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RCL: Motivation, performance and migration intentions of healthcare professionals across the lifespan: the role of work design and organizational factors

 

Efficiency and service quality of healthcare institutions depend on motivation and work quality (performance) of employed healthcare professionals. However, the majority of healthcare institutions in Lithuania are concerned by the demographic and social challenges of the 21st century as due to economic inequalities between European countries their medical professionals increasingly emigrate from Lithuania. The project is significant for attaining the objectives of the Welfare Society programme as the proposed research is focused on solving of complex demographic and social challenges associated with ageing issues, emigration of healthcare professionals, management of healthcare institutions and improvement of healthcare services.

In the proposed research project we investigate the problem of how to effectively manage and retain healthcare professionals in Lithuanian healthcare institutions. While doing so we aim to identify the work design as well as organizational factors that increase the motivation and performance and reduce turnover and emigration intentions of healthcare workers across the life span.

In the framework of the project we are intended to disclose the specifics of healthcare context and theoretically ground the impact of work design and organizational factors for individual work-related outcomes. Guiding by prof. F. Morgeson we will translate and validate Lithuanian Work Design Questionnaire measurement scales and empirically evaluate how work design and organizational factors affect work-related outcomes of healthcare professionals in different life span stages. Our managerial implications and practical recommendations will help healthcare institutions to develop and adapt organizational factors and work design in order to maintain high performance, motivation, and retention of healthcare professionals.

PROJECT RESULTS
 

Quality of care and the efficiency of healthcare institutions depend on the motivation and performance of healthcare professionals (HPs). However, along with the rest of the world there is a considerable international mobility of HPs within the EU (Glinos,2014). Due to a one-way flow of HPs from Lithuania to the more developed EU-economies, the country is facing increasing threats to sustainable quality of care due to labor shortages and accelerating age of the remaining labor, as the majority of leaving HPs are younger individuals. The research project investigates the problem of how to effectively manage and retain HPs in Lithuanian healthcare institutions. While doing so we aim to identify organizational factors that increase motivation, well-being, and performance as well as decrease emigration intentions of HPs across life-span. 

To answer the research questions, we collected qualitative and quantitative data from a large sample of medical professionals (doctors, nurses, residents) and medical students in diverse hospitals in Lithuania. Research findings were presented at AOM, Dutch HRM, International HRM and other conferences and are displayed in publications referenced in this summary. We found that 39 % of students, 21 % of residents, 12 % of nurses, and 6 % of physicians were decided to emigrate and emigration decisions were linked to individual (age, gender, family situation), organizational (teamwork climate, financial needs dissatisfaction), and societal factors (perceived social worth) (Goštautaitė, Bučiūnienė, Milašauskienė, Bareikis, Bertašiūtė, 2018). Next, HRM system increases work engagement and patient orientation of HPs due to the increases of basic need (autonomy, relatedness, and competence) satisfaction and this indirect effect is contingent upon employees’ age (Goštautaitė, Bučiūnienė, Milašauskienė, paper under review in IJHRM). We further show that HRM reduces junior doctors’ intentions to emigrate and the subsequent job search abroad even after other important emigration factors (i.e., age, gender, national identity, financial dissatisfaction, number of children, provision of medical equipment) are controlled for (Goštautaitė, Bučiūnienė, Mayrhofer, paper under preparation). HRM influences job search abroad via the perceived opportunities in home country. HRM practices have a stronger negative effect on burnout for the younger HPs (they burnout was significantly higher) than for their older counterparts (Bučiūnienė, Goštautaitė, Milašauskienė & Granskas, 2018). Finally, calling (for a medical profession) not only becomes stronger with increasing age (and progressing medical career) but also prevents burnout, an effect that is mediated by increased social worth (especially among senior professionals) (Goštautaitė, Bučiūnienė, Duffy & Kim, paper under review in Career Development International).

Together, this project contributes to a better understanding of organizational factors in a hospital that not only decrease the willingness to leave own country for work abroad but also lead to motivation, well-being, and performance of age-diverse HPs. Our research acknowledges “the very different effects that HRM activities may have on different categories of personnel” (Benschop, 2001, p. 1166) and answers calls for “a more nuanced understanding of international careers in their relevant geographical, historical, institutional and organizational settings” (Al Ariss & Crowley‐Henry, 2013, p.18). We contribute to theoretical grounding and empirical evidence of explanatory mechanism by which the interactions of HRM and employee age affect work outcomes. We also provide insights on how to reduce self-initiated expatriation of HPs through organizational practices. We formulate implications for policy-making and recommendations that help healthcare institutions to develop HRM and adapt organizational factors aiming at maintaining high performance, motivation, and retention of increasingly age diverse HPs.

 

Project duration: 01 2017-12 2018
Budget: 109 733 EUR
Project Manager: Prof. Dr. Ilona Bučiūnienė
Project research team: Žemyna Milašauskienė, Bernadeta Goštautaitė
Funding : Lithuanian Research Council programme "Welfare Society"