LEBANESE INTERNATIONAL UNIVIRSITY

The Problem of Job satisfaction and its effect on employee turnover in Hammoud hospital

Prepared by
Ziad Saad

Supervised by
Dr. Manal Khalil

Academic Year
Summer 2012

Table of Contents

DEDICATION DEDICATION.........................................................................................................................3 ACKNOWLEDGMENTS.......................................................................................................4 ABSTRACT............................................................................................................................5 The objective of this study is to explore the factors affecting employee turnover, employee job satisfaction and the impact of satisfaction on employee turnover at Hammoud Hospital. The survey instrument in the form of questionnaire was distributed to 32 employees..............5 The result of the preliminary findings indicated that the highest influencing factors affecting employees turnover was job dissatisfaction, explained by inadequate recognition and rewards for a job well done, the benefits received were not met with the employees needs, the salary and responsibilities were not compatible and the career path advancement was not compensate for lack of salary increase......................................................................................5 The overall finding results can be used for the hospitals to set the guidelines to improve the employees job satisfaction and reduce the turnover rate..........................................................5 Article I. LIST OF TABLES.....................................................................................................6 CHAPTER I: INTRODUCTION............................................................................................8 CHAPTER III: METHODOLOGY, STRUCTURE AND DESIGN OF THE PROJECT.....31

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DEDICATION

It is with great deal of sentiment; I would like to express my feeling of successful and appreciation to my beloved family members who assisted me in my graduate studies. Especially to my parents, who were my biggest champion and cheerleader! Who, over the years, modeled compassion and caring for others. Who were always there with the advice when I needed it - and sometimes I even took it! Who worked hard, to make sure we had what we needed. But most of all, worked hard to ensure we knew they loved us and supported us, even when they may not have agreed with the directions we took. I will not forget their support and love in my life. They always believed in me, supported me.

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ACKNOWLEDGMENTS

During these great moments of my graduate experience, it is my duty to appreciate the academic excellence at LIU. In a particular way, I am thankful to its academic constituencies. I am particularly grateful to Dr. Manal Khalil. I would like to take this opportunity express appreciation and gratitude for My God first; I will never forget the great support of Hammoud Hospital which makes out a space to feel comfort and relief during employees interview.

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ABSTRACT

The objective of this study is to explore the factors affecting employee turnover, employee job satisfaction and the impact of satisfaction on employee turnover at Hammoud Hospital. The survey instrument in the form of questionnaire was distributed to 32 employees. The result of the preliminary findings indicated that the highest influencing factors affecting employees turnover was job dissatisfaction, explained by inadequate recognition and rewards for a job well done, the benefits received were not met with the employees needs, the salary and responsibilities were not compatible and the career path advancement was not compensate for lack of salary increase. The overall finding results can be used for the hospitals to set the guidelines to improve the employees job satisfaction and reduce the turnover rate.

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Article I. LIST OF TABLES

TABLE 1: Descriptive statistics..............................................................................................31 TABLE 2: Gender...................................................................................................................31 TABLE 3: Educational level...................................................................................................32 TABLE 4: Marital status.........................................................................................................33 TABLE 5: Absentiesm............................................................................................................33 TABLE 6: Working overtime.................................................................................................34 TABLE 7: Proud by working to the organization...................................................................34 TABLE 8: Job security...........................................................................................................35 TABLE 9: Job satisfaction......................................................................................................36 TABLE 10: Change current job..............................................................................................36 TABLE 11: Cause of changing the job...................................................................................37 TABLE 12: Correlation (change current job and job security)...............................................38 TABLE 13: Correlation (job satisfaction and changing current job).......................................38 TABLE 14: Correlation (changing current job and working overtime)...................................39 TABLE 15: Correlation (changing current job and feeling proud by working to the organization)...........................................................................................................................39 TABLE 16: Correlation (change current job and cause of changing the job)..........................40 TABLE 17: Correlation ( cause of changing current job and job satisfaction)........................40

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LIST OF FIGURES
FIGURE 1: DEDICATION.........................................................................................................................3 ACKNOWLEDGMENTS.......................................................................................................4 ABSTRACT............................................................................................................................5 The objective of this study is to explore the factors affecting employee turnover, employee job satisfaction and the impact of satisfaction on employee turnover at Hammoud Hospital. The survey instrument in the form of questionnaire was distributed to 32 employees..............5 The result of the preliminary findings indicated that the highest influencing factors affecting employees turnover was job dissatisfaction, explained by inadequate recognition and rewards for a job well done, the benefits received were not met with the employees needs, the salary and responsibilities were not compatible and the career path advancement was not compensate for lack of salary increase......................................................................................5 The overall finding results can be used for the hospitals to set the guidelines to improve the employees job satisfaction and reduce the turnover rate..........................................................5 Article I. LIST OF TABLES.....................................................................................................6 CHAPTER I: INTRODUCTION............................................................................................8 CHAPTER III: METHODOLOGY, STRUCTURE AND DESIGN OF THE PROJECT.....31

