Bridging the Gaps in Employee Motivation: A Comparative Study of Hospitals in Jacksonville, Florida
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Abstract
Purpose: Motivation is a powerful tool that plays a key role in driving and exciting employees, resulting to improved performance. It is crucial in driving employees to outstanding performance contributing to improved performance and healthcare. This study explored on the existing gaps on factors that influenced employee motivation in the healthcare sector. It compared employee motivation in private and public hospitals in Jacksonville, Florida where leadership style, working environment, career development and reward system are key ingredients analyzed.
Design/methodology/approach: The study employed comparative research on 35 healthcare professionals who had served for at least 2 years in 5 hospitals (3 private and 2 public) in Jacksonville, Florida. An online survey was used to obtain information on leadership style, working environment, career development and reward system which are key ingredients to motivation.
Findings: The study observed that healthcare professionals working in public hospitals and those working in the private hospitals were greatly motivated by good leadership, conducive working environment, career development opportunities and a good reward system. Leadership and work environment was critical to all the employees working in the hospitals. However, the private hospitals were more keen on the reward system, work environment and career development while the public hospitals showed some concern on reward system and work environment which were key ingredients driving employee motivation.
Significance: Many studies on employee motivation have been done in the past. This paper fills a gap on factors driving employee motivation in private and public hospitals. It provides more information on what keeps these healthcare professionals going.
List of Figures
Figure 1: Conceptual Framework ………………………………………………………………….14
List of Tables
Table 1: Traditional Motivation Theories………………………………………………………..…….11
Table 2: Motivating Factors……………………………………………………………………….…….16
Table 3: Demographic Characteristics of Participants………………………………………………18
Table 4: Descriptive Statistics……………………………………………………………………….…..19
Table 5: t-Test: Two-Sample Assuming Unequal Variances…………………………………………20
Introduction
Workers or employees of any organization are believed to be the key resources to the success of the organization. The most important asset in many businesses in the current world is human asset. Most, if not all businesses in different sectors, need staff to engage in the organization’s operations making staff an important asset. The healthcare sector is no exception. Healthcare facilities, pharmacies, and nursing homes among others all need staff to engage in daily operations. Healthcare workers, in particular, play a critical role in people’s lives. They save lives through treatment and preventive measures. Healthcare workers can be found in the public and private service sector that are part of the healthcare sector.
The healthcare sector consists of a diverse array of industries employing millions of staff to engage in the activities that range from manufacturing to healthcare services to research among others. Drug manufacturers such as pharmaceutical firms and biotechnology firms and medical equipment makers employ millions of workers to assist in manufacturing. Healthcare facilities such as clinics, nursing homes and hospitals are no exception. They employ millions of staff to provide the required services and help operate the facilities. According to Knowles (2018), the U.S healthcare industry became the largest employer in the last quarter of 2017. This means that it surpassed the retail and manufacturing industries that have always been the largest employers. More workers will be employed in the healthcare sector in the years to come due to the aging population.
The U.S healthcare service sector comprises of public and private facilities that are significant contributors to the U.S economy. The healthcare and social assistance sector contributed to the country’s gross domestic product 3.5% and 3.1% in 2018 and 2019 respectively (Howells & Morgan, 2020). The gross output in this sector was $2,523.8 billion and 2.648.0 billion in 2018 and 2019 respectively. According to the U.S Bureau of Economic Analysis (2020), there was an increase of 3.3% of real gross output for social assistance and health care in the last fourth quarter on 2019. There was a rise in ambulatory healthcare services. Such demands can only be met with a well-motivated healthcare workforce.
Healthcare facilities that view their staff as the most valuable and volatile asset to the facility are more likely to invest in them compared to those that are not. They engage in employee motivation strategies that drive high levels of performance as well as attract and retain top talents. These may range from setting clear expectations, good reward system, conducive working environment, accurate and timely feedback, recognition and work/life balance among others (Hasan, 2018). These factors are vital in attracting prospective job applicants who will help an organization achieve its goals and tend to vary from one employee to the other across different industries. Since the healthcare sector is competitive like other sectors, it is important for healthcare facilities to get their strategies right to attract high-caliber employees for improved quality of services and excellent reputation.
