Ethical Culture Influence On Patient Satisfaction Case Study Essay

Ethical Culture Influence On Patient Satisfaction Case Study Essay

Ethical Culture Influence On Patient Satisfaction Case Study Essay

Chapter 1: Introduction to the Study

Introduction

Healthcare organizations operate in uncertain times of healthcare reform. Therefore, strong, ethical and professional leadership can guide organizations to act in the best interest of the staff and patients. Ethical culture, with its expected input of virtuousness and emotional wellbeing, can positively enhance outcomes independently of individual employee’s specific value and ethics, as a result, managerial efforts should be heavily focused on creating an ethical culture (Ruiz-Palomine, Martinez-Canas, & Fontrodona, 2013). Improving employee’s perceptions of ethics in the organization, such as fairness, clarity of expectations, accountability, and leadership prioritization, could impact healthcare organizational outcomes (Cohen, Foglia, Kwong, Pearlman & Fox, 2015). In the current health care arena, the level of patient satisfaction depends on clinical leadership and nurses’ ability to communicate effectively during the delivery of care (Moore et al., 2016).Ethical Culture Influence On Patient Satisfaction Case Study Essay

The drive to provide effective communication to the patient stems from new financial sanctions implemented by CMS, which can withhold two percent of hospitals’ inpatient payments (CMS, 2016). The consequence of the new financial sanctions is that acute care hospitals focus on increasing patient satisfaction and organizational performance through improving communication (Mazurenko et al., 2016). Recent studies on hospital communication indicate that an open dialogue between patients and nurses positively influences the patients’ experiences and satisfaction assessments (Ford, Huerta, Diana, Kazley, & Menachemi, 2013). These links between organizational ethical culture and outcome verifies the importance of organizational ethical culture and its impact on productivity and customer satisfaction.Ethical Culture Influence On Patient Satisfaction Case Study Essay

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There is very limited empirical research on the relationship between an organizational ethical culture and patient satisfaction in health care organizations. According to Riivari and Lasma, (2014), organizational ethical culture influences innovation and they have concluded that strong ethical culture has a direct impact on organizational culture and innovation. Nevertheless, this study did not include other aspects of an organization’s outcome such as financial outcome, productivity, efficiency, commitment, and work satisfaction. Riivari and Lasma, (2014), recommended further research to include these outcomes. Ethical leadership behavior is related to the perception of ethical climate, and ethical climate mediates the influence of the managers on individual ethical behavior outcome (Demirtas & Akdogan, 2015). However, findings of this study cannot be generalized to other industries and they suggested further research should include other variables and outcomes as counter-production and group level behaviors.

The aim of this research is to address the gap in literature and explore healthcare organizational ethical culture’s impact on patient satisfaction. Improving patient satisfaction and organizational performance has been a challenge for healthcare organizations. In the past, research on organizational ethical culture and performance has yielded limited results on ethical culture influence on the healthcare industry, in particular, its effect on patient satisfaction (Cohen et al., 2015). Hence, when healthcare organizations possess high level of ethical culture they experience less staff turnover, more productivity, increased patient safety, cost effectiveness, and a high level of patient satisfaction. Effective leadership in healthcare is important for the achievement of optimal patient outcomes (Wong, Cummings, & Ducharme, 2013). Recent studies on hospital communication indicate that an open dialogue between patients and nurses positively influences the patients’ experiences and patients’ satisfaction assessments (Ford, Huerta, Diana, Kazley, & Menachemi, 2013). Nursing care has the most substantial impact on the HCAHPS overall rating top-box percentage with measuring patient satisfaction and can have implications on hospitals reimbursements (Wolosin, Ayala, & Fulton, 2012).Ethical Culture Influence On Patient Satisfaction Case Study Essay

There are a number of studies that have identified the relationship between ethical culture, climate and moral distress in healthcare (Atabay et al., 2015; Oh & Gastmans, 2015). Other studies explored the correlation between ethical climate and organizations’ effectiveness including job satisfaction turnover and commitment (Demirtas & Akdogan, 2015; Huang, You &Tsi, 2011; Ebtisam Aly, 2017). However, the proposed study will offer new insight into the application of corporate ethical virtues on patient care delivery and patient satisfaction regarding nursing communication. The findings of this study will contribute to the body of knowledge concerning ethical theory and model, as well as its relationship to patient satisfaction. The specific focus of this study lies in the examination of a relationship between organizational ethical virtues in nursing and patient satisfaction in a large academic hospital.Ethical Culture Influence On Patient Satisfaction Case Study Essay

The researcher will use a quantitative methodology to examine the relationship between nursing ethical culture and patient satisfaction at a large academic center in North East United States. The primary foundation of this study is the Corporate Ethical Virtues (CEV) model as it formulates normative and multi-dimensional measures for evaluating the ethical culture of an organization (Kaptein, 2008). This study seeks to investigate the relationship between nursing ethics as perceived by frontline nursing and patient satisfaction. The researcher will collect data using the corporate ethical virtues model (CEV) to measure ethical culture (Kaptein, 2013), facilitated by using Survey Monkey, a web-based survey tool. The Opinion Meter, which is based on the questions on the Hospital-Consumer Assessment of Healthcare Providers and Systems (HCAHPS; CMS, 2015), will be used to measure patient rating of nurses’ communication during their hospitalization. The Opinion Meter survey will be administered directly to the patient that is assigned to the same nurse (Appendix G).Ethical Culture Influence On Patient Satisfaction Case Study Essay

The remainder of this chapter will focus on the background of the study, statement of the problem, purpose of the study, the proposed research questions and hypotheses, how this research will advance scientific knowledge, and the significance of the study. Moreover, this chapter contains a brief overview of ethical leadership, organization’s ethical culture, patient satisfaction, as well as rationale for using quantitative research methodology and the research design. This chapter will conclude with a list of the definition of terms, assumptions, limitations, delimitations, and a summary organization of the rest of the study.Ethical Culture Influence On Patient Satisfaction Case Study Essay

According to ethical leadership theory, leaders influence follower’s ethical decisions and actions through social learning and exchange processes, communication of ethical standards, and the use of performance management systems for employee conduct and accountability (Brown & Trevino, 2006). A two-stage model was developed and tested by Steinbauer, Renn, Taylor, and Njoroge (2012) to explain how ethical leadership relates to followers’ ethical judgments in an organizational context. Drawing from social learning theory, the researchers investigated followers’ perceived accountability as a linking mechanism between ethical leadership and followers’ self-leadership as focused on ethics. Thus, they argue that a follower’s self-leadership, focused on ethics, is a behavioral manifestation of the follower’s perceived accountability and social learning process. Taken together these factors explain how ethical leadership influences followers ethical conduct. In addition, the study investigated the relationship between ethical leadership and followers ethical decisions.

