Workplace empowerment for front-line health workers creates higher job satisfaction

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.