- Nursing assistants, paramedics, technicians and other frontline health workers make up about half of the health care workforce.
- Frontline health workers reported higher job satisfaction and perceived quality of care provided when their workplaces implemented multiple supportive policies like team-based work practices and incentivized pay.
- Traditionally, employers invest less in entry-level frontline worker job satisfaction and retention because these workers may be less difficult to replace.
Frontline health workers—including nursing assistants, paramedics and pharmacy technicians—who received a combination of benefits and support from their employers had higher job satisfaction, a new study found.
The research, published in the journal Health Services Research, found supervisor support, team-based work practices offered in tandem with flexible work arrangements and incentivized pay were also associated with higher perceived quality of care.
While previous studies have linked such practices to positive outcomes, Emmeline Chuang, Ph.D., professor of health management and policy at San Diego State University, found the best results come from employers who used a number of methods bundled together. The study followed and surveyed more than 650 frontline workers in 13 large not-for-profit health care centers.
Frontline health workers, which account for about half of the health care workforce, include community health workers, nursing assistants and technicians. Registered nurses are midlevel providers, Chuang said.
“There’s evidence showing when you empower those frontline workers, it increases the likelihood that you catch patient errors,” she said.
Furthermore, according to the study, frontline health workers are the fastest growing segment of the health work force and are destined to increase under health reform.
Executives and senior management traditionally have paid less attention to the job satisfaction of these types of workers because they are thought to be easily replaceable and require a lower level of education, note the study authors. However, improving their job satisfaction could reduce turnover and lead to a better quality of care.
“For the most part, these kinds of practices are not used all that much,” said Nicholas G. Castle, Ph.D., professor of health policy at the University of Pittsburgh.
To change that, employers need to realize that savings and improved quality that can result from simple methods such as providing greater responsibility to frontline workers, he said.
These work practices could help to keep workers happy without breaking the bank with large pay raises, a move that is economically unfeasible today, Castle said.
The study authors note limitations to the study, including the fact that their small sample comprised primarily not-for-profit hospitals and community health centers with an expressed commitment to investing in front line workers and the fact that they measured staff perceptions of care rather than observed clinical measures of care. Future research could link these findings to surveys of patient satisfaction in a nationally representative sample of health care organizations.
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Health Services Research is the official journal of the AcademyHealth and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422-2646 or firstname.lastname@example.org. HSR is available online at www.blackwell-synergy.com/loi/hesr.
Chuang, E., et al. (2012). A Configurational Approach to the Relationship Between High Performance Work Practices and Frontline Healthcare Worker Outcomes. Health Services Research online.