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Proposal 1
Proposal 1
Proposal 1
In Partial Fulfillment
of the Requirements for the Degree
Master of Arts in Nursing
By
September 2019
CHAPTER I
INTRODUCTION
the next. According to Manhertz (2011), different organizations in the United States
reported that the highest percentage of turnover occurs within specific employee groups.
while in Europe, respondents were more likely to report that retention is not an issue at
While some countries face challenges due to the migration of domestically trained
health care workers, other countries have experienced a rapidly growing domestic market
for health care services due to “medical tourism”. Overall, World Health Organization
(WHO) estimates that there is a global shortage of about 4.3 million health care workers.
These shortages are aggravated by the migration of health care workers away from the
Florentine (2018) says that employees leave the organization to look for greener
pastures, practically speaking, look for a job that will sustain them financially. When
employees leave, productivity sinks, morale suffers and colleagues struggle with an
retention of employees is one of the major issues that the healthcare sector is facing
currently. According to Florentine, determining the primary reason why employees are
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leaving will help hospital management to plan for a strategy on how to increase employee
retention and that the best solution is to keep the workers happy so they don’t leave.
successful health system. The health workforce includes medical practitioners, nurses,
midwives, allied health care professionals, health administrators as well as other public
health personnel. A country’s health workforce can be expensive to train and shortages
can be difficult to fill quickly, due to the lead time in recruiting and training new staff.
Over the past 25 years, international trade in skilled services has increased dramatically
This current issue in employee shortage prompted and influenced the inquiry to
motivation for them to remain in their jobs and to perform well. Likewise, this paper also
professionals and business executives. For many countries, one of the many challenges
they are facing is how to retain sufficient numbers of qualified employees to meet their
needs (WHO, 2008). According to a research report of Society for Human Resource
Management (SHRM, 2018) (Employee Job Satisfaction and Engagement: The Doors of
Opportunity are Open), one of the leading factors that contribute to job satisfaction of
employees is compensation or pay. Practices that contribute to retention arise in all areas
of Human Resource, and all roles within an organization will need to work together to
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develop and implement multifaceted retention strategies. One of the effective processes
their employees as valued contributors, the employees will stay. To this day, companies
train their employees, offer competitive compensation plans, and increase benefits to
secure their loyalty. However, despite these efforts, many organizations still experience
shortage and high turnover rates. Healthcare organizations spend considerable effort in
marketing their facilities to patients and even physicians. Likewise, the same type of
effort should be directed at attracting and retaining employees. In order to attract the
employees want their personal and practical needs to be met, employers need to offer the
compensation, benefits, and scheduling that employees desire (Gering and Conner, 2002).
is not the only explanation for behavior. “Motivating is the management process of
influencing behavior based on the knowledge of what make people tick” (Luthans, 1998).
Motivation is the process of stimulating people to action and to achieve a desired task.
One way of stimulating people is to use an effective motivation, which makes workers
more satisfied with and committed to their jobs. However, Luthans (1998) says that
money is not the only motivator. According to him, there are other incentives which can
Akintoye (2000) insists that money remains the most important and effective
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symbolizes insubstantial goals like security, power, prestige, and a feeling of
Every reward system is based on the assumption that rewarding employees would
attract, retain and motivate workers (Krass, 2014). Becca Krass (2014) says that anything
that can attract an employee’s attention and motivate them to work can be called as an
incentive and this motivate behaviors. An incentive aims at improving the overall
compensation.
organization’s goals and may serve as an important tool for employee retention. However,
it may also have a negative impact on the employees’ performance by causing them to
take shortcuts or become very focused on the incentivized targets (HCA, 2015).
Internationally, the main reason why employees leave is largely a result of unsatisfactory
The term incentive entices or stimulates one to act in a desired direction. It has
the power to motivate and may be grouped into financial incentives, and non-financial
2018). According to Manhertz (2011) there are four important strategies that employers
can implement to retain employees and one of these strategies is to offer competitive
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Incentives or rewards are very important for an employees’ job satisfaction
because it fulfill their basic needs. Attractive compensation packages are an important
factor in retention because they fulfill financial and material desires as well as providing
the means of indicating an employee’s status and position of power in the organization.
