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Articles 1 - 13 of 13
Full-Text Articles in Labor Relations
Superbugs Versus Outsourced Cleaners: Employment Arrangements And The Spread Of Health Care-Associated Infections, Adam Seth Litwin, Ariel C. Avgar, Edmund R. Becker
Superbugs Versus Outsourced Cleaners: Employment Arrangements And The Spread Of Health Care-Associated Infections, Adam Seth Litwin, Ariel C. Avgar, Edmund R. Becker
Adam Seth Litwin
On any given day, about one in 25 hospital patients in the United States has a health care–associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners—“environmental services” (EVS) in hospital parlance—must take on the important task of defending hospital patients (as well as staff and the broader community) from the spread of HAIs. Despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached …
Measurement Error In Performance Studies Of Health Information Technology: Lessons From The Management Literature, Adam Seth Litwin, Ariel Avgar, Peter Pronovost
Measurement Error In Performance Studies Of Health Information Technology: Lessons From The Management Literature, Adam Seth Litwin, Ariel Avgar, Peter Pronovost
Adam Seth Litwin
Just as researchers and clinicians struggle to pin down the benefits attendant to health information technology (IT), management scholars have long labored to identify the performance effects arising from new technologies and from other organizational innovations, namely the reorganization of work and the devolution of decision-making authority. This paper applies lessons from that literature to theorize the likely sources of measurement error that yield the weak statistical relationship between measures of health IT and various performance outcomes. In so doing, it complements the evaluation literature’s more conceptual examination of health IT’s limited performance impact. The paper focuses on seven issues, …
Explaining The Health Information Technology Paradox, Ariel Avgar, Adam Seth Litwin
Explaining The Health Information Technology Paradox, Ariel Avgar, Adam Seth Litwin
Adam Seth Litwin
Excerpt] The substantial gap between the promise inherent in upgrading information systems in health care and the documented reality has baffled health care scholars. Why is a technology so clearly capable of creating efficiencies, increasing safety, and promoting greater information sharing and coordination across professionals failing to live up to expectations?
Review Of Cleaning Up: How Hospital Outsourcing Is Hurting Workers And Endangering Patients, Adam Seth Litwin
Review Of Cleaning Up: How Hospital Outsourcing Is Hurting Workers And Endangering Patients, Adam Seth Litwin
Adam Seth Litwin
[Excerpt] Researchers sensitive to the plight of low-wage workers in advanced industrialized economies have long sought to convey the magnitude of the problem by retelling sorrowful tales of worker exploitation. Sadly, even their most sympathetic readers have numbed to these accounts. Author Dan Zuberi has found a clever way to transcend this apathy in his new monograph based on about 100 interviews plus behind-the- scenes observations of the impact of hospital support staff outsourcing on patients and workers. Through a well-developed understanding of the work process and changes in the employment relationship, he ties outsourcing and the resulting exploitation of …
How Does Market Making Affect Industrial Relations? Evidence From Eight German Hospitals, Ian Greer, Thorsten Schulten, Nils Böhlke
How Does Market Making Affect Industrial Relations? Evidence From Eight German Hospitals, Ian Greer, Thorsten Schulten, Nils Böhlke
Ian Greer
The introduction of market mechanisms matters for industrial relations. In the German hospital sector, national liberalization policies have put immense pressure on local management and worker representatives and led to the growth of a low-wage sector. In case studies of eight hospitals, we find some locales where market making has led to union revitalization and mobilization, but this effect varies. Using an eight-way comparison, we infer a configuration of three aspects of the local political economy – labour markets, politics, and codetermination rules – that together provide a well fitting explanation for both variation and change.
Social Movement Unionism And Social Partnership In Germany: The Case Of Hamburg’S Hospitals, Ian Greer
Social Movement Unionism And Social Partnership In Germany: The Case Of Hamburg’S Hospitals, Ian Greer
Ian Greer
This paper traces the emergence of social movement unionism in Hamburg, Germany, as labor’s channels of influence have broken down and economic pressures have intensified. Trade unionists have responded to the privatization of the municipal hospitals by mobilizing members and building coalitions around issues beyond their members’ immediate interests, including democracy and public service quality. Although the loss of union influence has facilitated social movement unionism, in East Germany economic crisis has had a demobilizing effect.
