Effect of Staff Attitudes Effect of Staff Attitudes on Quality in Clinical on Quality in Clinical Microbiology ServicesMicrobiology Services

Ms. Julie SimsMs. Julie Sims

Laboratory Technical specialistLaboratory Technical specialistStrengthening of Medical Laboratories in the Strengthening of Medical Laboratories in the

Caribbean: Caribbean Health Research CouncilCaribbean: Caribbean Health Research Council44thth May 2007 May 2007

Aims and ObjectivesAims and Objectives

This research study entitled ‘The This research study entitled ‘The Effect of Staff attitude on Quality in Effect of Staff attitude on Quality in Microbiology Laboratories’ was Microbiology Laboratories’ was performed in order to investigate the performed in order to investigate the effect of an individual’s perception of effect of an individual’s perception of laboratory climate, climate quality laboratory climate, climate quality and job satisfaction on the quality of and job satisfaction on the quality of Microbiology laboratory serviceMicrobiology laboratory service

BackgroundBackground

The area of job satisfaction is under-The area of job satisfaction is under-researched in the Caribbean region, in researched in the Caribbean region, in particular in the medical field. particular in the medical field.

Microbiology was chosen as the specific Microbiology was chosen as the specific area within the laboratory field because area within the laboratory field because it is a subjective science, and because it is a subjective science, and because stringent quality control is required in stringent quality control is required in order to obtain accurate results order to obtain accurate results

Methodology Methodology

Research was conducted in twenty-Research was conducted in twenty-one countries, with questionnaires one countries, with questionnaires being sent to 69 laboratories.being sent to 69 laboratories.

291 questionnaires were distributed, 291 questionnaires were distributed, 194 were returned; response rate of 194 were returned; response rate of 67% (UK response rate was 38%) 67% (UK response rate was 38%)

Study MaterialsStudy Materials The study utilized two self-report The study utilized two self-report

questionnairesquestionnaires The first questionnaire contained 3 scales:The first questionnaire contained 3 scales:

Laboratory Climate ScaleLaboratory Climate Scale Climate for Quality ScaleClimate for Quality Scale Job Satisfaction Scale. Job Satisfaction Scale.

Additional demographic questions Additional demographic questions included: included: age, current employer, gender, current grade age, current employer, gender, current grade

and length of time workedand length of time worked

Laboratory Climate ScaleLaboratory Climate Scale Respondents were asked to rate their perception Respondents were asked to rate their perception

of laboratory climate on a five point scale from of laboratory climate on a five point scale from strongly disagree (1) to strongly agree (5). strongly disagree (1) to strongly agree (5).

The areas of laboratory climate that were The areas of laboratory climate that were examined included:examined included: supervisory stylesupervisory style co-worker relationsco-worker relations task characteristicstask characteristics employee competenceemployee competence layout of laboratorylayout of laboratory performance-reward relationship performance-reward relationship equipment & supplies. equipment & supplies.

Climate for Quality & Job Climate for Quality & Job Satisfaction ScaleSatisfaction Scale

Climate for Quality ScaleClimate for Quality Scale Respondents were asked to rate their Respondents were asked to rate their

perception of the climate for quality in their perception of the climate for quality in their laboratory on a scale from strongly disagree laboratory on a scale from strongly disagree (1) to strongly agree (5). (1) to strongly agree (5).

Job Satisfaction ScaleJob Satisfaction Scale Respondents were asked to rate their Respondents were asked to rate their

satisfaction with various aspects of their job satisfaction with various aspects of their job on a scale from very dissatisfied (1) to very on a scale from very dissatisfied (1) to very satisfied (4).satisfied (4).

AnalysisAnalysis Statistical Package for Social Sciences Statistical Package for Social Sciences

(SPSS) 14.0 was used to analyze the (SPSS) 14.0 was used to analyze the collected data. collected data.

Reliability analysis was conducted on all Reliability analysis was conducted on all the scales the scales

The reliability coefficients for the The reliability coefficients for the departmental climate section and the job departmental climate section and the job satisfaction section indicated that these satisfaction section indicated that these scales were highly reliable. scales were highly reliable.

..

