The impact of employee empowerment on continuous improvement of health care: an empirical and comparative study between hospitals
Abstract
The study has been aimed to know the impact of Employee Empowerment on CI of health care between hospitals (government and private). The required data for the purpose of this study were collected by a questionnaire designed on the basis of related practices. It consisted of 73 items divided into two domains, the first one to measure employee empowerment practices (37 items), and the second one to measure CI practices (36 items). The study sample was applied to the (326) respondents; The total number of respondents from hospitals was 326; That is, 76% of the total number of the target group, which is (431) respondents, with a response rate of 96%, which is high percent because the researcher distributed the questionnaires personally. Using IBM SPSS and a comparative descriptive-analytical approach. Three themes emerged from the respondents’ trends. First, the existence of employee empowerment application in government hospitals was moderately level, and in private hospitals was in a high level, and also the existence of CI application in government hospitals was in a low level, and in private hospitals was in a high level. Second, there is a strong correlation between employee empowerment and CI of health care in hospitals (government, private). Third, there is statistically significant impact at the level (α ≤ 0.05) of the Employee empowerment on CI of health care whether the dimensions of CI are combined or fragmented in hospitals. The limitation of this study was in fixed bureaucracy structure in governmental hospitals and competitiveness issues in private hospitals. The study dealt with a dependent variable that was rarely studied by previous Arab studies and also rarely comparative study between profit and nonprofit hospitals.
Keyword : employee empowerment, continuous improvement (CI), health care, government and private hospitals
How to Cite
Al-Rjoub, S. R., Aldiabat, B. F., & Ait Yassine, F. L. Y. (2023). The impact of employee empowerment on continuous improvement of health care: an empirical and comparative study between hospitals. Business: Theory and Practice, 24(1), 13–23. https://doi.org/10.3846/btp.2023.16667
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
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Areiqat, A., & Zamil, A. (2011). The role of empowerment in crisis management in business organizations. Asian Journal of Business Management, 3(3), 188–195. https://www.researchgate.net/publication/220007632
Assaf, A. M. M. (2011). Scientific theory of management, management theory of values. Zahran Publishing & Distribution House.
Aul, K., Bagnall, L., & Bumbach, M., Gannon, J., Shipman, S., McDaniel, A., & Keenan, G. (2021). A key to transforming a nursing curriculum: Integrating a continuous improvement simulation expansion strategy. SAGE Open Nursing, 7. https://doi.org/10.1177/2377960821998524
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Bailie, R., Matthews, V., Brands, J., & Schierhout, G. (2013). A systems-based partnership learning model for strengthening primary healthcare. Implementation Science, 8(143), 1–12. https://doi.org/10.1186/1748-5908-8-143
Banerjee, S. (2019). Employee empowerment and job performance: The case of a few selected BPOs/KPOs in the city of Pune. International Journal of Engineering and Advanced Technology (IJEAT), 8(6S). https://doi.org/10.35940/ijeat.F1150.0886S19
Barberato Henrique, D., Godinho Filho, M., Marodin, G., Lopes de Sousa Jabbour, A. B., & Chiappetta Jabbour, Ch. J. (2020). A framework to assess sustaining continuous improvement in lean healthcare. International Journal of Production Research, 59(10), 2885–2904. https://doi.org/10.1080/00207543.2020.1743892
Berwick, D. M. (2019). Sounding board: Continuous improvement as an ideal in health care. In Management of health care (pp. 183–186). Routledge. https://doi.org/10.4324/9780429450242-17
Bessant, J., Caffyn, S., Gilbert, J., Harding, R., & Webb, S. (1994). Rediscovering continuous improvement. Technovation, 14(1), 17–29. https://doi.org/10.1016/0166-4972(94)90067-1
Bhuiyan, N., & Baghel, A. (2005). An overview of continuous improvement: From the past to the present. Management Decision, 43(5), 761–771. https://doi.org/10.1108/00251740510597761
Brown, D. (1996). An experimental approach to organization development. Prentice-Hall.
Butler, M., Szwejczewski, M., & Sweeney, M. (2018). A model of continuous improvement programmed management. Production Planning & Control, 29(5). https://doi.org/10.1080/09537287.2018.1433887
Chandhok, G., & Saranya, J. (2019). The impact of employee empowerment in organizational performance with special reference to IT sector. International Journal of Recent Technology and Engineering (IJRTE), 8(2S8), 2277–3878. https://doi.org/10.35940/ijrte.B1090.0882S819
Daft, R. (2010). Organization theory and design (10 ed.). South-Western Cengage Learning.
