1 494 ABSTRACT ASSESSING JOB SATISFACTION LEVEL OF EMPLOYEES IN A TERTIARY CARE HOSPITAL -A TOOL FOR TALENT RETENTION MS. SYEDA AMTUL YAFE* *Head & Associate Professor, Department of Hospital Management, Deccan School of Management, Owaisi Hospital & Research Center, DMRL X Roads, Hyderabad , India. Employee job satisfaction is the fulfillment, gratification and enjoyment that comes from work. It s not just the money or the fringe benefits, but the feelings employees receive from the work itself. Hospital is a highly labour intensive organization, where the satisfaction of employees is vital for achieving the organizational objectives, since there is high employee end customer interaction. There are two basic sources of job satisfaction-- the employees pride in their work and the work environment both physical and interpersonal. Review of literature suggests that among other things, the ability to deliver health care service, the quality of the work, the opportunity to learn and express creativity, the sense of pride in their profession impact job satisfaction of employees in a healthcare setting. Individuals may vary to the degree in which each of these factors contributes more or less to their own job satisfaction. But the end result is that high job satisfaction typically leads to career success for employees and talent retention for organizations. This study aims at finding out job satisfaction level of staff in a tertiary care Hospital. The study was conducted for a sample size of 100 medical professionals and chi-square test was applied. One of the primary reasons for evaluating employee satisfaction is to improve the quality of patient care and to retain qualified health professionals. This paper would like to assess the job satisfaction level of employees, identify the factors influencing job satisfaction and offer suggestions to improve the job satisfaction level of employees for retention. KEYWORDS: Employee job satisfaction, Talent retentions, Quality of Patient care, Health professionals, Tertiary care hospital. INTRODUCTION Retaining talented employees is the greatest challenge faced today by organizations. Human asset is the most important asset and retaining them is more important than finding a successor to the vacant position. The cost of employee turnover is from 40% - 100% of an employee's annual salary, when productivity, recruiting costs, reduced efficiency in transition and time is considered.
2 495 The challenge is not only to attract the best talent but also to retain them. Rising opportunities for carrier development, lifestyle decisions, job changing, unbalanced work life, poor mentoring and stress are some factors which influence an individual's decision to continue or quit. Job satisfaction and occupational success are major factors in personal satisfaction, self-respect, self-esteem, and self-development. To the worker, job satisfaction brings a pleasurable emotional state that can often leads to a positive work attitude. A satisfied worker is more likely to be creative, flexible, innovative, loyal and will tend to add more value to an organization. For the organization, job satisfaction of its workers means a work force that is productive, retained, motivated, committed to high quality performance and reduction in complaints, grievances, absenteeism, turnover, and termination; as well as improved punctuality and worker morale. Job satisfaction is also linked with a healthier work force and has been found to be a good indicator of longevity. IMPORTANCE OF EVALUATING EMPLOYEE SATISFACTION There is a definite link between employee attitudes and patient satisfaction. If employees are unhappy or dissatisfied, despite their best efforts; it is difficult for them to conceal this factor when interacting with patients and other staff members. One of the primary reasons for evaluating employee satisfaction is to identify problems and try to resolve them before they impact on patient care and treatment. Improving the quality of patient care in hospitals is a vital and necessary activity. Patients report they receive less individual attention than ever before. They complain that doctors and nurses are too busy tending to the technical aspects of care to provide the much needed attention to patients personal needs. Not only is it important in terms of quality of patient care, assessing employee satisfaction is a critical component in retaining qualified health professionals. Many health care providers feel frustrated and disillusioned in jobs they expected to find fulfilling. They have less time to do a quality job of caring for patients; they are continually expected to cut corners, but see waste and feel unable to change the situation; they feel unappreciated and they feel their skills are underused. This leads to low morale, staff turnover, and overall disenchantment with job opportunities in health care. REVIEW OF LITERATURE According to Weiss Job satisfaction is defined as a pleasurable emotional state resulting from appraisal of one s job, an effective reaction to one s job and an attitude towards one s job. 1 Herzberg et al reviewed more than 150 studies and listed various job factors of job satisfaction as Intrinsic aspect of job, Supervision, Working conditions, Wage and salaries, Opportunities for advancement, Security, Company and management, Social aspect of job, Communication and Benefits. 2 In a study conducted by Al-Eisa Ibrahim S et al a self-administered questionnaire based on socio-demographic characteristics and job satisfaction was given to 89 participants. The study consisted of 42 males and 47 females; 56.2% were Kuwaiti, 82.0% were married and 73.0% had children. The results of study showed that the overall satisfaction was 61.8%. Significantly the
