Date of Award

5-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Industrial-Organizational Psychology

Committee Chair/Advisor

Dr. Thomas W. Britt

Committee Member

Dr. Robert R. Sinclair

Committee Member

Dr. Marissa L. Shuffler

Committee Member

Dr. Emily L. Hirsh

Abstract

Emergency Physicians (EPs) work in stressful and unpredictable work environments. Due to these factors and the nature of their work scheduling (in shifts), EPs experience heightened levels of adverse work outcomes. As such, it is important for EPs to believe their shift schedule is fair, and for them to have adequate recovery time away from work. The present research examined the effects of Emergency Department leadership approving a 1-hour increase to EP shifts, equating to roughly two fewer shifts per month (8-hour shifts will become 9-hour shifts). As such, EPs should experience more time off from work per month, allowing for more recovery time. This study sought to examine the effectiveness of this system-level intervention, in addition to contextual factors outside of the shift intervention, on EP outcomes through a quasi-experimental, mixed-model design. Survey data were collected at two points in time, two months apart. The first survey assessed Work Schedule Justice perceptions and relevant outcomes prior to the shift change, and the second survey collected perceptions on the same constructs two months after the shift change occurred. Semi-structured interviews were conducted in the Spring after the second survey was closed to provide context for the quantitative results. Data on shifts EPs worked for six months were also collected. Shift data analyses concluded that the EPs did work fewer shifts overall, fewer hours overall, fewer 8-hour shifts, and more 9-hour shifts after the intervention was implemented. Survey data showed that Procedural Shift Schedule Justice was the only variable that significantly changed in a positive direction as a function of time. Thematic analyses from semi-structured interviews highlighted five themes relevant to the shift change, contextual information surrounding events occurring in tandem with the change in the ED, as well as overall EP shift preferences. EPs frequently stated that although they experienced fewer shifts per month, the shifts themselves were more stressful due to understaffing within the ED. These findings can be used to understand the multifaceted nature of implementing an organizational intervention and the importance of collecting multiple data types to understand the findings.

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