Dale, B. G., Van Der Wiele, T., & Van Iwaarden, J. (2007). Managing quality. John Wiley & Sons.
Dana, B. (2004). Continuous quality improvement (CQI) readiness assessment process and tool. American Health association.
Deming, W. E. (1982). Quality, productivity and competitive position. Massachusetts Institute of Technology.
Dimitmades, Z. S. (2001). Empowerment in total quality: Designing and implementing effective employee decision-making strategies. Quality Management Journal, 8(2), 19–28. https://doi.org/10.1080/10686967.2001.11918949
Evans, J. R., & Lindsay, W. M. (2020). Managing for quality and performance excellence (11th ed.). Cengage Learning.
Fabiane, L. Toledo, J. Dario, A. (2021). Relationship between continuous improvement and innovation performance: An empirical study in Brazilian manufacturing companies. Total Quality Management & Business Excellence, 32(9), 981–1004. https://doi.org/10.1080/14783363.2019.1653178
Fernandez, S., & Moldogaziev, T. (2013). Employee empowerment, employee attitudes, and performance: Testing a causal model. Public Administration Review, 73(3), 490–506. https://doi.org/10.1111/puar.12049
Fryer, K. J., Antony, J., & Douglas, A. (2007). Critical success factors of continuous improvement in the public sector: A literature review and some key findings. The TQM Magazine, 19(5), 497–517. https://doi.org/10.1108/09544780710817900
Gary, Y., & Becker, W. (2006). Effective empowerment in organizations. Organization Management Journal, 3(3), 210–231. https://doi.org/10.1057/omj.2006.20
Gatchalian, M. M. (1997). People empowerment: The key to TQM success. The TQM Magazine, 9(6), 429– 433. https://doi.org/10.1108/09544789710187037
Gilmore, S. (2013). Introducing human resource management. In S. Gilmore, & S. Williams (Eds.), Human resource management (2nd ed., pp. 3–20). Oxford University Press.
Goetsch, D. L., & Davis, S. B. (2016). Quality management for organizational excellence (6th ed.). Prentice Hall.
Graham, R. N. J., & Woodhead, T. (2020). Leadership for continuous improvement in healthcare during the time of COVID-19. Clinical Radiology, 76(1), 67–72. https://doi.org/10.1016/j.crad.2020.08.008
Hirzel, A.-K., Leyer, M., & Moormann, J. (2017). The role of employee empowerment in the implementation of continuous improvement: Evidence from a case study of a financial services provider. International Journal of Operations & Production Management, 37(10), 1563–1579. https://doi.org/10.1108/IJOPM-12-2015-0780
Holt, G. D., Love, P. E. D., & Jawahar Nesan, L. (2000). Employee empowerment in construction: An implementation model for process improvement. Team Performance Management: An International Journal, 6(3/4), 47–51. https://doi.org/10.1108/13527590010343007
Hughes, G. D. (2003). Add creativity to your decision processes. The Journal for Quality and Participation, 26(2), 4.
Imai, M. (1997). Gemba Kaizen: A commonsense, low-cost approach to management. McGraw Hill.
Imai, M. (1986). KAIZEN: The key to Japan’s competitive success. McGraw-Hill.
Jevanesan, Th., Antony, J., Rodgers, B., & Prashar, A. (2019). Applications of continuous improvement methodologies in the voluntary sector: A systematic literature review. Total Quality Management & Business Excellence, 32(3–4), 431–447. https://doi.org/10.1080/14783363.2019.1588723
Juran, J. M., Godfrey, A. B., Hoogstoel, R. E., & Schilling, E. G. (1999). Juran’s quality handbook (5th ed.). McGraw Hill.