Self-leadership is the process of leading, motivating and controlling ones overt behavior in order to achieve self-defined goals. The research found that ethical leadership is positively related to followers’ self-leadership focused on ethics. Furthermore, a follower’s perception of his responsibility fully accounted for this leadership. In addition, the study revealed that followers’ self-leadership based ethics were positively associated with followers’ ethical decision-making only when they employed deliberative approaches to decision-making. In addition, the study provided support for the notion that deliberate application of self-leadership, with a focus on ethics, leads to higher moral judgment. These findings provide support for the important of leadership ethics on different type of leadership as self-leadership.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Drawing from social learning and moral identity theories, Mayer, Aquino, Greenbaum, and Kuenzi (2012) conducted two studies. In their first study, they examined the antecedents and consequences of ethical leadership. In their second research, they empirically examined the uniqueness of ethical leadership constructs as compared to related leadership paradigms. These concepts include idealized influence, interpersonal justice, and informational justice. The first study revealed a positive relationship between ethical leadership a leader’s moral identity symbolization, and moral identity internalization. Negative relationships were found between ethical leadership, unethical behavior and relationship conflict. In the second study, a leaders’ moral identity was positively related to ethical leadership, idealized influence, interpersonal justice, and international justice. Ethical leadership was negatively related to unit outcomes. In both studies, ethical leadership partially mediates the effects of a leaders’ moral identity.Ethical Culture Influence On Patient Satisfaction Case Study Essay

According to Mayer et al. (2012), ethical leadership matters when leaders emulate desired ethical behavior, and use rewards and punishment to reinforce ethical behavior. Under such circumstances, employees are less likely to engage in unethical behavior and practices. Therefore, leaders can play an important role in reducing negative outcomes. Leaders set the ethical tone of the organization and are instrumental in encouraging ethical behavior while reducing interpersonal conflict among their subordinates.

Okam and Akyuz (2011) examined the impact of ethical leadership behavior on an employee’s intrinsic and extrinsic job satisfaction. These researchers also examined the effect of loyalty to supervisors. The research analysis revealed that ethical leadership is effective in driving supervisor loyalty and increases job satisfaction. In addition, ethical leadership has a significant, positive correlation with both intrinsic and extrinsic job satisfaction. Due to the limited sampling size of the study, the authors suggested further studies to include inclusion of cultural variables and wider, more extensive samples.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Drawing from social learning theory Brown et al. (2005) found that direct reports’ perceptions of ethical leadership were stronger when leaders exhibited higher, cognitive moral development. Zu et al. (2016) and Mayer et al. (2012), found that a leader’s moral identity and moral attentiveness are associated with followers’ perceptions of ethical leadership behavior patterns. According to Mayer et al. (2012), ethical leadership matters when leaders emulate desired ethical behavior, and use rewards and punishment to reinforce ethical behavior. Under such circumstances, employees are less likely to engage in unethical behavior and practices. Steinbauer et al. (2012) explained how ethical leadership relates to followers’ ethical judgments in an organizational context and found that ethical leadership is positively related to followers’ self-leadership focused on ethics. Okam and Akyuz (2011) found that ethical leadership has a significant, positive correlation with both intrinsic and extrinsic job satisfaction.

Based on the social learning theory, these studies concluded that ethical leadership can impact followers’ ethical behaviors. Brown et al. (2005) and Zu et al. (2016) focused on the relationship between leadership moral identity and development and outcome. However, Steinbauer et al. (2012) supported the deliberate application of self-leadership, with a focus on ethics which leads to higher moral judgment. When Okam and Akyuz (2011) examined the impact of ethical leadership behavior on an employee’s intrinsic and extrinsic job satisfaction, they added that ethical leadership is effective in driving supervisor loyalty and increases job satisfaction. Therefore, the proposed research will attempt to examine the relationship of ethical leadership and patient satisfaction.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Drawing from cognitive evaluation theory, Yidong and Xinxin (2012), proposed a multi-level model to explore how ethical leadership influences employees to adopt innovative behavior in the workplace through the mediation of intrinsic motivation at both individual and group levels. The research revealed that an individual’s innovative workplace behavior was positively related to both individual perceptions of ethical leadership and group ethical leadership, while individual intrinsic motivation mediated the relationship. In addition, the study showed that a group’s intrinsic motivation mediated the relationship between a group’s ethical leadership and innovative work behavior. Some of the study includes the cross-sectional design which prevents the authenticity of causal relationship between the variables. Furthermore, the sample in China may restrict the external validity of the conclusions drawn. The author suggested replicating the study in other cultures and countries.

Ma, Cheng, Ribbens, and Zhou (2013) examined the influence of ethical leadership on employee creativity through the mediation of knowledge sharing and self-efficiency. The participants were employees and supervisors from four Chinese companies. The findings of the research revealed that ethical leadership at the individual level can positively predict employee creativity. Thus, ethical leadership can increase employee creativity through cognitive and motivational mechanisms. Therefore, in order to increase employee creativity, leadership needs to support ethical leadership and encourage behaviors and practices that emphasize knowledge sharing and self-efficiency. The conclusions therein further support the findings of Ta and Lu (2014) which explored the idea that an individual’s innovativeness in the workplace positively related to both individual perception of ethical leadership and group ethical leadership. Therefore, the authors suggested that managers should develop ethical leadership styles by emphasizing morality in the workplace, developing follower’s respect and dignity, and empowering their followers to strive toward innovative practices. These finding stress the vital of ethical leadership on practices which is relevant to the proposed research of ethical leadership and its impact on nursing communication.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Drawing from cognitive evaluation theory, Yidong and Xinxin (2012) revealed that an individual’s innovative workplace behavior was positively related to both individual perceptions of ethical leadership and group ethical leadership, while individual intrinsic motivation mediated the relationship. Ma et al. (2013) revealed that ethical leadership at the individual level can positively predict employee creativity. Yidong and Xinxin (2012) study showed that a group’s intrinsic motivation mediated the relationship between a group’s ethical leadership and innovative work behavior. Moreover, Ma et al. (2013) concluded that ethical leadership can increase employee creativity through cognitive and motivational mechanisms. The conclusions provided further support the findings of Ta and Lu (2012) which explored the idea that an individual’s innovativeness in the workplace positively related to both individual perception of ethical leadership and group ethical leadership

In two multisource studies, Hortog and Belschak (2012) tested a model proposing that work engagement acts as a mediator in the relationship between ethical leadership, employee initiative and counterproductive work behavior. The study investigated whether ethical leadership always forms authentic ethical identity. In a second study, the authors added Machiavellianism to the model which is a strategy of social conduct that involves manipulating others for personal gain. The author did not find support for Brown and Trevino (2006), indicating that Machiavellianism is negatively related to ethical leadership. However, they found that positive effects of ethical leader behavior can be supported when leaders are highly Machiavellian. The first aim of the study was to investigate the role of work engagement in the ethical leadership process. The research finding in both studies revealed that ethical leadership was significantly related to both employee’s initiative and counterproductive work behavior.Ethical Culture Influence On Patient Satisfaction Case Study Essay In addition, these relationships were mediated by work engagement. The findings of these studies suggested that ethical leaders affect followers’ self-esteem and identity by emphasizing the methods by which followers’ effort related to attaining important moral goals and values. This quantitative research was done in the field adding external validity. However, experimental research is stronger when based upon internal validity (Hartoge & Bleschak, 2012). The authors suggested future experimental and longitudinal research to address these limitations.

