Diffusion of MRSA practices in health care settings: The role of trust and media selection in staff preventive behaviors during organizational change
Within an overarching diffusion of innovations theoretical framework (Rogers, 1999), the study employs media richness perspective (Daft & Lengel, 1986) to theorize the contribution of organizational trust (Hon & Grunig, 1999) and information acquisition through communication channels on staff adoption of key behaviors in reducing nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) within healthcare settings.^ Results indicate 88% of the information and resources available (IR) related variance assigned to attitudes is mediated by organizational climate (CLI) and climate completely mediates the effect of organizational support (OS) on attitudes. Contrary to research hypotheses, the positive relationship between IR and climate is stronger at lower levels of IR and weaker at higher levels of IR (bIR X TR = -.104, p = .044) and the relationship between OS and climate is stronger at lower levels of OS and weaker at higher levels of OS (bOSxTR = -.091, p = .032). Trust significantly explains 11.3% of variance in discussions with unit members and 8.3% of the variance in face to face meetings with supervisor, and 3.3% of variance in staff attitudes and 7.2% in social norms. 45% of the IR-related variance and 36% of OS related variance assigned climate was significantly mediated by the use of discussions with unit members and face-to-face meetings with supervisors. No support was obtained for the theory of planned behavior on staff behavior.^ The findings suggest that: (a) provision of information regarding practices remove uncertainty in climate and account for the strong role of climate in mediating the influence of IR and OS on staff attitudes; (b) trust forms a significant relational factor in contextual behaviors underlying climate and staff outcomes (positive attitude and subjective norms toward change); and (c) richer channels are vital for translating the effect of organizational climate on staff attitudes. The study highlights the importance of the traditional message flow model in achieving tangible organizational outcomes in health care.^
Howard E. Sypher, Purdue University.
Health Sciences, Occupational Health and Safety|Mass Communications|Health Sciences, Epidemiology