Left to right: Dr. Sabrina Wong, Dr. Daniel Skarlicki, and Dr. Charlyn Black

Can you remember a time when a health care provider went beyond the call of duty? Maybe a nurse spent extra time getting to know you or held your hand during a difficult time. In health care, this is known as patient-centred care.

Dr. Daniel Skarlicki, Edgar F. Kaiser Chair of Organizational Behaviour and professor in the Organizational Behaviour and Human Resources Division at the UBC Sauder School of Business, was hearing a lot about patient-centred care from health care professionals in the Executive MBA in Health Care program. To him, it sounded like a business concept called organizational citizenship behaviour (OCB).

OCB is the tendency for individuals to go above the call of duty to aid colleagues and achieve organizational goals. By applying an OCB approach to health care, and particularly to nurse work, Skarlicki hopes to bring new understanding to measuring and improving the quality of care and ultimately develop a list of key factors that predict patient-centred care.

In nursing, OCB is what nurses call “the hidden work of nursing,” says co-investigator Dr. Sabrina Wong, associate professor in the School of Nursing and faculty in Centre for Health Services and Policy Research (CHSPR) at UBC. “No one gets credit for being a nice person,” she says. “We all get rewarded based on the things that can be counted,” like the number of immunizations performed.

In busy, crowded, and understaffed health care settings, there’s a tendency to focus on these technical aspects of care, such as getting the correct medication to patients. But research shows that delivering patient-centred care can improve patient
satisfaction, clinical outcomes, and even job satisfaction for the provider. What’s not well understood, however, is how to encourage such behaviour.

The three-year study, which includes Dr. Charlyn Black, professor at the UBC School of Population and Public Health and associate director, CHSPR, will involve a series of surveys and focus groups with about 150 patients and 400 nurses to develop tools for indentifying and measuring patient-centred care within nursing environments.

Skarlicki has begun to identify which of the predictors of OCB literature are most likely to be present in a health care setting.  Factors such as autonomy, giving someone the ability to choose their focus, as well as respect and fairness, can lead to OCB.

He also expects recognition for contribution to be a predictor: if a nurse spends time with an upset patient but is then disciplined for being away from the nursing station, this will be interpreted as the institution not valuing patient-centred care.

Finally, “If nurses feel like they have a voice in the decisions, they are likely to become engaged in citizenship behaviour,” says Skarlicki. “Voice really matters as a predictor of organizational citizenship behaviour.”