3 496 higher the age the higher the job satisfaction. There were no significant differences in overall job satisfaction for nationality, sex, marital status and number of children. GPs were less satisfied with the rate of pay and the amount of variety in work but more satisfied with their colleagues. Young physicians appear to need more attention and Job satisfaction of primary health care physicians is critical for improvement of health systems. 3 Al-Enezi. Naser et al took a stratified random sample size of 500 nurses working in Ministry of Health hospitals in Kuwait and a questionnaire was distributed among them to identify factors related to the job satisfaction of nurses and the effect of selected background characteristics on the global satisfaction scale by using the McCloskey Mueller Satisfaction Scale. Factor analysis identified five factors: satisfaction with (a) professional opportunities; (b) praise and recognition; (c) scheduling of duty; (d) control and responsibility, and (e) extrinsic rewards. These together explained 59.5% of the total variance. Nurses were found to be dissatisfied with two of five factors: professional opportunities and extrinsic rewards and satisfied with the remaining three factors, although levels of satisfaction were not very high. The relationship of job satisfaction with nationality and marital status was positive and significant. However, a higher level of educational qualification showed an inverse relationship with job satisfaction. Based on findings, recommendations were made to develop a strategy to improve various aspects of nurses professional development and extrinsic rewards. 4 A descriptive, co-relational and cross-sectional study conducted by Mosadeghrad Ali Mohammad et al to gain a better understanding of the relationships between job satisfaction and organizational commitment of employees, and their impact on turnover intention at Isfahan Hospitals. Data was collected by the distribution of two questionnaires among 629 employees of these hospitals through a stratified random sampling method. The results indicate that hospital employees are moderately satisfied with their jobs and committed to their organization. Employees' job satisfaction and organizational commitment were closely inter-related and correlated with turnover intention (P < 0.001). The positive correlation between the two was expected, but there was also unexpected correlation with turnover intention. As job satisfaction and organizational commitment have strong correlation with turnover, it was suggested to reinforce them by applying the right human resource policies. 5 RESEARCH METHODOLOGY STATEMENT OF PROBLEM Job satisfaction is very important for a person s success in his/her professional life and for the development of the organization he/her is working for. This study aims at finding out job satisfaction level of staff in the organization and its impact on talent retention. OBJECTIVES 1. To assess the job satisfaction level of employees in a tertiary care hospital. 2. To identify the factors which influence job satisfaction.
4 To offer suggestions to improve the job satisfaction level of employees for retention. RESEARCH DESIGN: The research design adopted for the project is descriptive in nature. SAMPLING UNIVERSE: 300 bedded Tertiary care hospital in Secunderabad. SAMPLING DESIGN: The sampling technique employed for the research is Probability sampling. SAMPLING METHOD: Stratified Random sampling The different Strata into which the population of study is divided in this research are as follows: i) Medical ii) Non- Medical iii) Nursing PROPORTIONAL ALLOCATION Population size for Medical N 1 = 190 Population size for Non- medical N 2 = 328 Population size for Nursing N 3 = 372 Total Population size N = 890 Required sample size n = 100 Calculation of sample size from each stratum: i) For Medical: P 1 = 190/890 n 1 = ( 190/890) 100 n 1 = 21.3 = 21 (approx.) ii) For Non-medical : P 2 = 328/890 n 2 = (328/890) 100 n 2 = 36.8 = 37 (approx.) iii) For Nursing: P 3 = 372/890
5 498 n 3 = (372/890) 100 SAMPLE SIZE: 100 n 3 = 41.7 = 42 (approx.) DATA COLLECTION: Primary data is collected using structured questionnaire with closedended questions. DATA ANALYSIS: The acquired data is analyzed using statistical methods like simple statistical methods, Chi- Square. LIMITATIONS 1. The study is subjected to the understanding, bias and prejudices of respondents. 2. The study was conducted under constrained accessibility and short time-span. DATA ANALYSIS AND INTERPRETATION JOB SATISFACTION STATUS TABLE 1: JOB SATISFACTION STATUS Frequency Percent Valid Percent Valid Satisfied Source: Primary Data Dissatisfied Total GENDER BASED ANALYSIS TABLE 2: GENDER OF THE RESPONDENTS Frequency Percent Valid male female Total Source: Primary Data
