Developing our understanding of patronizing frontline employees

Growth Culture and Public Hospital Performance: The Mediating Effect of Job Satisfaction and Person-Organization Fit

This study investigates and interprets the role of growth organizational culture (GOC), person-organization fit (POF) and job satisfaction (JS) in predicting hospital performance (HP). This research adopted a quantitative methodology using data collected from 513 respondents in three cities across China. Smart-PLS 3 was used to evaluate the measurement model and structural model. Growth organizational culture has a significant positive impact on hospital performance (β = 0.191, p < 0.001). Person-organization fit (54.74%) and job satisfaction (29.26%) have partial mediating effects between growth culture and hospital performance. The research revealed that the GOC, POF, and JS play a substantial role in promoting HP. All the direct relationships were positive and significant. The findings suggest that establishing a growth culture environment for physicians is an effective strategy to improve physicians' job satisfaction and person-organization fit. This strategy provides a new path to improve the hospitals performance through promoting organizational culture. Future studies should test the findings in an interventional design.

Precursors and outcomes of work engagement among nursing professionals-a cross-sectional study

BACKGROUND

Health services organizations must understand how best to lower nursing professionals' turnover intentions, and increase their job satisfaction and the quality of care provided to patients. This study aims to examine whether work engagement (WE) is a significant predictor of the achievement of these preferred organizational goals. The study also aims to examine whether organizational culture and organizational climate can manage the WE of nursing professionals and indirectly contribute to the accomplishment of the preferred organizational goals.

METHODS

In detail, a cross-sectional questionnaire survey study was conducted through a convenience sampling of a total of N = 164 nurses, from four Norwegian public hospitals. Structural equation modeling was employed in testing the hypothesis in the conceptual model, using Stata software. Furthermore, mediation analyses were achieved through use of the "medsem" package in the Stata software, in testing whether the proposed direct and indirect effects were statistically significant, and the type of mediation found.

RESULTS

The three key findings from this study are: i) WE of nursing professionals was found to be positively related to service quality of care (β = 0.551) and job satisfaction (β = 0.883). Job satisfaction fully mediates the relationship between WE and turnover intention and in itself explains almost 60% (R² = 0.59) of turnover intention; ii) nursing professionals' perception of organizational culture (β = 0.278) and collaboration climate (β = 0.331) were both directly related to their WE; and iii) WE fully mediates the relationship between organizational culture/climate and service quality of care and job satisfaction. Moreover, WE partially mediates the relationship between collaborative climate and job satisfaction.

CONCLUSIONS

The WE of nursing professionals is highly correlated to their job satisfaction. WE and turnover intentions are (fully) mediated by job satisfaction. Employers should therefore focus on improving the job satisfaction of nursing professionals. The WE of nursing professionals is a common key factor for such improvement. Consequently, leaders and managers should continuously manage nursing professionals' WE, focusing on such areas as organizational culture and climate, because WE is an effective means of enabling multiple desirable outcomes for hospital organizations.

The role of organizational attractiveness in an internal market-oriented culture (IMOC): a study of hospital frontline employees

Background

Hospitals need to understand how to reduce their frontline employees’ turnover rate as well as how to positively engage them and improve their service. Central to these issues, we find, is the employees’ perception of their organization’s attractiveness. This objective of this paper is to clarify how the role of organizational attractiveness relates to frontline employees’ perception of their internal market-oriented culture as well as their turnover rate, engagement, and service quality. To our knowledge, no previous research has explored the role of organizational attractiveness from a frontline employee perspective in health-service organizations.

Methods

The conceptual framework we developed was tested in a quantitative study. We sent a questionnaire to nurses in several public hospitals in Norway. We then analyzed the data with confirmatory factor analysis and structural equation modeling in Stata. Further, we performed multi-group comparisons to test heterogeneity in personal characteristics. The indirect effects were tested by mediator analyses.

Results

We made three main findings. First, organizational attractiveness has a significant positive effect on frontline employees’ engagement (β = 0.833) as well as on the service quality they provide to hospital patients (β = 0.472). Additionally, it significantly lowers their turnover rate (β = − 0.729). Second, the ‘internal market-oriented culture’ (IMOC) has a significantly positive effect on organizational attractiveness (β = 0.587) and explains a total of 35% of the variance in organizational attractiveness. Third, organizational attractiveness fully mediates the relationship between “internal market-oriented culture” (IMOC) and frontline employees’ engagement and the service quality they provide to patients, and it partially mediates the relationship with the turnover rate.

Conclusions

This study proves that organizational attractiveness is vital for hospital managers to focus on, as it affects employees’ perception of whether the organizations is a great place to work. It reveals the need for those same managers to develop an internal market-oriented culture (IMOC) directed toward hospital frontline employees, as it has both a direct effect on organizational attractiveness and an indirect effect on employees’ engagement, turnover intention, and service quality.

Electronic supplementary material

The online version of this article (10.1186/s12913-019-4144-8) contains supplementary material, which is available to authorized users.

Towards internal marketing practices in enhancing job engagement

Purpose

The purpose of this study is to explore the contribution of internal marketing (IM) practices in enhancing job engagement in Jordanian hospitals. Four dimensions of IM are considered in this study, namely, employees empowerment, employees motivation, information sharing and work environment.

