This study examines employee perceptions of organizational climate and the relationship between climate elements and job satisfaction at a private healthcare organization. It surveyed 139 employees, including medical doctors, nurses, and health officers. The study found that teamwork and innovation explained a considerable amount of variation in job satisfaction. There was also a significant difference found between medical doctors and nurses in their reported levels of job satisfaction, which may be influenced by differences in their salary levels.
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Employee Perceptions
This study examines employee perceptions of organizational climate and the relationship between climate elements and job satisfaction at a private healthcare organization. It surveyed 139 employees, including medical doctors, nurses, and health officers. The study found that teamwork and innovation explained a considerable amount of variation in job satisfaction. There was also a significant difference found between medical doctors and nurses in their reported levels of job satisfaction, which may be influenced by differences in their salary levels.
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THE EMPLOYEE PERCEPTIONS OF
ORGANIZATIONAL CLIMATE AND ITS
RELATIONSHIP WITH JOB SATISFACTION IN A PRIVATE HEALTHCARE ORGANIZATION Mehmet Y. Yahyag!" Ye#te$e %&'e()ty" T*(+ey ABSTRACT This study examines both employee perceptions of organizational climate and the relationship between climatic elements and job-satisfaction in a private healthcare organization. It presents an empirical study that covers 13 participants namely! medical doctors! nurses and health officers. The variables of teamwor" and innovation explained a considerable part of the variation in job-satisfaction. The relationship between the degree of formalization and teamwor"! innovation and communication deserves the attention! and in certain extent! indicates the interplay between job-satisfaction and overall performance. # practical outcome of the study is the importance of the formation of a supportive climate through the use of managerial s"ills. Top management of any organization should ta"e into consideration of the positive outcomes of focusing on innovation and teamwor" in organizations. It is also worth to note that though the job-satisfaction level of employees are high! there is a significant difference between medical doctors and nurses in this regard. INTROD%CTION This study examines both employee perceptions of organizational climate and the relationship between climatic elements and job satisfaction in a private healthcare organization. It presents an empirical study that covers 139 participants from three groups of professionals such as medical doctors nurses and health officers. In terms of the relevant literature though there is a relationship between certain environmental factors and organizational outcomes !"opopolo #$$#% &handler 'eller ( "yon #$$1) it is not clear that similar associations exist in different wor* cultures other than typical +estern cultures. ,ince the ultimate objective of scientific investigations is to reach universal facts it is of concern in the scientific community to reach similar conclusions in different wor* cultures to support modern management theories. The conceptual basis of modern organization and management that is broadly spea*ing -merican oriented !,ee .ofstede 1993) and mainly is based on the empiric evidence derived from the studies mostly conducted in the ,tates and in /uropean countries. -lthough economic and cultural characteristics of the countries have a certain degree of influence on the business world social theories should be applicable to the real world in terms of scientific approaches. In this respect the socio0cultural position of Tur*ey may be of interest due to the fact that Tur*ey is *nown for having a blend of +estern and /astern culture and is economically behind the almost all of /uropean countries. It is the author1s opinion that empirical evidence may well be interpreted as an effort for falsification of existing organization and management theories and is of importance.