Employee motivation is of utmost importance to any organization. Motivation can simply be defined as the willingness of an individual or group to expand energy in order to attain a goal (Hiriyappa, 2015). It is a function or force that activates energies for action of people towards attaining a goal. Employees are motivated in different ways. Some ways are simple like appreciating an employee’s achievement through a simple “thank you” while others are complex schemes like the reward system. Additionally, employees in the private and public healthcare facilities may have preferences when it comes to motivation factors. Since employees are motivated by different factors, it is significantly important for an employer to understand what motivates his employees and act accordingly.
Statement of the Problem
Jobs provide people across the world with income and personal satisfaction. However, they also pose as health and safety risks. Employees working in healthcare facilities such as hospitals and clinics are at increased risks of safety and health issues. Poor pay, poor working conditions, unequal opportunities and inadequate resources are other factors that lead to employee turnover, absenteeism and poor performance in the healthcare sector. Since healthcare professionals tend to be critical in the health and lives of people, they need to be motivated to willingly give their best.
This study aims to find out “what really motivates healthcare professionals working in public and private hospitals?” It aims to explore on four key ingredients of employee motivation from the perspective of healthcare professionals in hospitals in Jacksonville, Florida. It seeks to test these hypothesis;
H0: There is no significant differences in employee motivation in public and private hospitals
H1: There is significant differences in employee motivation in public and private hospitals
Significance of Study
This study aims to fill the gaps that exist in employee motivation in public and private hospitals. It identifies what really motivates healthcare professionals working in public and private hospitals. First, this information tends to illustrate the best employee motivating factors in both sectors that will benefit management in both public and private hospitals. This will provide insight into motivational needs of employees working for hospitals guiding management when creating employee motivational programs for private and public hospitals.
Second, it will emphasize on the need to understand that healthcare professionals are motivated by different factors. It illustrates that what motivates those employed in public hospitals most may differ with that that motivates those employed in private hospitals. Such differences may assist healthcare facilities in attracting as well as retaining top talent by adopting proper motivation strategies in private and public facilities. Employers will use it as a guide to ensure that their employees are well-motivated to minimize turnover and absenteeism which is quite costly. They will be knowledgeable on where to invest their efforts when it comes to employee motivation. The study will also generate meaningful data that may be used as a guide for further research on employee motivation in healthcare facilities. Further research may be performed on healthcare facilities such as clinics using other motivation ingredients.
Limitations of Study
This study excluded healthcare professionals who had served the hospitals for less than 2 years. Second, data was collected only from 5 hospitals which could limit the generality of the findings. Third, it was collected through online survey only. Additionally, it focused on four factors that influence employee motivation leaving out other important factors like work/life balance and career development. Future research should expand on sample size, explore on more motivation factors and engage a series of interviews for more information as this can affect the results.
Ethical Issues
Ethical issues surrounding this research included biasness, honesty and integrity issues and confidentiality. Biasness was avoided in all aspects of this research including giving equal chances to all qualified groups levels among healthcare workers to participate in the study. Integrity and honesty issues were avoided by reporting the research honestly and accurately. Guidelines were followed to protect sensitive information of the participants.
Literature Review
This section explores on existing literature on employee motivation. It provides a comprehensive overview of existing knowledge on employee motivation in the current period. It enhances understanding on what has already been done and the existing gaps that need to be filled.
Motivation
According to Latham (2007), motivation is simply a set of energetic forces originating within and beyond an individual that initiate and regulate behavior. The energetic forces are triggered by an individual’s needs as well as external factors. On the other hand, Shah and Gardner (2008) define motivation as forces within an individual that activate as well as direct towards certain goals. They also define motivation as psychological processes that not only arouses but also directs voluntary actions towards achieving a goal. It is a power that strenghtens behavior to achieve an objective.
