TABLE OF CONTENT
Title ii
Certification iii
Approval iv
Dedication v
Acknowledgement vi
Table of Content vii
List of Tables xi
List of Appendices xii
CHAPTER ONE: INTRODUCTION
Background to the study 1
Statement of the problem 7
Purpose of the study 7
Objectives of the study 8
Research Question 8
Hypothesis 8
Significance of the study 9
Scope of the study 9
Operational definition 10
CHAPTER TWO: LITERATURE REVIEW
Concept of Industrial Harmony 11
Factors influencing industrial harmony 16
Workplace communication 16
Interdisciplinary collaboration 23
Equitable remuneration 27
Theoretical review 34
Empirical Review 36
Summary of Literature Review 40
CHAPTER THREE: RESEARCH METHOD
Research design 42
Area of study 42
Population of study 43
Sample 43
Inclusion criteria 44
Sampling procedure 44
Instrument for data collection 44
Validity of instrument 45
Reliability of instrument 45
Ethical consideration 45
Procedure for data collection 46
Method of data analysis 46
CHAPTER FOUR: PRESENTATION OF RESULTS
Distribution of respondents by gender, discipline and years in service 47
Perceived influence of interdisciplinary collaboration 49
Scores on perceived influence of interdisciplinary collaboration 51
Perceived influence of workplace communication on industrial harmony 53
Discipline specific scores on perceived influence of workplace communication 55
Perceived influence of equitable remuneration on industrial harmony 57
Discipline specific scores on perceived influence of equitable remuneration 59
Perceived influence of interdisciplinary collaboration 61
Summary of ANOVA on influence of interdisciplinary collaboration 62
Perceived influence of workplace communication on industrial harmony 64
Summary of ANOVA on influence of workplace communication 65
Perceived influence of equitable remuneration on industrial harmony 67
Summary of ANOVA on influence of equitable remuneration 68
Summary of major findings 69
CHAPTER FIVE: DISCUSSION OF FINDINGS
Determination of perceived influence of interdisciplinary collaboration 71
Assessment of perceived influence of workplace communication 73
Determination of influence of equitable remuneration – – 75
Determination of difference in interdisciplinary collaboration 76
Determination of difference in workplace communication 77
Determination of difference in equitable remuneration 78
Implication for Nursing 80
Limitation of the study 81
Summary 81
Suggestion for further studies 83
Recommendations 84
References
Appendices
LIST OF TABLES
Table 1: Distribution of respondents by gender, discipline and years in service .……… . . . 47
Table 2: Influence of interdisciplinary collaboration on industrial harmony ……………..49
Table 3: Discipline specific scores on influence of interdisciplinary collaboration …………51
Table 4: Influence of workplace collaboration on industrial harmony ………………………53
Table 5: Discipline specific scores on influence of workplace communication …………….55
Table 6: Influence of equitable remuneration on industrial harmony ……………………….56
Table 7: Discipline specific scores on influence of equitable remuneration …………………58
Table 8: There is no significant difference on influence of interdisciplinary collaboration ….59
Table 9: Summary of ANOVA on influence of interdisciplinary collaboration ………………60
Table 10: There is no significant difference on influence of workplace communication …….61
Table 11: Summary of ANOVA on influence of workplace communication …………………62
Table 12: There is no significant difference on influence of equitable remuneration …………63
Table 13: Summary of ANOVA on influence of equitable remuneration ……………………..64
LIST OF APPENDICES
Appendix 1: Proportionate Selection of Respondents
Appendix 2: Questionnaire
Appendix 3: Letter of Introduction
Appendix 4: Ethical Clearance Certificate
ABSTRACT
This study was
conceived to determine the factors influencing industrial harmony among health
care professionals in UNTH, Ituku-Ozalla, Enugu State. The study was specifically
aimed at assessing the influence of interdisciplinary collaboration, workplace
communication and equitable remuneration among health care professionals on
industrial harmony. The study used a descriptive survey design. Non probability
purposive sampling was used to select medicine, nursing, pharmacy and medical
laboratory science disciplines. The population of study was 1371, with a sample
size of 300 health care professionals,consisting of eighty doctors, one hundred
and ten nurses, twenty pharmacists and fourteen Medical Laboratory Scientists.A
researcher-developed questionnaire was employed to collect data from the
respondents. Analysis of Variance was used to test the hypotheses at a 0.05
level of significance. Results showed that theperceived influence of
interdisciplinary collaboration among health care professionals on industrial
harmony was statistically significant with the health care professionals
reporting a favourable interdisciplinary collaboration (2.86 ±0.76, p= 0.0000).
