CSIRO PUBLISHING
Australian Health Review, 2015, 39, 290–294 http://dx.doi.org/10.1071/AH14198
Factors that affect job satisfaction and intention to leave of allied health professionals in a metropolitan hospital Natalie A. Wilson BSc(Nutrition & Psychology), MSc(Nutrition & Dietetics), MBA(Health Management), Dietetics Manager South Western Sydney Local Health District, Dietetics Department, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW 1871, Australia. Email: [email protected]
Abstract Objective. The purpose of the present study was to determine the aspects of the allied health professional’s job that contribute most to job satisfaction and intention to leave in a metropolitan hospital. Method. Data were collected via a questionnaire that was emailed to all clinical allied health staff at Campbelltown and Camden Hospitals in New South Wales, Australia. The participants then rated their level of satisfaction with various job aspects. Results. A significant correlation was found between several job satisfaction factors and intention to leave in this study group, including quality of supervision, level of competency to do the job, recognition for doing the job, advancement opportunities, autonomy, feelings of worthwhile accomplishment, communication and support from the manager. Conclusion. In relation to Herzberg’s job satisfaction theory, both intrinsic and extrinsic work factors have been shown to have a significant correlation with intention to leave in this study group. This information can assist workforce planners to implement strategies to improve retention levels of allied health professionals in the work place. What is known about the topic? Job satisfaction is a significant predictor of retention in the workplace for allied health professionals in rural and remote areas; however, limited research has reviewed predictors of job satisfaction of allied health professionals in metropolitan hospitals. What does this paper add? This paper provides evidence that job satisfaction factors are important predictors of intention to leave for allied health in metropolitan hospitals, and that both intrinsic and extrinsic job satisfaction factors have a significant correlation with intention to leave. What are the implications for practice? Those involved in workforce management of allied health professionals can implement strategies to improve job satisfaction and assist with retention of the allied health workforce. Received 6 November 2014, accepted 10 February 2015, published online 7 April 2015
Introduction Human resource literature indicates there is strong empirical evidence to support a causal relationship between job satisfaction and retention in the health workforce.1–3 Furthermore, researchers have found that job satisfaction is one of the most significant predictors of employee retention in a variety of occupational settings, including the healthcare system, and that low morale and job dissatisfaction are correlated with increased turnover rates in organisations.4,5 Research on allied health professionals in Australia has confirmed that increased job satisfaction is related to retention rates, and that job satisfaction is specifically affected by management structures, lack of career structure and lack of professional support.6–8 Furthermore, Dodd et al.9 found that allied health professionals are more likely to stay with an organisation when they are able to attain higher levels of competency, have professional development opportunities and good peer support and the organisation has a continuous learning culture. Journal compilation AHHA 2015
Several allied health and nursing studies have used Herzberg’s two factor theory10,11 of motivation to explain the association between motivation, job satisfaction and retention factors.12–14 Herzberg’s theory differentiates between intrinsic aspects of the job (called motivators) and extrinsic aspects of the job (called hygiene factors). Intrinsic or motivator factors include those factors that affect the professional’s internal satisfaction or other factors controlled primarily by the person, whereas extrinsic or hygiene factors include external benefits provided by organisations.15 Motivator factors are considered sources of satisfaction and include a sense of achievement, recognition, the work itself, opportunities to take responsibility and opportunities for advancement. Hygiene factors de-motivate when they are inappropriate, and include supervision, interpersonal relations, physical work conditions, salary, benefits and job security. Hygiene factors result in neither a satisfied nor dissatisfied state, whereas motivator factors can increase job satisfaction.13–15 www.publish.csiro.au/journals/ahr
Job satisfaction and intention to leave
