Impact of Structural Employee Empowerment on Hospital Ratings: Mediating Role of Social Climate and First-Line Managers’ Resilience

Abstract

Objective

The purpose of this article is to investigate the relationship between the structural empowerment of first-line health managers and health facility performance, examining the mediating roles of resilience and social climate in shaping the ratings of Slovak hospitals. Additionally, we aim to investigate the deeper mechanisms of this relationship, particularly the impact of resilience and the social climate, which can positively influence it.

Materials and Methods

The data collection was conducted through a questionnaire survey in February 2022. Respondents included 540 healthcare managers at the first level of management from 44 Slovak hospitals, all of which were part of the evaluation by the Institute for Economic and Social Reforms (INEKO). The analysis involved the use of the PLS-SEM method to examine the relationships between variables and assess direct and indirect effects, utilizing SmartPLS 3.3 software.

Results

The findings reveal a positive association between the structural empowerment of first-level managers and the ranking of health facilities. The hypotheses regarding the mediation of both variables - First-Level Managers’ (FLMs) resilience and social climate - are supported, whether considered separately or jointly. In the case of joint mediation, a significant portion of the indirect effect is conveyed through FLMs’ resilience, suggesting a potential avenue of support from hospital management to enhance health facility ratings.

Conclusion

Structural empowerment of first-line managers establishes the conditions for improving the ratings of health facilities. The total effect is significantly more pronounced in promoting their resilience and fostering a supportive social climate.

Keywords:

• health facility performance
• healthcare management
• social climate
• resilience
• hospital rating

Abbreviations

FLMs, First-line Managers; FLMR, First-line Managers’ Resilience; SE, Structural Empowerment; SC, Social Climate; INEKO, Institute for Economic and Social Reforms.

Ethical Approval

Ethical clearance for the study was granted by the Ethics Committee of the University of Economics in Bratislava. All ethical considerations pertaining to the research were meticulously observed. The research objectives were clearly communicated to the participants, who were encouraged to contribute their data. Data collection was conducted with utmost regard for the confidentiality of the respondents. Participants signified their agreement to partake in the study. The voluntary consent to participate was upheld as a fundamental ethical tenet, with a simultaneous emphasis on ensuring participants were thoroughly informed about the study’s objectives, procedures, and potential risks. The study adhered to the guidelines outlined in the Declaration of Helsinki.

Acknowledgments

We would like to express our sincere gratitude to VEGA n. 1/0010/23, VEGA n. 1/0623/22 and VEGA n. 1/0188/24 for their generous support, which significantly contributed to the successful completion of this research.

Author Contributions

Each author contributed significantly to the conception and design, data acquisition, analysis, and interpretation of the study. They actively participated in drafting the article and critically revising it for important intellectual content. All authors endorsed the submission to the present journal, provided final approval for the version intended for publication, and committed to being accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.