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This study aims to examine to what extent the relationships between hospital workers’ perceptions of lean leadership behaviour, their engagement and the hospital unit’s perceived performance are mediated by job demands.

The data (n = 1,624) come from a lean implementation study in a Dutch hospital and are analysed using structural equation modelling in Mplus (v8.4).

The results confirm that lean leadership behaviour is related to employee engagement and hospital unit performance as perceived by employees, and these relationships are partially mediated through job demands. More specifically, the authors found that the type of job demand explains the direction of mediation effects. On the one hand, so-called challenging demands positively mediate the relationships between lean leadership behaviour and its outcomes. Conversely, hindering demands negatively mediates the relationship between lean leadership behaviour and perceived unit performance.

The authors recommend hospital organisations and human resources managers start by helping hospital leaders understand the underlying mechanisms that explain the effects of leadership on employees’ perceptions and, second, support their frontline leaders by providing training, coaching and feedback on how to influence job demands in a way that creates an optimal work environment for hospital employees.

The authors contribute to the literature by building upon insights from the job demands-resources model to explain the effects of lean leadership behaviour and by investigating the relevance of lean leadership in a hospital context, given the phenomenon’s strong roots in manufacturing.

The purpose of this paper is twofold: first, to examine whether workers in various hospital job groups differ in their perceptions of the provision of managerial support, and of their up-to-date expertise (UDE), willingness to change (WTC) and employment opportunities (EO). Second, to examine whether and how the relationships between managerial support, workers’ UDE, WTC and their EO are moderated by hospital job type.

Survey data were collected from 1,764 employees of three Dutch hospitals. ANOVAs and structural equation modeling were used to test the hypotheses.

The research findings indicate significant differences between the hospital job groups with regard to UDE, WTC and EO. No support was found for differences on managerial support nor for a moderating effect of hospital job type. The latter means that the relationships of managerial support with workers’ UDE, WTC and EO are independent of job type.

Based on the findings, a classification system is constructed that shows how hospital workers’ UDE, WTC and EO can be explained by the combination of the educational level required by a job and its degree of specialization.

The purpose of this paper is to examine the relationship between employer’s investments (through job characteristics and managerial support) and employees’ employment opportunities, with employability, conceptualized as perceived up-to-date expertise and willingness to change, as a mediating variable.

Hypotheses are tested using structural equation modeling on survey data collected from 1,626 employees of three Dutch hospitals.

Consistent with the hypotheses, the results indicate that job characteristics and managerial support are indirectly related to employees’ beliefs on employment opportunities, with the relationship mediated by up-to-date expertise and willingness to change. Further, managerial support is directly related to employees’ employment opportunities.

This paper shows that employers, by providing an attractive and challenging job in combination with adequate supervisory support, can enhance their employees’ employability and employment opportunities.

This paper contributes to the literature by elaborating a consistent conceptualization and measurement of employability, by incorporating as antecedents both job characteristics and managerial support, and by examining to what extent employability mediates between these antecedents and employment opportunities. Previous studies refer to the same definition of employability but conceptualize this in different ways, and focus on either job characteristics or managerial support, and so fail to provide a systematic and comprehensive examination.