Working in institutional care: higher quality of work is associated with higher quality of care

Abstract

Background: This study examines whether, on a unit-level, quality of work (psychosocial job characteristics and organizational factors) is associated with quality of care provided. Furthermore, on the basis of the energy depleting process and motivational process described by the Job Demands-Resources model it is tested whether this association is mediated through employee fatigue and commitment. Methods: About 45,000 employees working in 845 units of organisations providing care for mentally and/or physically disabled filled in self-report questionnaires assessing quality of work, fatigue (CIS-20), organisational commitment, and quality of care provided by their unit. Findings: Aggregated data on unit level yielded significant associations between quality of work aspects and quality of care provided. Higher quality of care was related to higher staffing resources, better work procedures, higher job control, and more social support between colleagues. Mediation analysis confirmed a partial mediating role of employee fatigue and organisational commitment in the quality of work – quality of care relationship. Discussion: The findings suggest that improving quality of work may enhance quality of care, partially through improving health/energy and motivation of employees.