Theperceived influence of workplace communication among health care
professionals on industrial harmony was statistically significant with the
respondents reporting poor workplace communication among the health care
professionals and with the management (2.31 ±0.79, p= 0.0160). The result for
influence of equitable remuneration of health care professionals on industrial
harmony was notstatistically significant, with the health care professionals
reporting dissatisfaction with their remunerations (2.49 ±1.00, p=0.821). The
result showed that there existed good interdisciplinary collaboration among health
care professionals but also a need for improvement and a more inclusive
approach. Workplace communication among health care professionals in UNTH needs
improvement to promote healthy working environment. Health care professionals’
remuneration was not very satisfactory and a more equitable remuneration is neededto
boost industrial harmony and help forestall industrial disharmony.
CHAPTER ONE
INTRODUCTION
Background to the Study
Workplaces are complex systems. Within the typical healthcare organization there are many interactions between so many different types of people – colleagues, board members, patients, clients, and the general public. In a typical hospital setting, no single discipline or specialty can meet all of a patient’s needs.
Industrial harmony refers to a friendly and cooperative agreement on working relationships between employers and employees for their mutual benefit (Laden, 2012). Industrial harmony is a situation where the employees and management cooperate willingly for the company’s commercial objectives and the employees’ benefits. This creates a high level of satisfaction. Industrial harmony is an abstract concept. It is necessary but its existence is not felt in most organizations’ management, resulting in tense working environment. This is largely because most organizations believe that they are the only ones that can be wronged. They fail to acknowledge that many of their practices could compromise relations with their employees. Industrial harmony therefore, according to Puttapalli and Vuram (2012), involves the relationship between employers and employees with respect to the terms and conditions of employment in the workplace.
Industrial harmony could be achieved when workers and management of an organization work hand in hand without any friction. Even when there are differences in opinion, if agreement is achieved in an atmosphere of mutual trust and confidence, industrial harmony is assured. According to Mukoro (2013), industrial harmony requires that people in management understand their responsibilities and possess the requisite training and authority to discharge them. Also, employees must understand their duties and responsibilities and be abreast with the organizational objectives and make progress towards achieving them. There must be effective interchange of information between management and employees. The author stated that employees should cooperate with trade unions in establishing effective procedures for negotiations on terms and conditions of service, and conflict resolution. Employers should ensure that they honour agreements with employees. Management maintains a communication system which secures the interchange of information and views which must be factual and objective between different levels of employees. Many organizations in Nigeria are bedeviled by many problems caused by inefficient and ineffective management styles or strained relationship between management and the staff (Osanwomi & Ugiagbe, 2013). This has led to intermittent conflicts between employers and employees. In the health care sector, these conflicts have dire consequences, resulting in loss of lives of clients whose health have been decimated by illness. Many of the conflicts may have been between employees over perceived preferential and discriminatory treatments by the employers in the multidisciplinary workplaces such as health care.
The health care delivery process involves significant interaction of the patient with multiple groups of health care practitioners having different levels of educational and occupational preparations. Managing diverse workplace relationships often requires balancing multiple demands. Organization members need to collaborate and be concerned with the well-being of all those who work to advance the mission of the organizations. Just as it is important for the staff to cooperate in order to enjoy harmonious operations, the clients of health care organizations need them to collaborate and communicate effectively for them to have the best care. A hospitalized patient for example, may need a physician to provide diagnosis and treatment plan, a nurse to administer medications, help with bathing and toileting, a phlebotomist to take blood samples; a dietician to monitor food intake, a physiotherapist to help in muscle strengthening and flexibility, a social worker to coordinate home care on discharge (O’Daniel & Rosenstein, 2008). If there is no collaboration between these disciplines, the patient will be denied comprehensive and efficient management.
Collaboration in health care is health care professionals undertaking complementary roles and cooperatively working together, sharing responsibilities for problem-solving and making decisions to fashion out and execute plans for patient care. Interdisciplinary collaboration between healthcare professionals is described as working together, sharing in decision-making around health and social issues, to formulate and carry out plans for patient care and solving patients’ problems (Bridge, Davidson, Odegard, Maki, &Tomkowiak, 2011). Interdisciplinary collaboration includes the interactions, relations, cohesion, communication, and coordination between healthcare professionals (Hassankaneh, 2013). Positive outcomes occur when there is effective communication and collaboration among health care professionals. The absence of interdisciplinary collaboration may result in higher possibility of errors and omissions in patient care. In any organization where collaboration is non-existent, abusive and disruptive behaviours are present, burnout, lowered job satisfaction and decision to leave the profession have been reported (Sirota, 2007).
Webster’s Dictionary defines communication as “the imparting or interchange of thoughts, opinions, or information by speech, writing, or signs. Communication is vital to any social system as it creates an environment of trust, harmony and proficiency (Mukoro, 2013). Workplace communication is necessary for efficiency, harmony, raised morale and increased productivity. It is important for employers of labour to communicate with the employees to help them understand what duties they are to perform and how to go about them, what rules to obey, why management requires certain actions or has taken certain actions, what challenges or prospects the employer is facing and why workers’ demand may not be realized.