2rior to focusing on the research a general review of the relevant literature would be of help to examine the association between wor* environments and certain organizational outcomes in relation to the application of modern management theory in a health care organization. $%opyright &''3 by the (lobal )usiness and Technology #ssociation 1 The,(et-a! Ba-+g(,*&# J,. Sat)/a-t,& 3ne of the *ey elements of affective employee attitudes is job satisfaction. It is an emotional response toward various facets of one4s job. In ,pector1s words !1995 p.#16) job satisfaction is 7an attitudinal variable that reflects how people feel about their jobs as well as various aspects of them.8 -s it is stressed in the literature there are five job dimensions as the underlying facets of a job which could be grouped as the wor* itself pay for job promotion opportunities supervision and co0wor*ers !"uthans 1999% "oc*e 19:5). In terms of wor* environment the role of climatic elements has been important for resulting in improvement of organizational outcomes such as job satisfaction. ;ob satisfaction is related to life satisfaction and overall performance of organizations as well as absenteeism turnover and organizational citizenship 7which entails such behaviors as helping cowor*ers !<) ma*ing constructive statements about the wor* unit and promoting a positive wor* climate8 =mstot !1999 p.:#). In a very recent study "opopolo !#$$#) asserts that there are five dimensions !groups of variables) that account for explaining the variance in the job satisfaction construct. The first four dimensions !nature of interpersonal relationships nature of hierarchy nature of wor* and focus on support and rewards) are in exact conformance with the dimensions of organizational climate concept as developed by ,chneider >rief and ?uzzo !1995) but the fifth one includes internal motivation and moral values as well. @esearch on job satisfaction has continued recently as an outstanding subject of investigation. The scholars and researchers !see 'im #$$#% Aagy #$$#) have been wor*ing on the development of new measurement devices for measuring the concept of job satisfaction by using a single or a few items in the Buestionnaire. O(ga&0at,&a! C!mate 3rganizational climate is related to the wor* atmosphere that covers ways and methods underta*en by organizational members for organizational functioning. -ccording to Taguiri and "itwin !1959) climate is 7the relatively enduring Buality of the total environment that !a) is experienced by its members !b) influences their behavior and !c) can be described in terms of the values of a particular set of characteristics !or attributes) of the organization8 !p.#C). "in !1999) also defines the concept of organizational climate as the shared perceptions about organizational conditions. "in !1999) bases his definitions on "itwin and ,tringer1s !1959) organizational climate Buestionnaire. This well0*nown measurement device covers nine dimensions of the concept of organizational climate such as structure responsibility reward ris* ta*ing support warmth standards conflict and identity. ,chein1s definition of the climate concept is 7the feeling that is conveyed in a group by the physical layout and the way in which members of the organization interact with each other with customers or with other outsiders8 !199# p.9). ,chneider >rief and ?uzzo !1995) define four dimensions of organizational climate as nature of interpersonal relationships nature of hierarchy nature of wor* and focus on support and rewards. Isa*sen "auer /*wall and >ritz !#$$$0$1 p.1:#) assert if the concept of climate is analyzed at an individual level it would be named 7psychological climate8. 7+hen aggregated the concept is called organizational climate8 "ofBuist and Dawis developed The Einnesota ,atisfaction Fuestionnaire in 195: and the theory 7is constructed around the assumption that each person see*s to achieve and maintain correspondence with his or her environment8 !&oo* et. al. 1991 p.#1). +hen a person establishes a relationship with others he or she tends to fulfill the reBuirements of his or her environment !satisfactoriness) but expects to be satisfied in fulfilling his or her own reBuirements by the wor* environment. Re)ea(-h Hy$,the)e) It still is one of the top subjects in the field of organizational behavior that some dimensions !e.g. bureaucracy support innovation) of the concepts of organizational culture and climate are overlapping !,chneider 199$% Denison 1995). The study of Gey and >eamish !#$$1 p.9C5)) is a noteworthy one for indicating the similar and $%opyright &''3 by the (lobal )usiness and Technology #ssociation # contrasting dimensions of the concepts of organizational culture and climate. ,ome researchers li*e ,hadur et. al. !1999) and .ood and 'oberg !1991) used +allach1s !1993) 3rganizational &ulture Index !3&I) as an instrument for measuring organizational climate and tried to understand the degree of association between certain climatic elements and the job satisfaction construct. There is enough empirical evidence !,ee "opopolo #$$#) that indicates an association between wor* environmental elements and certain affective employee attitudes such as job satisfaction and organizational commitment. The results of another empirical study conducted by &handler 'eller and "yon !