AnalysisAnalysis Pearson’s r was conducted to determine the Pearson’s r was conducted to determine the

correlation between the dependent variable correlation between the dependent variable laboratory quality and the independent variables laboratory quality and the independent variables of climate for quality, laboratory climate and job of climate for quality, laboratory climate and job satisfaction. satisfaction.

A multiple regression was performed, which A multiple regression was performed, which indicated that type of employer was a significant indicated that type of employer was a significant variable variable

A regression was conducted between laboratory A regression was conducted between laboratory quality and type of employer. quality and type of employer.

This indicated that in the Caribbean, the This indicated that in the Caribbean, the perception of the type of employer may have an perception of the type of employer may have an impact on the laboratory qualityimpact on the laboratory quality

ResultsResults

The employee perception was that:The employee perception was that: Ministry of Health laboratories had a Ministry of Health laboratories had a

higher mean laboratory quality score as higher mean laboratory quality score as compared to private authorities and compared to private authorities and regional health institutions regional health institutions

Overall, private labs had the highest Overall, private labs had the highest mean laboratory climate score, as mean laboratory climate score, as compared to labs under the Ministry of compared to labs under the Ministry of Health, and the regional health Health, and the regional health institutionsinstitutions

ResultsResults

High, positive perception of task High, positive perception of task characteristics, co-worker relations, characteristics, co-worker relations, employee competence, job satisfaction employee competence, job satisfaction and layout of laband layout of lab

Medium perceptions for laboratory climate, Medium perceptions for laboratory climate, climate for quality and supervisory styleclimate for quality and supervisory style

Low, negative perceptions of performance Low, negative perceptions of performance reward relationship and equipment & reward relationship and equipment & supplies supplies

High RatingsHigh Ratings

Layout of the LaboratoryLayout of the Laboratory Employee competenceEmployee competence Task characteristics*Task characteristics* Co-worker relationsCo-worker relations Job satisfactionJob satisfaction

**Task characteristics refer to components of the Task characteristics refer to components of the task that the employee performs and the extent task that the employee performs and the extent to which the job allows them to use their to which the job allows them to use their knowledge, skills and abilities, and allows for a knowledge, skills and abilities, and allows for a variety of tasks to be performedvariety of tasks to be performed

High RatingsHigh Ratings

Layout of the LaboratoryLayout of the Laboratory Results show that the layout of the lab is Results show that the layout of the lab is

important in achievement of laboratory quality.important in achievement of laboratory quality. Employee competenceEmployee competence

The level of employee competence has The level of employee competence has implications for laboratory quality.implications for laboratory quality.

Task characteristicsTask characteristics These results show that task characteristics These results show that task characteristics

are very important in achieving a high quality are very important in achieving a high quality in the laboratories.in the laboratories.

High RatingsHigh Ratings

Co-worker relationsCo-worker relations These results show the importance of peer These results show the importance of peer

interactions in the workplace and that interactions in the workplace and that organizations should strive to promote friendly organizations should strive to promote friendly interaction among colleagues. interaction among colleagues.

Job satisfactionJob satisfaction Results showed that in the Caribbean, the Results showed that in the Caribbean, the

participants’ job satisfaction level is 38.4 out of participants’ job satisfaction level is 38.4 out of a possible score of 60, while in the UK rate was a possible score of 60, while in the UK rate was 37.3 and the USA was 46.0. 37.3 and the USA was 46.0.

Medium RatingsMedium Ratings

Climate for quality*Climate for quality* Supervisory styleSupervisory style

**Climate for quality refers to Climate for quality refers to employee’s attitudes toward quality employee’s attitudes toward quality issues such as managements issues such as managements commitment to quality assurance and commitment to quality assurance and standards of staff trainingstandards of staff training

Medium RatingsMedium Ratings

Climate for qualityClimate for quality There is a relatively high positive There is a relatively high positive

relationship with climate for quality and relationship with climate for quality and job satisfactionjob satisfaction

Supervisory style Supervisory style These positive correlations indicate the These positive correlations indicate the

importance of the supervisory approach importance of the supervisory approach that is adopted by authority figures and that is adopted by authority figures and the implication this can have for the implication this can have for laboratory quality.laboratory quality.

Low RatingsLow Ratings

Performance reward relationshipPerformance reward relationship Equipment and suppliesEquipment and supplies Laboratory climateLaboratory climate

Low RatingsLow Ratings

Performance reward relationshipPerformance reward relationship From the analysis, one can see that it is From the analysis, one can see that it is

important that employees perceive that important that employees perceive that distribution of rewards is based on good distribution of rewards is based on good performance.performance.