An organization’s reward system can greatly affect employee performance and their
profitable company. Increasing business revenue is a joint effort and often requires
hardworking and productive employees. Financial incentives have long been thought,
(Jenkins et. al, 1998). The international interest in using financial incentives to improve
activities are naturally motivated which means they are carried out because the activity is
inherently satisfying and not because it carries an external reward, and there is evidence
et.al, 2007).
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Theoretical Framework
American business are those of Frederick Herzberg and Abraham Maslow. Frederick
Herzberg, a psychologist, proposed a theory about job factors that motivate employees.
developed a theory about the rank and satisfaction of various human needs and how
Maslow first published Motivation and Personality in 1954 which introduced his
theory about how people satisfy various personal needs in the context of their work. He
pattern of needs recognition and satisfaction that people follow in generally the same
sequence. He also theorized that a person could not recognize or pursue the next higher
need in the hierarchy until her or his currently recognized need was substantially or
needs is the earliest and most widely known theory of motivation. Maslow’s theory
summarizes human needs into five basic categories beginning with the basic
psychological needs and continuing through safety, belonging and love, self-esteem and
self-actualization. In his theory, the lowest unsatisfied need becomes the dominant, or the
most powerful and significant need. The most dominant need activates an individual to
act to fulfill it. On the other hand, satisfied needs do not motivate. An individual pursues
to seek a higher need when lower needs are fulfilled. Maslow’s hierarchy of needs is
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often illustrated in the shape of a pyramid where the basic needs are at the bottom and the
most complex need at the top. Figure 1 illustrates Maslow’s Hierarchy of needs.
Maslow stated that people are motivated to achieve certain needs and that some
needs take precedence over the other. Our most basic need is for physical survival, and
this will be the first thing that motivates our behavior. Once the first level is fulfilled, the
Physiological needs, the first level in Maslow’s pyramid, include the most basic
needs for humans to survive, such as air, water and food. Maslow emphasized that our
body and mind cannot function well if these requirements are not satisfied as these are
the most dominant needs of all. So if someone is missing everything in his/her life,
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probably the major motivation would be to fulfill his/her physiological needs rather than
any others. A person who is lacking food, safety, love and esteem, would most probably
hunger for food (and also for money, salary to buy food) than for anything else.
After having satisfied the first need, Safety needs are next in line. This refers to a
person’s desire for security or protection. Basically, everything looks less important than
safety and protection. This includes personal security, financial security, health and well-
being, safety mesh against accidents, illnesses and their adverse impacts.
The third on Maslow’s list of needs is the need to belong and to be accepted among
their social groups. The need for interpersonal relationships motivates behavior. People
need to love and be loved – both sexually and non-sexually by others. Depending on the
power and pressure of the peer group, this need for belonging may overbear the
physiological and security needs. When they are unsatisfied, a person will immediately
eliminate the lack of friends, peers and partner. Many people suffer from social
nervousness, loneliness, social isolation and also clinical depression because of the lack
classified this into two categories: (i) esteem for oneself which includes dignity,
achievement, and independence, and (ii) the desire for reputation or respect from others
such as status and prestige. Humans need to feel valued, such as being useful and
necessary in the world. In our society most people long for a stable and high valuation of
themselves. The most stable and the healthiest self-esteem is based on respect from
others.
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Self-actualization reflects an individual’s desire to grow and develop to his/her
fullest potential. People like opportunities, choosing his/her own versions, challenging
positions or creative tasks. Maslow described this level as the “need to accomplish
everything that one can, to become the most that one can be”. Self-actualization is
experiences.
people’s attitudes about work, also called the Motivation-Hygiene Theory or the dual-
factor theory. Herzberg developed the theory that people’s job satisfaction depends on
two kinds of factors. Factors for satisfaction (motivators/ satisfiers) and factors for
conditions, and salary are hygiene factors rather than motivators. Herzberg’s theory states
that the absence of hygiene factors can create job dissatisfaction, but their presence does
not motivate or create satisfaction (table 2). In contrast he determined from the data that
the motivators were elements that enriched a person’s job; he found five factors in
particular that were strong determiners of job satisfaction: achievement, recognition, the
associated with long-term positive effects in job performance while the hygiene factors
performance, which quickly fell back to its previous level. Satisfiers describe a person’s
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relationship with what she or he does, many related to the tasks being performed.
