The impact of the use of employee functional flexibility on patient safety

Abstract

Purpose

The purpose of this study is to examine the effect of the use of unit-level functional flexibility on one particular patient outcome, unit-acquired pressure ulcers, and the potential moderating influences of coworker support and workload.

Design/methodology/approach

This study uses an archival approach, examining data from 68 hospital units.

Findings

The results indicate that a unit's higher use of functionally flexible nurses in one-quarter was associated with a higher number of pressure ulcers among the unit's patients the following quarter. This detrimental effect was significantly diminished when coworker support within the unit was high. Unit-level nurse workload did not have any moderating influence.

Research limitations/implications

One of the scholarly contributions of this study is that it links greater use of functionally flexible employees to a negative patient safety outcome at the unit level. As most of the variables used in the study were archival measures, future research could examine the replicability of these findings using other indicators and measures.

Practical implications

Beyond healthcare settings, the results prompt managers in industries where there has been growing use of functional flexibility (e.g., banking) to think about the associated unintended negative consequences. That said, the results also point to coworker instrumental support as a means by which to mitigate negative outcomes.

Originality/value

Although functional flexibility has been shown to positively correlate with a number of organizational performance indicators, this is one of the very few studies that has examined its negative consequences, particularly on patient safety.

Citation

Salvador, R.O., Gnanlet, A. and McDermott, C. (2020), "The impact of the use of employee functional flexibility on patient safety", Personnel Review, Vol. 50 No. 3, pp. 971-984. https://doi.org/10.1108/PR-10-2019-0562