#$$1) suggest positive influence of certain climatic elements !e.g. managerial support innovation) on the organizational outcomes. +hen organizational procedures are perceived by the members of an organization the organization is assumed to have a high degree of bureaucratic nature in terms of formalized and strict organizational rules !,hadur et.al.1999% "o* ( &rawford #$$1). &onseBuently a negative association is li*ely to occur between formalization and perceived job satisfaction of employees1. The level of job satisfaction varies in accordance with various aspects of the job% it would be logical to assume one of the determinants of these aspects is related to the amount of salary. ,ince there is a difference between the salaries of medical doctors nurses and health officers it may well be an influencing factor in terms of the job satisfaction levels of the three groups. In terms of the relevant theoretical bac*ground regarding the association between climatic elements and job satisfaction below stated hypotheses are formulatedH .1H The innovation and managerial support are the strongest climatic elements in explaining the variance positively in job satisfaction. .#H There is a positive relationship between the climatic elements and job satisfaction with the exception of degree of formalization. .3H The level of job satisfaction differs for each group of professionals. .6H The employee perceptions of organizational climate differ for each group of professionals in relation to their level of job satisfaction. .CH There is no difference in the level of job satisfaction and socio0demographics characteristics of the participants. Meth,# The Re)ea(-h O.1e-t'e The objective of this study is to examine both employee perceptions of organizational climate and the relationship between climatic elements and job satisfaction in a private healthcare organization. ,ample and procedure The study was performed in one of the well0*nown private healthcare institute with a capacity of 1#$ beds in Istanbul Tur*ey in ;une #$$#. There were a total of 19C professionals namely medical doctors nurses and health officers at the time of data collection period in ;une #$$#. The answers were provided from 139 out of 19C participants reaching a response rate of :C percent. The total number of the respondents in the author1s view covers a large enough sample to employ necessary statistical analyses in accordance with the study objective. The Mea)*(eme&t I&)t(*me&t)
The organizational climate measurementH This Buestionnaire is 50point "i*ert scale ranging from 7totally agree8 !5) to 7totally disagree8 !1). It comprised #6 items that relate to six dimensions of the concept of organizational climate !19 items) and contains 5 items about socio0demographics. The measurement instrument is developed by the author and based on both "itwin and ,tringer1s !1959) 3rganizational &limate Fuestionnaire and the study of ,chneider >rief and ?uzzo !1995). The Buestionnaire was used recently in two different studies !Di*men ve Iahyagil #$$1% $%opyright &''3 by the (lobal )usiness and Technology #ssociation 3 Iahyagil #$$1) in Tur*ey. The reliability analyses of these studies were found as !&ronbach alpha J $.9$$5 and $.91:1). Gurthermore the exploratory factor analyses indicated satisfactory construct validity at a very high significance level !i.e. pK .$$1). The job satisfaction measurementH The short version of Einnesota ;ob ,atisfaction Fuestionnaire was employed. "ofBuist and Dawis !1959) designed the original scale and it has been widely used in Tur*ey after having translated into Tur*ish and tested properly !?orgun 199C). The device is C0point "i*ert scale Buestionnaire. It contains #$ items twelve of which are related to intrinsic factors while the six items are related to the extrinsic factors and two items cover wor* conditions and cowor*ers. The Re)ea(-h De)g&
The study has an explanatory design and is analytical in nature. It is a field study. The Re)ea(-h F&#&g) The socio0demographic information about the participants namely medical doctors nurses and health officers is given in Table1. TABLE 23 S,-,4Dem,g(a$h- Data /,( Pa(t-$a&t) . ,ub0scale values A L . ?ender Eale 5$ 63.# Gemale :9 C5.9
;ob0position Eed. doctors !#9 E M 5 G) 3C #C.# Aurses !9 E M C: G) 5C 65.9 .ealth0officers !#3 E M 15 G) 39 #9.$ NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN -s a result of the reliability analyses of the both measurement instruments one of the two0teamwor* variables out of 19 variables in organizational climate Buestionnaire was excluded and the &ronbach alpha coefficient was found as .9#$6 for remaining 1: variables and as .956C for the job satisfaction Buestionnaire both indicating statistically highly significant values. - rotated factor analysis was performed for organizational climate Buestionnaire to understand 7the maximum amount of common variance in a correlation matrix 7by reducing 7a data set from a group of interrelated variables into a smaller set of uncorrelated factors8 !Gield #$$$ p.6#3). Gactor analyses are useful to find out similarities between theoretical