Equipment & Supplies Equipment & Supplies It can be seen that employee’s perception of It can be seen that employee’s perception of

the availability of equipment and supplies has the availability of equipment and supplies has a significant relationship with the variables a significant relationship with the variables climate for quality and job satisfaction.climate for quality and job satisfaction.

Low RatingsLow Ratings

Laboratory climate Laboratory climate It is important to note that in the Caribbean, many It is important to note that in the Caribbean, many

laboratories are not accredited, and there is laboratories are not accredited, and there is limited participation in External Quality limited participation in External Quality Assessment Schemes, hence no labs in this study Assessment Schemes, hence no labs in this study had high laboratory quality scores and this may had high laboratory quality scores and this may have affected the correlations that were have affected the correlations that were produced. produced.

Therefore, although laboratory quality scores Therefore, although laboratory quality scores were very low, laboratories may have had a were very low, laboratories may have had a positive laboratory climate and climate for quality.positive laboratory climate and climate for quality.

ConclusionsConclusions

The results show that employee The results show that employee perceptions are very important to the perceptions are very important to the achievement of a high laboratory achievement of a high laboratory quality, and that activities to create a quality, and that activities to create a positive laboratory climate should be positive laboratory climate should be encouraged. encouraged.

This is supported by data produced This is supported by data produced in the UKin the UK

. .

ConclusionsConclusions

One of the most critical problems that the study One of the most critical problems that the study revealed was the low perception of the revealed was the low perception of the performance reward relationship performance reward relationship

It is important in the work environment that It is important in the work environment that employees perceive that when rewards are employees perceive that when rewards are distributed it is based on good performance and not distributed it is based on good performance and not on extraneous variables such as friendship or on extraneous variables such as friendship or seniority.seniority.

These rewards do not have to be monetary, since These rewards do not have to be monetary, since studies have shown that intangible rewards, such studies have shown that intangible rewards, such as praise, are valued by employees. as praise, are valued by employees.

These findings are crucial towards the achievement These findings are crucial towards the achievement of a high quality laboratory and therefore should be of a high quality laboratory and therefore should be addressed.addressed.

ConclusionsConclusions

The results also show that employees The results also show that employees think that there is insufficient equipment & think that there is insufficient equipment & supplies (encompasses staff) in order to supplies (encompasses staff) in order to efficiently perform their duties. efficiently perform their duties.

This can negatively affect the laboratory This can negatively affect the laboratory climate and ultimately laboratory quality climate and ultimately laboratory quality since if employees do not think there is since if employees do not think there is adequate equipment they will be able to adequate equipment they will be able to carry out their work tasks. carry out their work tasks.

LimitationsLimitations

The sample methodology was not random, a The sample methodology was not random, a consecutive sample was used, therefore the consecutive sample was used, therefore the results are only valid for this sample and there results are only valid for this sample and there are implications for generalizing the results to are implications for generalizing the results to all Caribbean medical laboratories. The labs all Caribbean medical laboratories. The labs used were based on accessibility and used were based on accessibility and willingness to participate. willingness to participate.

The scales used are highly subjective.The scales used are highly subjective. No laboratory in the Caribbean has been No laboratory in the Caribbean has been

accredited, therefore no lab could have accredited, therefore no lab could have obtained the maximum laboratory quality score. obtained the maximum laboratory quality score. This is important to consider, since some labs This is important to consider, since some labs may have the satisfactory laboratory climate. may have the satisfactory laboratory climate.

RecommendationsRecommendations

A random sampling technique should be A random sampling technique should be chosen. To do this one would need to chosen. To do this one would need to acquire a comprehensive list of all acquire a comprehensive list of all laboratories in the Caribbean.laboratories in the Caribbean.

From our analysis, it is clear that other From our analysis, it is clear that other factors affect laboratory quality in the factors affect laboratory quality in the Caribbean, and additional research Caribbean, and additional research should be conducted to identify these should be conducted to identify these variables. variables.

