Procena zadovoljstva poslom i motivacija kao menadžerska sredstva za unapređenje kvaliteta rada zdravstvenih ustanova

Introduction: Contemporary turbulent environment, influenced by the rapid development of technologies and techniques, economic changes in the world, as well as changes in the labor market are influencing change in organizations, companies, and institutions. Human resources have been given a key role in a successful business, and are the focus of today's management. Having satisfied employees is one of the preconditions for the organization success and the study of the links between their satisfaction and productivity, which some writers have identified as a search „for the Holy Grail." Because of this, many studies confirm the crucial influence of employee satisfaction and motivation in the quality of health care institutions. The main objective of the research: Assessing the degree of health workers’ satisfaction in health facilities of Nisava District, various aspects of the work (the components of satisfaction) conditions, opportunities to be educated, support of the superiors, the possibilities for promotion, available equipment. The specific objectives are: a) Consideration of the health workers degree of satisfaction in primary health care, the secondary and tertiary health care b) Comparison of job satisfaction through certain components, as well as overall satisfaction among health professionals at different positions and professions (doctors, other health care professionals); c) Comparison of job satisfaction through certain satisfaction components, as well as overall satisfaction among health workers in relation to gender, seniority and other relevant characteristics; e) The impact of employee satisfaction on quality of work. The ultimate goal is: Defining a new questionnaire that will address disadvantages of the existing one, in order to gain better insight of employee satisfaction. Proposal of methodological guidelines for managers (management of health institutions), in order to improve motivation and employee satisfaction. Method: This is across sectional study, conducted in medical facilities at primary, secondary, and tertiary level of health care as well in institutions covering multiple levels of health, conducted in Nisava district in year 2010.. Data is collected in 8 institutions at the primary level, 4 facilities at secondary level, 2 tertiary institutions (including the Clinical Center with 27 clinics) and 1 institution covering multiple levels of health care. Out of 5.425 employees who were present on the day of the survey, the questionnaire was taken by 4.707 employees, whereas 3.899 employees completed and returned the questionnaire (response rate 82.8%). The study used an anonymous questionnaire defined by the Republic Committee for Quality, the Ministry of Health of the Republic of Serbia. Results and significance of the dissertation: The job satisfaction of the examinees is on the upper level of the category „neither satisfied, nor dissatisfied“. The most satisfied employees are working at the primary health care level, then the tertiary, secondary and institutions on various levels. Health professionals are less satisfied than other employees. Health professionals in institutions at primary health care are the most satisfied and are the least psychologically and physically burdened. Medical doctors are more satisfied in relation to other health professionals. The biggest emotional and physical exhaustion is with employees at the tertiary level of health care. The least emotionally exhausted are employees at the primary health care level, the least physically exhausted are employees in the facility at multiple levels of health care. Comparing job satisfaction five years ago and today, the highest percentage believes that there is "no difference" in satisfaction. More than half of employees, plans to remain in the public sector, more than a third of employees does not think about changing jobs, and only one-tenth would like to go to the private health sector or to do jobs outside the health sector. Employees in management positions are more satisfied, compared to other employees, but they are significantly more emotionally and physically exhausted. Looking at the scores of grouped factors of satisfaction, communication indicator has the highest value. The second is organizational indicator, then motivational indicator. Structural indicator has the lowest value among all tested parameters and is a segment that will require further study and range of activities for future improvement. Health care professionals’ satisfaction significantly affects the quality of health care institutions and health care institutions at the primary level, in this research, where their employees, were the most satisfied, are highly ranked by the quality of work. Contribution of this thesis is the proposal of a new questionnaire for the assessment of employee satisfaction in health care facilities, proposal of measures for the research methodology improvement and proposal of measures managers in the context of employee satisfaction improvement