Design/methodology/approach

The study adopts quantitative research design. In total, 200 self-administrated questionnaires are distributed to respondents in Jordanian hospitals using a convenient sample. Only 162 questionnaires were returned with a response rate of 81 per cent.

Findings

The study concludes that there is a significant effect of IM with its different dimensions on job engagement in Jordanian hospitals. However, employees’ motivation is the most important dimension for enhancing job engagement.

Practical implications

The study recommends that Jordanian hospitals have to focus on IM practices that motivate, empower and retain their employees.

Originality/value

The study provides practical evidence about IM philosophy in human resources development in health-care services.

Antecedents and consequences of employee engagement revisited

Purpose

In 2006, Saks (2006) published one of the first empirical studies of the antecedents and consequences of employee engagement. Since then dozens of studies on engagement have been published and most of them have used the Utrecht Work Engagement Scale (UWES) to measure work engagement. The purpose of this paper is to revisit Saks (2006) to try and address some issues that have arisen during the last ten years and to assess the generalizability of his findings and model using the UWES measure of work engagement and single-item measures of job and organization engagement.

Design/methodology/approach

Additional analyses was conducted using the data from Saks (2006) including measures of each job characteristic, the use of the UWES measure of work engagement, and single-item general measures of job engagement and organization engagement. In addition, a review of engagement research was conducted as well as research that used Saks’ (2006) measures of job engagement and organization engagement.

Findings

The results indicate that skill variety is the main job characteristic that predicts job engagement. The results of the analysis using the UWES measure of work engagement found that job characteristics and perceived organizational support are significant predictors of work engagement, and work engagement predicts job satisfaction, organizational commitment, organizational citizenship behavior and intentions to quit and mediates the relationship between the antecedents and the consequences. Similar results were found using the single-item measures of job engagement and organization engagement. A review of the engagement literature indicates general support for the Saks (2006) model of the antecedents and consequences of employee engagement and for his measures of job and organization engagement. A revised and updated model is provided with additional antecedents and consequences.

Practical implications

The results indicate that organizations can drive employee engagement by focusing on skill variety as well as providing social support, rewards and recognition, procedural and distributive fairness, and opportunities for learning and development. In addition, organizations can assess employee engagement more frequently and easily by using single-item measures of job and organization engagement.

Originality/value

This paper provides an update and revision of the Saks (2006) model of employee engagement and suggests that the main findings are similar when using the UWES measure of work engagement and single-item general measures of job engagement and organization engagement.

Evaluating the evidence on employee engagement and its potential benefits to NHS staff: a narrative synthesis of the literature

Background

Recent studies have suggested engagement is linked with beneficial outcomes for individuals and organisations. Despite growing demand for resources and advice on engagement within the NHS, there has been no systematic evaluation of how engagement strategies can be developed and operationalised within the NHS.

Objectives and research questions

To evaluate evidence and theories of employee engagement within the NHS and the general workforce to inform policy and practice. Four research questions focused on definitions and models of engagement; the evidence of links between engagement and staff morale and performance; approaches and interventions that have the greatest potential to create and embed high levels of engagement within the NHS; and the most useful tools and resources for NHS managers in order to improve engagement.

Review methods

Evidence was evaluated using a narrative synthesis approach involving a structured search of relevant academic databases and grey literature. The search yielded a final data set of 217 items, comprising 172 empirical papers, 38 theoretical articles, four meta-analyses and three books. From the grey literature, only 14 items were used in the analysis.

Main findings

There is no one agreed definition or measure of engagement. Existing approaches were grouped under three headings: a psychological state; a composite attitudinal and behavioural construct; and employment relations practice. Most fell under the first category, with the Utrecht Work Engagement Scale being the most prevalent. Most theorising around engagement used the job demands–resources framework. Thirty-five studies considered engagement and morale, and the most consistent finding was a positive link between engagement and life satisfaction, and a negative link between engagement and burnout. Some studies suggested that engagement was positively associated with organisational commitment and job satisfaction and negatively linked to turnover intentions. Of 42 studies that looked at performance and engagement, the strongest support was found for a link between engagement and individual in-role performance and a negative link between engagement and counterproductive performance outcomes. A link between engagement and higher-level performance outcomes was also found. Of 155 studies that explored approaches and interventions that promote engagement, the strongest support was found for the following: positive psychological states including resilience; job-related resources and job design features; positive leadership; perceived organisational support; team-level engagement; training and development. Only a small proportion of studies were based in health-care settings, making the application of evidence to wider contexts limited. Studies identified in the grey literature suggested that the focus of practitioner material was more on wider managerial issues than on psychological factors.

Conclusions

The synthesis highlights the complex nature of the engagement evidence base. The quality of evidence was mixed. Most studies were cross-sectional, self-report surveys, although the minority of studies that used more complex methods such as longitudinal study designs or multiple respondents were able to lend more weight to inferences of causality. The evidence from the health-care sector was relatively sparse. Only a few studies used complex methods and just two had taken place in the UK. The evidence synthesis suggests that employers might consider several factors in efforts to raise levels of engagement including development and coaching to raise levels of employee resilience, the provision of adequate job resources, and fostering positive and supportive leadership styles.

Funding

This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HSDR) programme.