Research has found that job satisfaction among allied health professionals is related to motivator factors such as teamwork, the work environment, adequate staffing, opportunities for training and professional development, involvement in decision making, autonomy and a practice environment consistent with the professional’s own values. Alternatively, hygiene factors, such as lack of family leave, inflexible work schedules, lack of competitive pay and lack of supervision, were negatively correlated with job satisfaction.15–19 The aim of this study was to determine the aspects of the allied health professional’s job that contribute most to job satisfaction and intention to leave in a metropolitan hospital. Methods Participants in the present study were allied health employees at Campbelltown and Camden Hospitals in New South Wales (NSW), Australia, and included dietitians, occupational therapists, physiotherapists, podiatrists, social workers and speech pathologists. The survey used in the research project was a combination of two survey instruments in the final survey. The first was the Measure of Job Satisfaction instrument used by Trayner and Wade,20 which was initially used to measure nurse job satisfaction. This survey tool was used, because research had shown that the factors affecting the job satisfaction of nursing staff are similar to those that affect allied health. This survey tool was used in conjunction with the survey instrument of Lyons et al.,21 which was used to assess the level of job satisfaction of allied health graduates. The survey instrument of Lyons et al.21 had a high internal consistency measurement (chronbachs alpha score = 0.93), whereas the Measure of Job Satisfaction instrument designed by Trayner and Wade had high levels of both reliability and construct validity.22 A comprehensive literature review was also completed to ensure that the content of the questionnaire was relevant to allied health professionals. The questions included in the survey were shown to be key factors affecting job satisfaction of allied health, and support Herzberg’s satisfaction theory in terms of hygiene and motivator factors. Once finalised, the questionnaire and project plan were submitted to South Western Sydney Area Health Service Ethics Committee and, on approval, piloted on a sample group of 10 allied health staff at nearby hospitals. The questionnaire was then sent via work email using the SurveyMonkey online survey program. Data were collated via a questionnaire using four different methods. The first section of data (19 questions) related to level of satisfaction or dissatisfaction evaluated on a five-point Likert scale. These data were collated into frequency of responses, mean s.d. and correlation analysis. The second section of data contained one question that asked whether the participant intended to leave their current job and required a ‘yes’ or ‘no’ response. The data were collated into percentages before correlation analysis was conducted. The third section of data was from two questions that were open ended and were collated into themes based on the responses and literature relating to job satisfaction. These data were then checked by a colleague in terms of themes and accuracy of data collation. Finally, the last section of data consisted of demographic questions related to age, professional
Australian Health Review
291
level, length of tenure, type of work, professional group, gender and primary place of work. These questions were collated in terms of frequency of response and tabulated into percentages and were used to describe the sample. Results Demographic data There were 90 participants in the study, with 56 participants completing surveys, yielding a response rate of 62%. Response rates of similar job satisfaction surveys range from 49% to 72%.11,20,21 Professional groups that participated in the study varied in the number of responses, with some groups having better response rates than others. The highest response rate was from Speech Pathology (84.6%), followed by Dietetics (80%), Occupational Therapy (62%), Social Work (55%), Physiotherapy (41%) and Podiatry (20%). Factors related to job satisfaction The first 19 questions in the questionnaire asked respondents to rate their satisfaction with a particular factor of job satisfaction on a five-point Likert scale. The options were: 1, very dissatisfied; 2, dissatisfied; 3, neither satisfied nor dissatisfied; 4, satisfied; and 5, very satisfied. Table 1 lists the questions and their mean s.d. response scores; Table 2 lists the frequency of response data. The highest mean score for the reported job satisfaction indices was 4.23 0.77, which was related to the level of competency to do the job, followed by autonomy Table 1. Summary of mean (þ s.d.) scores for job satisfaction indices evaluated on a five-point Likert scale ranging from 1 (very dissatisfied) to 5 (very satisfied) Job satisfaction index The quality of supervision I receive in my job The amount of professional development opportunities I have in my workplace My level of competency to do my job The recognition I receive for doing my job The opportunities for advancement that exist in my workplace The feeling of worthwhile accomplishment I get from doing my job The communication I have with my manager The opportunity I have to have input into departmental decisions The feeling that my work environment is in line with professional values The level of autonomy I have in my job My relationship with the people I work with The support I receive from my manager The condition of my physical work space My current salary The workload in my current position The level of staffing in my team The balance between my work and home life The access I have to flexible work hours All things considered, how satisfied are you with your current job?
