CLIMA ORGANIZZATIVO E SICUREZZA IN OSPEDALE

According to the systemic or interactive approach, the organizational climate consist of the shared perceptions of the work environment by the employees. The evidence supports that an unfavourable organizational climate could be a danger for the health and safety of the workers. The indexes, derived from the administrative data or any other “objective” source of information (other then the workers), are only partially able to detect the latent causes of some safety negative outcome as injures or sickness absence. In determining the origin of these adverse events, it is necessary to directly ask the employees and consider their perception of the organizational framework and of any apparent danger. In this field of research the self-report questionnaire appears a valid instruments of investigation because it is able to collect reliable data on the target population with acceptable costs. OBJECT OF RESEARCH The aim of the research, described in this present thesis, is developing a questionnaire for the study of the relations within organizational climate and worker safety in a general hospital for the Lombardy public heath trust system. Secondary, the research has the purpose to review, the empirical framework, the construct of “climate” from the labour security point of view. METHODS AND INSTRUMENTS The final questionnaire has 118 items and 18 domains, grouped into 5 sections. It derives from over the 50% by validated rating scale: Job Content Questionnaire (27-item version); Effort Reward Imbalance (12- item version); Maslach Burnout Inventory (31- item version). The survey has a cross sectional design and has been administered, on March 2010, to 1206 operators allocated in the health departments of surgery, medicine, emergency and diagnostic services. We also performed an analysis of a tools of administrative data, regarding the worked hours, sickness absences and injuries, on 1996 employees, the whole work force of the general hospital during the period 1st January 2007 to 31st December 2009. MAIN RESULTS: The analysis of variance, carried out on administrative data, confirms the usefulness of this methodology for detecting the risk group of negative safety outcomes, as injuries or sickness absence but not the latent risk factors. According with the literature on the emergent risk in the worker population, the results identify the presence of some risks for safety in specific subgroups of employees as adults over 50, women and young workers under 30, The factor analysis shows that the questionnaire has 5 dimensions where the 18 theoretical domains converge. Of the original scales, only the domain “Job demand” (JCQ) retains its original construct, the others were split into three main dimensions: factor 1 (8 or 7 domains), factor 2 (4 or 3 domains), factor 4 (3 or 2 domains). The factor 3 includes the questions on safety climate and attitude. CONCLUSION: The factor 1 aggregates the items on the organization and the quality of the interactions with superiors and colleagues. In this dimension are aggregated most of the items that describe well-known psychosocial risk as autonomy (JCQ), reward (ERI), leadership and relation with co-worker (JCQ). The construct of this item is consistent with the definition of organizational climate according to the systemic approach. Factor 2 aggregates all the items derived by the subscale of the MBI and over-commitment by ERI. This dimension seems to express the level of psychological discomfort and/or maladjustment with the job but with a construct that differs by the original definition of. Burnout. If this results are confirmed in the future, a revision of the concept of burnout, will be.