Managers Concern Regarding Employee Empowerment in Jordanian Public Hospitals

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1 Managers Concern Regarding Employee Empowerment in Jordanian Public Hospitals Dr.Naser Ibrahim Saif 1 Assistant professor, Head of Department of Hospital Management, Faculty of Administrative & Financial Sciences, Philadelphia University. Dr. Afnan Sharif Saleh 2 Assistant Professor, Department of Architecture Engineering, Faculty of Engineering, Philadelphia University. Abstract This study is aimed at determining the extent of managers for the implementation of employee empowerment in Jordanian hospitals. A questionnaire was developed and distributed to a sample of 277 employees of Jordanian hospitals, with an overall response rate of 81.4%. This study concluded that Jordanian hospital managers are concerned about the implementation of employee empowerment practices. It is suggested that support and follow-up must be provided for employee empowerment practices through the MOH or the establishment of a neutral department dedicated to this purpose. Key words: Empowerment, employee, hospital managers, Jordanian hospitals. 1. Introduction 1.1 Introducing the Problem More than 70% of organizations currently implement an empowerment initiative for at least part of their workforce (Barling & Cooper, 2008). In addition, most managers agree that employee empowerment is desirable (Fetterman & Wandersman, 2005), and it has been embraced by a variety of organizations and industries. Further, it is regarded as an end state to which all organizations should aspire (Hechanova, Alampay, & Franco, 2006). Employee empowerment has received wide recognition as an important subject in management circles, primarily because it is considered a fundamental element of managerial and organizational success, and it increases when power and control are shared in an organization (Ongori & Shunda, 2008). The World Health Organization consistently emphasizes employee empowerment (Burton, 2011). Moreover, it is widely advocated in hospitals as critical to improve hospital performance and health outcomes (Smith & Liehr, 2008). One study asserted that no strategy in a health organization would succeed unless employees are passionate about it (Padhi & Palo, 2005). However, there is little knowledge of employee empowerment in Jordanian healthcare organizations. The concern of managers for the implementation of employee empowerment in Jordanian hospitals requires elucidation (Batieha, 2012). Therefore, the present study examines the extent to which employee empowerment practices are implemented in Jordanian hospitals. COPY RIGHT 2013 Institute of Interdisciplinary Business Research 78

2 1.2 Literature Review Jordanian Public Hospitals The Ministry of Health (MOH) in Jordan is the government agency responsible for all health-related issues in the country by virtue of Public Health Law No. 54, issued in To achieve its goals, the MOH developed a comprehensive health policy to ensure delivery of preventive health care and treatment for all citizens and to create a healthy environment in order to ensure a healthy society. The MOH provides secondary health care services, and to some extent, tertiary health care services through 30 government hospitals, distributed among all provinces in the Kingdom that provide high coverage and comprehensive health services to citizens. These hospitals include 4235 beds (approximately 38% of all hospital beds in the Kingdom). In all sectors, beds and 101 hospitals are available (Ministry of Health, 2012) Empowerment The literature contains several definitions of empowerment, and each offers a different perspective. For example, one study defines it as the process of enhancing individual or group capacity to make choices and transforming those choices into desired actions and outcomes (Alsop, Bertelsen, & Holland, 2006). Another defines it as the process of decentralized decision making whereby managers offer more discretion and autonomy to front-line employees (Woodside & Martin, 2008). The term empowerment in management literature appears to have become general usage in the early 1980s (Rao, 2000). By the mid-1980s, it was commonplace in both management texts and in the vocabulary of organizations (Gill, Flaschner & Bhutani, 2010). It was used to refer to job enrichment through participation and managerial practices such as the transfer of organizational power and delegation (Lashley, 2001). Empowerment was later regarded as a means of energizing followers through leadership, enhancing self-efficacy by reducing powerlessness, and increasing intrinsic task motivation. From 1990 until recently, many researchers have further expanded the concept of empowerment as a psychological process involving intrinsic motivation and a process of perceived control that builds competence and energizes people to achieve goals (Ahmad & Oranye, 2010). Further, empowerment is the act of moving people and events toward improving performance (Kinlaw, 1995). These multiple approaches to empowerment have made it a difficult concept to define, as it may change according to the situation and times. In the workplace, empowered employees have the power and authority to make quick and informed decisions to advance a task or solve a problem (Tschohl, 2010). Empowerment enables employees to work quickly and efficiently. It is one of several requisite principal elements in any organization s grand design for the continuous improvement of overall quality of products and services. Their effectiveness to produce results determines the efficacy of those empowered (Gamage & Pang, 2003). Empowerment of employees is one of the most important factors in business success (Bass& Bass, 2008). It refers to the ways in which staff members can make decisions without consulting their bosses or managers (Magala, 2006). These decisions may be small or large, depending upon the degree of power with which the company wishes to invest employees. Employee empowerment can extend from individual training to converting an entire company to an empowerment model. Conversely, it might merely mean allowing COPY RIGHT 2013 Institute of Interdisciplinary Business Research 79

