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Healthcare street level bureaucrats' (SLBs') delivery of public value: The next step
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DOI：10.1080/09540962.2025.2592983.png)
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Abstract
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This study provides a better understanding of the interactive nature of multiple factors affecting healthcare employees' delivery of quality services to the public, entitled 'public value'. Organizations want their employees to be engaged in delivering quality services to the public. However, organizations may want and expect their employees to deliver services in line with organizational directives. The authors found that healthcare employees are driven by more than organizational directives; instead, professional and personal drivers also affect 'what' and 'how' clinical care is delivered. This may mean that healthcare employees may deliver services that exceed organizational expectations. As past research shows that the services delivered by employees are likely to be of greater value to the public, there is probably evidence-based professional evidence for normalizing (allocating adequate resources) such practices to ensure they are accepted, adopted and well-funded. This study tests a measure of public value for professional healthcare street level bureaucrats (SLBs) entitled 'proactive clinical care' (PCC). Healthcare SLBs' public value (PCC) captures their professional values, standards, codes of practice and 'quality-of-life' social value orientation. The authors examine whether three organizational and personal antecedents impact SLBs' public value (PCC). The analytical method involves structural equation modelling of survey data from 259 healthcare professionals (doctors, nurses) collected at two points in time with a four-week time lag. The results show a small, significant impact of organizational change on SLBs' public service motivation (PSM). The variance in PSM and line managers' public value explained almost a third of SLBs' delivery of public value (PCC). The findings address a gap in public administration scholarship about the factors affecting SLBs' delivery of public value, in particular, identifying the organizational and personal antecedents impacting professional SLBs' delivery of public value (PCC).
Keywords:
History of organizational change
proactive clinical care
public service motivation (PSM)
public value
street level bureaucrats (SLBs)
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