When Does Marketisation Lead To Privatisation? Profit-Making In English Health Services After The 2012 Health And Social Care Act, Nick Krachler, Ian Greer
When Does Marketisation Lead To Privatisation? Profit-Making In English Health Services After The 2012 Health And Social Care Act, Nick Krachler, Ian Greer
Ian Greer
Governments world-wide have attempted to use market mechanisms and privatisation to increase the quality and/or reduce the cost of healthcare. England’s Health and Social Care Act 2012 is an attempt to promote privatisation through marketisation in the National Health Service (NHS). While the health policy literature tends to assume that privatisation follows from private-sector entry points, we argue that this is more likely if firms expect to make a profit. This paper examines the link between privatisation and marketisation in England drawing on 32 semi-structured interviews with private-sector and public-sector respondents, campaigners, and other experts conducted 6-10 months after the …
Effects Of Unionization On Graduate Student Employees: Faculty-Student Relations, Academic Freedom, And Pay, Sean Rogers, Adrienne E. Eaton, Paula B. Voos
Effects Of Unionization On Graduate Student Employees: Faculty-Student Relations, Academic Freedom, And Pay, Sean Rogers, Adrienne E. Eaton, Paula B. Voos
Sean Edmund Rogers
In cases involving unionization of graduate student research and teaching assistants at private U.S. universities, the National Labor Relations Board has, at times, denied collective bargaining rights on the presumption that unionization would harm faculty-student relations and academic freedom. Using survey data collected from PhD students in five academic disciplines across eight public U.S. universities, the authors compare represented and non-represented graduate student employees in terms of faculty-student relations, academic freedom, and pay. Unionization does not have the presumed negative effect on student outcomes, and in some cases has a positive effect. Union-represented graduate student employees report higher levels of …
The Ins And Outs Of Change Of Shift Handoffs Between Nurses: A Communication Challenge, John S. Carroll, Michele Williams, Theresa M. Gallivan
The Ins And Outs Of Change Of Shift Handoffs Between Nurses: A Communication Challenge, John S. Carroll, Michele Williams, Theresa M. Gallivan
Michele Williams
Background: Communication breakdowns have been identified as a source of problems in complex work settings such as hospital-based healthcare. Methods: The authors conducted a multi-method study of change of shift handoffs between nurses, including interviews, survey, audio taping and direct observation of handoffs, posthandoff questionnaires, and archival coding of clinical records. Results: The authors found considerable variability across units, nurses and, surprisingly, roles. Incoming and outgoing nurses had different expectations for a good handoff: incoming nurses wanted a conversation with questions and eye contact, whereas outgoing nurses wanted to tell their story without interruptions. More experienced nurses abbreviated their reports …
Organizational Strategies For The Adoption Of Electronic Medical Records: Toward An Understanding Of Outcome Variation In Nursing Homes, David B. Lipsky, Ariel C. Avgar, James Ryan Lamare
Organizational Strategies For The Adoption Of Electronic Medical Records: Toward An Understanding Of Outcome Variation In Nursing Homes, David B. Lipsky, Ariel C. Avgar, James Ryan Lamare
David B Lipsky
[Excerpt] An important element in president-elect Obama's economic stimulus proposal is his plan to invest a significant proportion of federal dollars in installing electronic medical records (EMR) in U.S. healthcare institutions. In emphasizing the need for EMR, Obama is following the advice of numerous healthcare experts who have pointed out that the healthcare sector lags behind other industries in the use of computer technology. They believe the widespread use of EMR would help reduce medical errors, control the costs of healthcare, and lead to significant improvements in the quality of care Americans receive. In this paper we present preliminary results …
Dissecting The Workforce And Workplace For Clinical Endocrinology, And The Work Of Endocrinologists Early In Their Careers, Claude Desjardins, Mark A. Bach, Anne R. Cappola, Ellen W. Seely, Ronald G. Ehrenberg
Dissecting The Workforce And Workplace For Clinical Endocrinology, And The Work Of Endocrinologists Early In Their Careers, Claude Desjardins, Mark A. Bach, Anne R. Cappola, Ellen W. Seely, Ronald G. Ehrenberg
Ronald G. Ehrenberg
[Excerpt] No national mechanism is in place for an informed, penetrating, and systematic assessment of the physician workforce such as that achieved by the National Science Foundation (NSF) for the periodic evaluation of the nation’s scientists and engineers. Likewise, knowledge of the workforce for clinical research is enigmatic and fragmentary despite the serial recommendations of “blue-ribbon” panels to establish a protocol for the recurrent assessment of clinical investigators early in their careers. Failure to adopt a national system for producing timely, high-quality data on the professional activities of physicians limits the application of improvement tools for advancing clinical investigation and …
Do Tournaments Have Incentive Effects?, Ronald Ehrenberg, Michael Bognanno
Do Tournaments Have Incentive Effects?, Ronald Ehrenberg, Michael Bognanno
Ronald G. Ehrenberg
Much attention has been devoted to studying models of tournaments or situations in which an individual's payment depends only on his or her output or rank relative to that of other competitors. Academic interest derives from the fact that under certain sets of assumptions, tournaments have desirable normative properties because of the incentive structures they provide. Our paper uses nonexperimental data to test whether tournaments actually elicit effort responses. We focus on professional golf tournaments because information on the incentive structure (prize distribution) and measures of individual output (players' scores) are both available. We find strong support for the proposition …
Physicians’ Work, Alice A. Oberfield, Pamela S. Tolbert
Physicians’ Work, Alice A. Oberfield, Pamela S. Tolbert
Pamela S Tolbert
[Excerpt] In order to evaluate the full impact of such changes on physicians' work and the health care system, it is necessary to understand the forces bringing change about. Thus, we begin by providing a brief history of the contemporary medical care system, then turn to an assessment of current trends and their consequences for the practice of medicine.