6 499 CHI SQUARE TEST FOR GENDER OF THE RESPONDENTS AND JOB SATISFACTION Null Hypothesis (H0): Job satisfaction is independent of gender of the employee Alternate Hypothesis (H1): Job satisfaction is dependent on gender of the employee COUNT TABLE 3: DATA FOR CHI-SQUARE TEST BETWEEN GENDER AND JOB SATISFACTION describes the satisfaction status of the respondent satisfied dissatisfied Total gender of the employee male female Total Source: Primary Data CHI SQUARE TEST TABLE 4: CHI-SQUARE TEST BETWEEN GENDER AND JOB SATISFACTION Value Df Asymp. Sig. (2-sided) Pearson Chi-Square.587 a INTERPRETATION: Since P value is >0.05, Null Hypothesis is accepted and Alternate Hypothesis is rejected, which implies the job satisfaction is independent of the gender of the employee
7 500 EXPERIENCE BASED ANALYSIS (IN STUDY HOSPITAL) TABLE 5: EXPERIENCE OF THE RESPONDENTS (IN STUDY HOSPITAL) Frequency Percent Valid Percent Valid less than 6 months months - 1 year years above 5 years Total Source: Primary Data CHI SQUARE TEST FOR EXPERIENCE OF THE RESPONDENTS IN STUDY HOSPITAL AND JOB SATISFACTION Null Hypothesis (H0): Job satisfaction is independent of experience of the employee in study hospital. Alternate Hypothesis (H1): Job satisfaction is dependent on experience of the employee in study hospital. COUNT TABLE 6: DATA FOR CHI-SQUARE TEST BETWEEN EXPERIENCE & JOB SATISFACTION describes the satisfaction status of the respondent satisfied Dissatisfied Total Experience in study hospital less than 6 months months - 1 year years above 5 years Total Source: Primary Data
8 501 CHI SQUARE TEST TABLE 7: CHI-SQUARE TEST BETWEEN EXPERIENCE AND JOB SATISFACTION Value df Asymp. Sig. (2-sided) Pearson Chi-Square a INTERPRETATION: Since P value is >0.05, Null Hypothesis is accepted and Alternate Hypothesis is rejected, which implies the job satisfaction is independent of the experience of the employee in study hospital. DEPARTMENT BASED ANALYSIS TABLE 8: DEPARTMENT OF THE RESPONDENTS Frequency Percent Valid Percent Valid MEDICAL NON MEDICAL Source: Primary Data NURSING Total
9 502 TABLE 9: EMPLOYEE SATISFACTION SURVEY S. No Components disagree somewhat disagree Neutral somewhat agree agree Total 1 Cleanliness of common areas Sufficient materials & equipments Job clarity Cooperation bet departments Liberty Process and procedure easy to work Salary structure Adequate technical training Cooperation bet co-workers Effective Conflict resolution Fair treatment by supervisor Value to suggestions Communication by top management Rewards & Recognition Decision making Awareness of employee rights Good place to work Will recommend to others Survey helps in understanding needs Clear understanding of policies Source: Primary Data
10 503 FIGURE 1: EMPLOYEE SATISFACTION SURVEY JOB SATISFACTION INDEX There is a five-point scale in the questionnaire based on which the employee responses range from Agree, Somewhat Agree, Neutral, Somewhat Disagree to Disagree. The total number of questions with answers against each response is calculated. (5, 4, 3, 2, 1) The TOTAL SCORE RECEIVED = (total number of responses of 5 * 5)+(total number of responses of 4 * 4)+(total number of responses of 3 * 3)+(total number of responses of 2 * 2)+(total number of responses of 1 * 1) Calculate the MAXIMUM TOTAL SCORE This gives the INDEX which is the (TOTAL SCORE RECEIVED / MAXIMUM TOTAL SCORE) * 100 CALCULATION OF JOB SATISFACTION INDEX JSI = (Total Score Received/Maximum Total Score) * 100 = (8156/ 10000) * 100 = 81.56
11 504 FINDINGS AND SUGGESTIONS FINDINGS The Job Satisfaction Index of the employees at study hospital is in a scale of 100 is % of employees are satisfied with their jobs, while only 3.0% dissatisfied Most respondents (55%) are female, while only 45% are male Most respondents (46%) have 1-5 years of experience in study hospital, 30% of the respondents have 6 months to 1 years experience, 13% have more than 5 years, while only 11% have less than 6 months experience in study hospital Most respondents (42%) are from Non-Medical department, 37% are from Nursing, while only 21% are from Medical department Most respondents (68%) agree that common areas are kept clean, only 1% disagree and 2% have no opinion on the same. This implies that the cleanliness and hygiene of the hospital is satisfactory. Most respondents (49%) agree that they have materials and equipments to do their work right, only 5% disagree while 9% did not share their opinion. This implies that they should revisit the infrastructure available to employees. Most respondents (62%) agree that they are explained the duties and responsibilities entailed in their job description, only 5% disagree while 2% did not share their opinion. This implies that the employees should be properly briefed about their responsibilities towards their work. Most respondents (51%) agree that different departments cooperate with each other; only 3% disagree while 7% did not share their opinion. This implies that the interdepartmental co-operation can be made better. Most respondents (45%) feel free to offer comments and suggestions, 12% disagree while 11% did not share their opinion. This implies that suggestions from people should be more welcome. Most respondents (52%) find that the process and procedures at study hospital make it easy for them to work well; only 3% disagree while 8% did not share their opinion. This implies that processes can be made more approachable to people to ensure best results. Most respondents (37%) agree that their salary is decided according to their experience and skills, 24% disagree while 4% did not share their opinion. This implies that the salary structure should be reviewed and transparency should be maintained.