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CHAPTER I: INTRODUCTION
Organizations invest a lot on their employees in terms of induction and training, developing, maintaining and retaining them in their organization. Therefore, managers at all costs must minimize employees turnover. Although, there is no standard framework for understanding the employees turnover process as whole, a wide range of factors have been found useful in interpreting employee turnover. Therefore, there is need to develop a fuller understanding of the employee turnover, more especially, the sources- what determines employee turnover, effects and strategies that managers can put in place minimize turnover. One of these factors is job satisfaction; theories propose that if the employee is satisfied and happy in his job then he will not change his job. As inspired from the title, the research is going to talk about job satisfaction in general and how can it affect on employee turnover in Hammoud hospital. Nowadays all companies have a common goal which is to increase productivity and reduce costs, and one way to reach that goal is to satisfy the employee to use all his abilities and creativity while doing his job, and they seek to find the factors which effect on satisfaction. This research is going to find a relation between job satisfaction and employee turnover. Research questions that we are going to try to answer are: 1. 2. What is the relationship between job satisfaction and Employee What methods can a company follow in order to decrease turnover and turnover? increase satisfaction?

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CHAPTER II: OVERVIEW OF JOB SATISFACTION AND EMPLOYEE TURNOVER

A. 1. JOB SATISFACTION: DEFINITIONS

Employee satisfaction is the terminology used to describe whether employees are happy and contented and fulfilling their desires and needs at work. Many measures purport that employee satisfaction is a factor in employee motivation, employee goal achievement, and positive employee morale in the workplace. Job satisfaction has been defined as a pleasurable emotional state resulting from the appraisal of ones job; an affective reaction to ones job; and an attitude towards ones job. Weiss (2007) has argued that job satisfaction is an attitude but points out that researchers should clearly distinguish the objects of cognitive evaluation which are affect (emotion), beliefs and behaviors. This definition suggests that we form attitudes towards our jobs by taking into account our feelings, our beliefs, and our behaviors. 2. Two Factor Theory (Motivation Hygiene Theory)

Fredrick Herzbergs Two factor theory (also known as Motivator Hygiene Theory) attempts to explain satisfaction and motivation in the workplace. This theory states that satisfaction and dissatisfaction are driven by different factors motivation and hygiene factors, respectively. Motivating factors are those aspects of the job that make people want to perform, and provide people with satisfaction. These motivating factors are considered to be intrinsic to the job, or the work carried out. Motivating factors include aspects of the working environment such as pay, company policies, supervisory practices, and other working conditions. While Herzbergs model has stimulated much research, researchers have been unable to reliably empirically prove the model, with Hackman & Oldham suggesting that Herzbergs original formulation of the model may have been a methodological artifact. Furthermore, the theory does not consider individual differences, conversely predicting all employees will react in an identical manner to Page|9

changes in motivating/hygiene factors. Finally, the model has been criticized in that it does not specify how motivating/hygiene factors are to be measured. 3. How employees can express dissatisfaction?

Employee dissatisfaction can be expressed in a number of ways. For example, rather than quit, employees can complain, be insubordinate, steal organizational property, or shirk a part of their work responsibilities. Exhibit 3-6 offers four responses that differ from one another along two dimensions: constructive/destructive and active/passive. They are defined as follows: Exit: Behavior directed toward leaving the organization, including looking for a new position as well as resigning. Voice: Actively and constructively attempting to improve conditions, including suggesting improvements, discussing problems with superiors, and some forms of union activity. Loyalty: Passively but optimistically waiting for conditions to improve, including speaking up for the organization in the face of external criticism and trusting the organization and its management to "do the right thing." Neglect: Passively allowing conditions to worsen, including chronic absenteeism or lateness, reduced effort, and increased error rate. Exit and neglect behaviors encompass our performance variables-productivity, absenteeism, and turnover. But this model expands employee response to include voice and loyalty-constructive behaviors that allow individuals to tolerate unpleasant solutions or to revive satisfactory working conditions. It helps us to understand situations, such as those sometimes found among unionized workers, for who low job satisfaction is coupled with low turnover. Union members often express dissatisfaction through the grievance procedure or through formal contract negotiations. These voice mechanisms allow union members to continue in their jobs while convincing themselves that they are acting to improve the situation.

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4.