According to Dagne, Beyene, and Berhanu (2015), motivation in the work context can simply be defined as the degree of willingness of an individual to arouse and maintain efforts towards achieving organizational goals. It is an internal process that can be stimulated by the workplace environment and internal features of an individual. These explanations are focussed on energy or forces of individuals that are driven by a number of factors. The process or procedure of stimulating the energetic forces can be explained by the following motivation theories.
Motivation Theories
Employees in various industries have various competing needs driven by different motivators. Some are driven by job security and achievement while others are driven by rewards and incentives. There are quite a number of motivation theories that help illustrate what triggers employees for outstanding performance. Common traditional motivation theories include the motives and needs theory by Maslow that posits that employees are driven by five levels of needs which include psychological, social, safety, self-actualizing and ego/esteem (Dagne, Beyene, & Berhanu, 2015), the expectancy theory by Vroom that posits employees believe that work effort results to rewards and performance and the equity and justice theory by Adam that posits that employees are driven by equity between them and their colleagues (Lee & Raschke, 2016). A summary of five traditional motivation theories is provided in the below table.
Traditional Theory Motivating Principle
Maslow’s Hierarchy of Needs Theory (1943) Hierarchy of needs from bottom to top psychological, safety, social/love esteem/ego, and self-actualizing drive employees .
Vroom’s Expectancy Theory (1964) Work effort is driven by expected outcomes like rewards and performance.
Herzberg’s Motivation Theory (1959) Workplace environment results to dissatisfaction or satisfaction of employees
Adam’s Equity and Justice Theory (1963) Employees work to maintain fair relationship in comparison to colleagues.
Locke’s and Latham’s Goal Setting (1990) Goals set drive performance with clear and hard goals resulting to better performance than easy goals
Table 1: Traditional Motivation Theories (Lee & Raschke, 2016)
Revolutionizing of traditional motivation theories has been at the heart of some researchers to make the theories more comprehensive. Current research on employee motivation has broadened this thinking to include fields such as psychology, biology and neuroscience to help understand what really motivates employees . It is the responsibility of management to understand the factors that really motivate its employees to maximize organizational performance.
Factors that influence Employee Motivation
There are a number of factors that trigger the energetic forces within an individual to work towards achieving certain objectives and goals in the workplace. Money is one key factor that has influential value on employees. Many employees are attracted and motivated to work in organizations that offer good pay. It is a significant motivational strategy. A study conducted by Dagne, Beyene, and Berhanu (2015) in three public hospitals in West Shoa Zone, Egypt illustrated that health professionals motivation level was 63.6% but varied across the hospitals. The researchers reported that health professionals who got financial benefits monthly were more motivated compared to those who did not get the financial benefits. Environmental factors impacted doctors more than nurses. Supervisor-related factors like leadership varied on their influence on motivation with regards to other variables. They concluded that health professionals are motivated by factors related to hospital location, financial benefits, supervisor and job consent. It is the responsibility of management to provide financial benefits appropriately for health professionals.
However, a study done by Hasan (2018), on Minneapolis Company illustrated that employees were triggered to give their best by factors like security, career advancement and specificity of work. Pay remains a motivating factor though not a highly desired factor for employee motivation. Poor working environments, inadequate resources, poor management structures often result to poor responsiveness, poor productivity and high employee turnover.
Acccording to Humayon and his team (2018), there were fewer healthcare professionals in Pakistan hospitals because of lack of involvement, lack of medicines and poor management. The team performed a study on public hospitals of Pakistan that focused on innovation, management involvement and staff motivation to analyze organizational performance. The study in three public hospitals in South Punjab involved 90 employees. The research findings indicated that management level and innovation strong influenced employee retention and organizational performance. From this research, it is clear management or leadership is a critical factor in motivating employees.