constructs and the facts from real world. TABLE 53 Fa-t,( A&a!y)) /,( O(ga&0at,&a! C!mate 6*e)t,&&a(e $%opyright &''3 by the (lobal )usiness and Technology #ssociation 6 'E3 and >artlett1s Test 'aiser0Eeyer03l*in Eeasure of ,ampling -deBuacy. :5$ >artlett1s Test of ,phericity -pprox. &hi0,Buare 53C$66 df 135 ,ig. $$$ ,ince 'E3 value lies between .:$ and .9$ this implies an appropriate pattern of correlations and >artlett1s test that is statistically highly significant indicates the @0matrix is not an identity test thus the factor analysis is suitable for further statistical procedures. The analysis extracted six factors that explain 56.36 L of the total variance in the concept of organizational climate. This result indicates the explanatory power of the measurement instrument in tapping the conceptual dimensions of organizational climate. TABLE 73 R,tate# Fa-t,( A&a!y)) &omponents "oading values . Gactor label <.. << . formalization0reward support formalization1 $.:69 reward# $.5:3 innovation1 $.556 support# $.5$6
innovation0reward nature of wor* innovation3 $.5:9 innovation# $.5:6 nature of wor*# $.CC9 reward1 $.C3$
job0itself ( communication nature of wor*3 $.961 communication# $.C#: formalization# $.69C
job0itself ( teamwor* communication nature of wor*1 $.:C3 teamwor*1 $.:1C communication1 $.C9#
support ( innovation support1 $.:55 innovation6 $.C61
nature of wor* ( reward nature of wor*6 $.969 mechanism reward1 $.6:# NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN AoteH Oarimax with 'aiser Aormalization criterion for loading J .6$ $%opyright &''3 by the (lobal )usiness and Technology #ssociation C @esults of factor analyses showed that conceptual clarity exists in the dimensions of organizational climate through six factors. There is only one variable !reward1) loaded onto more than one variable. Gurthermore the items loaded very strongly on particular factors. The items of factors which are related to innovation managerial support and reward mechanism and indicate content validity. The composition of these variables is consistent with the theoretical articles and the outcomes of some recent empirical studies conducted in the same field !2arry #$$$% ,hadur et. al. 1999% "in 1999) as well as with some empirical studies conducted in Tur*ey !Iahyagil #$$1% Di*men ( Iahyagil #$$1). 2articularly the first factor that revealed formalization together with reward mechanism managerial support and innovation is outstanding. It implies the possibility of the existence of formal nature !i.e. level of bureaucracy) organizational structure may establish a harmony with three components of modern management. Gactor # suggests the importance of innovation and reward and factor 3 focuses on the interdependence between the nature of wor* formalization and communication flow. ,ince The Einnesota ;ob ,atisfaction Fuestionnaire accepts values higher than !5C) as high level of satisfaction the overall job satisfaction level of the respondents !for all three professional groups) indicates !E J :$.5:) a high level of satisfaction. The job satisfaction level of the respondents is also calculated according to their gender and it is found that the job satisfaction level of male respondents !E J :3.$3) is higher than that of females !59.99). Hy$,the)) Te)t&g .1H The innovation and managerial support are the strongest climatic elements in explaining the variance positively in job satisfaction.
- regression analysis was employed and the result indicated a moderate support for this hypothesis. The variables of teamwor* and innovation explained almost thirty percent of the variance in the dependent variable of job satisfaction at a highly significant level as shown in Table :. Teamwor* is able to explain more than 1P#$ of the total variation in job satisfaction. Durbin +atson test confirms that this result does not occur by chance. G value also indicates the significance of regression model at a very high significance level !pK .$$1). TABLE 83 Reg(e)),& A&a!y)) /,( J,. Sat)/a-t,& Eodel ,ummary!c) @ @ ,Buare -djusted @ ,Buare ,td. /rror of the /stimate &hange ,tatistics Durbin0 +atson Eodel @ ,Buare &hange G &hange df1 df# ,ig. G &hange 1 6:6!a) ##6 #19 1$35$:5 ##6 3953$ 1 13: $$$ # CCC!b) 3$9 #99 99#113 $96 15659 1 135 $$$ 1:99 a 2redictorsH !&onstant) T/-E+3@' 1 b 2redictorsH !&onstant) T/-E+3@' 1 IAA3O-TI3A 1 c Dependent OariableH ;3> ,-TI,G-&TI3A
The result of regression analysis indicates that the contribution of the variable of teamwor* is very high !Q J .6:) even together with the variable of innovation !QJ.39 ( .3$). Eoreover T value also indicates this result is correct at a very high !pK .$$1) significance level. $%opyright &''3 by the (lobal )usiness and Technology #ssociation 5
.#H There is a positive relationship between the climatic elements and job satisfaction with the exception of the degree of formalization.