Yuki, Mahsud, Hassan, and Prussia (2013) assessed the validity of a new questionnaire for measuring aspects of ethical leadership and examined how ethical leadership related to Leadership Member Exchange (LMX) and work performance.

Based on previous theory and research, the author developed and assessed a new ELQ design. The Ethical Leadership Questionnaire (ELQ) is a comprehensive instrument that includes important elements of ethical leadership such as integrity, honesty, fairness, communication of ethical values, ethical behavior, guidance and altruism. The study revealed that the ELQ has high reliability as well as discriminant, criterion – related validity. In addition, the ELQ explained additional variance in both LMX and overall leader effectiveness. The primary purpose on this survey study and analysis was to assess the validity of the new ELQ questionnaire. The findings also revealed that ethical leadership makes a small but significant contribution to the explanation of the leaders’ member exchange and managers’ effectiveness.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Resick, Hargis, Shao and Dust (2013) proposed that ethical leadership is associated with employees’ negative moral equity judgments of workplace deviance, discretionary antisocial behavior such workplace deviance (WPD), and positive moral equity judgments of discretionary prosocial organizational citizenship (OCB). In addition, the authors proposed that these moral equity judgments are cognitive psychological mechanisms that link or mediate the relationship between ethical leadership and employee engagement in both OCS and WPD.

According to Resick (2013), ethical judgments of specific sets of discretionary behaviors link ethical leadership with employee discretionary behavior. The influence of ethical leadership occurs directly among immediate followers, and indirectly across hierarchical level through ethical culture and senior leadership influence (Schaubroeck et al., 2012). Therefore, leaders need to be encouraged in their efforts to embed their assumptions and expectations regarding ethical conduct among organizational followers by creating ethical culture and engaging in ethical leadership practice (Schaubroeck et al., 2012). The ethical work climate can affect the moral contentment of an organization. Ethical leaders can empower their followers to emulate them in participating in ethical decisions that prioritize morality, social value and collective interest within the organization (Choi, Villa, & Kwak, 2015). These findings continue to support the need for further research on ethical climate and organization outcome.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Ethical culture and organization. Organizations are constantly seeking to enhance their members’ creativity, innovativeness, and ethical behavior to gain and sustain a competitive edge in today’s marketplace. Schaubroeck et al. (2012) developed and tested a model linking ethical leadership to unit ethical culture, both across and within organizational levels. The authors examined how both leadership and culture relate to ethical cognition and behaviors of lower level followers.

The research model was drawn from Schein (1985, 2010) to explain senior leaders influence on ethical conduct of followers and subordinates by embedding their expectations and assumptions into the organizational ethical culture. A multilevel model was developed in order to understand how leadership and culture influence ethically-related cognitions and behaviors. The questionnaire of this quantitative research focused only on the effects of higher-level leaders’ behavior and ethical culture outcome at the frontline organizational level. Moral efficiency was measured with five items that was developed by Hannah and Avolio (2010). Ethical culture was measured using the ten-item ethical culture scale (Trevino et al., 1998). Ethical leadership was measured using the 10-items ELS (Brown et al., 2005)

The study revealed that ethical leaders indirectly influence their immediate followers’ cognitions, such as moral efficiency and behaviors, such as transgressions. In addition, ethical leadership influences ethical culture within each hierarchical level, and it extends in parallel level across hierarchical levels. The study found that ethical leadership is positively related to ethical culture of lower levels. Leaders who exhibit high level of ethical leadership may facilitate the influence of subordinate-leader’s ethical leadership on their followers.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Schaubroeck et al. (2012) suggested that leaders should be encouraged to embed their assumptions and expectations regarding ethical conduct throughout the organization. They need to engage in ethical leadership in order to create strong ethical culture. One limitation of this study is the potential to generalize the findings to other organizational context; therefore, the authors suggested further research to be conducted in other type of organizations. The proposed study will focus on nursing ethical leadership impact on healthcare organization.

The organizational leaders’ main task in regards to establishing a culture of character is to lead by example and empower each organizational member to take personal action that demonstrates the organization’s commitment to ethics in its relationship with employees, customers, shareholders, and suppliers (Sims & Suser, 2013). In addition, the leader needs to serve as an ethical role model and mentor to others and must take practical steps to replace maliciousness and indifference with a culture of integrity and honesty, and ethical organization that can secure long term benefits to all (Sims & Suser, 2013).Ethical Culture Influence On Patient Satisfaction Case Study Essay

Demirtas and Akdogan (2015) examined a mediated model of ethical leadership on ethical climate, turnover intention, and affective commitment. The study proposed that managers are role models in their organization when they possess ethical leadership behavior which influences the perception of ethical climate. Ethical leadership was measured using Brown et al. (2005) 10-item ethical leadership scale. The finding of this quantitative correlational study revealed that ethical leadership is significantly correlated to ethical climate, affective commitment, and turnover intention. In addition, ethical leadership behavior is related to the perception of ethical climate, and ethical climate mediates the influence of the managers on individual ethical behavior outcome. The authors emphasized that ethical working environment can benefit both employees and organization. The sample of the study included a wide variety of organizations and job position; however, the sample was not demographically diverse. Therefore, the finding cannot be generalized to other industries or cultures. The authors recommended conducting further research to consider other organizations culture and include additional outcome variables. The proposed research identified the gap, and it will address and examine the relationship of nursing ethical leadership which is a diverse population, and its impact on the variable of nurses’ communication with patients.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Neves and Story (2015) examined the relationship between ethical leadership and organizational deviance through affective commitment to the organization, and proposed this relationship is conditional on the supervisor’s personal reputation for performance; moral standards are coupled with work effectiveness. A sample of 2,024 employees and their respective supervisors was collected from eighteen organizations, including industry, tourisms, service health, counseling, transportation, energy, and financial services. Ethical leadership was measured using Brown et al. (2005) 10-items-scale. This quantitative study used descriptive statistics, reliabilities, and tested the correlation between variables. The finding of the research supported the hypothesis that ethical leadership is significantly related to affective commitment to the organization, especially when supervisors also have a high reputation for performance which in turn is associated with decreased organizational deviance.

