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CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Job satisfaction among Health Records Practitioners is an important indicator in evaluating the effects of job satisfaction on quality of service delivery of Health Information Management. Job satisfaction is the degree to which people like their jobs. Hospitals are interested in job satisfaction of their staff, because it is positively correlated with certain desired outcomes and contribute to reduce significantly the rate of absenteeism and job turnover (Tomy 2017).

According to Barrein (2017), it is one of the most complex area facing today’s managers when it comes to managing their employees. Unfortunately, job satisfaction has not still received the proper attention from neither scholars nor managers of various organizations.

Low job satisfactions can result in increased staff turnover and absenteeism, which affects the efficiency of health services. In many countries employers pay close attention to the subjective well-being of their employees and its impact on their jobs.

Many studies explained that job satisfaction has strong relationships with productivity, absenteeism and turnover among healthcare employees across the world and it affects employees’ organizational commitment and quality of healthcare services. Multiple factors may be responsible to influence job satisfaction.

This study focused on tertiary hospitals because they have a more structured health information management department when compared with other types of hospitals. Tertiary hospitals stand at the peak of health care in Nigeria offering specialized healthcare services with referrals from primary and secondary health facilities. In every tertiary hospital in Nigeria, the first point of call is the Health Information Management Department, also known as the Health Records Department. The Health Information Management Department, apart from being patients’ first port of call, serves a number of other functions in a hospital. They provide Health Records Management functions which include creation, maintenance, and disposal of patients’ records. This is followed with coding and indexing of these records to reflect the respective diagnoses and surgical operations of the conditions suffered by patients. Also, the department ensures the prompt availability of patients’ records to authorized caregivers, thereby allowing for consistency in treatment. This is an indication of the custodian services rendered by the health information management department. Specifically, personnel working in the department render some patient-special services such as initiating patients into the hospital register, thereby generating a unique identifier while also capturing patients’ personal identifying information; retrieval of patients’ Health Records during subsequent visits, handling and monitoring movements of patients’ case notes. They are also charged with stamping and registration of official documents such as death certificates and sick leave, as well as assigning and recording patients’ next appointment dates. The above mentioned indicates the pivotal role being played by the Health Information Management Department in the overall hospital service delivery. Hence, one could posit that patients’ satisfaction with the quality of services delivered by the health information management department could contribute to determining their satisfaction with the overall hospital services.

However, studies documenting the influence of patient’s perception of the Health Information Management Personnel service quality on satisfaction are scarce. Hence, this study intends to contribute to the hospital service quality discourse by examining the effect of job satisfaction on the quality of patient health records in tertiary health institution.

According to Luke (2014), various Health Professionals exist in all categories of tertiary health institutions in Nigeria. Numerous industrial actions and strikes have been recorded within the shortest period of years involving all health professionals or selected professionals or particular professional at a time.

Job satisfaction is an essential measurement for managers as well as for policy makers. Although the definition of job satisfaction is not clear, it remains a primary factor in achieving an excellent system (Huber, 2019). Developing a high level of commitment among nurses is one of the main human resource department policies. Shared values, including vocational commitment towards patient care and nursing are factors that influence nurses positively (McCabe, 2018). Other important factors include strong leadership, teamwork and support. Health Records practitioners acknowledge that training and development factors are important factors in Health Care Delivery. Focusing on the job satisfaction issues of these employees can be a constructive strategy to increase retention of current personnel, as well as to attract qualified professionals. Since they play a significant role in social life, the responsibility of Health Care institutions for public health cannot be underestimated. The productive use of personnel can improve the performance of employees as well as increase job satisfaction. Medical care is a service industry that differs from others because of its work requirements, which encompass and combine many talents with a variety of necessary and important expertise (Fang et al., 2009).

