Quality of Work Life in Hospital

Employee

Rosliana Mahardhika *

Program Master of Hospital Administration and Management University Muhammadiyah

Yogyakarta

Abstract Low quality of work life were linked to poor professional conduct and increased
risk of medical errors. This article introduces the definition, influencing factors and
improvement strategy to the quality of worker life, which can provide references for
managers to understand the factors affecting the quality of employee work life and choose
effective measures to improve the quality of employee work life.

Keyword: Quality of Work Life, Hospital, Employee

Low quality of work life has been linked to hastened retirement, poor professional
conduct, increased risk of medical errors, as well as deleterious effects on personal health and
relationships Some physicians and nurses could be described symptoms of overt depression,
then a progression to clinical depression and suicide. Moreover, the negative emotion is
contagious, which may cross over from one nurse to another. Given the importance of ICU
nurses, these psychological problems mentioned above may threat the strength hand
sustainability of ICU. Thus, effective strategies should be adapted to relieve the burn out and
improve their quality of work life. In previous studies, here are some psychological
intervention methods were reported to relieve the burn out and other psychological problems
for nurses and medical doctors, such as the Mindfulness-Based Stress Reduction (MBSR),
Cognitive Behavior Therapy (CBT), Balint Group (BG) and soon. (Huang et al., 2020)

Hospital Work Environment Most hospitals provide care to sick patients regardless of
their ability to pay. Yet as nurses are aware, hospitals must generate revenue to stay in
business. Although the Affordable Care Act has provided coverage for previously uninsured
patients, the law has also changed the way hospitals are reimbursed for care. For example,
hospital reimbursement is now evaluated based on a number of metrics including patient’s
length of stay, industry guidelines for admissions criteria, hospital readmission, hospital-
acquired illnesses, and patient satisfaction ratings. The Occupational Safety and Health
Administration (OSHA; 2014) describes hospitals as some of the most stressful places to
work with potential hazards that include life-threatening injuries and illnesses complicated by
overwork, understaffing, tight schedules, paperwork, intricate or malfunctioning equipment,
complex hierarchies of authority and skills, dependent and demanding patients, and patient
deaths. (Mullen, 2015)

Employees can be empowered by providing them with the necessary working

conditions otherwise defined as the work-life quality (QWL). Psychological empowerment
can reduce stress and bring positive changes in the working environment of the nurses. QWL
is a combination of eight work characteristics in the workplace to achieve psychological
empowerment. QWL factors are related to compensation, working environment, work hours,
safety, and security at the workplace, development for future roles, and working with a cause
for the society. The non-availability of QWL factors was the major cause of poor
performance and leaving among nursing professionals. Enhancing the QWL enables the
health service providers to recruit and keep qualified and inspired staff to provide health
facilities to their customers. Good health services delivery is associated with nursing staff that
were provided better QWL to enhance psychological empowerment in reducing the effects of
burnout. (Permarupan et al., 2020)

The quality of employee work life is all about conducive and fun environment in the
workplace and is a key factor in determining productivity and better performance. The quality
of nursing work life consists of five sub-variables, namely the work environment, the
relationship with the manager (head nurse), work conditions, job perception, and support
services, which are interconnected with each other. The impact of lack of fulfillment of these
five sub variables will cause psychological and physical disturbance. The quality of work life
is a psychosocial factor that can affect the occurrence of the risk of musculoskeletal
disorders. It is been identified psychosocial factors (mental fatigue) had a strong influence on
the incidence of musculoskeletal disorders, and the risk level was 2 times higher than
respondents who did not have psychosocial complaints3. This gives an indication of the
relationship between the quality of nursing work life and work-related musculoskeletal
disorders, but in Indonesia the results of this study cannot be used as strong data due to
differences in habitual, cultures and work environments. (Sulastri and Pompey, 2020)

In comparison to their urban counterparts, nurses and physicians in rural settings face
more challenging working conditions. In addition to the difficult working conditions common
to urban settings, specific challenges to rural areas include limited access to specialized care,
geographical distance from specialized centers, poor emergency transport capabilities, and
limited training. Rural healthcare facilities also face chronic problems with staff recruitment
and retention. In fact, almost every country reports shortages of health professionals in rural
areas. This shortage could increase the workload of regular staff, negatively affecting morale
and making healthy lifestyles difficult to achieve. Working in such conditions is likely to
contribute to burnout and to poor quality of work life (QWL). Policy-makers need evidence
that would allow them to identify which factors could increase the recruitment and retention
of nurses and physicians practicing in rural areas. (Bragard et al., 2015)

