Organizational Care Impact on Work Commitment: A Study in the Health Care Field ()
Subject Areas: Organizational Behavior and Theory
1. Introduction
Organizational commitment is an important variable to consider in light of the high costs associated with turnover. It has been defined as “a psychological link between the employee and his or her organization that makes it less likely that the employee will voluntarily leave the organization”. Commitment relates to an employee’s attachment, identification and involvement with the organization. Employees with strong organizational commitment stay with the organization because they want to [1] . Organizational commitment has been positively related to job performance, organizational citizenship behaviors and job satisfaction [2] . Six areas of work life (workload, control, rewards, community, fairness and values) act as organizational antecedents of employee engagement or burnout [3] . Much of the interest in organizational commitment stems from reports of positive consequences on employee behavior and desirable work outcomes from organizational commitment.
In clinical sciences, physicians’ satisfaction plays a great role in their performance and therefore is reflected as satisfaction and compliance among their patients. Similarly, public health professionals’ satisfaction in their jobs would determine the quality of the service delivery for their respective communities. Satisfaction of job among health care professionals (HCPs) is a vital part of ensuring their high concern in the profession they are engaged in. The rapid changes in medical practice in the past quarter century have stimulated considerable interest in measuring HCPs perceptions and attitudes about their work [4] . Low levels of job satisfaction among HCPs may affect HCPs-patient relationships and compromise quality of care. High quality patient care requires the presence of a committed workforce that is fully engaged in its work and settings that empower them to provide the care they are educated to provide. Dissatisfaction with professional work among HCPs has also been associated with inappropriate prescribing patterns, lower levels of patient satisfaction, and decreased patient compliance with prescribed medications and follow-up appointments [5] . HCPs turnover is also greater in organizations with higher levels of dissatisfaction. High turnover can disrupt continuity of care and can increase costs. Finally, high levels of dissatisfaction decrease HCPs commitment to the practice setting and, if persistent, can lead to mental strain and burnout [6] . We aimed to assess the level of and determine the factors influencing work commitment amongst health care professionals working in tertiary care health settings of Karachi.
2. Materials and Methods
It was a cross sectional study carried out during the span of February to August 2015. The study population comprised of HCPs working in tertiary care hospitals of Karachi. Sampling techniques of the study were nonsystematic randomized. Questionnaires were distributed in different charitable and non-charitable tertiary care hospitals of Karachi. The basic tool selected to conduct the study was questionnaire which was developed through the review of literature and researches available in this area. The questionnaire was designed in a way that it comprises of two portions. First portion consists on demographics associated 5 questions. The second portion had 22 questions to assess the impact of organizational care on job performance amongst health care professionals. Items rated on a Likert scale ranging from 1 = strongly disagree to 5 = strongly agree. Prior verbal ethical approval was taken from each institution’s head of department to instigate the study in their institute. Each institution’s head of department and the health care professionals’ participating in the study were briefed about the rationale of the study. Participants were assured about the confidentiality of their personal information and responses. The filled questionnaires were analyzed by using SPSS 20.0. Descriptive statistics were used to demonstrate participants’ demographic information and their response to the questionnaire items. To observe the influence of age, gender, type of organization, job status and salary on the responses, one way ANOVA was adopted, using p < 0.05 level of significance.
3. Results and Discussion
Out of 250 survey questionnaires, only 187 were returned back in useable form. Hence the response rate was 74.8%. Table 1 showed the demographic of the study population. The study population comprised of 69% males and 31% females. Near about 46% of the participants belonged to the public sector and 54% belonged to private sector hospitals. Mass population 78% was rendering their services on permanent basis and 42% was earning more than 50,000 PKR.
Table 2 revealed the opinion of healthcare professionals towards questionnaire items. Mass population (71%) feel honored to be the part of their organization. 72% opined that in their organization employee gets promoted
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Table 1. Characteristics of study population.
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Table 2. Opinion of healthcare professionals towards questionnaire items.
on the basis of their seniority whereas more than half opined that employee get promoted on the basis of their qualification and quality of work.
Rousseau suggests the key to strengthening employees’ psychological attachment in the contemporary workplace is to either reinforce perceptions of organizational membership or demonstrate organizational care and support for employees, or both. Strong perceptions of organizational membership exist when individuals and the organization have common interests, and individuals perceive that their relationship with the organization forms an “us” [7] . In our study, 64% of participants opined whenever organization makes any key decision their opinion is considered. 68% did not agree that their work load is manageable and they feel under pressure to perform well. Research has shown that because of a growing emphasis on learning in today’s careers, opportunity for learning at work may be an important determinant of employees’ job attitudes and behaviors. Because opportunity for learning at work is increasingly desired by employees today, its provision should help elicit employees’ perceptions of a quality relational exchange with their employers and therefore reciprocation in terms of organizational commitment [8] . In current study, only 33% agreed that they are assigned task that provide opportunity to utilize their knowledge and educational background and their day to day task is related to their capabilities and skills. While only 37% enjoy doing their day to day task. 31% have an opinion that organization welcomes their suggestion for improvement whereas only 29% said that their suggestion for organization betterment was implemented.
The importance of job security stems from the fact that it is critical for influencing work-related outcomes. For instance, job security is an important determinant of employee health; for the physical and psychological wellbeing of employees; for employee turnover; for employee retention; for job satisfaction; and for organizational commitment [9] . However in our study only 18% agreed that their organization provides job security. Ashford examined the impact of job insecurity on organizational commitment, job satisfaction, and job performance. They reported that job insecurity leads to reduced commitment and reduced satisfaction, but it has no impact on job performance [10] . Iverson also reported that increases in job security lead to greater organizational commitment [11] . Other study conducted in Pakistan also revealed that public health professionals reported low satisfaction with professional development opportunities, recognition, poor salaries and benefits, not being involved in decision making, doing a lot of irrelevant task and having sufficient time pressure [12] . Employees’ needs and motivators differ so it is significant to recognize what motivates them to execute their activities.
Supportive relations at work may be critically important to the maintenance of psychological well-being and physical health. Researchers investigating the workplace have long recognized social support and the closely related concepts of interpersonal warmth, trust, and openness as core dimensions of organizational or communication climate that may affect many organizational outcomes, including job satisfaction and performance. The lack of understanding between subordinates and superiors may account for some of the inconclusiveness in some areas as motivation, leadership, and performance appraisal. This seems particularly true concerning the association between performance and rewards [13] . In current study only 13% have good relationship with superiors. However, more than 50% has good relationship with subordinates. To observe the influence of age, gender, type of organization, job status and salary on the responses, one way ANOVA was adopted using p < 0.05 level of significance (Table 3).
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Table 3. Influence of age, gender, type of organization, job status and salary on the responses.
4. Conclusion
Public health professionals’ commitment to their jobs would determine the quality of the service delivery for their respective communities. Our findings suggest the interventions of policy makers to trigger those factors that increase levels of work commitment among health care professionals.
Acknowledgements
The authors wish to acknowledge Natasha Arif, Amin-Ur-Rehman and Nida Gul for their support in compiling the data.
NOTES
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*Corresponding author.