ORIGINAL ARTICLE

DETERMINANTS OF EMPLOYEE
SATISFACTION: A SURVEY OF HEALTHCARE
WORKERS OF A GROUP OF HOSPITALS IN
KARACHI
Muhammad Ahmar Jamal1, Anoop Dawani2, Syed Hasan Danish3, Minhaj Qidwai4, Farah Ahmad3
1
United Energy Pakistan
2
Ziauddin Hospital Clifton
3
Department of Community Health Sciences, Ziauddin University
4Director of IBA, Karachi

ABSTRACT

Background: To assess the satisfaction levels of employees in a health care organization at Karachi, Pakistan.

Methods: A cross sectional survey was conducted on 598 employees working at University and tertiary care
hospital for a period of 5 months. Purposive sampling technique was used for collection of data. All employ-
ees working for at least one year at any level of management were included in the study. Part time employ-
ees, visiting staff, those absent at the time of data collection and those who refused to consent were exclud-
ed from the study. Self administered questionnaires were utilized for the purpose of data collection. Entire
analysis was performed using SPSS version 20. P value less than 0.05 was taken as significant. For descriptive
statistics frequency and percentages were calculated for categorical variables while mean and standard
deviation for numerical variables. Analysis of Variance was applied to see association between different
groups. The study was approved by the ethical review board.

Results: Majority 69.4% (n=415) employees were found to be satisfied. Upper management was seen to have
slightly lower scores of satisfaction compared to middle and lower management levels. Between clinical &
non-clinical side there was also no significant difference observed in the satisfaction level. Satisfaction levels
were seen directly proportional to age and length of service. When overall benefits were seen non clinical
side 61% (n=84) were found to be more dissatisfied than clinical side 40% (n=53).

Conclusion: Study findings conclude that majority employees were satisfied. However most were dissatisfied
with the overall benefit package and vacation policy.

KEY WORDS: Employee satisfaction, Management, Tertiary care hospital

INTRODUCTION Motivated and satisfied workers are a source of

strength for a health care organization continuously
Employee job satisfaction is vital for ensuring the determined to meet stipulated targets 3. Motivated
quality of work, services, productivity, turnover and workers strive for skills enhancement, better perfor-
performance of a health-care organization. It plays mance and alignment with organizational goals 4.
an effective role in employee’s performance which Many organizations realize the need to monitor the
is translated into health, well-being and satisfaction employee satisfaction levels since dissatisfaction
of the patients 1. Job satisfaction is determined by a can have detrimental impact on the working of the
comparison of one’s prior expectations about the organization5. Research studies have been
job and the actual effects on private life. Satisfied conducted abroad and locally to study the
employees tend to be more productive and com- employee job satisfaction levels. A multi-center
mitted to their employees, with a direct correlation study of hospital workers in Central West Ontario,
between staff satisfaction and patient satisfaction Canada demonstrated that job satisfaction is a
`in healthcare organizations 2 multidimensional concept with some commonali-

Corresponding Author: Farah Ahmad*

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 DETERMINANTS OF EMPLOYEE SATISFACTION: A SURVEY OF HEALTHCARE WORKERS OF A GROUP OF HOSPITALS IN KARACHI