JOB SATISFACTION: THE SYMPTOMS, FACTORS, &

EFFECTS ON EMPLOYEE PERFORMANCE 4.1. Warning signs Few top performers leave out of the blue. Usually, indicators begin to appear well in advance of the moment they give their notice. Here are some of the most common signs that an employee is considering departure: Dissatisfied employees miss more workdays than their colleagues. Pay attention when an individual starts using up accrued personal or vacation days it could be a sign he or she is interviewing with potential employers. 4.2. Decline in work habits Chronically missed deadlines, decreased productivity and a higher incidence of errors could indicate that the employee has mentally checked-out and is just going through the motions. 4.3. Interpersonal problems When a previously motivated, affable employee starts arguing with coworkers or complaining about management, its often symptomatic of job dissatisfaction that could lead to departure. 4.4. Changes in attitude Withdrawal from the social aspects of work is common among employees who are thinking of leaving. Previously outgoing staff members may suddenly seem quiet or down and spend most of their time in their offices or cubicles. Teamoriented employees who used to volunteer for projects may abruptly lose interest in anything outside the scope of their direct job responsibilities. 4.5. Subtle behavioral changes Employees have frequent medical appointments and spend more time doing online research. Formerly prompt employees become habitually tardy or take longer P a g e | 11

lunch hours. They receive more incoming calls than average and may even seek the privacy of a conference room to conduct phone conversations. 4.6. Pre-emptive measures To prevent the loss of a valued employee, take action as soon as we feel we have sufficient evidence of the persons intention to leave. Find out what motivates our employee. Meet one-on-one with the employee and ask frankly if he or she is shopping for a new job. When confronted with a direct question, most people respond candidly. If the employee acknowledges conducting a job search, find out the reasons why and propose corrective steps. For example, if the employee is looking for work at a more senior level, offer an expansion of responsibilities, if appropriate. For employees looking for new challenges, discuss ways their current position could be fortified or propose lateral moves within our firm. If the individual is having problems with a specific coworker or manager, explore the possibility of reassignment to another division or supervisor. 5. FACTORS OF JOB SATISFACTION

The end result of quality of wok life is the overall satisfaction one receives from a job. The factors affecting quality of work life have been presented, but there are others that affect job satisfaction. The factors affecting job satisfaction can be divided into three main areas: internal factors, external factors, and individual factors. 5.1. INTERNAL JOB SATISFACTION FACTORS

Six job satisfaction factors are inherent in the work itself. They are: The work Job variety Task specialization Autonomy Goal determination Feedback and recognition These factors are closely associated with the job itself and are the most difficult to alter without leaving the job. P a g e | 12

5.1.1.

The Work

The prime factor in job satisfaction is the work itself. Ti is difficult, if not impossible, to have job satisfaction if we hate the work we are doing. However, sometimes people claim to hate their job when in fact just hate doing the job for their current employer. These people actually like the work; they just don't like the people they are currently doing it for. Others may dislike some aspect of their job. To avoid unnecessary career changes, it is important to distinguish between disliking the work and disliking current employer. 5.1.2. Job Variety

Job satisfaction generally increases as the number of skills used in performing a job increases. Additionally, job satisfaction generally increases as the amount of knowledge needed to perform a job increases. These two factors, required skills and quantity of knowledge, combine to form job variety. The opposite of job variety is task specialization. 5.1.3. Task Specialization

When taken to an extreme, task specialization can create jobs with few tasks that repeat every five or ten seconds. It is easy to see how jobs with such low job variety would provide little job satisfaction for some people. Other people, however, can accept limited job variety. What is an acceptable level of job variety is something that must often be left to each individual. 5.1.4. Autonomy

Autonomy refers to the level of control people have over their work. The more freedom people have over the pace of their work and the methods they may employ to perform it, the more autonomy they have. As autonomy, or freedom, increases, so does job satisfaction. The need for autonomy is sometimes felt more strongly in people trying to fulfill the higher need on Maslow's hierarchy of needs. These higherlevel needs would include the need for status and self-esteem, self-actualization, and knowledge. 5.1.5. Goal Determination

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Goal determination refers to the freedom people have to establish their own work goals and to determine goals and success criteria can lead to increased job satisfaction. Freedom to determine goals may not increase job satisfaction, but in most cases having clear, explicit goals is better than having vague ones. Increase job satisfaction may also come from having goals determined and meeting them, as well as having the freedom to set those goals. 5.1.6. Feedback and Recognition

In this context, recognition can be differentiated from feedback by frequency and significance. Recognition is received from a manager, and it is received less often but carries greater significance than feedback. Recognition might be an employee-ofthe-month award, whereas feedback may be as simple as a "Good job" from a manager. Feedback may also be inherent in the work. As an example, when a repair person fixes something and makes it work once again, the success is obvious when the item again functions. Instantaneous, direct feedback like this that is inherent in the work is the ideal form of feedback. This also points to some other facets of feedback that must be present if the feedback is to increase job satisfaction. 5.2. EXTERNAL JOB SATISFACTION FACTORS

The external job satisfaction factors are related to the work or to the working environment. Those related to the work itself are either easier to separate from the work than the internal factors or they are easier to change. They include: Achievement Role ambiguity and role conflict Job security Supervision Organizational culture Work schedules

These factors are listed here roughly I order of descending control a worker has over them. At the beginning of the list is those that workers have more control over; at the end are those workers generally having less control over. P a g e | 14

5.2.1.

