Family Health Teams workers in Rio de Janeiro: leadership aspects in a study on organizational climate

Santos, Leda Jung dos; Paranhos, Maurício Sangama

doi:10.1590/1413-81232017223.33112016

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ARTICLE • Ciênc. saúde colet. 22 (3) • Mar 2017 • https://doi.org/10.1590/1413-81232017223.33112016 copy

Family Health Teams workers in Rio de Janeiro: leadership aspects in a study on organizational climate

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Organizational climate is understood as the formal or informal perception of policies, practices, actions and organizational procedures, and is a factor of influence in the efficiency of the results, as well as in the conduct of people that are part of an organization. This paper describes one of organizational climate realms, namely, leadership, comparing the strata of professional categories of the Family Health Teams in the city of Rio de Janeiro. Thus, an administrative-based survey was carried out with a sample of n = 9,590 people in 187 primary healthcare units (71 Family Clinics and 116 Municipal Health Centers). The results show that all items that measure the realm of “leadership” were positively evaluated with differences between strata (p-value <0.001). We recommend conducting regular studies and holding leadership workshops in the very health units, as well as using distance-learning tools to exchange information and train staff.

Organizational climate; Family health teams; Primary healthcare

Realm	Question
01. Information	06. Is information about the Municipal Health Secretariat (SMS) communicated to employees with clarity, speed and security?
	07.Do I know the strategies and goals of the Municipal Health Secretariat of Rio de Janeiro?
	08. Do I know and update myself through the channels and communication means that SMS, managers and directors use to disseminate information about the strategies, projects, actions and results of the Municipal Health Secretariat?
	09. Do I know and access the blog of my facility?
02. Interpersonal relationship	10. Who do you consider as your immediate supervisor?
	11.Your immediate supervisor is open to receiving and acknowledging criticisms, opinions and contributions of his/her employees.
	12. Do I feel a true team spirit and welcome when I need to work with people from another facility?
	13.Are employees of this unit well cared for regardless of their color, race, age, gender, belief or sexual orientation?
03. Relationship and recognition	14.Do all have the opportunity to receive special recognition (a compliment, thanks for well-performed care or exceeding expectations?
04. Leadership	15.Do we celebrate overcoming, results and achievements in this facility?
	16. I realize that my immediate supervisor is in line with the other supervisors. Do they all convey the same message to their teams?
	17. Does my manager / director keep me informed about important day-to-day SMS issues?
	18. Does my immediate supervisor know how to coordinate people and distribute tasks appropriately?
	19. Do I get clear feedback on the progress of my work and my attitudes?
05. Professional development	20. Does my immediate supervisor help and encourage my professional development?
	21. Does my immediate supervisor encourage ideas and suggestions and consider them in a heartfelt way?
	22. If someone treats me unfairly from my facility or coordination, do I believe that I will be heard and will eventually receive treatment?
	23.When you start working in the facility, do you feel welcome and quickly understand your activities and goals?
	24. Does my facility offer courses/trainings and encourage me to pursue self-development to improve the way my work is done?
06. Remuneration	25. Do I consider my salary fair compared to the labor market?
07. Satisfaction	26.Am I satisfied with how my facility contributes to society?
	27. Am I satisfied with my professional activities and consider that my work contributes to the success of my facility?
	28.Net Promoter Score
	29a. List features that motivate you to continue working with us:
	29b. List features that discourage you from continuing to work with us:
	30. How do you rate your level of satisfaction in working in your facility?
	31. Are you satisfied with your immediate supervisor?
	32. Would you recommend your facility to someone in your family or friend?
	33. Do I believe that users who use my facility are satisfied with the service?
08: Administration/ management	34. Would you like to work in another facility?
	35. Do you believe that your manager is transparent with the public funds he/she administers? (E.g. warehouse, office supplies, etc.)
	36. I believe that public funds allocated by the municipality to the facilities are well managed. (E.g., drug logistics, campaign supplies and uniforms).
	37. I notice that my facility is concerned about the good management of public funds (turning off the lights at the end of the day, turning off the air conditioning, preventing waste of inputs and preserving assets).
	38. With regard to my facility’s care capacity, I believe that it…?