The finding suggested that ethical leadership contributes significantly to the development of employee organization relationship (EOR) through social exchange mechanisms. The study found that the strength of the relationship between supervisors’ ethical conduct and employees’ commitment to the organization depends on the supervisor’s reputation for performance. In addition, the researchers found that ethical leadership was indirectly related to employee deviance through an improvement in the EOR. The study found that ethical behaviors combined with high reputations for performance were able to produce the highest level of affective commitment to the organization and the lowest levels organizational deviance. The authors suggested further research to focus on the mechanisms linking ethical leadership and employees’ behavior, particularly how multiple mechanisms operate simultaneously.Ethical Culture Influence On Patient Satisfaction Case Study Essay

According to Sims and Suser (2013), the organizational leaders’ main task in regards to establishing a culture of character is to lead by example and empower each organizational member to take personal action that demonstrates the organization’s commitment to ethics in its relationship with employees, customers, shareholders, and suppliers. Schaubroeck et al. (2012) reveled that ethical leaders indirectly influence their immediate followers’ cognitions, such as moral efficiency and behaviors, such as transgressions.

Sims and Suser (2013) argued the leader needs to serve as an ethical role model and mentor to others and Schaubroeck et al. (2012) suggested that leaders should be encouraged to embed their assumptions and expectations regarding ethical conduct throughout the organization. One limitation of this study is the potential to generalize the findings to other organizational context; therefore, the authors suggested further research to be conducted in other type of organizations. Demirtas and Akdogan (2015) revealed that ethical leadership is significantly correlated to ethical climate, affective commitment, and turnover intention. The authors emphasized that ethical working environment can benefit both employees and organization. Moreover, the authors Demirtas and Akdogan (2015) recommended conducting further research to consider other organizations culture and include additional outcome variables. The finding of Neves and Story (2015) suggested that ethical leadership contributes significantly to the development of employee organization relationship (EOR) through social exchange mechanisms. The study found that the strength of the relationship between supervisors’ ethical conduct and employees’ commitment to the organization depends on the supervisor’s reputation for performance. The main argument of all these studies is that ethical leadership in a key for healthy and productive environment. In addition, in these studies ethical leadership was measured using Brown et al. (2005) 10-items-scale.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Ethical virtues and organizational outcomes. The Greek notion of virtue (arête) means excellence, and it does not separate an individual’s ethics from his or her occupational competence. Both Plato and Aristotle used examples of doctors, coaches, and musicians to point out the relationship between moral and professional excellence. Virtues are dynamic and contribute to an individual’s self-knowledge and self-control (Ciulla, 2012). Virtues provide useful methods of understanding leadership; they encompass moral qualities that an individual can have only if he or she practices them. Virtues, like traits, are dispositions to behave in certain ways. Unlike traits, however, virtues are intentionally selected, deliberately strengthened and behaviorally predictive (Ciulla, 2013).

Kaptein (2008) approaches ethical organizational culture through ethical virtues. Virtue ethics are based on the ideas of Plato and Aristotle and both. Solomon (1999, 2000, 2004 and Kaptein, 1998, 1999) applied the virtue theory in an organizational context. According to the theory, both individuals and organizations require certain virtues for moral behavior. According to Solomon (1992), virtues ethics do not impose prohibit principles or rules of business of behaviors. However, it fosters an intrinsic motivation that leads to successful ethical and business behaviors. Virtue ethics shift the focus from actions and conducts to agent and character (Kaptein, 2016).Ethical Culture Influence On Patient Satisfaction Case Study Essay

Kaptein’s (2011) study had three objectives. The first objective was the collection of data for a broad study of the current status of ethics management in organizations. The second objective was to provide managers with benchmarking information and practical suggestions for managing ethics in their work group. The third objective was to train the analytical and consulting skills of their students. The research findings revealed that six dimensions of ethical culture are negatively related to observe unethical behavior: ethical role modeling management, ethical role modeling of supervisors, capability to behave ethically, commitment to behave ethically, openness to discuss ethical issues, and reinforcement of ethical behaviors. Two of the eight dimensions, clarity of ethical standards and visibility of unethical behavior, were not significantly related to unethical behavior. However, in contrast to previous study of Kish- Gephart et al. (2010), this study found that ethical culture has more powerful effect than ethical climate.Ethical Culture Influence On Patient Satisfaction Case Study Essay

The study of Kish- Gephart et al. (2010), contributed to the understanding and development of theory on organizational ethical culture. It opened several avenues for future research on the relationship between ethical culture and unethical behavior, the internal dynamics of ethical culture, managing and improving organizational ethical culture, and future development of ethical culture measurements. At least six distinct dimensions of ethical culture were relevant in explaining unethical behavior in organizations. In conclusion, this study presented an advanced model for organizational ethical culture assessments.

The study of Kaptein (2011) examined the influence of the ethical culture of organization on employee response to observed wrongdoing. This quantitative study based on 5,065 respondents from the United States consisted of working adults in fifteen selected industries. The author examined the relationship between five types of responses and eight dimensions of ethical culture: clarity, congruency of local management, congruency of senior management, feasibility, supportability, transparency, discussability, sanctionability. The study findings revealed that three internal actions—confrontation, reporting to management and calling an ethics hotline—were positively related to at least four of the eight dimensions of ethical culture. The two other responses—inaction and external whistleblowing—were negatively related to at least four of the eight dimensions of ethical culture.

This study demonstrated that not all the dimensions of ethical culture were related to positive response (internal action) and not all negatively related to negative response (in action and external whistleblowing) from employees who observed wrongdoing. The ethical culture of an organization is important in encouraging employees to correct observed wrongdoing (Kaptein, 2011). The study revealed that four dimensions of clarity, supportability, discussability, and sanctionability are relevant in encouraging employees to intervene and report to management and ethics hotline. The study emphasized the importance of correcting wrongdoing by creating a culture that encourages employees to report and take appropriate action.

Many organizations are adopting ethical programs in order to prevent or reduce unethical behavior. However, the question that faces this organization is which and when to adopt these ethical programs. Kaptein (2015) examined the effectiveness of ethical programs with reference to the scope, composition and sequence of adopted components. Ethical Culture Influence On Patient Satisfaction Case Study Essay This quantitative study was based in 5,065 participants working in different organizations in the US. The unethical behavior was measured by a 36-item unethical behavior scale (Kaptein, 2008). The objective of an ethics program was to influence employee’s behavior promote ethical behavior and inhibit unethical behavior. The impact of ethics programs on employees’ behavior was measured using the CEV model that developed by Kaptein (2008b, 2011b). Nine components of ethics programs were identified and examined.

The study findings revealed that there is a direct relationship between the number of components adopted and the frequency of observed unethical behavior. However, no relationship was found between pre-employment screening and unethical behavior. In addition, the research found that the best sequence for adopting ethics program components is a code of ethics, ethics training and communication, accountability policies monitoring and auditing, and investigating and correction. These five ethical programs were directory related to less unethical behavior. Furthermore, ethics report line, incentive policies, and ethics officers were indirectly related to less unethical behavior.