Dissatisfiers, on the other hand, have to do with a person’s relationship to the context or
environment in which she or he performs the job. The satisfiers relate to what a person
does whole the dissatisfiers relate to the situation in which the person does what he or she
Supervision-Technical Recognition
Table 1: Dissatisfiers and Satisfiers on the Job (Scanlan and Keys, 1987).
Hygiene Motivational
If Not Present JOB DISSATISFACTION NO JOB SATISFACTION
If Present NO JOB SATISFACTION JOB SATISFACTION
Table 2: The Relationship of Hygiene and Motivational Factors (Scanlan and Keys,
1987).
factors correspond to Maslow’s lower levels of need and must be dealt with if job
dissatisfaction does not cause difficulties. Once these needs are fulfilled, as in Maslow’s
theory, the job content factors become the motivators or the self-actuating factors.
Management cannot ignore factors such as salary or fringe benefits because a failure to
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Figure 2: Maslow and Herzberg Related (Ozguner, Z. & Ozguner, M., 2014)
The study aims to determine the differences in perceptions of the regular employees
on different levels (rank and file, middle managers, senior managers, executives) of the
Davao Medical School Foundation Inc. Hospital about financial incentives as the primary
CHAPTER II
METHOD
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This chapter presents the methods to be utilized by the researcher in data
gathering as well as descriptions on the research setting, the participants, measures, and
Design
Setting
Hospital, a level 2 hospital with 154-bed capacity. It is one of the three clusters of the
Davao Medical School Foundation Inc. and has been existing since 2003.
Participants
Participants for this study are regular employees that belong to different levels
such as rank and file, middle managers, senior managers and executives, 10% from the
total number of regular employees from each level will be randomly selected.
Measures
Needs and Frederick Herzberg’s Two Factor Theory. Questionnaires is divided into two
parts. Part 1 will be answered whether or not their specific needs in each level of
Maslow’s needs are met or not met. The second part of the questionnaire will be based on
Procedure
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For this study, the researcher will seek permission and approval to obtain a
complete list of regular employees per employment level. Once the list is available, the
researcher will identify 10% of employees per level to be tested. Identified employees per
questionnaires, consent will be secured, brief introduction of the study will be presented
and specific instructions will be given. Questionnaires will then be distributed to the
participants and their answers will be handled with strict confidentiality. The participants
will have the option to write their names on the questionnaires however, they are required
to fill up identifiers such as age, sex, length of service, unit or department assigned.
Permission from the ethics committee of the Davao Medical School Foundation
will be obtained prior to the start of the study. Questionnaires will be personally
confidentiality.
References:
6 Sales Incentive Strategies that Will Delight Your Finance Team by Becca Krass, Feb.
26, 2014 (https://www.salesforce.com/blog/2014/02/sales-incentive-strategies.html)
Effective incentive strategies for every organisational goal by HCA, Jan. 14, 2015
(https://www.hcamag.com/hr-news/effective-incentive-strategies-for-every-
organisational-goal-195562.aspx)
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Incentive Types: Financial and Non-Financial Incentives – Explained! By Smriti Chand
(http://www.yourarticlelibrary.com/hrm/incentives/incentives-types-financial-and-non-
financial-incentives-explained/35360)
8 Reasons Good Employees Leave and how you can prevent it by Sharon Florentine, Feb.
2, 2018 (https://www.cio.com/article/2858746/careers-staffing/9-reasons-good-
employees-leave-and-how-you-can-prevent-it.html)
Worldwide Trends in Employee Retention: How to keep your best employees in any
market by Huntley Manhertz, Jr., Ph.D., June 2011
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retention.pdf)
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The Vital Few: Referral Strategies to Protect and Grow Your Healthcare Business by
Stewart Gandolf (https://www.healthcaresuccess.com/blog/physician-marketing/doctor-
referrals-8020.html)
How to create a winner marketing plan to your hospital by Dr. Hesham Dabah, August 8,
2015 (https://www.linkedin.com/pulse/how-create-winner-marketing-plan-your-hospital-
dr-hesham-dabah-)
Healthcare Marketing Strategy: A Guide for Getting More Patients, September 19, 2018
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Effect of reward system among healthcare workers performance: a case study of
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