Score 3.59 ± 1.07 3.75 ± 1.01 4.23 ± 0.77 3.36 ± 1.11 3.09 ± 1.02 3.82 ± 1.03 3.66 ± 1.08 3.39 ± 1.15 3.45 ± 1.23 3.93 ± 0.85 3.86 ± 0.90 3.71 ± 1.11 3.40 ± 1.08 3.54 ± 0.89 3.38 ± 1.02 2.89 ± 1.14 3.52 ± 1.14 3.33 ± 1.01 3.68 ± 0.90
292
Australian Health Review
N. A. Wilson
Table 2. Frequency of responses for each question VD, very dissatisfied; D, dissatisfied; N, neither satisfied nor dissatisfied; S, satisfied; VS, very satisfied Questions The quality of supervision I receive in my job The amount of professional development opportunities I have in my workplace My level of competency to do my job The recognition I receive for doing my job The opportunities for advancement that exist in my workplace The feeling of worthwhile accomplishment I get from doing my job The communication I have with my manager The opportunity I have to have input into departmental decisions The feeling that my work environment is in line with professional values The level of autonomy I have in my job My relationship with the people I work with The support I receive from my manager The condition of my physical work space My current salary The workload in my current position The level of staffing in my team The balance between my work and home life The access I have to flexible work hours All things considered, how satisfied are you with your current job?
(3.93 0.85) and a feeling of worthwhile accomplishment (3.82 1.03). The lowest mean score was 2.89 1.14, related to level of staffing, followed by opportunities for advancement in the workplace (3.09 1.02) and then access to flexible work hours (3.33 1.01). The overall frequency of rate of satisfaction for the study group was 67.9%, with 17.9% of the study group responding that they were neither satisfied nor dissatisfied with their current job and 14.3% reporting dissatisfaction with their job. The job indices that scored highest in relation to satisfaction included level of competency to do the job (85.7%), autonomy in job (78.6), relationships with colleagues (76.8%), a feeling of worthwhile accomplishment from doing the job (71.4%) and professional development opportunities (67.8%). The job satisfaction indices that scored highest in relation to dissatisfaction included level of staffing (42.8%), opportunities for advancement (32.8%), work environment in line with professional values (30.4%), input into departmental decisions (26.8%) and workload (25%). To determine the aspects of the job that contribute most to job satisfaction and intention to leave, Pearson correlation was calculated with a P-value of
Australian Health Review, 2015, 39, 290–294 http://dx.doi.org/10.1071/AH14198
Factors that affect job satisfaction and intention to leave of allied health professionals in a metropolitan hospital Natalie A. Wilson BSc(Nutrition & Psychology), MSc(Nutrition & Dietetics), MBA(Health Management), Dietetics Manager South Western Sydney Local Health District, Dietetics Department, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW 1871, Australia. Email: [email protected]
Abstract Objective. The purpose of the present study was to determine the aspects of the allied health professional’s job that contribute most to job satisfaction and intention to leave in a metropolitan hospital. Method. Data were collected via a questionnaire that was emailed to all clinical allied health staff at Campbelltown and Camden Hospitals in New South Wales, Australia. The participants then rated their level of satisfaction with various job aspects. Results. A significant correlation was found between several job satisfaction factors and intention to leave in this study group, including quality of supervision, level of competency to do the job, recognition for doing the job, advancement opportunities, autonomy, feelings of worthwhile accomplishment, communication and support from the manager. Conclusion. In relation to Herzberg’s job satisfaction theory, both intrinsic and extrinsic work factors have been shown to have a significant correlation with intention to leave in this study group. This information can assist workforce planners to implement strategies to improve retention levels of allied health professionals in the work place. What is known about the topic? Job satisfaction is a significant predictor of retention in the workplace for allied health professionals in rural and remote areas; however, limited research has reviewed predictors of job satisfaction of allied health professionals in metropolitan hospitals. What does this paper add? This paper provides evidence that job satisfaction factors are important predictors of intention to leave for allied health in metropolitan hospitals, and that both intrinsic and extrinsic job satisfaction factors have a significant correlation with intention to leave. What are the implications for practice? Those involved in workforce management of allied health professionals can implement strategies to improve job satisfaction and assist with retention of the allied health workforce. Received 6 November 2014, accepted 10 February 2015, published online 7 April 2015