The healthcare sector is important, and the quality and efficiency of service depend to a large extent on human labour. Poor worker motivation can greatly affect health outcomes and patient safety. Poor worker motivation is common and can manifest as lack of courtesy to patients; tardiness and absenteeism; poor process quality, such failure to conduct proper patient examinations; and failure to treat patients in timely manner Gilson et al., (2014). In the workforce, it can manifest in high staff turnover rates, high vacancy rates and indifferent performance, Lynne and Bennett, (2019). Job satisfaction is complex and multifaceted concept which can mean different things to different people. Job satisfaction is usually linked with motivation, but the nature of this relationship is not clear. Satisfaction is not the same as motivation. Job satisfaction is more of an attitude, an internal state. It could, for example be associated with personal feeling of achievement, either quantitative or qualitative Mullins, (2015).

In the study researcher has set up or to analyze effect of job satisfaction among the health record professional staff in the performance and motivation for improved professional service delivery on patient health record in University of Ilorin Teaching Hospital and in Nigeria in general.

1.2 Statement of the Problem

Machado-Taylor, Ernest, Robert et al (2017) stated that employees dissatisfaction stems from inadequate and non-competitive salaries and further lack of job satisfaction due to non-monetary reasons. This also involves the degree to which individuals are considering fair the compensation they receive for their work, when compared to the earnings received by the other members of the same tertiary hospital

During Student industrial work experience (SIWES) in University of Ilorin Teaching Hospital, the researcher observed the following: that staff are poorly motivated despite the over-whelming duty they do, un-professional conducts such that patients folder were given to patients by hand to take to the attending physician, making relations and friends aware of one’s health status, the researcher noted that this is highly unethical, employees commented that they are not satisfied with their jobs due to poor motivation and appraisal by their employer, therefore making them not to perform their job with diligence and focus.

1.3 Objectives of the Study

The main objective of the study is to evaluate the effects of job satisfaction on quality of service delivery of Health Information Management in University of Ilorin Teaching Hospital and in Nigeria in general.

The specific objectives of the study are:

To find-out the determinants of job satisfaction among Health Information Management staff
To evaluate level of importance of job satisfaction on the quality of service delivery
To find-out challenges of Health Information Management as regards Job satisfaction
To suggest solution to the challenges of job satisfaction on the performance of Health Information Management.

1.4 Research Questions

The following research questions are analyzed in order to achieve the study objectives:

What are the determinants of job satisfaction among Health Information Management staff?
To what level is job satisfaction important on the quality of service delivery in University of Ilorin Teaching Hospital?
What are the challenges of Health Information Management as regards Job satisfaction?
How does job satisfaction influence the quality of service delivery?

1.5 Significance of the Study

Findings from the study will be of immeasurable importance to the Nigerian government and all citizens of Nigeria. It will serve as a manual that will guide hospitals on how to go about on health records management to raise their standard of service. It will as well help to bridge the gap that might have existed in the health records activities.

The study will add to the body of existing knowledge in Literature, It will serve as a base line for future study and will help students equip themselves in the current studies of health records management. The study would raise awareness to the University of Ilorin Teaching Hospital administration and management on the job satisfaction levels of her health information management professional staff for adequate measures. It would also encourage efficient and effective health care system through job satisfaction in University of Ilorin Teaching Hospital and Nigeria by extension.

In addition, it sought to recommend effective ways of improving the quality of patient health record through job satisfaction. Moreover, the outcomes of this study would provide the government, management, Nigeria tertiary health institution views of attitude of satisfied and dissatisfied workforce at the workplace and consequently, guide them in their negotiations for better condition of service.

Although measures are put in place to ensure the performance and motivation for Health Records Professionals at University of Ilorin Teaching Hospital is improved to provide professional service delivery on patient

1.6 Scope and limitation of the study

This study investigated the effects of job satisfaction on quality of service delivery of Health Information Management. Evaluating Health Records as a tool in the growth and development of Nigerian seems too broad for the time frame of this research work therefore; the scope of this work was confined towards University of Ilorin Teaching Hospital.