Riivari and Lamsa (2014) examined the relationship between ethical organizational culture and organization innovativeness. This quantitative empirical study was based on a total of 719 respondents from all levels of Finnish organizations. In this study, the authors applied the corporate ethical Virtues (CEV) model (Kaptein, 2008). This model formulates normative and multidimensional measured of organizational ethical culture evaluations. According to Kaptein (2008), the virtuousness of an organization can be determined but the extent to which the culture of the organization stimulates its members to act ethically and prevent them from acting ethically. The CEV model consists of eight virtues or qualities: clarity, congruency of supervisor, congruency of management, feasibility, supportability, transparency, discussability and sustainability. Organizational innovativeness was measured using Wang and Ahmed (2004) model. The model includes five dimensions: product innovativeness, market innovativeness, process innovativeness, behavior innovativeness and strategic innovativeness.Ethical Culture Influence On Patient Satisfaction Case Study Essay

The study findings revealed that organization’s ethical culture is positively associated with their organizational innovativeness. Different dimensions of ethical culture were found to be inversely associated with different dimensions of organizational innovativeness. The findings of this study suggested that the relationship between ethical culture and organizational innovativeness can be varying between organizations. The researchers found that congruence of management had the highest effect on organizational innovativeness overall and specifically on process and behavioral innovativeness. This research revealed that there is a relationship between ethical organizational culture and specific organizational outcomes and organizational innovativeness. Ethical behaviors of senior management have an important role and effect on organizational innovativeness. The authors suggested conducting further research on ethical leadership related to other group of outcomes such as productivity, efficiency, work satisfaction, and employee commitment.

Huhtala, Feldt, Hyvonen and Mauno (2012) investigated the relationship between ethical organizational culture and a number of personal managerial goals. The purpose of this study was to enrich the knowledge about ethical organizational culture and the manner in which ethical virtues may promote different work goals. This empirical mixed method study was based on a sample of 811 Finnish managers from different organizations in both middle and upper management level. Using quantitative approach, ethical organizational culture was measured using the system CEV questionnaire (Kaptein, 2008). The scale included eight dimensions: clarity, congruency of supervisors and management, feasibility, supportability, transparency, discuss ability, sanction ability.Ethical Culture Influence On Patient Satisfaction Case Study Essay

The research findings revealed that the more ethical the organizational culture was perceived as being, the more organizational goals were reported by managers which relate to organizational success and performance. Ethical organizational culture was a favorable working environment that promotes organizational commitment. The individual CEV dimensions revealed that ethical behavior of supervisors and senior management in particular, alongside supportability and discussability, characterized a favorable working environment that promotes organizational goals. The most important contribution of this study was to establish that ethical organizational culture functions as context for setting personal work goals. Leadership and management practice are important elements related to setting personal work goals. Therefore, organizations need to ensure that their leadership exhibits good examples in ethical actions, reliability, and responsibility.

The study of Huhtala, Mauno and Feldt (2015) aimed to investigate the degree to which employees’ perception of their organizational ethical culture is shared with work units. In addition, this study examined the association between ethical culture and occupational well-being, such as burnout and work engagement, at both individual and work-unit levels. Ethical organizational culture was measured using the 58-item CEV questionnaire (Kaptein, 2008) that included all eight dimensions of the scale. The findings of Huhtala, Mauno and Feldt (2015) study revealed that ethical culture is associated with occupational well-being at both the individual and work unit level. In addition, shared perceptions of ethical organizational culture among work unit members was related to lower burnout and higher work engagement as both outcomes are shared experience. The results of this study are important implications for working life. The CEV scale (Kaptein, 2008) can be used as a practical tool to assess ethical organizational culture in different work units (Huhtala, Tolvanen, Mauno, & Feldt, 2015).Ethical Culture Influence On Patient Satisfaction Case Study Essay

According to Cecilia (1998) and Brown et al. (2005) leadership should be a key source of ethical guidance for an organization. Kaptein (2015) study showed that the effectiveness of an ethics program depends on its scope and composition and the sequence in which the components are adapted. Future research was suggested to include different types of organizations. A study conducted by Huhtala, Kangas, Lamsa and Feldt (2013) aimed to discover whether managers’ self-evaluations of their ethical leadership style was associated with their assessment of the ethical organizational culture. Riivari and Lamsa (2014) study findings revealed that organization’s ethical culture is positively associated with their organizational innovativeness. Different dimensions of ethical culture were found to be inversely associated with different dimensions of organizational innovativeness. Huhtala et al. (2012) found that ethical organizational culture was a favorable working environment that promotes organizational commitment. Huhtala et al. (2015) found that ethical culture is associated with occupational well-being at both the individual and work unit level. The CEV scale (Kaptein, 2008) was used for all these studies and recommended to be used as a practical tool to assess ethical organizational culture in different work units. Therefore, the proposed study will be based on the CEV model Kaptein (2008) and it will address the gap of Riivari and Lamsa’ (2014) study.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Ethical leadership in healthcare. According to Piper (2011) ethics are central to decisions for improving patient care and overall healthcare quality and safety. Ethics come from the moral courage to act for the well-being of others. The organizational mission is central to the delivery of patient care. Therefore, organizational leadership must be accountable to the board and the community in delivering safe and quality care that meets patient expectations.

Healthcare leaders face current and continuous ethical challenges in creating a culture to improve patient safety and quality, while simultaneously reducing medical errors and preventing patient harm and death. Patient and family-centered care is important as it emphasizes patient involvement in their own treatment and inclusion of their families. Hence, patient families are engaged as partners regarding patient decision and intervention.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Healthcare organizations that have succeeded in fostering patient-centered care have gone beyond ordinary contexts of quality improvement, measurement and audit by adopting a strategic organizational approach to patient focus (Luxford, Safran, & Delbanco, 2011). Thus, patient satisfaction is related to the level that patients and families are involved in hospital care. Therefore, in order to improve quality of care and patient satisfaction, patients and their families need to be to be involved throughout the medical care. Patient satisfaction is measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The survey measures patient experience regarding physicians and nurses’ communication and interactions with patients, responsiveness of hospital staff, pain management, administration of medication, cleanliness of the hospital and quietness of the hospital at night. The patient is also asked to rate the hospital and their willingness to recommend the facility to others.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Nurses are a vital and central component of the healthcare system. These professionals constitute the largest group within the healthcare system. Nursing leadership plays a central role in promoting staff clinical competencies and quality improvement of patient care. Therefore, leaders’ ethical actions and behavior can impact employees’ performance and patient outcomes (Backhand & Shovit Bath, 2016). Thus, ethical competency forms an important part of a nurse leader’s general competency. Leadership ethical competency enables nursing staff to create and adhere to core ethical standards and motivates frontline nursing staff in the provision of care by nurses to patients (Backhand & Shovit Bath, 2016). According to The Joint Commission’s report (TJC; 2008), intimidating and disruptive behavior can foster medical errors, decrease patient satisfaction, increase costs, and foster outcomes which may cause qualified employees to leave the organization. The majority of clinicians are seeking to work in a healthy and ethical environment. Therefore, zero tolerance for disruptive behavior can improve collaboration and cooperation among healthcare employees.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Gokce, Guney, and Katrinli (2014) aimed to determine the doctor’s perception of leadership behavior and their commitment to the organization. The study focused on the concepts of leadership, organizational commitment, and organizational culture. This study revealed that organizational commitment of doctors is positively related to leadership behavior. However, organizational culture did not act as a moderator in the relationship between leadership and organizational commitment. The research findings suggested that leadership behavior, as perceived by doctors, have an effect on their organizational commitment and less effect on organizational culture. The main limitation of this study was the single location and the limitation to one group of healthcare providers. Therefore, the authors suggested further research to include nurses, administrative staff, and other diverse groups of healthcare employees. The proposed study will focus on frontline nursing staff perception of ethical leadership.Ethical Culture Influence On Patient Satisfaction Case Study Essay