ties across organizations; however, there are certain utilized for the purpose of data collection. Entire
predicators of job satisfaction which are unique to analysis was performed using SPSS version 20. In lieu
one’s workplace 6, 4. Another study was carried out of errors data was cleaned prior to analysis. It was
in Cyprus to study association between job satisfac- initially entered into Microsoft excel and all inconsis-
tion and motivation in doctors and nurses, who tencies were resolved. P value less than 0.05 was
showed that worker satisfaction and motivation taken as significant. For descriptive statistics
was, related to monetary and non-monetary incen- frequency and percentages were calculated for
tives especially intrinsic factors 7. categorical variables while mean and standard
deviation for numerical variables. Association
Studies in Pakistan showed dissatisfaction amongst between demographic profile and satisfaction
public sector healthcare workers was due to poor level was carried out through Chi square test. Analy-
salaries and working environment, lack of respect, sis of Variance was applied to see difference in
unbalanced responsibilities, and lack of control, mean scores between different groups. P value less
time pressure and opportunities for professional than 0.05 was taken as significant. The study was
development 8. Local health care system lacks approved by the ethical review board.
sufficient data on satisfaction and motivational
levels of healthcare workers 9. Therefore, the prime
objective of our study is to identify employee RESULT
satisfaction levels amongst different cadres of
health workers in hospital and University in Karachi. The total sample size was n=598. Participants
belonged to all three levels of management, upper
management had 6% (n=35) participation, whereas
METHODS middle management had 31% (n=198). Lower man-
agement had the maximum number of participants
This cross sectional study was conducted from 63% (n=379). We further divided the participants into
August 2015 to December 2015 for a time duration clinical and non-clinical departments and it was
of 5 months .Participants were selected from private found that 43.1% (n=258) were from clinical whilst
tertiary care hospital consisting of three campuses 56.9% (n=340) were from the non-clinical side. When
along with University employees. These campuses the participants were stratified on the basis of age
were located in different districts of Karachi. A majority 61% (n=365) were from 21-34 years age
sample size of n=450 was calculated through Open group whilst the second highest group was from
Epi version 3.03. Altogether the final sample corre- 35-44 years comprising 23.9% (n=149). Majority of
sponded to n= 598 participants. The bound of error participants were male 77.8% (n=465) and 63%
is taken at 5% with 95% confidence interval. (n=376) were married. When the length of service
was enquired majority 82.6% (n=494) were working
The sample size was inflated to accommodate non since more than 2 years. Majority participants
response and incomplete questionnaires. The wanted to continue with their jobs indefinitely 74%
sample was selected through purposive sampling (n=442).
technique with non response by just 2 subjects.
Participants consisted of employees of all ages The mean score of this survey came out to be 56.4
working at the hospital and University for at least +/- 3.9. Overall majority 69.4% (n=415) employees
one year. Part time employees, visiting staff, those were found to be satisfied When the satisfaction
absent at the time of data collection and those level between the different levels of management
who refused to consent were excluded from the was observed it was seen that upper management
study. had slightly lower scores as compared to other
levels of management, though this difference was
The employee survey questionnaire was developed not statistically significant (ANOVA P value 0.265).-
on a liker scale of agree and disagree with 36 state- Similarly when we compared the satisfaction level
ments corresponding to the working hours, benefit of clinical & non-clinical side there was also no
packages, supervisor managerial skills, working significant difference was observed in the satisfac-
environment and work description. Satisfaction was tion level of both the groups showing high level of
given a 2 while dissatisfaction was taken as 1. Maxi- satisfaction (Pooled t test, P value 0.930).The age
mum score was 72 while minimum was 36. Partici- group of 45-55 years and above was found to be
pants were briefed on the objectives of the slightly less satisfied as compared to other age
research and consent was taken prior to inclusion in groups, though this difference was not statistically
the research. Self administered questionnaires were significant (ANOVA P value 0.996).

24 Journal
Pakistan PAKISTAN JOURNAL OF
of Rehabilitation MEDICINE
2013 AND
Volume 2 DENTISTRY
(Issue 1) 2016, VOL. 5 (02)
 MUHAMMAD AHMAR JAMAL, ANOOP DAWANI, SYED HASAN DANISH, MINHAJ QIDWAI, FARAH AHMAD

Significant difference in satisfaction level was (n=53). Similarly dissatisfaction over the administra-
observed in participants who wanted to quit the job tion vacation policy was more profound among
soon and those who wanted to continue either non-clinical side 57.4% (n=108) as compared to
indefinitely or more than 5-10 years. (ANOVA P value clinical side 42.6% (n=80).
0.001).
When the participants were asked to give their
When satisfaction level for overall benefits were recommendations for improving the existing bene-
compared between clinical and non clinical fits from their administration, more than 50%
departments, non clinical side 61% (n=84) were highlighted medical cover for parents and annual
found to be more dissatisfied than clinical side 40% bonuses.