2earson &orrelation test results indicated job satisfaction has positive and highly significant relationship with all of the basic climatic dimensions with the exception of the variable of the nature of wor*. Though this hypothesis was not supported what is outstanding is the degree of correlation !.33) between job satisfaction and formalization. TABLE 93 The (e!at,&)h$ am,&g -!mat- 'a(a.!e) a&# 1,. )at)/a-t,&
Oariables ,uppor t Innovatio n &ommunica tion Gormali zation Teamwor * ;ob0 satisfaction Gormalizati on .61$RR .6:CRR .6#6RR 1.$ .3:9RR .3#9RR Teamwor* .#3$RR .#69RR .319RR .3:9RR 1.$ .6:6RR &ommunic ation .636RR .3:9RR 1.$ .6#6RR .319RR .###RR ,upport 1.$ .6C#RR .636RR .61$RR .3:9RR .#63RR Innovation .6C#RR 1.$ .3:9RR .6:CRR .#69RR .36$RR @eward .656 .539RR .3C1RR .359RR .1$6 .##6RR RR $.$1 significance level .3H The level of job satisfaction differs for each group of professionals. The job satisfaction level of medical doctors is calculated as !EJ :$.6$) !EJ5:.::) for nurses and !EJ:$.#6) for health officers. -n -A3O- analysis was performed to test the third hypothesis and the results !G value J 6.66#) indicated there is highly significant !pK$.$1) difference in perceived job satisfaction levels of three professional groups. 2ost .oc tests were also performed to determine which groups differed and the analysis indicated that there is a difference in perceived job satisfaction levels of doctors and nurses. TABLE : A&,'a a&a!y)) /,( 1,. )at)/a-t,& !e'e!) ,/ th(ee g(,*$) ,/ em$!,yee) ;3> ,-TI,G-&TI3A ,um of ,Buares df Eean ,Buare G ,ig. >etween ?roups 1:$3C99 3 C5:955 666# $$C +ithin ?roups 1:#C593# 13C 1#:9#9 Total 1995$63# 139
.6H The employee perceptions of organizational climate differ for each group of professionals in relation to their level of job satisfaction. Three regression analyses were performed to test this hypothesis. The influence of climatic variables on the prediction of job satisfaction differed for each group of participants. -lthough the variable of teamwor* explained 1#.1L of the variance in job satisfaction for medical doctors Durbin0+atson test indicated that this result implies an auto0correlation and conseBuently is Buestionable. The variables that accounted for the variance in the dependent variable of job satisfaction were innovation !#6.5L) teamwor* !9.9 L) and formalization !6.CL) for nurses. Ginally the variables of teamwor* !36L) and formalization !:.3L) explained the amount of variance in job satisfaction for health officers. Durbin0+atson test values also confirm that these results are not found by mere chance. Therefore hypothesis 6 was supported for job satisfaction and the result of testing has conformity with the outcomes of factor analysis. $%opyright &''3 by the (lobal )usiness and Technology #ssociation : .CH There is no difference in the level of job satisfaction and socio0demographics characteristics of the participants. T0test and -A3O- analyses were performed for testing this hypothesis. Ao difference came out for socio demographics but perceived job satisfaction levels of employees were differed by gender. ,ince the ratio of females to all of the respondents is C:L and 9:.5 percent of nurses is female wor*ers !in contrast 93 percent of doctors is male) it would be logical to say the difference in the perceived job satisfaction level of employees is related to their profession rather than their gender. Discussion Girst in accordance with the results of both factor analysis and regression analyses the variables of formalization innovation reward mechanism and teamwor* were found as the most influencing variables of the organizational climate in relation to the high level of perceived job satisfaction. @esearch results indicate the increasing importance of teamwor* and innovation in modern management in spite of the difference in national as well as organizational cultural attributes if one considers the fact that this study was conducted in Tur*ey which is not a prototype of +estern culture yet the results are in conformity with that of similar studies !as cited in this study) conducted mainly in the ,tates. I presume one of the reasons for these results may well be related to fact that the respondents of this study are all professionals wor*ing in a professional organization. ,econd the role of formalization that is worth to note as one of the major climatic variables in the perceptions of both nurses and health officers. ,ince health services and hospitals have often been considered as traditional and bureaucratic broadly spea*ing professionals especially nurses wor*ing in health institutions are subjected to the bureaucratic forces and may have little opportunity for innovation and creativity !"o* ( &rawford #$$1). The results of statistical analyses indicated a positive correlation of $.33 between formalization and job satisfaction level of three professional groups in contrast to the initial expectations. This result has also conformity with the studies of both ,chmid !#$$#) and ,hadur et.al. !1999). -ll of the results derived from both this one and other cited studies indicate the role of formalization regarding the bureaucratic nature of organizations. In terms of the reBuirements of modern management what can be said is formalization moderates the relationship between the employee perceptions of organizational climate as one of the organizational properties. This will be certainly related to the establishment of a harmony between the degree of formalization and the execution of daily organizational procedures by emphasizing the formation of an innovative sprit in organizations. That is I believe why formalization has also rather high degree of correlation with some of the climatic variables such as innovation !.6:) and managerial support !.61) in this study. @egarding healthcare institutions the study4s contribution is the empirical evidence that indicate the lin* between managerial support reward mechanism teamwor* and certain wor* outcomes such as job satisfaction despite the limitations of its relatively small size. Gurthermore 5 climatic dimensions which were investigated in this study are in conformity with a large number studies related to the measurement of organizational climate in general !Gey ( >eamish #$$1% ;ohnson #$$$% ,hadur et. al. 1999% "in 1999) and particularly in health sector !'irsh #$$$). Though the dimensions of organizational climate concept are not identical in each of these studies broadly spea*ing all of the empirical evidence gives meaningful clues for both scholars and practitioners. 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