According to the National Center of Ethics in Healthcare (NCEHC) in the Department of Veterans Affairs (VA), ethics quality means that healthcare organizational practices must be consistent with widely accepted ethical standards, norms, and expectations of the healthcare organization (Foglia et al., 2012). In order to improve ethics quality in healthcare, organizations need to examine their overall ethical practices, consistency and alignment with the organization’s standards, norms, and expectations (Pearlman, Bottrell, Altemose, Foglia, & Fox, 2013).

Foglia, Cohen, Pearlman, Bottrell, and Fox (2013) evaluated the association between employee sensitivities to ethical leadership (EL), ethical environment culture (EEC) and perceptions of the organization’s overall ethical quality. The study analyzed 88,605 VA employees’ responses to the 2010 IESS questions. The purpose of this study was to characterize employee perceptions of EL/EEC in VA hospitals, and to evaluate the association between employees’ perceptions of EL/EEC and perceptions of the organization overall ethics quality. The research revealed that physicians and employees with higher levels of supervisory responsibility were more likely to have positive perceptions of EL and EEC concepts as related to overall organizational ethics quality. Most VA employees perceived their organization as ethical when employees are treated fairly. VA manager and physician perceptions of organizations ethics were more than non- physician and non-managers employees. Different VA facilities perceptions of organizational ethics vary considerably across facilities. The findings of this study support the important relationship among ethical leadership, organizational environment and culture, and connections to ethics quality (Foglia et al., 2013).Ethical Culture Influence On Patient Satisfaction Case Study Essay

According to Fox (2012), in order to evaluate ethics quality, a well-defined conceptual model is imperative, along with an expert team of evaluators, commitment to responsiveness, availability, and tailoring the evaluation methods to the target audience. One of the innovative aspects of integrated ethics is that it emphasizes that ethical practices in healthcare organizations depend not only on specific decisions and actions, but also on the organizational system and processes that influence decision-making and implementation (Crigger & Wynia, 2013).

The moral dimensions of the ethical leader refer to their strategies to influence their followers’ ethical conduct. These strategies can be affected through role modeling of ethical behavior, setting clear ethical standards, and the implementation of reward and punishment to ensure compliance with established standards. Chughtai (2015) examined the effect of ethical leadership on safety, performance, and the mediating role of job autonomy and self-efficiency on this relationship. The findings of the research revealed a positive relationship between ethical leadership and both self-efficiency and job autonomy. Ethical leadership behavior can have an impact on the components of performance, safety compliance and safety participation.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Walumbwa, Morrison, and Christensen (2012) suggested that ethical leadership can lead to higher in-role performance for groups of staff. The authors argued that the two key mechanisms of the group are: group conscientiousness, which is the emergent state, and group voice which is the group process. The study revealed a strong positive relationship between ethical leadership and group in- role performance. The study suggested that, when leaders were perceived by their members as ethical and displayed high levels of ethical behavior, the group members performed more effectively. Hence, ethical leadership is an important factor of group in-role performance which can lead to better organizational outcomes. In addition, the group consciousness and group voice mediated the ethical leadership-group performance relationship. The conclusion highlights the practical value of group voice for group performance. In addition to the theoretical implication, the study may have practical implications in creating high performance teams which demonstrate high ethical standards, model ethical conduct, and benefit in the rewards associated with ethical compliance and activities.Ethical Culture Influence On Patient Satisfaction Case Study Essay

The study of Suhonen, Stolt, Gustafsson, Katajisto, and Charalambous (2014) revealed association between ethical climate, the professional practice environment and the level of perceived individualized care. The study emphasized that ethical climate is an important determinant of individualized care. Utriainen, Ala-Mursula, and Kyngas (2015) performed a study aimed at developing theoretical models of hospital nurses’ well-being within the workplace. According to the theoretical model, the well-being of hospital nurses at work is constructed upon patients experiencing a high quality of care, support among nurses, cooperation, collaboration, satisfaction, challenging and meaningful work, freedom of expression, opportunity for professional development, two-way communication, and fair and supportive leadership. The study revealed that collegial relationships, meaningful professional development and fair leadership play a major role in well-being of hospital nurses. Agheorghiesei, Iliescu, Gavrilovici, and Opreas’ (2014) study aimed to identify hospital executive opinions regarding the relevance of ethical audit procedures in the accreditation process of Romanian hospitals. The study revealed that Romanian managers consider the introduction of ethical audit within the accreditation process as relevant and appropriate. They believe that ethical monitoring is beneficial for healthcare organizational performance. Ethical auditing could impose standards and requirements in the healthcare system which are productive and improve ethical performance in healthcare.

Walumbwa et al.(2012) revealed that ethical leadership is an important factor of group in-role performance which can lead to better organizational outcomes The study of Suhonen et al. (2014) also revealed association between ethical climate, the professional practice environment and the level of perceived individualized care. In addition, Chughtai (2015) suggested that ethical leadership behavior can have an impact on the components of performance, safety compliance and safety participation. The findings of Foglia et al. (2013) study support the important relationship among ethical leadership, organizational environment and culture, and connections to ethics quality. However, according to Utriainen et al. (2015), collegial relationships, meaningful professional development and fair leadership play a major role in well-being of hospital nurses. Agheorghiesei et al. (2014), added that ethical monitoring is beneficial for healthcare organizational performance. Gokce et al. (2014) examined doctors’ perception of leadership behavior and their commitment to the organization and suggested further research to include other healthcare professional such nurses. Nurses are a essential and crucial component of the healthcare system. The proposed research will focus on nurses’ perception of organizational ethical culture and its impact on patient satisfaction related to nurses’ communication.Ethical Culture Influence On Patient Satisfaction Case Study Essay

