1996 OPEN FORUM Abstracts
JOB REDESIGN UTILIZATION WITH CROSS-TRAINING OF RESPIRATORY CARE PERSONNEL IN FLORIDA ACUTE CARE HOSPITALS.
Oliver J. Drumbeller, EdD, RRT, David C. Shelledy, PhD, RRT, Douglas L. Murphy, PhD, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
BACKGROUND: We assessed the extent to which job redesign factors (JRF) were utilized for cross-training of respiratory care practitioners (RCPs) in Florida acute care hospitals. The four categories of JRF studied were: work characteristics, education and training, satisfaction and incentives for cross-training. METHOD: Education Directors at all 240 acute care hospitals in Florida were surveyed using an instrument validated by a panel of experts. Each was asked to respond to the use of JRF utilized in cross-training of RCPs at their hospital. Results: There were 109 usable surveys returned (45%). Of these, 45 (41%) had cross-trained RCPs using JRF. Results are reported as percentage of respondents performing cross-training of RCPs using specific job redesign elements.
Work Characteristics Percentage Using JRF for Cross Training
Employee Allowed Choice for Cross-Training 60
Supervisor Prepared to Support RCPs for Cross-Training 84
Cross-Training Increased Skill Complexity 74
Cross-Training Increased Level of Job Challenge 87
Cross-Training Increased Skill Diversity 89
Education and Training
Included Cognitive Content 91
Included Affective & Human Relations Content 55
Included Clinical Decision Making Content 77
Included Safety Content 93
Cross-Training Included Stress Management 40
Cross-Training Allowed for RCP Skill Maintenance 100
Programs Monitored Quality of Patient Care 91
Programs Allowed for Job Streamlining to Perform Whole Job 66
Programs Allowed for Employee "Buy In" 75
Incentives for Cross-Training
Increased Pay for Cross-Training 34
Increased Paid Time Off for Cross-Training 7
Increased Recognition for Cross-Training 64
Increased Career Promotion Opportunities 45
All listed JRF were used. The most frequently used JRF were: allow for RCP skill maintenance (100%), inclusion of safety content (93%), cognitive content (91%), monitoring for quality of care (91%), allowed for increasing skill diversity (89%), allowed for increasing level of job challenge (87%) and supervisor prepared to support RCPs for cross-training (84%). The least used JRF elements were increased paid time off for cross-training (7%) and increased pay for cross-training (34%). Other less frequently used JRF were inclusion of stress management (40%), increased career promotion opportunities (45%), affective and human relations content (55%) and employee allowed choice for cross-training (60%). Conclusions: All acute care hospitals cross-training RCPs included JRF as part of their cross-training programs. Allowing maintenance of RCP skills was universally supported as part of job redesign. There was little support for use of financially based incentives to motivate RCPs to be cross-trained as a part of hospital job redesign. Attention to job redesign factors may improve success of RCP cross-training.