Leadership involves getting things done and in the right way which is critical to the success of every organization. Good leaders should be empowering, dedicated, engaged and committed to their followers. This allows them to focus on their jobs thus improve performance and productivity. A study by Selesho & Naile (2014), on 184 teaching staff from 13 high schools helps illustrate the role of leaders in motivating employees. Autocratic and transformational leadership styles and their influence of emplyee motivation was analyzed. The study revealed that a strong relationship exists between transformational leadership behaviors and employee commitment. It further highlighted encouraging creativity, inspiring shared vision and building trust which are roles of leaders were positive aspects that motivate staff.
Similarly, Afolabi, Fernando, and Bottiglieri (2018) identify leadership or management as signficant in employee motivation. The team identifies managerial support, appreciation and conducive working conditions as aspects of motivation. The team conducted a systematic review on 30 publications on organizational factors motivating healthcare employees in both developing and developed countries. The reviews included studies from countries like England, Kenya, Vietnam, Malawi and India among others. They focussed largely on public healthcare facilities though private facilities were also included in the reviews. Out of the 30 reviews, only 14 studies were used for the research. The partcipants in the 14 studies included nurses, dentists and doctors. Management and leadership were key motivating factors that recurred in the 14 articles reviewed. From these studies, strong demotivating factors were lack of support, poor management and lack of teamwork from supervisors. Minimal supervison was evident among healthcare workers in rural areas leaving them with feelings of isolation and abandonment.
High poverty levels in developing countries illustrated that salary was a signficant motivating factor. However, five studies illustrated that financial incentives alone were not enough to motivate healthcare professionals. This is inline with research findings obtained from the Minneapolis Company where pay was not considered as a highly motivating factor . Professional development was also a motivating factor. At least 11 of the 14 studies illustrated that career development and in-service training were very important motivating factors. Employees were motivated to give their best when they were equipped with knowledge for optimal performance of their duties. Other motivating factors illustrated were promotion (in 7 of the 14 studies), working conditions (in 7 of the 14 studies), reward, appreciation and recognition ( in 8 of the 14 studies). Demotivating factors included staff shortage and work load (in 6 of the 14 studies) among others (Afolabi, Fernando, & Bottiglieri, 2018).
Theoretical Framework
From the above, existing literature, we understand that there are several factors that influence employee motivation. These factors are leadership, pay, rewards system, working environment, career development, promotion, training, job security, support, teamwork and recognition.
Main Objective
The main objective of this study is to find out the differences and similarities in motivating factors that influence employees in public and private hospitals.
Conceptual Framework
This study’s conceptual framework is as follows:
Figure 1: Conceptual Framework (Author, 2020)
biggest challenge faced by hospital industry is to measure and retain the organizational performance. Hospitals are
now crucial and an effective service system for the health and well-being of the public [30]. Organization demands
to lie on employees in hospitals are increasing when the whole industry is restructuring, and reforming their
reorganizations at national and regional level[27]. Therefore, in order to achieve the organization performance, there
must be engagement of employees from all sides. It will not only allow better hospital patients but also less
expensive care of patients.
Pakistan hospitals are facing serious issues in service delivery [24]. There are multiple reasons that contribute to
these issues. This sector is bearing from fewer professionals including doctors and nurses[4]. Lack of medicine in
hospitals, lack of involvement of employees in their job and spend time in other activities, and absence of
management involvement to monitor and evaluation the system is affecting the organization performance [24].
Today administration of employees is a great challenge at organizational levels[27]. Therefore, human resources are
well developed in association with the organizational goals and objectives[30]. Hence, success of the organizations
depends on the quality of the employees that runs every day affairs of the organizations [25]
Hospital industry has become a highly competitive and speedily growing service industry around the world. The
biggest challenge faced by hospital industry is to measure and retain the organizational performance. Hospitals are
now crucial and an effective service system for the health and well-being of the public [30]. Organization demands
to lie on employees in hospitals are increasing when the whole industry is restructuring, and reforming their
reorganizations at national and regional level[27]. Therefore, in order to achieve the organization performance, there
must be engagement of employees from all sides. It will not only allow better hospital patients but also less
expensive care of patients.