3 employees to independently make decisions (Speegle, 2010). For successful employee empowerment, management must ensure that employees understand their responsibilities, give people authority corresponding to their assigned responsibilities, establish standards of excellence that require employees to achieve accuracy at the first attempt, provide people with training that will enable them to meet specified standards, inform people that they need to efficiently perform their jobs, trust their employees, permit failure, and treat people with dignity and respect. In addition, employees must receive feedback on their performance and be recognized for their achievements (Sims, 2002). Good management is vital to support continuous improvement of employee empowerment in organizations (Kandula, 2001) and must be demonstrated at all levels of the organization (Ongori & Shunda, 2008). A good manager can perceive the thoughts of others, offer verbal expression to their feelings, and delegate and empower employees, thereby bringing the organization s vision to fruition. Further, good management inspires subordinates, creates a vision for the organization, and empowers employees through training and development (Sambrook & Stewart, 2007). For this research, empowerment practices are defined in terms of employees perceptions of their situation, coupled with the productive actions that power-sharing leads them to perform. The concept of empowerment practices consists of five dimensions: (a) sharing information, (b) involving employees in planning processes and decision making, (c) delegating authority, (d) rewarding performance, and (e) providing performance feedback. An empowered work environment is characterized by (a) mutual trust, (b) support and encouragement, and (c) team orientation. 1.3 Objectives and Hypotheses This study reviewed employee empowerment practices in Jordanian public hospitals. Specifically, it investigated the concern of managers regarding the implementation of employee empowerment practices in Jordanian public hospitals. In addition, it determined differences between managers concern levels regarding the implementation of employee empowerment practices in Jordanian public hospitals on the basis of demographic variables (age, qualification, and work experience). Employee empowerment is an important and necessary issue that business organizations (including hospitals) must practice and apply. Hospitals are vital and basic organizations. The extent to which employee empowerment practices have been applied in hospitals vary, and questions related to the concern of managers regarding the implementation of these practices in Jordanian public hospitals remain unanswered. In this context, the following hypotheses were developed: H01: There is no concern among hospital managers regarding the implementation of employee empowerment practices. H02: Demographic variables (age, qualification, and work experience) do not significantly influence the concern levels of hospital managers regarding the implementation of employee empowerment practices in Jordanian public hospitals. COPY RIGHT 2013 Institute of Interdisciplinary Business Research 80

4 2. Method A quantitative approach was adopted for this study. Statistical and content analysis were used for secondary and primary data. Secondary data were obtained by referring to previous scholarly research. Primary data were collected using a questionnaire, which was designed on the basis of other researchers approaches to the problem, which were identified in literature review. The questionnaire employed a five-point Likert scale, and the responses included strongly agree, agree, I do not know, disagree, and strongly disagree. The questionnaire contained two parts; the first included questions related to workers demographic information (age, qualification, and work experience). The second part evaluated the respondents commitment and comprised questions to measure managers concern about the implementation of employee empowerment practices from the perspective of workers. To validate the instrument, the questionnaire was assessed by three specialists in healthcare organization management. Their views were considered in the revision of the questionnaire. The Statistical Package for Social Sciences version 17.0 (SPSS, Inc., Chicago, IL, USA) was used to analyze the data from the questionnaire. Cronbach s α = 87.7%, indicating that the questionnaire items were sufficiently reliable. The arithmetic mean, standard deviation, one-sample t-test, and one-way analysis of covariance (ANCOVA) were used to analyze responses to the questionnaire. A comprehensive containing method for the study population comprised five Jordanian public hospitals, in which 340 questionnaires were distributed. In total, 277 questionnaires were deemed valid for analysis (response rate: 81.4%). 3. Results 3.1 Participants The participants in this study were employees in Jordanian public hospitals at the time of the study. Table 1 indicates the sample profile. The majority of respondents were male (85.6%), indicating that the majority of hospital workers in Jordan are males. Most of these workers (60.2%) were over 40 years old. The educational qualification of participants were as follows: 19.1% had a Bachelor s degree, 46.9% had a Friendship s degree, and 27.8% had a Master s degree or Ph.D., indicating that respondents were qualified to implement modern management concepts. In addition, 41.9% of respondents had over 25 years of experience in health care. COPY RIGHT 2013 Institute of Interdisciplinary Business Research 81