Introduction Human resource literature indicates there is strong empirical evidence to support a causal relationship between job satisfaction and retention in the health workforce.1–3 Furthermore, researchers have found that job satisfaction is one of the most significant predictors of employee retention in a variety of occupational settings, including the healthcare system, and that low morale and job dissatisfaction are correlated with increased turnover rates in organisations.4,5 Research on allied health professionals in Australia has confirmed that increased job satisfaction is related to retention rates, and that job satisfaction is specifically affected by management structures, lack of career structure and lack of professional support.6–8 Furthermore, Dodd et al.9 found that allied health professionals are more likely to stay with an organisation when they are able to attain higher levels of competency, have professional development opportunities and good peer support and the organisation has a continuous learning culture. Journal compilation AHHA 2015
Several allied health and nursing studies have used Herzberg’s two factor theory10,11 of motivation to explain the association between motivation, job satisfaction and retention factors.12–14 Herzberg’s theory differentiates between intrinsic aspects of the job (called motivators) and extrinsic aspects of the job (called hygiene factors). Intrinsic or motivator factors include those factors that affect the professional’s internal satisfaction or other factors controlled primarily by the person, whereas extrinsic or hygiene factors include external benefits provided by organisations.15 Motivator factors are considered sources of satisfaction and include a sense of achievement, recognition, the work itself, opportunities to take responsibility and opportunities for advancement. Hygiene factors de-motivate when they are inappropriate, and include supervision, interpersonal relations, physical work conditions, salary, benefits and job security. Hygiene factors result in neither a satisfied nor dissatisfied state, whereas motivator factors can increase job satisfaction.13–15 www.publish.csiro.au/journals/ahr
Job satisfaction and intention to leave
Research has found that job satisfaction among allied health professionals is related to motivator factors such as teamwork, the work environment, adequate staffing, opportunities for training and professional development, involvement in decision making, autonomy and a practice environment consistent with the professional’s own values. Alternatively, hygiene factors, such as lack of family leave, inflexible work schedules, lack of competitive pay and lack of supervision, were negatively correlated with job satisfaction.15–19 The aim of this study was to determine the aspects of the allied health professional’s job that contribute most to job satisfaction and intention to leave in a metropolitan hospital. Methods Participants in the present study were allied health employees at Campbelltown and Camden Hospitals in New South Wales (NSW), Australia, and included dietitians, occupational therapists, physiotherapists, podiatrists, social workers and speech pathologists. The survey used in the research project was a combination of two survey instruments in the final survey. The first was the Measure of Job Satisfaction instrument used by Trayner and Wade,20 which was initially used to measure nurse job satisfaction. This survey tool was used, because research had shown that the factors affecting the job satisfaction of nursing staff are similar to those that affect allied health. This survey tool was used in conjunction with the survey instrument of Lyons et al.,21 which was used to assess the level of job satisfaction of allied health graduates. The survey instrument of Lyons et al.21 had a high internal consistency measurement (chronbachs alpha score = 0.93), whereas the Measure of Job Satisfaction instrument designed by Trayner and Wade had high levels of both reliability and construct validity.22 A comprehensive literature review was also completed to ensure that the content of the questionnaire was relevant to allied health professionals. The questions included in the survey were shown to be key factors affecting job satisfaction of allied health, and support Herzberg’s satisfaction theory in terms of hygiene and motivator factors. Once finalised, the questionnaire and project plan were submitted to South Western Sydney Area Health Service Ethics Committee and, on approval, piloted on a sample group of 10 allied health staff at nearby hospitals. The questionnaire was then sent via work email using the SurveyMonkey online survey program. Data were collated via a questionnaire using four different methods. The first section of data (19 questions) related to level of satisfaction or dissatisfaction evaluated on a five-point Likert scale. These data were collated into frequency of responses, mean s.d. and correlation analysis. The second section of data contained one question that asked whether the participant intended to leave their current job and required a ‘yes’ or ‘no’ response. The data were collated into percentages before correlation analysis was conducted. The third section of data was from two questions that were open ended and were collated into themes based on the responses and literature relating to job satisfaction. These data were then checked by a colleague in terms of themes and accuracy of data collation. Finally, the last section of data consisted of demographic questions related to age, professional