Thank YouThank You

CORRELATIONSCORRELATIONS

Laboratory Quality

Laboratory Climate

Climate for Quality

Laboratory Climate

Climate for Quality

Laboratory Quality

r = 0.38**

r = 0.83**

r = 0.30**

r = 0.69**

r = 0.04

r = 0.07

Diagram comparing Diagram comparing CorrelationsCorrelations

United Kingdom Caribbean

Variables Supervisory Style

Co-worker Relations

Task Characteristics

Employee Competence

Layout of Laboratory

Performance Reward Relationship

Equipment & Supplies

Co-worker Relations

0.313**0.313**

Task Characteristic

s

0.432**0.432** 0.258**0.258**

Employee Competence

0.304**0.304** 0.413**0.413** 0.273**0.273**

Layout of Laboratory

0.305**0.305** 0.412**0.412** 0.272**0.272** 1.0**1.0**

Performance Reward

Relationship

0.536**0.536** 0.273**0.273** 0.360**0.360** 0.211**0.211** 0.212**0.212**

Equipment & Supplies

0.421**0.421** 0.276**0.276** 0.403**0.403** 0.329**0.329** 0.333**0.333** 0.408**0.408**

Climate for Quality

0.705**0.705** 0.283**0.283** 0.435**0.435** 0.312**0.312** 0.314**0.314** 0.511**0.511** 0.461**0.461**

Job Satisfaction

0.525**0.525** 0.300**0.300** 0.475**0.475** 0.246**0.246** 0.2480.248 0.472**0.472** 0.453**0.453**

Laboratory Quality

0.0850.085 0.1180.118 0.0460.046 0.0020.002 0.0020.002 -0.035-0.035 0.1160.116

Bar Chart showing distribution of Bar Chart showing distribution of Laboratory QualityLaboratory Quality

2.7

7

31.9

10.3

24.3

15.7

8.1

00

5

10

15

20

25

30

35

Per

cent

age

of L

abs

Bar Chart showing Bar Chart showing Laboratory ClimateLaboratory Climate

0

16.7

55.4

26.9

1.1

0

10

20

30

40

50

60

Perc

enta

ge o

f Lab

s

Very Poor Poor Fair Good Very Good

Bar Chart showing Climate Bar Chart showing Climate for Qualityfor Quality

0.5

9.7

47.8

26.9

1.10

5

10

15

20

25

30

35

40

45

50

Per

cent

age

of L

abs

Very Poor Poor Fair Good Very Good

Bar Chart showing Job Bar Chart showing Job SatisfactionSatisfaction

3.8

39.8

53.8

2.7

0

10

20

30

40

50

60

Perc

enta

ge

Very Low Low High Very High

Bar Chart showing Bar Chart showing Supervisory StyleSupervisory Style

4.3

19.4

40.3

33.3

2.7

0

5

10

15

20

25

30

35

40

45

Perc

enta

ge

Very Poor Poor Fair Good Very Good

Bar Chart showing Co-Worker Bar Chart showing Co-Worker RelationsRelations

4.8

15.1

29.6

42.5

8.1

0

5

10

15

20

25

30

35

40

45

Per

cent

age

Very Bad Bad Fair Good Very Good

Bar Chart showing Task Bar Chart showing Task CharacteristicsCharacteristics

1.64.8

31.7

53.2

8.6

0

10

20

30

40

50

60

Perc

enta

ge

Very Poor Poor Fair Good Very Good

Bar Chart showing Employee Bar Chart showing Employee CompetenceCompetence

3.8

17.2

29

41.9

8.1

0

5

10

15

20

25

30

35

40

45

Perc

enta

ge

Very Poor Poor Fair Good Very Good

Bar Chart showing Layout of Bar Chart showing Layout of LabLab

3.8

17.2

29

41.9

8.1

0

5

10

15

20

25

30

35

40

45

Perc

enta

ge

Very Poor Poor Fair Good Very Good

Bar Chart showing Bar Chart showing Performance Reward Performance Reward

RelationshipRelationship

8.2

37.540.8

12.5

1.1

0

5

10

15

20

25

30

35

40

45

Per

cent

age

Very Poor Poor Fair Good Very Good

Bar Chart showing Equipment Bar Chart showing Equipment & Supplies& Supplies

10.2

31.7 32.8

23.1

2.2

0

5

10

15

20

25

30

35

Perc

enta

ge

Very Poor Poor Fair Good Very Good