5 Table 1. Demographic characteristics of subjects in this study Variable Variable categories Frequency % Sex Male Female Less than Age More than Higher Diploma Bachelor s Degree Qualification Friendship Degree Master s Degree Ph.D Less than 5 years Experience 5 15 years years years To explore the concern levels of hospital managers regarding the implementation of employee empowerment practices, the approach adopted in this study was based on those of previous studies. To interpret the results and responses of participants, the following system was utilized. Significant mean values 3.6 indicated meaningful application of employee empowerment practices in the workplace. Mean values ranging from 2.31 to 3.60 indicated some application of employee empowerment practices, and those 2.31 indicated low application of employee empowerment practices in the workplace and an urgent need for improvement in this area. Table 2 lists the mean values and standard deviations of all participant responses. These values reflect the concern levels of Jordanian hospital managers regarding the implementation of employee empowerment practices. Table 2. Means and standard deviations of subjects responses regarding the implementation of employee empowerment practices No. Empowerment Practices Mean SD 1 I am involved in making decisions that affect my work I am offered the opportunity to suggest improvements I participate in establishing the goals and objectives for my job I can access the information I need to make good decisions My supervisor values my suggestions and requests My supervisor encourages me to suggest ways to improve job quality My supervisor encourages me to suggest ways to improve productivity My supervisor encourages me to continually develop my job skills COPY RIGHT 2013 Institute of Interdisciplinary Business Research 82

6 9 My supervisor keeps me informed of job problems or concerns Higher management shares information with people at all levels People at my level receive the resources needed to do the job well Higher management values ideas and suggestions from my level I have access to my supervisor s superiors when required Higher management has sufficient understanding of my job to evaluate my performance Higher management is concerned about training people at my level for advancement We have common values Higher management focuses on human investment We have work independence and job inflexibility Higher management is concerned about creating association We have strategies to work under pressure and improve performance The mean values for the responses ranged from 4.0 to 2.2, signifying that the managers concern levels regarding empowerment practices ranged from low concern (<2.31) to highest concern (>3.6). Areas in which high concern was observed are listed on lines 7, 11, 15, and 18 of the table (20% of all items in the questionnaire). This demonstrates a managerial weakness in terms of concern regarding the implementation of employee empowerment practices in other areas. However, public hospital workers agreed that there was progress in terms of the implementation of employee empowerment practices, as indicated by the values in lines 1, 2, 5, 6, 8, 10, 12, 13, 17, 19, and 20, which constitute 60% of all items in the questionnaire. Poor progress was indicated in terms of the implementation of employee empowerment practices listed in lines 3, 4, 14, and 16, which constitute 20% of all items in the questionnaire. 3.2 Hypothesis Testing H01: There is no concern among hospital managers regarding the implementation of employee empowerment practices. Table 3. T-test results for Hypothesis 1 SD Mean H1 Result Sig-t t-tabulated t-calculated Reject 0,00 1, A one-sample t-test was used to test this hypothesis. Table 3 indicates that t-calculated (82.87) exceeds its tabulated value (1.96) and Sig-t is <0.05. Therefore, we reject the null hypothesis and accept the alternative one. This suggests that the concern levels among hospital managers regarding the implementation of employee empowerment practices was acceptable (M = 3.04, SD = 0.61). H02: Demographic variables (age, qualification, and work experience) do not significantly influence the concern levels of hospital managers regarding the implementation of employee empowerment practices in Jordanian public hospitals. COPY RIGHT 2013 Institute of Interdisciplinary Business Research 83

7 Table 4. Differences between hospital managers in the implementation of employee empowerment practices according to demographic variables ANCOVA Variable H0 Result F-calculated F-tabulated Sig-F Age Reject Qualification Reject Experience Accept To measure the managers concern regarding the implementation of employee empowerment practices, an ANCOVA was employed. As indicated in Table 4, significant differences were observed for age (p =.00) and qualification (p =. 00). By contrast, there was no significance of experience (p =.63). 4. Discussion & Recommendations Based on the results of this study, the following conclusions can be derived. Jordanian hospital managers are concerned about the implementation of employee empowerment practices. Significant differences were found in the concern levels between managers of Jordanian public hospitals owing to two demographic variables: qualification and work experience. Moreover, access to information in hospitals can be difficult, and worker participation in decision making must be improved for effective implementation of employee empowerment practices. Various recommendations can be made as a result of the findings of this study. Support and follow-up must be provided for employee empowerment practices through the MOH or the establishment of a neutral department dedicated to this purpose. The interest of hospital leaders in the application of employee empowerment practices must be increased. Finally, employees must be motivated to participate in decision making regarding the implementation of employee empowerment practices in hospitals and access to information must be improved. COPY RIGHT 2013 Institute of Interdisciplinary Business Research 84

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9 Smith, M. J., & Liehr, P. R. (2008). Middle Range Theory for Nursing. New York: Springer Publishing Company. Speegle, M. (2010). Quality Concepts for the Process Industry. Canada: Nelson Education. Tschohl, J. (2010). Empowerment: A Way of Life. Minnesota: Best Sellers Publishing. Woodside, A. G., & Martin, D. (2008). Tourism Management: Analysis, Behaviour, and Strategy. London. COPY RIGHT 2013 Institute of Interdisciplinary Business Research 86