Pakistan hospitals are facing serious issues in service delivery [24]. There are multiple reasons that contribute to
these issues. This sector is bearing from fewer professionals including doctors and nurses[4]. Lack of medicine in
hospitals, lack of involvement of employees in their job and spend time in other activities, and absence of
management involvement to monitor and evaluation the system is affecting the organization performance [24].
Today administration of employees is a great challenge at organizational levels[27]. Therefore, human resources are
well developed in association with the organizational goals and objectives[30]. Hence, success of the organizations
depends on the quality of the employees that runs every day affairs of the organizations [25].
Research Methodology
Research Design
This study adopted quantitative method, in particular, comparative research. Comparative research was used to analyze and compare differences and similarities in motivating factors among healthcare professionals in public and private hospitals. This study viewed the influence of four ingredients; leadership style, working environment, career development and rewards system as influencing factor on motivating healthcare professionals perform better in their healthcare duties. These variables were examined to give substantial results that would provide significant insight on the factors in the study.
Research Participants
Random sampling was used to select the hospitals and healthcare professionals for the study. This sampling method is not only easy but gives each sample equal chance for participation. The sample size comprised of 5 hospitals in Jacksonville, Florida. From the 5 hospitals; 2 of which were public and 3 private, 35 healthcare professionals were selected to participate. It should be noted that the healthcare professionals were nurses and doctors only who had served in their current jobs for a minimum of 2 years. These two groups of healthcare professionals were selected because providing healthcare services is of importance to everyone. The participants were both seniors and juniors in the chosen hospitals.
The participants were encouraged to engage in the study to completion as the results would be useful to organizations, healthcare workers as well as researchers. Data was obtained through online survey due to the current restrictions on movement as well as social distancing. The sample size was 35 with a response rate of 32 (91.4%). This response rate was good, probably, because the survey was done online and the fact that most healthcare professionals were busy due to the Covid-19 pandemic.
Data Collection
The study focused on primary data from the participants. Structured questionnaires were used in the online survey to gather information from the 32 healthcare professionals. The questionnaires contained only 15 closed-ended questions. It was divided into two sections; Section I (5 questions) which sought the respondent’s biographical data including gender, age, qualification, marital status and department of work. Section II sought employee understanding as well as experience of motivation. For example, Please rank the following motivating factors as per your priority on a scale of 1- 4 by indicating 1, 2, 3, or 4 where 4= Excellent, 3 = Good, 2=Average, 1=Poor
Motivating Factors Scale (1-4)
Rewards System
Leadership
Career Development
Working Environment
Table 2: Motivating Factors
Section II of the questionnaire explored on motivating factors used in both public and private hospitals. The Likert-type scale of questions was greatly used in this section where the participants were requested to rate their agreement levels to given statements. For example, Please tick 1,2,3,4, or 5 based on the following, Are you excited to getting up to go to work? (Where 5=Strongly agree, 4=Agree, 3=Neutral, 2=Disagree, 1=Strongly disagree).
Data Analyses Procedure
Descriptive statistics was used to analyze the data collected through the basic measures of central tendency; mean, mode and median and the standard deviation. The mean was aimed at proving the average score on the distributions. Since the study involved comparison of the motivating factors private and public hospitals, ANOVA was used to test the hypothesis. It aimed at illustrating the significant difference between these motivating factors selected for the study.