Australian Health Review
291
level, length of tenure, type of work, professional group, gender and primary place of work. These questions were collated in terms of frequency of response and tabulated into percentages and were used to describe the sample. Results Demographic data There were 90 participants in the study, with 56 participants completing surveys, yielding a response rate of 62%. Response rates of similar job satisfaction surveys range from 49% to 72%.11,20,21 Professional groups that participated in the study varied in the number of responses, with some groups having better response rates than others. The highest response rate was from Speech Pathology (84.6%), followed by Dietetics (80%), Occupational Therapy (62%), Social Work (55%), Physiotherapy (41%) and Podiatry (20%). Factors related to job satisfaction The first 19 questions in the questionnaire asked respondents to rate their satisfaction with a particular factor of job satisfaction on a five-point Likert scale. The options were: 1, very dissatisfied; 2, dissatisfied; 3, neither satisfied nor dissatisfied; 4, satisfied; and 5, very satisfied. Table 1 lists the questions and their mean s.d. response scores; Table 2 lists the frequency of response data. The highest mean score for the reported job satisfaction indices was 4.23 0.77, which was related to the level of competency to do the job, followed by autonomy Table 1. Summary of mean (þ s.d.) scores for job satisfaction indices evaluated on a five-point Likert scale ranging from 1 (very dissatisfied) to 5 (very satisfied) Job satisfaction index The quality of supervision I receive in my job The amount of professional development opportunities I have in my workplace My level of competency to do my job The recognition I receive for doing my job The opportunities for advancement that exist in my workplace The feeling of worthwhile accomplishment I get from doing my job The communication I have with my manager The opportunity I have to have input into departmental decisions The feeling that my work environment is in line with professional values The level of autonomy I have in my job My relationship with the people I work with The support I receive from my manager The condition of my physical work space My current salary The workload in my current position The level of staffing in my team The balance between my work and home life The access I have to flexible work hours All things considered, how satisfied are you with your current job?
Score 3.59 ± 1.07 3.75 ± 1.01 4.23 ± 0.77 3.36 ± 1.11 3.09 ± 1.02 3.82 ± 1.03 3.66 ± 1.08 3.39 ± 1.15 3.45 ± 1.23 3.93 ± 0.85 3.86 ± 0.90 3.71 ± 1.11 3.40 ± 1.08 3.54 ± 0.89 3.38 ± 1.02 2.89 ± 1.14 3.52 ± 1.14 3.33 ± 1.01 3.68 ± 0.90
292
Australian Health Review
N. A. Wilson
Table 2. Frequency of responses for each question VD, very dissatisfied; D, dissatisfied; N, neither satisfied nor dissatisfied; S, satisfied; VS, very satisfied Questions The quality of supervision I receive in my job The amount of professional development opportunities I have in my workplace My level of competency to do my job The recognition I receive for doing my job The opportunities for advancement that exist in my workplace The feeling of worthwhile accomplishment I get from doing my job The communication I have with my manager The opportunity I have to have input into departmental decisions The feeling that my work environment is in line with professional values The level of autonomy I have in my job My relationship with the people I work with The support I receive from my manager The condition of my physical work space My current salary The workload in my current position The level of staffing in my team The balance between my work and home life The access I have to flexible work hours All things considered, how satisfied are you with your current job?
(3.93 0.85) and a feeling of worthwhile accomplishment (3.82 1.03). The lowest mean score was 2.89 1.14, related to level of staffing, followed by opportunities for advancement in the workplace (3.09 1.02) and then access to flexible work hours (3.33 1.01). The overall frequency of rate of satisfaction for the study group was 67.9%, with 17.9% of the study group responding that they were neither satisfied nor dissatisfied with their current job and 14.3% reporting dissatisfaction with their job. The job indices that scored highest in relation to satisfaction included level of competency to do the job (85.7%), autonomy in job (78.6), relationships with colleagues (76.8%), a feeling of worthwhile accomplishment from doing the job (71.4%) and professional development opportunities (67.8%). The job satisfaction indices that scored highest in relation to dissatisfaction included level of staffing (42.8%), opportunities for advancement (32.8%), work environment in line with professional values (30.4%), input into departmental decisions (26.8%) and workload (25%). To determine the aspects of the job that contribute most to job satisfaction and intention to leave, Pearson correlation was calculated with a P-value of