Table 1: Effect of Different Variables on Employees Satisfaction (n=598)

EMPLOYEE SATISFACTION
SATISFIED DISSATISFIED

n % n %
Level of Management Upper Management 21 5.1 14 7.7

Middle Management 130 31.3 54 29.5

Lower Management 264 63.3 115 62.8

Department Clinical 179 69.4 79 30.6

Non Clinical 236 69.4 104 30.6

Age of Employee Under 21 Years 6 54.5 5 45.5

21-34 years 257 70.4 108 29.6

35-44 years 103 72 40 28

45-54 years 35 58.3 25 41.7

55 years and above 14 73.7 5 26.3

Length of Service < than 2 years 70 67.3 34 32.7

2-5 years 224 70 97 30

5-10 years 114 70.4 48 29.6

> Than 10 years 7 63.6 4 36.4

Gender of the Male 316 68 149 32

Employee
Female 99 74 34 26
Marital Status Married 263 70 113 30

Unmarried 152 68.5 70 31.5

Continuation of Job Quit Soon 15 43 20 57

Work for next 5-10 71 59 50 41

years

Work Indefinitely 329 74 113 26

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DETERMINANTS OF EMPLOYEE SATISFACTION: A SURVEY OF HEALTHCARE WORKERS OF A GROUP OF HOSPITALS IN KARACHI

Overall Benefit Package Verus Satisfaction level n=598

250

200
Overall Benefit Package
150 Dissatisfied

Overall Benefit Package

100 Neutral

Overall Benefit Package

50
Satisfied

Upper Middle Lower

Management Management Management

Figure 1: Overall Benefit Package and the Satisfaction Level of the Employees

Vacation Policy versus satisfaction level n=598

Vacation Policy Satisfied Vacation Policy Neutral

Vacation Policy Dissatisfied

Low Management

Middle Management

Upper Management

Figure 2: Vacation Policy and the Satisfaction Level of the Employees

DISCUSSION of Canada showed that there was no difference in

satisfaction levels amongst different levels of man-
In our study satisfaction level were found to be agement comprising of non-supervisor, non-desig-
highest among lower management employees nated and designated supervisory staff at the hospi-
63.6% followed by middle management 31.3% & tal 11.
upper management 5.1%. A previous survey by
Bahalkhani et al in public sector tertiary care hospi- Our study showed that male employees (32 %) were
tal of Islamabad demonstrated that merely 14% of dissatisfied more with their jobs as compared to 26%
employees comprising of nurses belonging to all male employees. An earlier study by Riaz et al
levels of management were satisfied with their showed that 72% females & 65% males were overall
working condition 8. Similarly, a study by Riaz et al in dissatisfied with their job conditions 10. These findings
teaching hospitals of Karachi showed that 68% were further supported by Roopalekha et al who
doctors of all cadres were dissatisfied with their jobs showed that overall females were less dissatisfied
10
. However study by Brown et al in private hospitals than male employees 12.

26 PAKISTAN JOURNAL OF MEDICINE AND DENTISTRY 2016, VOL. 5 (02)

 MUHAMMAD AHMAR JAMAL, ANOOP DAWANI, SYED HASAN DANISH, MINHAJ QIDWAI, FARAH AHMAD

The un-married employees (31.5%) were marginally CONCLUSION

more dissatisfied as compared to married employ-
ees (30%) at the hospital. Similar findings of Shahnaz The results of the study highlighted some of the
et al who reported below average work motivation important factors related to workers satisfaction
scores for 25.8% un-married and 26.3% married pertinent to our circumstances. Majority employees
employees (nurses) 9 .No clear difference was seen from all management levels were satisfied with their
in satisfaction levels on clinical and non clinical job. Most employees were dissatisfied with the
sides. These findings were different compared to vacation policy and benefit packages.
other studies (Abida et al) carried out in the country
13
. Our findings were still better than an earlier study
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