There must be clear communication of critical information among team members to achieve effective clinical care. The communication of simple orders, if inappropriately made or misunderstood, poorly interpreted or ignored, may generate tension. When health care professionals fail to communicate effectively, patient safety is at risk (Joint Commission Resources, 2005). Lack of communication creates situations where medical errors can occur (O’Daniel & Rosenstein, 2008). This may lead to frustration; erode trust and respect, thereby creating more tension that increases the likelihood of errors and mistakes. The patient would, most likely, be the victim of this breakdown in communication. Improving health care professionals’ communication can improve the quality of professional services to the patients (Azimi, Ashktorab, Bagheri, & Bagherzadeh, 2011).
Remunerationis traditionally seen as the total income of an individual and may comprise a range of separate payments determined according to different rules. Remunerations may include salary and incentives. Incentives may be monetary or non-monetary. Money remuneration is one major motivator of workers and organizations have used it to attract, retain and lure workers. Remuneration strategies are employed by organizations in the health care sector to motivate their staff and improve efficiency (Buchan, Thompson, & O’May, 2000). Equitable remuneration is a term that defines equal pay for equal work. The attempt here is to put all individuals on an even pay scale regardless of class, creed, race, or sex (Vitez, 2015). Many governments create laws to ensure equitable remuneration amongst workers in theorganization. In the Nigeria health care system, there are different remuneration schedules for different professions and these have been viewed as discriminatory. Often, the discrepancies in remunerations have been responsible for much unrest in the health care sector. Remuneration has been found over the years to be one of the policies the organization can adopt to increase their workers performance and thereby increase the organizations productivity (Akanbi, 2013). As organizations strive towards achieving stability and efficiency, equitable remuneration may be a strategy to assist in achieving these goals and restore the needed industrial harmony in the health care system, which is often disrupted by conflict.
Organizational conflicts and failures are common in many organizations, and poor management styles have contributed significantly to these. It has been observed that conflict is a sign that something is wrong somewhere (Osanwomi & Ugiagbe, 2013). The many professionals engaged in patient care in the health care environments imply that there exist significant stressful and complex environments that are prone to conflict. Conflict can be described as a process in which one party perceives that its interests are being opposed or negatively affected by another party (Kreitner & Kinicki, 2010). Hospital employees experience conflict quite frequently in the workplace (Berman-Kishony, 2011, Guidroz, Wang & Perez, 2011). This is largely due to its high stress environment and the variety of stakeholders involved (Shin, 2009). It is important that health care administrators learn to recognize the precursors to conflict in order to avert any ill effects such as industrial actions, (Patton, 2014). Kreitner and Kinicki, (2010) noted that the issues that result to conflict may be genuine or illusory. Nonetheless, the resultant conflict is real (Patton, 2014). Antecedents to conflict, as enunciated by Kreitner and Kinicki (2010), include personality and/or value differences, blurred job boundaries, battle for limited resources, democratic decision-making, collective decision-making, poor communication, competition among departments, unreasonable work expectations, unmet and/or unrealistic expectations (regarding salary, advancement or workload), etc. The majority of health care conflicts arise from interpersonal or inter-professional communication difficulties (Shin, 2009). Conflicts are manifested in diverse forms. According to Osanwomi and Ugiagbe, (2013), forms of protests that are shown collectively by employees are exemplified by mass meetings, resolutions, demonstrations, and strike (withdrawal of services).
Interdisciplinary collaboration is believed to have many benefits and also ameliorating the ills of industrial disharmony. The benefits of interdisciplinary collaboration include improved patient outcomes, cost saving, reduced length of hospital admission, increased job satisfaction and retention, and improved teamwork, enable workers to communicate openly and directly and reduced conflicts. Collaboration and effective communication is necessary in health care organizations. Poor collaboration is likely to be caused by, or to result in conflict (Leever, Hulst, Berendsen, Boendemaker, Roodenburg & Pols, 2010). Hastie and Fahy (2011) emphasized the need for changing organizational structures and policies to promote opportunities for natural dialogue between health care professionals.An environment (workplace) that has the right mix of interdisciplinary collaboration, communication and equitable remuneration may empower workers, stimulate creativity of workers, promote teamwork and learning, promote comfort with implementing change, motivate staff to accept increased responsibility and develop workers’ potential, and foster collaboration with peers.
It is on this backdrop that this study would attempt to assess perceived factors influencing industrial harmony among health care professionals at UNTH, Ituku-Ozalla, Enugu.
Statement of the Problem