Kaye, M., & Anderson, R. (1999). Continuous improvement: The ten essential criteria. International Journal of Quality & Reliability Management, 16(5), 485–509. https://doi.org/10.1108/02656719910249801
Kim, P. B., Lee, G., & Jang, J. (2017). Employee empowerment and its contextual determinants and outcome for service workers: A cross-national study. Management Decision, 55(5), 1022–1041. https://doi.org/10.1108/MD-02-2016-0089
Lameijer, B. A., Boer, H., Antony, J., & Does, R. J. M. M. (2021). Continuous improvement implementation models: A reconciliation and holistic metamodel. Production Planning & Control. https://doi.org/10.1080/09537287.2021.1974114
Laschinger, H. K. S. (2008). Effect of empowerment on professional practice environments, work satisfaction, and patient care quality: Further testing the nursing work life model. Journal of Nursing Care Quality, 23(4), 322–330. https://doi.org/10.1097/01.NCQ.0000318028.67910.6b
LeBrasseur, R., Whissell, R., & Ojha, A. (2002). Organisational learning, transformational leadership and implementation of continuous quality improvement in Canadian hospitals. Australian Journal of Management, 27(2), 141–162. https://doi.org/10.1177/031289620202700203
Luxford, K. (2010). The forgotten tenet: Client focus and quality improvement in health care. Building Quality in Health Care, 4(2), 10–12.
MacLean, S. (2021). A conceptual continuous improvement framework to examine the “problems of understanding” applied research. Higher Learning Research Communications, 11(2) 1–21. https://doi.org/10.18870/hlrc.v11i2.1252
Mahmoud, S. M., & Mahmoud, A. H. (2007). Empowering factors in enhancing the leadership characteristics of the director (analytical study of the opinions of directors working in the Ministry of Higher Education and Scientific Research). Journal of Management and Economics, 67.
Marjani, A. B., & Alizadeh, F. (2014). The impact of empowerment on employees performance in standards office of Tehran. International Journal of Academic Research in Economics and Management Sciences, 3(4), 36–43. https://doi.org/10.6007/IJAREMS/v3-i4/1055
McDermott, O., Antony, J., Sony, M., & Daly, S. (2022). Barriers and enablers for continuous improvement methodologies within the Irish pharmaceutical industry. Processes, 10(1), 73. https://doi.org/10.3390/pr10010073
Metcalf, A. Y., Habermann, M., Fry, T. D., & Stoller, J. K. (2018). The impact of quality practices and employee empowerment in the performance of hospital units. International Journal of Production Research, 56(18), 5997–6014. https://doi.org/10.1080/00207543.2018.1475763
Ministry of Health. The Hashemite Kingdom of Jordan. (2020). Annual Report. www.moh.gov.jo
Mokhtar, R., Jaafar, N. H., Sukiman, S. A., & Rahman, A. B. A. (2012). Continuous Quality Improvement (CQI) readiness towards Malaysian Quality Assurance (MQA). In International Conference on Management, Economics and Finance Proceeding (pp. 231–241). ResearchGate.
Najm, N. A., & Alhmeidiyeen, M. S. (2019). Managerial innovation: An attempt to interpretation and evaluation. Review of Applied Socio- Economic Research, 17(1), 26–41.
Newitt, D. (1996). Beyond BPR & TQM – Managing through processes: Is Kaizen enough? In IEE Colloquium on Beyond TQM and Re-Engineering-Managing Through Process. IET. https://doi.org/10.1049/ic:19960785
Pérez Rave, J. I., Fernandez Guerrero, R., & Correa Morales, J. C. (2020). Critical thinking and continuous improvement: A scientific text mining approach. Total Quality Management & Business Excellence, 33(1–2). https://doi.org/10.1080/14783363.2020.1787824
Robbins, S. P., & Judge, T. A. (2009). Organizational behavior. Pearson Prentice Hall.
Rodgers, B., & Jiju, A. (2021). In pursuit of a culture of continuous improvement: Scotland’s national ambulance service. International Journal of Public Administration. https://doi.org/10.1080/01900692.2021.2009857
Roslin, E. N., Ahmed, S., Ahamat, M. A., Bahrom, M. Z., & Ibrahim, N. (2019). The impact of employee involvement and empowerment in Lean Manufacturing System implementation towards organizational performances. International Journal on Advanced Science Engineering and Information Technology, 9(1), 188–193. https://doi.org/10.18517/ijaseit.9.1.7116
Ross, B., Sibthorpe, B., & Gardner, K., & Si, D. (2008). Quality improvement in indigenous primary health care: History, current initiatives and future directions. Australian Journal of Primary Health, 14(2), 53–57. https://doi.org/10.1071/PY08022
Sahoo, C. K., & Das, S. (2011). Employee empowerment: A strategy towards workplace commitment. European Journal of Business and Management, 3(11), 46–54.
Sekaran, U., & Bougie, R. (2016). Research methods for business: A skill-building approach (7th ed.). John Wiley & Sons.
Stewart, G. L., & Brown, K. G. (2009). Human resource management: Linking strategy to practice (1st ed.). John Wiley & Sons Inc.
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