According to Wong (2015), the mechanism of leadership effects on patient outcome is a very challenging topic and to date many of its impact is unknown. However, there is a connection between supportive leadership approach and positive patient safety outcome which includes lower medication errors, nosocomial infections and patient satisfaction (Wong, Cuming, & Ducharme, 2013). Healthcare leaders have considerable influence in the healthcare delivery due to their role and responsibilities. Walumbwa et al. (2012) suggested that ethical leadership can lead to higher in-role performance for groups of staff. Ethical leadership can improve workplace safety (Chughtai ,2015). Therefore, organizations need to develop and select ethical leaders. Collegial relationships, meaningful professional development and fair leadership play a major role in well-being of hospital nurses (Suhonen et al., 2014). Agheorghiesei et al. (2014) added that ethical monitoring is beneficial for healthcare organizational performance. Therefore, healthcare leaders require a shared vision approach that engagement of all their members in order to achieve this powerful and more lasting vision (Cumming, 2012). Ethical practices, values and principles are the foundation of the moral action and decision-making of professional practices. Nurses have an obligation to provide quality patient care. Therefore, nursing leadership has a major role in creating moral and ethical environments that are based in ethical practices (Bejarnason & Lasala, 2011). Patient satisfaction is part of patient evaluation of their care. Patient feedback provides an opportunity for healthcare organizations to establish strategic planning for healthcare quality improvement

Patient satisfaction. Healthcare systems continue to face challenges including high costs of technology, diminishing resources and an increasing demand for high quality and safe care. Financial sustainability is a key to survival. One important factor of sustainability in healthcare is the social component. The social component focuses on the organization’s identity and culture which includes collaboration, coordination, empowerment, diversity, equity, justice and fairness for all. Patient satisfaction is a key factor of the social element. Hence, this element is representative of the patient‘s experience regarding, service, accessibility, cost, quality and safe care.

The Center for Medicare and Medicaid Services (CMS, 2013), for the implementation of Value-based purchasing, tied hospital reimbursement to quality-care metrics, including patient ratings of their care experience, with a special emphasis on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) rating. These reimbursement standards placed further emphasis on the quality of care in general and patient perceptions of their care experiences, specifically.Ethical Culture Influence On Patient Satisfaction Case Study Essay

The CMS designed financial metrics which reward or penalize hospitals according to their HCAHPS scores. Such measures of patient satisfaction coupled with perceptions regarding their care can be significant in guiding healthcare organizations in terms of their operations and practice decisions. This low-cost methodology can yield out-sized returns through the adoption of best practices and responsiveness to patient needs and concerns. This management tool can assist organizations in improving patient outcome, organizational sustainability and stability. Hence, these metrics may enable healthcare organizations to retain current patients, attract new ones, and streamline the work flow throughout the organization.

The goal of patient satisfaction surveys is to understand (from a patient’s perspective) the quality of care, specific strengths and weaknesses, and identify areas where the delivery of care may be improved. The interest of measuring patient satisfaction was initiated and developed through the Center for Medicare and Medicaid Services (CMS), and The Agency of Healthcare Research and Quality (AHRQ). These initiatives resulted in the development of The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Patient satisfaction surveys also address the humanism of healthcare professionals. This survey touches upon qualities such as caring, compassion and concern, and the responsiveness of the healthcare professional to patient needs and concerns. Ethical Culture Influence On Patient Satisfaction Case Study Essay The second important element of humanism and respect is two-way communication skills. This component is critical to patient care, planning, intervention and decision-making. Therefore, central patient care places patients and their families at the center of effective communication between professional and patient outcome. In addition, patient satisfaction surveys address patient safety and confidentiality.

Patient satisfaction surveys offer and assess whether health professionals communicate and explain important information, as well as, the side effects of medications which are being administered. Patient understanding of their medications and side effects can provide guidance when seeking medical attention. However, patient satisfaction surveys do not address other hospitals associated problems such as infections, surgical complications, readmission rates and death rates (Junewicz & Youngner, 2015). The relationship between patient satisfaction and quality of care is still, largely unclear (Junewicz & Youngner, 2015). Quality of patient care can encompass many different aspects of healthcare, and to date no clear evidence exists to demonstrate that patient satisfaction data improves healthcare quality and safety. In addition, patient satisfaction scores can be biased due to patient’s mental status, patient’s desire and demands for drugs, and it can pressure providers to administer inappropriate care (Junewicz & Youngner, 2015).

The extent of nursing influence on patient satisfaction may be manifested by the HCAHPS survey. Parameters related to nursing interactions are included throughout the survey questionnaire. Measurements of nursing responses to patient needs include variables such as responding to call bells, treating patients with courtesy and respect, room quietness at night, communication of the nurse regarding patient care, medication requirements and discharge planning. Therefore, patient perceptions of the frontline nursing staff are a key element in patient satisfaction scores. In the clinical setting, nurses often value clinical leaders who embrace and operate with a strong moral compass (Mannix, Wilkes, & Daly, 2015). Therefore, a leadership style that incorporates an esthetic world view with a strong moral purpose can enhance the clinical nursing workplace.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Bjerdnaes et al. (2012) study investigated the effects of different predictors of overall patient satisfaction with hospital experience. Patient experience questions were based on the patient experiences questionnaire which comprised of 26 items including two items about expectations, one item about overall patient satisfaction, 14 questions about quality of life and 10 background questions. The research finding revealed that thirteen variables were significantly associated with overall patient satisfaction; two variables about fulfillment of expectations, eight about patient reported experience and three sociodemographic variables. The most important predictor of patient satisfaction with hospitals was patient reported experience with nursing service, followed by fulfillment of patient expectations, experience with doctors’ services, and perceived appropriate treatment.

Szecsenyi et al. (2011) research aimed to evaluate whether there is an association between patient satisfaction and job satisfaction of healthcare teams. The research revealed a positive correlation between non-physicians’ team members (nurses and others) and patient satisfaction. High job satisfaction by non-physicians was associated with high patient satisfaction. The result of this study revealed that satisfaction of non-physicians has a larger impact on patients’ evaluation on quality of care than the satisfaction of the physicians. One limitation of this study is limited sample and location.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Boev (2011) study first aim was to examine patient perception of nursing care associated with their hospitalization in the intensive care unit (ICU) using their existing unit of patient satisfaction survey. The second aim was to describe nurses’ perception of work environment with a defined sample of adult critical care units, using the Practical Environment Scale of the Nursing Work Index (PES-NWI). The last aim was to explore the relationship between nurses’ perception of work environment and patient satisfaction in the ICU using multilevel modeling as the basis for statistical analysis.

The research finding revealed that patients were very satisfied with their hospitalization. Nurses reported moderate satisfaction with work environment. Perception of nurse manager leadership and ability was significantly related to patient satisfaction. Favorable perception of the nurse managers was associated with increased patient satisfaction. The research provided preliminary support for the relationship between nurses’ perception of work environment and patient satisfaction in adult critical care. However, some limitation present due to secondary data, sample size, and the patient satisfaction instrument that has not been tested fully. Therefore, the researcher suggested further studies exploring the relationship between nurse perception and patient outcome.