Professional Strata	Sample performed (n)	Universe (N)	Response % (n/N)
Community Health Worker	4,436	5.447	81,4%
Health Surveillance Worker	612	2.709	22,6%
Pharmacist or pharmacy technician	269	370	72,7%
Nursing assistant / technician	847	1.064	79,6%
Oral health assistant / technician	455	625	72,8%
Family Dental Surgeon	301	412	73,1%
Family nurse	859	1.002	85,7%
Family doctor	741	1.224	60,5%
Resident doctor	147	155	94,8%
Team administ: technicians, managers	923	973	94,9%
Total	9,590	13.981	68,6%

Occupational category in the FHT	Never / almost never		Always	Almost always		Did not answer		Total
Occupational category in the FHT	Abs.V.	Relat Freq.	Abs.V.	Relat Freq.	Abs.V.	Relat Freq.	Abs.V.	Relat Freq.
Q15: We celebrate overcoming, results and achievements in this facility
Community health worker	784	17,7%	3.325	75,0%	327	7,4%	4.436	100,0%
Health surveillance worker	112	18,3%	469	76,6%	31	5,1%	612	100,0%
Pharmacist or pharmacy technician	31	11,5%	220	81,8%	18	6,7%	269	100,0%
Nursing assistant / technician	157	18,5%	617	72,8%	73	8,6%	847	100,0%
Oral health assistant / technician	67	14,7%	350	76,9%	38	8,4%	455	100,0%
Family Dental Surgeon	39	13,0%	249	82,7%	13	4,3%	301	100,0%
Family nurse	127	14,8%	681	79,3%	51	5,9%	859	100,0%
Family doctor	114	15,4%	584	78,8%	43	5,8%	741	100,0%
Resident doctor	24	16,3%	114	77,6%	9	6,1%	147	100,0%
Team administ: technicians, managers	123	13,3%	695	75,3%	105	11,4%	923	100,0%
Total	1.578	16,5%	7.304	76,2%	708	7,4%	9.590	100,0%
Q16: I realize that my immediate supervisor is in line with the other supervisors. They all convey the same message to their teams
Community health worker	724	16,3%	3.339	75,3%	373	8,4%	4.436	100,0%
Health surveillance worker	102	16,7%	475	77,6%	35	5,7%	612	100,0%
Pharmacist or pharmacy technician	37	13,8%	213	79,2%	19	7,1%	269	100,0%
Nursing assistant / technician	140	16,5%	621	73,3%	86	10,2%	847	100,0%
Oral health assistant / technician	60	13,2%	354	77,8%	41	9,0%	455	100,0%
Family Dental Surgeon	34	11,3%	249	82,7%	18	6,0%	301	100,0%
Family nurse	100	11,6%	694	80,8%	65	7,6%	859	100,0%
Family doctor	88	11,9%	600	81,0%	53	7,2%	741	100,0%
Resident doctor	13	8,8%	124	84,4%	10	6,8%	147	100,0%
Team administ: technicians, managers	107	11,6%	700	75,8%	116	12,6%	923	100,0%
Total	1.405	14,7%	7.369	76,8%	816	8,5%	9.590	100,0%
Q17: My manager / director keeps me informed about important day-to-day SMS issues
Community health worker		13,8%	3.450	77,8%	373	8,4%	4.436	100,0%
Health surveillance worker		14,9%	486	79,4%	35	5,7%	612	100,0%
Pharmacist or pharmacy technician		9,7%	224	83,3%	19	7,1%	269	100,0%
Nursing assistant / technician		13,8%	644	76,0%	86	10,2%	847	100,0%
Oral health assistant / technician		10,5%	366	80,4%	41	9,0%	455	100,0%
Family Dental Surgeon		9,0%	256	85,0%	18	6,0%	301	100,0%
Family nurse		9,1%	716	83,4%	65	7,6%	859	100,0%
Family doctor		9,7%	616	83,1%	53	7,2%	741	100,0%
Resident doctor		5,4%	129	87,8%	10	6,8%	147	100,0%
Team administ: technicians, managers		9,0%	724	78,4%	116	12,6%	923	100,0%
Total	1.163	12,1%	7.611	79,4%	816	8,5%	9.590	100,0%
it continues
Q18: My immediate supervisor knows how to coordinate people and distribute tasks appropriately
Community health worker		23,6%	3.018	68,0%	373	8,4%	4.436	100,0%
Health surveillance worker		16,0%	479	78,3%	35	5,7%	612	100,0%
Pharmacist or pharmacy technician		8,9%	226	84,0%	19	7,1%	269	100,0%
Nursing assistant / technician		19,2%	598	70,6%	86	10,2%	847	100,0%
Oral health assistant / technician		13,2%	354	77,8%	41	9,0%	455	100,0%
Family Dental Surgeon		7,6%	260	86,4%	18	6,0%	301	100,0%
Family nurse		10,9%	700	81,5%	65	7,6%	859	100,0%
Family doctor		10,4%	611	82,5%	53	7,2%	741	100,0%
Resident doctor		10,9%	121	82,3%	10	6,8%	147	100,0%
Team administ: technicians, managers		9,4%	720	78,0%	116	12,6%	923	100,0%
Total		17,6%	7.087	73,9%	816	8,5%	9.590	100,0%
Q19: I get clear feedback on the progress of my work and my attitudes.
Community health worker		16,1%	3.349	75,5%	373	8,4%	4.436	100,0%
Health surveillance worker		13,9%	492	80,4%	35	5,7%	612	100,0%
Pharmacist or pharmacy technician		6,3%	233	86,6%	19	7,1%	269	100,0%
Nursing assistant / technician		11,1%	667	78,7%	86	10,2%	847	100,0%
Oral health assistant / technician		7,7%	379	83,3%	41	9,0%	455	100,0%
Family Dental Surgeon		8,3%	258	85,7%	18	6,0%	301	100,0%
Family nurse		10,1%	707	82,3%	65	7,6%	859	100,0%
Family doctor		8,8%	623	84,1%	53	7,2%	741	100,0%
Resident doctor		14,3%	116	78,9%	10	6,8%	147	100,0%
Team administ: technicians, managers		8,2%	731	79,2%	116	12,6%	923	100,0%
Total		12,7%	7.555	78,8%	816	8,5%	9.590	100,0%