12 505 Most respondents (60%) agree that they receive adequate technical training; only 3% disagree while 7% did not share their opinion. This implies that technical training and learning is taken care of. Most respondents (33%) agree that people they work with are cooperative, 17% disagree while 11% did not share their opinion. This implies that they should take training for employees for their self development. Most respondents (56%) feel that they have easy and effective conflict resolution system, only 2% disagree while 9% did not share their opinion. This implies that they should have proper conflict resolution methods. Most respondents (68%) feel that they are treated fairly by their supervisors; only 2% disagree while 7% did not share their opinion. This implies that subordinates are treated fairly. Most respondents (39%) somewhat feel that top management pays careful attention to employee suggestions, only 7% disagree while 15% did not share their opinion. This implies that the senior management team should be more open to ideas made by the employees. Most respondents (49%) agree that top management communicates about the changes or decisions that affect the employees, only 5% disagree while 13% did not share their opinion. This implies that the senior management could enhance their communication channels to keep employees well informed about the changes in the company. Most respondents (26%) somewhat feel that they are not recognized and rewarded for good work, 19% feel that they are not at all recognized and rewarded for good work while 11% did not share their opinion. This implies that they should revisit the rewards and recognitions procedure. Most respondents (38%) feel that they are involved in decision making regarding areas that affect their work, only 8% disagree while 14% did not share their opinion. This implies that employee participation in decision making procedure should be encouraged. Most respondents (65%) feel that they are aware of employee and patient rights that exist at study hospital, only 3% disagree while 12% did not share their opinion. This implies that people are aware of their rights. Most respondents (65%) feel that study hospital is a good place to work, only 7% did not share their opinion while none disagreed. This implies that people are happy to work for study hospital. Most respondents (60%) state that they would recommend employment at study hospital, only 2% disagree while 18% did not share their opinion. This implies that people would recommend and promote working at study hospital.
13 506 Most respondents (61%) agree that this employee satisfaction survey will help the organization understand its employee needs, only 1% disagree while 10% did not share their opinion. This implies that they should start a survey to take feedback from people about their needs and expectations. Most respondents (64%) feel that they have a clear understanding of organizations policies; only 3% disagree while 9% did not share their opinion. This implies that people are aware of the company s policies. SUGGESTIONS Employees should be given proper Job Orientation at the time of joining. The Inter as well as Intra-Departmental communication should be effective, informative and systematic. Training programs should be conducted to develop interpersonal and soft skills of the employees. There should be transparency in Compensation and Benefit Plans. Proper Performance appraisal techniques should be followed periodically. Employee should be aware of their KRAs and also should have development plan discussions with supervisors. Periodic counseling of the employees should be done. They should revisit the infrastructure available to employees. Develop a highly conducive and proactive work culture. REFERENCES 1. Weiss, H. M. (2002). Deconstructing job satisfaction: separating evaluations, beliefs and affective experiences. Human Resource Management Review, 12, , p Herzberg, F., Mausner, B., Peterson, R. and Campwell, D. (1959). Job attitude: Review of research and opinion. Pitsberg: Psychological Services of Pitsberg. 3. Al-Eisa Ibrahim S et al (2005) Job Satisfaction of Primary Health Care Physicians at Capital Health Region, Kuwait Middle east journal of family 3 (3) 4. Al-Enezi. Naser et al (2001) Job satisfaction of nurses with multicultural backgrounds: a questionnaire survey in Kuwait Nursing Leadership 22(2)
14 Mosadeghrad Ali Mohammad et al (2005). A study of the relationship between job satisfaction, organizational commitment and turnover intention among hospital employees Health Services Management Research 21(4)