

The impact of the use of employee functional flexibility on patient safety

Association of Nursing Overtime, Nurse Staffing, and Unit Occupancy with Health Care–Associated Infections in the NICU

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