Ancarani, Di Mauro, & Giammanco, 2011) tested a model of organizational climate, its perception by medical and nursing staff and the impact on patient satisfaction. This cross-sectional study was based on a sample of 2,563 which consisted of 57 managers, 848 employees (621 nurses and 277 physicians), and 1,598 patients. The research found that different climates impact patient satisfaction differently, and human relation climate increases patient satisfaction. There is evidence in favor of the mediating effect of climate between the managers’ climate orientation and patient satisfaction. The researchers suggested that in order to improve patient satisfaction in hospital units, managers should improve climate toward staff coordination, cohesion, support and staff welfare. The main limitation of this study is the cross-sectional nature of the data. The researchers suggest further research in different setting of healthcare.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Aiken’s (2012) research aimed to investigate whether healthcare organization with improved nurse staffing and work environment can affect patient care and nurse work stability, in European countries. This research also was based on a cross-sectional study of 1,105 general acute hospitals, 488 in European countries, and 617 in four states in the United State. Patient satisfaction was measured using the Hospital Consumer Assessment of Healthcare Providers and System, (HCAHPS) instrument. The research findings revealed that patients in hospitals with better work environment were more likely to rate their hospital highly and recommend their hospitals. The study in these different countries indirectly indicates that organizational behavior and the retention of a qualified and committed nurse work force might be a promising area to improve hospital care safety and quality both nationally and internationally. One of the limitations in the study was that it relied on cross-sectional data which could not definitively establish causality.Ethical Culture Influence On Patient Satisfaction Case Study Essay

Effective leadership in healthcare is important for the achievement of optimal patient outcome. Wong, Cummings, and Ducharme (2013) in their systematic review of studies, examined the relationship between nursing leadership practices and patient outcome. A total of 20 studies suggested positive relationships between leadership styles and higher patient satisfaction, lower patient mortality, fewer medication errors, less restraint use and fewer hospital-acquired infections. The findings of this study provided support for the assertion that relational leadership practices are positively associated with the same categories of patient outcome. Effective leadership approach contributes to a healthy work environment which is through continual support, open and honest communications and trust (Wong et al., 2013). Trustworthy managers can inspire nurses’ commandment to their willingness to be engaged in patient care quality decisions. The dialogue and communication between leadership and frontline nursing staff to resolve patient care issues can decrease patient dissatisfaction, increase patient safety and quality care outcome (Wong et al., 2013).Ethical Culture Influence On Patient Satisfaction Case Study Essay

Nursing provides a holistic approach to patient care; hence, the relationship between the nurse and patient is therapeutic and based on trust and mutual understanding, as well as open communication which fosters mutual goal setting (Peplau, 1997). The implication of effective communication to the patient can lead to increased patient satisfaction, prevent loss of reimbursement, and potentially increase referrals. Improved nurse-patient communication would improve quality care, support a decrease in anxiety, elevate safety, and enable patients to develop trust in nursing care, which potentially may lead to improved patient outcomes. In essence, improved staff communication skills would eventually increase patient satisfaction (Oni, 2012). Based on the history of patient satisfaction, a great need exits to understand how healthcare leaders can sustain consistently high patient satisfaction scores within a department/unit. This research study will raise awareness within the healthcare sector as to how nursing leadership ethics can influence and sustain HCAHPS scores in the 90th percentile.Ethical Culture Influence On Patient Satisfaction Case Study Essay

A Press Ganey’s (2013) study identified Communication with Nurses as a rising tide measure among the eight HCAHPS dimensions of care. A rising tide measure is one whose change and trajectory in performance is correlated with multiple measures. This effect is important to understand when devising performance improvement strategies, for as the score of a rising tide measure increases, the scores of the associated measures are likely to rise as well.

Using data from a robust sample of 3,062 United States acute-care hospitals in the CMS Hospital Compare Database, Press Ganey’s (2013) research team conducted a hierarchical variable clustering analysis on all eight HCAHPS dimensions. The data was collected between October 1, 2009, and September 30, 2010, and was analyzed by performing a hierarchical variable clustering analysis on all eight HCAHPS dimensions. This type of analysis is different from a traditional correlation analysis, which looks at the relationship between two measures only. The variable clustering technique identifies multiple measures that “hang together” consistently, and the hierarchical analysis identifies which measure (or cluster of measures) leads the others. The objective of the analysis was to find out the leader of the HCAHPS dimensions and assist hospitals to strategically focus their performance improvement resources on high impact issues.

Press Ganey’s (2013) analysis identified five HCAHPS dimensions that consistently cluster together: communication with nurses, responsiveness of hospital staff, pain management, communication about medication, and overall rating. The finding revealed that communication with nurses led the other four measures. This means that when a hospital aims improvement efforts on the communication with nurses’ dimension, it can lead to gains in performance in the other four dimensions in the cluster.Ethical Culture Influence On Patient Satisfaction Case Study Essay

The CMS designed financial metrics which reward or penalize hospitals according to their HCAHPS scores. Effective leadership in healthcare is important for the achievement of optimal patient outcome. Effective leadership approach contributes to a healthy work environment which is through continual support, open and honest communications and trust (Wong et al., 2013). Nursing provides a holistic approach to patient care. Patient satisfaction surveys offer and assess whether health professionals communicate and explain important information. The implication of effective communication to the patient can lead to increased patient satisfaction and prevent loss of reimbursement. Oni (2012) argued that improve staff communication can lead to improve patient outcome. A Press Ganey’s (2013) study identified Communication with Nurses as a rising tide measure among the eight HCAHPS dimensions of care. Press Ganey’s (2013) analysis revealed that that communication with nurses led the other four measures such as responsiveness of hospital staff, pain management, communication about medication, and overall rating. However, According to Junewicz and Youngner (2015) quality of patient care can encompass many different aspects of healthcare, and there is no clear evidence exists to demonstrate that patient satisfaction data improves healthcare quality and safety.

According to Szecsenyi et al. (2011) the most important predictor of patient satisfaction with hospitals is patient reported experience with nursing service, followed by fulfillment of patient expectations, experience with doctors’ services, and perceived appropriate treatment. In addition, the study of Boev (2011) added that Perception of nurse manager leadership and ability was significantly related to patient satisfaction. Ancarani et al. (2011) suggested that in order to improve patient satisfaction in hospital units, managers should improve climate toward staff coordination, cohesion, support and staff welfare. The researchers suggested further research in different setting of healthcare. The proposed study will focus on nursing ethical leadership impact on nurses’ Ethical Culture Influence On Patient Satisfaction Case Study Essay communication.

Methodology. As evidence by the preceding review of literature, many quantitative studies and very few qualitative studies have been conducted. The literature review proceeded with ethical leadership perception. Jordan et al. (2013) quantitative study proposed that followers’ perception of ethical leadership depends on the executive leader’s cognitive moral development (CMD). The authors explain his findings by using the social learning theory framework. The study was cross sectional with limited samples of senior executives. However, the social learning theory supported the study direction. Drawing for the social learning theory, Steinbauer et al. (2012) tested and developed two stage models in order to investigate ethical leadership correlation to followers’ ethical judgment an organizational content. This quantitative correlational study used single item measures for perceived accountability and achieves judgment due to time and space limitations. In addition, the author defended their use of vignettes by pre-testing several vignettes with manipulation check to validate their conditions and they selected the best-improved vignette that fit the research design. Ethical Culture Influence On Patient Satisfaction Case Study Essay