Perceived Organizational Environment and Performance Reliability in the Case of Hospital Nurses

Abstract

Most hospital organizational environments in Japan are required to redesign the current organization into a new type of organization, namely a knowledge-based or an intelligent organization. Team care formation, for instance, which forms a hierarchy with medical doctors having an initiative, and simply gathering some disciplinary staff in plural areas, is not adequate. Redesigning an innovative organization is not possible without appropriate transformation into a flexible and resilient organization that can cope with the contingency of complex social environment. Professional staff in hospitals need to develop their work organization to be more flexible and adaptive to the changes in society. The accidental events which happen in hospitals are rarely controlled only by technical countermeasures or by traditional human resource management, but can be purposefully aligned by the appropriate application of knowledge management methodologies. Accuracy of human action is not merely acquired by avoiding erroneous behavior, rather it is ensured by continuously redesigning work organizational climate for the participants to take an autonomic action with the sense of organizational citizenship and social responsibility. The focus in this chapter is placed on the current situations of work organization of hospitals in Japan and on the comparison of perceived nursing work, incidence rates during 24 hours of nursing care work, and reduced reliability among four control modes of organizational environment, such as strategic, tactical, opportunistic, and scrambled. This study suggests that cognitive reliability on work conditions and on perceived work environment plays a critical role in improving performance reliability and in reducing human errors in order to provide a high quality of nursing care.