Research Findings and Interpretation
Random sampling was used to select the 35 respondents from the 5 hospitals. Structured questionnaires consisting of 15 questions were accessed by to 32 participants who turned up for the online survey. The participants were sent the link and login details to the survey. However, 30 of the 32 respondents successfully completed the survey. This represented approximately 85.7% of the participants. The demographic results of the study are shown in the table below
Item Frequency Percentage
Gender Female 20 66.7%
Male 10 33.3%
Age 20-30 years 21 70%
31-40 years 7 23.3%
41-50 years 2 0.6%
51 and above years None 0
Hospitals Private 18 60%
Public 12 40%
Qualification Certified Registered Nurse 21 70%
Certified Registered Doctor 9 30%
Marital Status Married 13 43.3%
Single 17 56.7%
Table 3: Demographic Characteristics of Participants
This table indicates that most of the participants were female 66.7% with males comprising of only 33.3%. At least 70% of the participants were aged 20-30 years with no participant aged 51years and above participating in this study. Majority of the participants worked in private hospitals (60%) compared to public hospitals (40%). There were more nurse participants (70%) compared to doctors (30%). Most of the participants were single (56.7%) compared to married persons (43.3%).
The descriptive results obtained from testing the four variables are illustrated in the table below
Reward System Leadership Working Environment Career Development
Mean 2.833333 Mean 2.833333 Mean 2.933333 Mean 2.9
Standard Error 0.192284 Standard Error 0.159621 Standard Error 0.143305 Standard Error 0.138547
Median 3 Median 3 Median 3 Median 3
Mode 4 Mode 3 Mode 3 Mode 3
Standard Deviation 1.053183 Standard Deviation 0.874281 Standard Deviation 0.784915 Standard Deviation 0.758856
Sample Variance 1.109195 Sample Variance 0.764368 Sample Variance 0.616092 Sample Variance 0.575862
Kurtosis -1.0239 Kurtosis -0.4745 Kurtosis -1.33185 Kurtosis 0.041098
Skewness -0.40412 Skewness -0.31943 Skewness 0.120883 Skewness -0.3348
Range 3 Range 3 Range 2 Range 3
Minimum 1 Minimum 1 Minimum 2 Minimum 1
Maximum 4 Maximum 4 Maximum 4 Maximum 4
Sum 85 Sum 85 Sum 88 Sum 87
Count 30 Count 30 Count 30 Count 30
Table 4: Descriptive Statistics
The above findings illustrate the mean, median and standard deviation of the four motivating factors. In terms of mean, rewards system scored 2.8, leadership 2.8, working environment 2.9 and career development 2.9 as well. This means that on average the participants felt that rewards offered in their workplaces had to be good for them to be motivated to give outstanding performance. In terms of median, all the four variables scored 3 meaning that the working environment, leadership, career development and reward system had to be good for an employee to be motivated. Lastly, in terms of mode, most of the participants needed excellent reward systems to be motivated while a good working environment, career development opportunities and leadership were essential for employee motivation.
The results of t-Test to assess significant differences on the motivating factors between the public and private hospitals is illustrated in the table below.
t-Test: Two-Sample Assuming Unequal Variances
Variable 1 Variable 2
Mean 0.725 0.8625
Variance 0.015833 0.002292
Observations 4 4
Hypothesized Mean Difference 0
df 4
t Stat -2.04265
P(T<=t) one-tail 0.055305
t Critical one-tail 2.131847
P(T<=t) two-tail 0.11061
t Critical two-tail 2.776445
Table 5: t-Test: Two-Sample Assuming Unequal Variances
From this table, the p value of the test is 0.11 which is greater than 0.05 the stated p value. This implies that the null hypothesis is accepted illustrating that there was no difference in mean scores of the four motivating factors between the public and private hospitals.
Conclusion
Employee motivation is driven by a number of motivating factors. Healthcare professionals in both private and public healthcare facilities are no exception. They too value rewards system, leadership, working environment and career development to drive their performances. These motivating factors tend to be prioritized in a similar manner in both public and healthcare facilities. It is the responsibility of organizations to ensure that they understand what motivates their employees and give them exactly that. This will not only benefit the employees but improve performance and productivity.