Occupational category in the FHT	Director	Manager	TR Doctor	Family doctor	TR Nurse	Nurse	Other	Did not answer	Total
Community health worker	60	927	10	99	72	2.934	85	249	4.436
(%)	1,4%	20,9%	0,2%	2,2%	1,6%	66,1%	1,9%	5,6%	100,0%
Health surveillance worker	25	267	14	1	27	25	228	25	612
(%)	4,1%	43,6%	2,3%	0,2%	4,4%	4,1%	37,3%	4,1%	100,0%
Pharmacist or pharmacy technician	9	171	5		10		59	15	269
(%)	3,3%	63,6%	1,9%	0,0%	3,7%	0,0%	21,9%	5,6%	100,0%
Nursing assistant / technician	28	300	12	2	116	306	27	56	847
(%)	3,3%	35,4%	1,4%	0,2%	13,7%	36,1%	3,2%	6,6%	100,0%
Oral health assistant / technician	13	275	21	2	7	7	108	22	455
(%)	2,9%	60,4%	4,6%	0,4%	1,5%	1,5%	23,7%	4,8%	100,0%
Family Dental Surgeon	13	267	4	-	-	2	7	8	301
(%)	4,3%	88,7%	1,3%	0,0%	0,0%	0,7%	2,3%	2,7%	100,0%
Family nurse	58	624	4	4	94	16	18	41	859
(%)	6,8%	72,6%	0,5%	0,5%	10,9%	1,9%	2,1%	4,8%	100,0%
Family doctor	46	525	85	8	1	16	26	34	741
(%)	6,2%	70,9%	11,5%	1,1%	0,1%	2,2%	3,5%	4,6%	100,0%
Resident doctor	-	19	63	12	1	1	42	9	147
(%)	0,0%	12,9%	42,9%	8,2%	0,7%	0,7%	28,6%	6,1%	100,0%
Team administ: technicians, managers	53	621	3	6	8	15	129	88	923
(%)	5,7%	67,3%	0,3%	0,7%	0,9%	1,6%	14,0%	9,5%	100,0%
Total	305	3.996	221	134	336	3.322	729	547	9.590
(%)	3,2%	41,7%	2,3%	1,4%	3,5%	34,6%	7,6%	5,7%	100,0%

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E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

LJ Santos and MS Paranhos participated in all stages of elaboration of this paper, such as literature review, preparation of questionnaire, data analysis and discussion.