THE HOLISTIC EXPLORATION OF THE MULTIFACETED RELATIONSHIP BETWEEN HEALTHCARE PROFESSIONALS’ JOB SATISFACTION AND QUALITY OF CARE.

Problem definition: Healthcare is a professional field, which most individuals will encounter at some point in their life, directly or indirectly. In the UK, healthcare organisations are facing significant challenges, including financial pressures, shortages in staffing levels, and changes in the way healthcare is delivered. In addition, patient demand for such healthcare systems has been increasing dramatically year on year, in part, due to societal changes towards unhealthier lifestyles. Consequently, amid such adversities, it is important to understand how these issues are affecting both the providers and receivers of healthcare. Therefore, the current study will explore how healthcare professionals’ job satisfaction relates to, and affects, the quality of care staff are able to provide. Unlike the multitude of healthcare research which tends to focus solely on clinical staff - defined here as those who are directly involved in patient care (Department of Health, 2016), the current study will also include staff in non-clinical roles in order to obtain a greater appreciation of the multi-disciplinary aspect of healthcare provision. The main areas under investigation in this study are, understanding the factors which influence healthcare professionals’ job satisfaction, determining if there are differences between clinical and non-clinical staff, and to understand the relationship between job satisfaction and quality of care. Literature: Job satisfaction and quality of care are the two principle concepts being explored throughout this thesis. An extensive review of the literature was carried out in order to establish existing knowledge concerning the individual constructs, as well as how they are related. The review allowed specific gaps to be identified. One crucial area highlighted, was that the links between job satisfaction and quality of care were significantly absent from the literature. Whilst some connections were evident, the holistic exploration as to how various components interlink appeared to be missing. Instead, analogous links were investigated from other sectors, such as job satisfaction and performance. Accordingly, the literature review chapters included general studies, as well as research based specifically in the healthcare domain. Method: Due to the relationship between job satisfaction and quality of care being somewhat neglected throughout existing research, the novelty of including a broad participant group, and the critical realist perspective of the researcher; qualitative semi-structured interviews were conducted. The interviews were conducted in two phases, 12 in the first phase and 15 in the second. Participants were recruited from a range of organisations throughout the UK and included a diversity of roles. In particular, an important objective of the study was to ensure that the selection of participants included both clinical and non-clinical staff. Once transcribed, the interviews produced a large amount of data (301 pages), which were analysed using thematic coding. Findings: A number of aspects relating to healthcare professionals’ job satisfaction at work emerged. The key factors included helping patients, teamwork, social network, cognitive aspects, demand and resources, as well as staff management. For the second key area of study, a comparison was made between clinical and non-clinical healthcare staff. In terms of the broad factors that arose, many appeared to affect participants irrespective of whether their roles were classed as clinical or non-clinical. That said, the manner in which these factors influence staff was nuanced. The overarching aim of the study was to explore the relationship between healthcare professionals’ job satisfaction and quality of care. Based on the analysis of the interviews it was suggested that this relationship is reciprocal. Specifically, satisfied employees are more likely to provide a higher level of care, however being able to deliver quality of care also impacts on healthcare professionals’ job satisfaction. Contribution: The study contributes to the job satisfaction literature by identifying several factors which appear to influence a wide range of healthcare professionals’ job satisfaction. Based on the data analysis, it has been suggested that the antecedents to job satisfaction can be categorised into three main areas: 1) universal factors, 2) individualistic factors, and 3) job specific factors. The overwhelming consensus across all staff regardless of job setting or role was that the primary factor influencing their job satisfaction was ‘helping patients’. The current study suggested that when outcomes of the care or service delivered are more immediate and have a greater impact, this has a greater affect on healthcare professionals’ job satisfaction than occasions where gradual changes to a patient occur over time. The study also provided a theoretical contribution by exploring the novel interrelationship between healthcare professionals’ job satisfaction and the quality of care an individual is able to provide. The relationship was determined as reciprocal, however, key factors influencing both of these concepts also emerged, these were: staff shortages and time to care. These concerns were found to be prominent across both clinical and non-clinical staff roles. The thesis also contributes to practice through several recommendations and suggestions which aim to improve both healthcare professionals’ job satisfaction and the quality of care they are able to deliver