Job satisfaction in health-care organizations.

Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations.

There has been considerable emphasis on human resource management in recent past. In an organization, productivity and quality of service depend entirely on the organization's ability to manage the human resource.[1] Human resource management encompasses organizational development, human resource development, and industrial relations. Human resource functions in an organization include everything that has to do with ‘people’, i.e., their recruitment, induction, retention, welfare, appraisal, growth, training, skill development, attitudinal-orientation, compensation, motivation, industrial relation and retirement, etc.[2]

All organizations operate within an internal and an external environment. Technology provides resources; structure defines the formal relationship of people in organization and both internal and external environment as well as influences the attitudes of people.[3]

How to get ‘people’ involved and motivated for excellence at work? The key to effective work performance is in understanding what domains of work are important for job satisfaction among clinicians.

The job satisfaction of an employee is a topic that has received considerable attention by researchers and managers alike. The most important information to have regarding an employee in an organization is a validated measure of his or her level of job satisfaction (Roznowski and Hulin 1992).[4] Thus, it is fruitful to say that managers, supervisors, human resource specialists, employees, and citizens in general are concerned with ways of improving job satisfaction.[5]

The foundation of job satisfaction theory was introduced by Maslow with a five-stage hierarchy of human needs, now recognized as the deprivation/gratification proposition. However, much of the job satisfaction research has focused on employees in the private sector.[67]

The motivation to investigate the degree of job satisfaction arises from the fact that a better understanding of employee satisfaction is desirable to achieve a higher level of motivation that is directly associated with patient satisfaction.

Offering the highest quality of health-care services possible to as many people who need them, within a given environment of social, material, financial, and human resources is the main goal of health-care systems and of every single health-care organization or unit within an organization. Achieving this goal requires a committed and high-quality workforce in health-care organizations. Due to the anticipated significant impact of human resources management on the quality of services and its increasing coverage in formalized quality systems, it is essential that a health-care establishment pays attention to the quality of human resources in early stages of development of a quality system. Attending to job satisfaction of staff is then a fundamental component of human resources quality. In particular, many researchers have demonstrated strong positive correlations between job satisfaction of medical staff and patient satisfaction with the services in these health-care settings.[8-12]

Organizations’ efficiency depends to a large extent on the morale of its employee. Behavioral and social science research suggests that job satisfaction and job performance are correlated.[13] Job satisfaction and morale among medical practitioners is a current concern worldwide.[14-16] Poor job satisfaction leads to increased physician turnover, adversely affecting medical care job satisfaction.[1718] Consequently, by creating an environment that promotes job satisfaction, a health-care manager can develop employees who are motivated, productive, and fulfilled. This in turn will contribute to higher quality patient care and patient satisfaction.[69]

JOB SATISFACTION: DEFINITIONS, FACETS, AND IMPORTANCE

Schermerhorn define job satisfaction as the degree to which individuals feel positive or negative about their jobs.[19] It is an attitude or emotional response to one's tasks as well as to the physical and social conditions of the workplace. Job satisfaction is motivational and leads to positive employment relationships and high levels of individual job performance.

According to Locke and Hanne, the definition could be ‘the pleasant emotional state which flows from someone realizing his or her motives (values) in the work’.[20] ‘Job satisfaction is simply how people feel about their jobs and different aspects of their jobs. It is the extent to which people like (satisfaction) or dislike (dissatisfaction) their job. As it is generally assessed, job satisfaction is an attitudinal variable’.[21]

Job satisfaction can be considered as a global feeling about the job or as a related constellation of attitudes about various aspects or facets of the job. The global approach and the facet approach can be used to get a complete picture of employees’ job satisfaction.[21] According to Werner, job satisfaction has five facets, which can be put together to measure a job descriptive index (JDI) as follows:

The work itself – responsibility, interest, and growth

Quality of supervision – technical help and social support

Relationships with co-workers – social harmony and respect

Promotion opportunities – chances for further advancement

Pay – adequacy of pay and perceived equity vis-à-vis others[2223]

Research tends to divide the characteristics of work into two broad categories: extrinsic variables and intrinsic variables. In 1957, Herzberg et al. made the distinction between the intrinsic rewards from the job and the extrinsic rewards from the job. The intrinsic factors refer to a job's inherent features – people's affective reactions to features integral to the work itself. The extrinsic work factors focus on issues that are external to the job itself, such as pay.[212425] The distinction between intrinsic and extrinsic work factors, rewards, motives, needs, etc., remains to be a useful tool in studies of many researchers.

There are important reasons why the researcher should be concerned with job satisfaction. The first is that people deserve to be treated fairly and with respect. Job satisfaction is to some extent a reflection of good treatment. It can also be considered as an indicator of emotional well-being or physiological health. The second reason is that job satisfaction can lead to behavior of employees that affects organizational functioning. Furthermore, job satisfaction can be a reflection of organizational functioning. Differences among organizational units in job satisfaction can be diagnostic of potential trouble spots.[26]

Dissatisfied workers are more likely to provide inferior services, and the physical and mental status and the social functioning of these workers can be affected substantially by the level of their job satisfaction.[27]

However, as Schermerhorn points out, job satisfaction alone is not a consistent predictor of individual work performance.[21]

IMPORTANCE OF STUDYING JOB SATISFACTION IN A HEALTH-CARE INSTITUTION

Hospital personnel have difficulties in meeting the needs of their patients if their own needs are not met[2829]; therefore, hospital managers have responsibilities to both staff and patients.[30]

According to the literature, job satisfaction in health-care organizations is related to many factors: optimal work arrangements; the possibility to participate actively in the decision-making process; effective communication among staff and supervisors; and to be able to express freely one's opinion. Collective problem solving and the attitude of management are also important to the satisfaction of the employees.[31-33]

Job satisfaction can be increased by attending to motivating factors, such as making work more interesting, requiring more initiative, creativity, and planning.[3435] This is especially relevant when budget constraints limit increases to pay and benefits.[36]

Managers who grasp the importance of factors affecting the well-being of staff are more likely to gain improved performance from the various groups of hospital staff.[37-39] It is of utmost importance to seek the opinions of employees and include them in decision-making and problem-solving processes.[32] This will improve satisfaction among the employees and make them feel that they are part of the organization.[30-32]