Work–life balance (WLB) is a contemporary acronym for achieving balance between

work and lifestyle ambitions. Although WLB is not well defined, the implication is that the
two experiences (work and home life) should be in a state of equilibrium for nurses to be
happy and healthy. Nurses often describe experiencing a lack of balance between their work
and life outside of work. Yet if a sense of balance between work and lifestyle demands could
be achieved, fewer nurses would report stress and more would be living healthier lives at
home and in the workplace. Most nurses are happier when experiencing feelings of
achievement and satisfaction from their work rather than trying to acquire an arbitrary sense
of work–life balance. (Mullen, 2015)

A high quality of work life (QWL) is essential for organizations to continue to attract
and retain employees. QWL is a comprehensive, department- wide program designated to
improve employee satisfaction, strengthening workplace learning and helping employees had
better manage change and transition. Dissatisfaction with quality work of life is a problem,
which affects almost all workers regardless of position or status. Many managers seek to
reduce dissatisfaction in all organizational levels, including their own. This is a complex
problem, however, because it is difficult to isolate and identify all of attributes, which affect
the quality of work life.(Saraji and Dargahi, 2006)

Considering the personal quality of work life in hospitals is the major concentrations
in many organizations and is one of the important factors for ensuring the stability of the
health system. The quality of life of these people is importance because of the occupation
type and its sensitivity. It seems that the relationship between the quality of work life
performance and the degree of nurses’ participation is an important factor in achieving a high
level of care quality. One study showed that the quality of work life has an important role in
the behavioral and skillful reactions of employees such as right effort and job participation,
type of performance, service delivery, desertion and changing job place. Nurses who based
their skills on the basis of scientific evidence have been able to make better decisions, make
better quality cares, reduce the hospitalization time and cost of patients. (Khoshnudi et al.,
2019)

The research on the quality of work life was initially put forward by the American
Automobile Industry Association. It emphasized that enterprises should pay more attention to
the occupational health of employees than their own economic benefits. In the medical
environment, the quality of work life can make positive contributions to medical institutions,
medical staff and patients, such as higher patient satisfaction. With the development of aging
population, the workload of nursing has increased, the relationship between nurses and
patients has become increasingly severe, and the brain drain of nursing personnel has
intensified. These have become important factors affecting the construction and development
of nursing disciplines. (Hu et al., 2019)

Healthcare industry has been facing notable challenges in terms of healthcare

specialists, low output, job dissatisfaction. These organizations strive to provide superior
service with limited resources. Healthcare administrators are now increasingly focused
towards studying and understanding the Quality of Work Life and the level of satisfaction of
their healthcare professionals. A health professional may operate within all branches of health
care, including medicine, surgery, dentistry, midwifery, pharmacy, psychology, nursing or
allied health professions. Health care practitioners can include a wide variety of other human
resources trained to provide some type of health care service. The healthcare industry has
been witnessing a crunch for healthcare professionals and this field has been facing
challenges of attrition due to increased work pressure, prolonged work hours, over burdening
work load, high stress levels, improper balance between work and personal life. Investigating
the effect of these issues and understanding the perception of these professionals is very
critical. (Suresh, 2019)
 Hsu’s (2003) focus group discussions on NQWL indicated that human relationships,
job value, and self-actualization were significant aspects of NQWL. Job value is a hidden
factor that affects how nurses value QWL and perceive their QWL experiences. Harvey and
McMurray (1994) assert that personal mastery experiences at similar tasks increase nursing
efficacy and lead to increased persistence. This means that the increased self-efficacy of
nurses should increase their vocational concept. This study assumes that how participants
view and value their job affects how they view and experience their QWL. Therefore, a
positive relationship exists between NQWL and vocational concept. Furthermore, the present
research found a weak relationship between self-efficacy and the organization aspects and a
statistically significant (p G .0001) correlation between all other scales, which indicates a
close interscale association. The assumption made by this research is supported by the
research findings of Pillai, Schriesheim, and Williams (1999) who found that the behavior of
leaders and managers affects the prevalence of these acts and that employee perceptions of
justice and fairness affect the incidence of organizational citizenship behavior. (Hsu, 2016)

