Longitudinal associations between organizational change, work-unit social capital, and employee exit from the work unit among public healthcare workers: a mediation analysis

Abstract

Objectives Organizational changes are associated with higher rates of subsequent employee exit from the workplace, but the mediating role of social capital is unknown. We examined the associations between organizational changes and subsequent employee exit from the work unit and mediation through social capital. Methods Throughout 2013, 14 059 healthcare employees worked in the Capital Region of Denmark. Data on work-unit changes (yes/no) from July‒December 2013 were collected via a survey distributed to all managers (merger, split-up, relocation, change of management, employee layoff, budget cuts). Eight employee-reported items assessing social capital were aggregated into work-unit measures (quartiles: low-high). Data on employee exit from the work unit in 2014 were obtained from company registries. Results We found a somewhat higher rate of employee exit from the work unit after changes versus no changes [hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.01-1.19] and an inverse dose‒response relationship between social capital and employee-exit rates (low versus high: HR 1.65, 95% CI 1.46-1.86). We also showed a higher risk of low social capital in work units exposed to changes [low versus high: odds ratio (OR) 2.04, 95% CI 1.86-2.23]. Accounting for potential mediation through social capital seemed slightly to reduce the association between changes and employee-exit rates (HR 1.07, 95% CI 0.98-1.16 versus HR 1.10). Conclusions Work-unit organizational changes prospectively predict lower work-unit social capital, and lower social capital is associated with higher employee-exit rates. Detection of weak indications of mediation through social capital, if any, were limited by inconsistent associations between changes and employee exit from the work unit.

Can a participatory organizational intervention improve social capital and organizational readiness to change? Cluster randomized controlled trial at five Danish hospitals

“…Public health research has in recent years provided evidence of a relationship between workplace social capital and individual worker health. Low social capital has been associated with several health‐ and work‐related factors, i.e., poor self‐rated health (Oksanen et al., 2008), a higher risk of mental‐health problems (Oksanen, Kouvonen, Vahtera, Virtanen, & Kivimaki, 2010; Tsuboya, Tsutsumi, & Kawachi, 2015), sickness absence (De Clercq et al., 2015; Rugulies, Hasle, Pejtersen, Aust, & Bjorner, 2016; Török et al., 2018), burnout (Kowalski et al., 2010), presentism, high exit rates (Jensen, Flachs, Skakon, Rod, & Bonde 2019), early retirement (Breinegaard, Jensen, & Bonde, 2017), individual well‐being, trust, and cooperation among colleagues and efficiency in production processes (Hasle & Møller, 2007). On the other hand, having both moderate and high social capital may buffer against perceived stress (Jay & Andersen, 2018).…”

Examining the Experiences of Remaining Employees after a Coworker Dismissal: Initial Message Characteristics, Information Seeking, Uncertainty, and Perceived Social Costs

“…Practically, the current study can help managers communicate coworker dismissals more effectively with remaining employees. The potentially adverse effects of organizational change should be considered when reorganizing a workplace (Jenson et al, 2018), in both small-scale and large-scale organizational change. First, managers should be aware of the role the grapevine plays in the distribution of information.…”

Advancing mediation analysis in occupational health research

“…When a mediator is a modifiable risk factor, this opens up new opportunities for interventions to block (part) of the exposure's effect on the outcome. Recent examples in Scandinavian Journal of Work Environment Health have addressed the mediating effect of wellbeing on the association between type of office and job satisfaction (1) and examined whether workplace social capital contributes to the association between organizational changes and employee exit from work (2).…”