High-Performance Work Practices in a Healthcare Setting

¶ … high-performance work practices benefit the nursing profession -- and moreover, how are high-performance work practices beneficial to the patient receiving care from the nurse? This paper delves into the concept of high-performance efforts in the nursing workplace.

Severe nursing shortages and the urgent concerns as to the quality of care resulting from these shortages has led to the increased implementation of high-performance work practices (HPWPs), according to assistant sociology professor Janette Dill and colleagues in the peer-reviewed journal Health Care Management Review. And it should be noted that the study that Dill and colleagues conducted relates not to nurses per se, but to the career development that HPWP offers for "unlicensed frontline healthcare workers." These workers are nursing assistants, mental health counselors, "patient care technicians" and "respiratory therapy technicians" (Dill, 319).

While they are not licensed as RNs, these workers make up 50% of the healthcare workforce (six million of these workers are in healthcare today) and hence, they are critical to the delivery of quality services and they are "…among the fastest growing occupations in the United States" (Dill, 319). The question posed by the authors is, because traditionally (due to the "low threshold" of entry qualifications) these unlicensed workers are "easily" replaced (and hence they aren't given much training), will a new policy that recruits and trains these workers benefit the workers and the healthcare organizations? (Dill, 319).

In other words, if healthcare employers offer career ladders and "tuition remission" to workers (who previously were expendable and had little or no chance to move upward in organizations), will they believe there is upward mobility available to them and hence become longer serving employees? The authors of this journal article used analysis to review a sample of 947 frontline health care workers in 22 healthcare organizations, to see if there was a relationship between HPWPs and a sense of future mobility for unlicensed workers at their workplaces. As part of the research and analysis, the authors expected that three continuous measures of employer support (HPWPs) would show the unlicensed workers that indeed their employers "support their career development and advancement": a) financial rewards -- the pay is fair for the work provided; b) autonomy ("It is basically my own responsibility to decide how my job gets done"); and c) workload ("There is not enough time to get the required work done..") (Dill, 322-23).

The 947 frontline workers that were interviewed (88% women; 24% Black; 27% Latino; 25% of another minority; 52% married; average age 37 years; 19% single mothers) and on average earned $12 an hour (albeit some were paid as low as $7 and others made as much as $31 an hour) (Dill, 323-24). The survey showed that when supported well by supervisors, their perceived mobility rose; and those with "higher financial rewards and autonomy in their current jobs have higher perceived mobility" (Dill, 324).