Purpose

The complexity and uncertainty of healthcare operations increasingly require agility to safeguard a high quality of care. Using a microfoundations of dynamic capabilities perspective, this study investigates the effects of nurses' implicit voice theories (IVTs) on the behaviors that influence their individual agility.

Design/methodology/approach

This research uses quantitative survey data collected from 2,552 Canadian nurses during the fourth wave of the Covid-19 pandemic in the fall of 2021. Structural equation modeling is used to test a conceptual model that hypothesizes the effects of three different IVTs on nurses' creativity, spontaneity, agility and the quality of care they deliver to patients.

Findings

The results reveal that voice-inhibiting cognitions (like “suggestions are criticisms for higher-ups”, “I first need a solution or solid data”, and “speaking up has negative repercussions”) negatively impact nurses' creativity and spontaneity in crafting solutions to problems they face daily. In turn, this affects nurses' individual agility as they attempt to adapt to changing circumstances and, ultimately, the quality of care they provide to their patients.

Practical implications

Even if organizations have little control over employees' pre-held beliefs regarding voice, they can still reverse them by developing and nurturing a voice-welcoming culture to boost their workers' agility.

Originality/value

This study combines two theoretical frameworks, voice theory and dynamic capabilities theory, to study how individual-level factors (cognitions and behaviors) contribute to nurses' individual agility and the quality of care they provide to their patients. It answers the recent calls of scholars to study the mechanisms through which healthcare operations can develop and sustain dynamic capabilities, such as agility, and better face the “new normal”.

中文翻译：

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让我们来谈谈：护士内隐建言理论对个体敏捷性和护理质量的影响

目的

医疗保健运营的复杂性和不确定性越来越需要敏捷性来保障高质量的护理。本研究使用动态能力视角的微观基础，调查护士的内隐建言理论 (IVT) 对影响其个体敏捷性的行为的影响。

设计/方法/途径

这项研究使用了在 2021 年秋季第四波 Covid-19 大流行期间从 2,552 名加拿大护士收集的定量调查数据。结构方程模型用于测试一个概念模型，该模型假设三种不同的 IVT 对护士创造力的影响，他们为患者提供的自发性、敏捷性和护理质量。

发现

结果表明，抑制发声的认知（如“建议是对上级的批评”、“我首先需要一个解决方案或可靠的数据”以及“大声疾呼会产生负面影响”）会对护士在制定解决方案时的创造力和自发性产生负面影响解决他们每天面临的问题。反过来，这会影响护士在尝试适应不断变化的环境时的个人敏捷性，并最终影响他们为患者提供的护理质量。

实际影响

即使组织几乎无法控制员工对声音的先入为主的信念，他们仍然可以通过发展和培育一种欢迎声音的文化来提高员工的敏捷性，从而扭转这些信念。

原创性/价值

本研究结合了声音理论和动态能力理论这两个理论框架，以研究个人层面的因素（认知和行为）如何影响护士的个人敏捷性和他们为患者提供的护理质量。它回应了学者们最近的呼吁，即研究医疗保健运营能够发展和维持动态能力（例如敏捷性）的机制，并更好地应对“新常态”。