背景:评估组织的内部动态已被证明可以提供可以帮助计划者和决策者改善服务交付的信息。良好的组织氛围,在这项研究中纳入了任务的明确性,团队凝聚力,员工自主权,通信,压力水平,对变革的开放已被证明特别重要。尽管如此,这方面缺乏证据,虽然已经确定了组织因素之间的关系,对可能支撑这些关系的机制知之甚少,一旦发现赤字,人们对如何解决赤字知之甚少。这项研究的目的是确定影响组织氛围的计划因素之间的关系,并探索哪些机制可以支撑这些关系。
方法:本文报告了一个横截面,并发,混合方法研究设计,在爱尔兰的12个离散的基于社区的处方服务提供商(组织)中。数据是使用员工调查[n=132]获得的,该调查利用了组织变革准备程度的测量和一对一的访谈[n=12]。定量数据分析使用多元线性回归模型,评估变量之间的关系,虽然采访是用绑架的方法分析的,两种类型的数据在解释阶段进行了综合.
结果:一系列相互依赖的因素被认为会影响组织的气候。调查发现,特定类型的资源,例如物理基础设施,培训,人力资源对于支持良好的组织氛围很重要,而需求更大的项目气候较差。职业成长的机会,员工的技能,并且可以使用电子通信也很重要。受访者报告说,僵化的组织等级制度和官僚主义,成瘾的哲学观点,压力,和工作人员更替受到资源供应减少的影响。相互依存的因素,如领导力,监督,员工关系,集体训练,也被认为受到资源的影响,被认为对项目有积极影响。资源并不是唯一的挑战,和实践中的方案和现有的资源是如何使用也被认为是贡献积极和消极的内部动态的服务。
结论:这项研究的主要发现表明,有效服务的组织受到一系列特定因素的影响,其中一些问题可以在没有额外资源的情况下解决。总的来说,员工对组织的看法可以为我们提供有价值的信息,以支持服务改进。使用混合方法方法不仅可以识别组织变量之间存在的关系,而且还可以帮助我们理解支撑这些关系的机制,重要的是,一旦发现赤字,如何解决赤字。为了改善物质滥用服务的工作方式,需要长期的系统方法来开发项目,其中包含了这项研究的一些发现,是必需的。
BACKGROUND: Assessing the internal dynamics of organizations has been shown to provide information that can help planners and policymakers improve service delivery. A good organizational climate, which in this study incorporates mission clarity, team cohesion, staff autonomy, communication, levels of stress, and openness to change has been shown to be of particular importance. Still, there is a dearth of evidence in this area, and while relationships between organizational factors have been identified, little is known about the mechanisms that might underpin these relationships, and there is little understanding of how to address deficits once they are identified. The objective of this study was to identify relationships between program factors that influence organizational climate and to explore which mechanisms might underpin these relationships.
METHODS: This paper reports on a cross-sectional, concurrent, mixed-methods study design, across twelve discrete community-based prescribing service providers (organizations) in Ireland. Data was obtained using a staff survey [n = 132] which utilized measurements of organizational readiness to change and one-to-one interviews [n = 12]. Quantitative data was analyzed using multivariate linear regression modeling which assessed relationships between variables, while interviews were analyzed using an abductive approach, both types of data were synthesized at the interpretation stage.
RESULTS: A range of interdependent factors were considered to affect the climate of organizations. Surveys identified that specific types of resources, such as physical infrastructure, training, and staffing resources were important for supporting a good organizational climate, while programs with greater needs had a poorer climate. Opportunities for professional growth, the skill sets of staff, and having access to e-communication were also significant. Interviewees reported that rigid organizational hierarchies and bureaucracy, philosophical views of addiction, stress, and staff turnover were influenced by the provision of fewer resources. Interdependent factors such as leadership, supervision, staff relationships, and collective training, also thought to be influenced by resources, were considered to positively influence programs. Resources were not the only challenge identified, and practices within programs and how existing resources are used were also thought to contribute both positively and negatively to the internal dynamics of services.
CONCLUSIONS: Key findings in this study identified that the organization of effective services is influenced by a range of specific factors, some of which can be addressed without additional resources. Overall, staff views of organizations can provide us with valuable information to support service improvement. Using a mixed methods approach can not only identify where relationships between organizational variables exist but can also help us to understand the mechanisms that underpin these relationships and, importantly, how to address deficits once they are identified. In order to improve how substance misuse services work, the need for a long-term systemic approach to program development, which incorporates some of the findings from this study, is required.