我们旨在探索潜在的机制和背景条件,通过这些机制和背景条件,领导可能会影响摩洛哥医院医疗服务提供者的“公共服务动机”。
我们在以下步骤中使用了现实主义评估(RE)方法:引出初始程序理论,设计研究,进行数据收集,进行数据分析和综合。在实践中,我们采用了多个嵌入式案例研究设计。
我们使用目的性抽样来选择代表极端病例的医院,这些医院使用2011年至2016年卫生部质量保证计划的数据进行了对比的领导实践和组织绩效得分。
我们执行,平均而言,在4家医院进行了17次个人深入访谈,并与不同干部进行了7次焦点小组讨论和8次小组讨论(管理人员,护士和医生)。我们收集了相关文件(例如,绩效审计,人力资源可用性)并进行了观察。
比较医院的干预-背景-参与者-机制-结果配置,使我们能够确认和完善我们的以下计划理论:“复杂的领导者,应用适当的交易组合,适应组织和个人特征的转型和分布式领导风格[I]可以增加公共服务动机,组织承诺和额外的角色行为[O]通过增加感知的主管支持和感知的组织支持和满足员工的基本心理需求[M],如果组织文化是有利的,并且在没有感知到的组织政治的情况下[C]\“。
在医院,复杂的职业官僚机构的原型,领导者需要能够根据员工的个人资料在不同的领导风格之间取得平衡,任务的性质和组织文化,如果他们想增强公共服务的动机,内在动机和组织承诺。
We aimed at exploring the underlying mechanisms and contextual conditions by which leadership may influence \'public service motivation\' of health providers in Moroccan hospitals.
We used the realist evaluation (RE) approach in the following steps: eliciting the initial programme theory, designing the study, carrying out the data collection, doing the data analysis and synthesis. In practice, we adopted a multiple embedded
case study design.
We used purposive sampling to select hospitals representing extreme cases displaying contrasting leadership practices and organisational performance scores using data from the Ministry of Health quality assurance programmes from 2011 to 2016.
We carried out, on average, 17 individual in-depth interviews in 4 hospitals as well as 7 focus group discussions and 8 group discussions with different cadres (administrators, nurses and doctors). We collected relevant documents (eg, performance audit, human resource availability) and carried out observations.
Comparing the Intervention-Context-Actor-Mechanism-Outcome configurations across the hospitals allowed us to confirm and refine our following programme theory: \"Complex leaders, applying an appropriate mix of transactional, transformational and distributed leadership styles that fit organisational and individuals characteristics [I] can increase public service motivation, organisational commitment and extra role behaviours [O] by increasing perceived supervisor support and perceived organizational support and satisfying staff basic psychological needs [M], if the organisational culture is conducive and in the absence of perceived organisational politics [C]\".
In hospitals, the archetype of complex professional bureaucracies, leaders need to be able to balance between different leadership styles according to the staff\'s profile, the nature of tasks and the organisational culture if they want to enhance public service motivation, intrinsic motivation and organisational commitment.