This research was not an exception to the usual problems associated with research in Nigeria. The researcher:

Could be with the problem of finance as the researcher may not have enough funds to visit necessary ventures to get necessary materials, collate date and receive responses from stakeholders
The availability of required data have continued to be a problem of Nigerian researchers as those data are not readily available and where available, are also well assembled for immediate use.
The assistant for the completion of the research also is an issue for a project as this.
Besides, to obtain information from the respondents was somehow difficult due to the busy nature of their work schedule
Nature of the professional jobs that makes some of the staff to be on shift or call duty during the time of visit to the hospital. Also, most of the time the available staff complains about busy nature of their job to attend to the research

Moreover, the study considered facets of job satisfaction such as compensation/pay, promotion, working conditions, relationship with co-workers, relationship with supervisor/managers, nature of work, management recognition, safety at the workplace, and training and development. However, there may be other factors that may affect job satisfaction level which the study did not explore.

However, these limitations have been put in perspective to ensure that outcome of this research shall not in any way be visited.

1.7 Organization of the study

The study was carried out to evaluate the effects of job satisfaction on quality of service delivery of Health Information Management. The project consists of five chapters. Chapter one entails the introduction to the study and hypothesis was derived. The chapter two contains the literature review; past and existing literature was discussed. Chapter three entails the research methodology; the design and sample. The chapter four is the data analysis and presentation of data. Chapter five entails the summary, recommendations and suggestion of further studies. All authors will be cited in the references, appendices will be attached.

1.8 Definition of Terms

Effect: is the result or outcome of a cause, a change which result or consequences of an action or other cause (Webstar Dictionary)

Health Record: Refers to a clinical, scientific, administrative and legal document of a patient care and treatment so as to assist in the treatment of present and future aliment (Adepoju 2016). It is usually recorded in chronological order so as to justify the diagnosis and warrant treatment and end result. Health Records is a clear, concise and accurate history of a patient life and written from the medical point of view. A health record is a collection of recorded facts concerning a particular patient (Lusi 2014).Health Record as used in the UK, a health record is a collection of clinical information pertaining to a patient’s physical and mental health, compiled from different sources. Health records contain demographic data, next of kin, GP details, and most of the following: medical history; examinations; diagnoses; treatment (including surgical procedures and drug therapy); results of investigations—labs (e.g. biochemistry, haematology, pathology), imaging (e.g., plain films, scans); alerts and warnings (e.g., allergies, blood group, obligatory drugs, etc.); record of preventative measures (immunizations, screenings—breast, cervical, faecal, occult blood); nursing records; clinical correspondence and referrals for treatment; consent forms for surgical procedures; theatre reports; discharge letters; post-mortem reports. Health records are maintained by, or on behalf of, the health professional concerned with the patient’s care and maintained as private documents under Caldicott guidelines.

Job Satisfaction:is a measure of workers’ contentedness with their job, whether they like the job or individual aspects or facets of jobs, such as nature of work or supervision (Ademi 2015). Job satisfaction can be measured in cognitive, affective, and behavioral components. Job satisfaction is defined as an extent to which people like or dislike their job which implies whether employees are happy and contented in fulfilling their desires and needs at work.

Motivation: is the word derived from the word ‘motive’ which means needs, desires, wants or drives within the individuals. It is the process of stimulating people to actions to accomplish the goals. In the work goal context the psychological factors stimulating the people’s behaviour can be – desire for money. (Webster Dictionary)

Performance: is the action or process of performing a task or function

Patient Health Record: This is defined as the collection of data complied on a patient to assist in a clinical care of present and future illness.

Quality: it is defined as being suitable for its intended (fitness for purpose) while satisfying customer expectations.

Service Delivery: This is the part of a health system where patients receive the treatment and supplies they are entitled to (Webster Dictionary).

Tertiary Health Institution: is a hospital that provides tertiary care, which is a level of health care obtained from specialists in a large hospital after referral from the providers of primary care and secondary care. Tertiary care is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital (Wikipedia).

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