Finding the Motivation to Change Happiness lies not in the mere position of money; it
lies in the joy of achievement, in the thrill of creative effort. —Franklin D. Roosevelt (1933)

A lifestyle coach can establish a process to support change. Generalist life coaches, as
well as nurse life coaches who have specific insight into the complexities of health care, are
available. Finding a coach is similar to finding any other counselor. Valuable sources for
finding a wellness coach to facilitate WLB include employer-sponsored employee assistance
programs (EAP), trusted coworker and friend referrals, or health coach training facilities.
Nurses must choose a coach who engenders trust and confidence. If an individual coach is not
realistic, other sources of support and encouragement may improve nurses’ responses to
conflicting demands. Improving work–life balance requires active, evidence-based strategies.
The process begins with self-reflection and progresses by taking action. Hospital nurses are
drawn to the environment for many of the same reasons that challenge their well-being. Yet
nurses can learn individual strategies to achieve a sense of balance and well-being. This
knowledge will support them as they become successful and effective at work, maintaining
roles outside the hospital that bring happiness and joy. Recognizing the need for and
committing to change are the starting points for creating effective WLB. (Mullen, 2015)

REFFERENCE

Bragard, I., Fleet, R., Etienne, A.-M., Archambault, P., Légaré, F., Chauny, J.-M., Lévesque,
J.-F., Ouimet, M., Poitras, J., Dupuis, G., 2015. Quality of work life of rural
emergency department nurses and physicians: a pilot study. BMC Res Notes 8.
https://doi.org/10.1186/s13104-015-1075-2
Hsu, M.-Y., 2016. A Quality of Working Life Survey Instrument for Hospital Nurses. Journal
of Nursing Research 24, 87–99. https://doi.org/10.1097/jnr.0000000000000098
Hu, H., Zhou, H., Mao, F., Geng, J., Zhang, L., Zhang, X., 2019. Influencing Factors and
Improvement Strategy to the Quality of Nursing Work Life: A Review. Yangtze
Medicine 3, 253–260. https://doi.org/10.4236/ym.2019.34024
Huang, H., Zhang, H., Xie, Y., Wang, S.-B., Cui, H., Li, L., Shao, H., Geng, Q., 2020. Effect
of Balint group training on burnout and quality of work life among intensive care
nurses: A randomized controlled trial. Neurology, Psychiatry and Brain Research 35,
16–21. https://doi.org/10.1016/j.npbr.2019.12.002
Khoshnudi, M., Safari, A., Vahedian-Shahroodi, M., Sadeghnejhad, H., Nejati Parvaz, N.,
2019. The Relationship between Health Literacy and Quality of Life in Nurses of
hospitals of Kashmar in 2018. Journal of Health Literacy 4, 9–17.
Mullen, K., 2015. Barriers to Work–Life Balance for Hospital Nurses. Workplace Health Saf
63, 96–99. https://doi.org/10.1177/2165079914565355
Permarupan, P.Y., Al Mamun, A., Samy, N.K., Saufi, R.A., Hayat, N., 2020. Predicting
Nurses Burnout through Quality of Work Life and Psychological Empowerment: A
Study Towards Sustainable Healthcare Services in Malaysia. Sustainability 12, 388.
https://doi.org/10.3390/su12010388
Saraji, G.N., Dargahi, H., 2006. Study of Quality of Work Life (QWL). Iranian Journal of
Public Health 8–14.
Sulastri, E., Pompey, C.S., 2020. Quality Of Nursing Work Life Of Associate Nurses And
Work-Related Musculoskeletal Disorders. UI Proceedings on Health and Medicine 4,
61–66. https://doi.org/10.7454/uiphm.v4i1.252
Suresh, K., 2019. Empirical Study on the Quality of Work Life of Nurses in Private
Hospitals. management 7, 92–102. https://doi.org/10.34293/management.v7i1.568