Achievement

Achievement refers to a person's success on the job. The general belief is that high achievers on the job have high job satisfaction. There are some, like the behavioral managers, who believe that job satisfaction leads to high achievement. The reverse of this situation may be even more important. People who are unsuccessful on the job have little, if any, job satisfaction. Therefore, the cure for low job satisfaction may be to increase job performance. Training, education, increased effort, or improved equipment may be the way to improve achievement and job satisfaction. 5.2.2. Role Ambiguity and Role Conflict

It is difficult for people to have high job satisfaction when they are unsure what their job entails. Not knowing what our job is or what our place is in the organization is referred to as role ambiguity. Clarifying the tasks that define our job and our place in the organization (in terms of authority and responsibility) can reduce role ambiguity. Reducing role ambiguity can lead to increased job satisfaction. It is possible for people to have minimal role ambiguity but to have conflicts with their role. A person may know what his or her job is and what his or her role in the organization is, but there might be conflicts between the parts of his or her role. Increased role conflict leads to lower job satisfaction. An example of role conflict occurs all too often when someone is given the responsibility for completing a task without being given the authority needed to do so. Other examples include conflict between getting the job done fast and getting the job done right, or getting the job done correctly even if it means redoing it and not wasting materials or other assets. 5.2.3. Job Security

Job security, an example of Frederick Herzberg's hygiene factors, may affect job satisfaction more when it is not present than when it is. When job security, the assurance of employment continuing in the future, is absent, there may be less job satisfaction. When present, job security may be taken for granted. Job security itself is affected by intrinsic and extrinsic factors. Some employers strive to offer job security; in other cases, job security is an integral part of the employer's culture. However, it sometimes appears that there are fewer and fewer of these employers in today's work environment. For years, IBM, AT&T, and P a g e | 15

public utilities were known for essentially offering employment for life. Recently, both IBM and AT&T have had large layoffs, and even some utilities have become leaner. Although employment-for-life firms may be difficult to find, many firms still offer significant job security for those who continue to learn, who are flexible and adaptable, and whose work adds real value to the firm. There is a large threat to job security, with some believing it will eventually become extinct. Additional intrinsic threats to job security and job satisfaction can originate with individual managers and the firm's performance. Through their behavior, individual managers may decrease job security and therefore decrease job satisfaction. Constantly reminding people that they are easily replaced, valueless, and disposable company assets decreases job security and satisfaction. Eliminating high-paid workers simply to reduce salary expense, lying off workers instantly if work slows down even slightly, and firing workers just before they become vested in the retirement plan are all actions that decrease job security. Poor performance or a poor financial condition of the firm can also reduce job security and satisfaction because the threat of a merger or the collapse of the firm appears more likely. There are also extrinsic factors, in addition to these intrinsic factors, that can have a negative impact on job security. 5.2.4. Supervision

Frederick Herzberg identifies the quality of supervision as a hygiene factor. This means that when the quality of supervision is poor, a worker can be com dissatisfied. When the quality is good, the worker is not dissatisfied (this does not mean that he or she is satisfied, however). In other words, a bad boss might make us miserable, but even a great boss won't make us jump out of bed in the morning because we can't wait to get to work for him or her. This may seem like a factor that we have little or no control over, but that may not be the case. Sometimes managers do not manage because of the way they are, but because of the way people force them to manage. The way a manager act often has as much or more to do with the subordinates than with the manager. Some people are lazy, untrustworthy, or unreliable. This may make an otherwise behavioral manager act as an authoritarian toward this one person. Workers, who perform their jobs, are on time, treat the manager with respect, and can P a g e | 16

be trusted to do the job without constant supervision may receive completely different treatment. All we need to do is decide how we are going to act and then do it. When we have earned the trust and respect of our manager, the quality of supervision may improve as the manager responds to this desirable situation. 5.2.5. Organizational Culture

The overall organizational culture and management style can increase or decrease job satisfaction. A manager may choose to use a classical or behavioral style of management. A subordinate may force a manager to use a classical style or may allow the manager to use a behavioral style. Or the organization's culture or climate may be classical or behavioral. In fact, many organizations have a classical, bureaucratic, or authoritarian culture. Although job satisfaction is often higher in no bureaucratic organizations, much depends on the individual. An individual needing close, classical supervision or not needing or wanting responsibility may not feel satisfied in a behavioral, employee-empowerment firm. An individual needing or wanting more freedom, more responsibility, or more autonomy may not be satisfied in a classical management atmosphere where these characteristics are in short supply. The important point here is that people should try to match their needs to a company that can meet those needs, thereby increasing job satisfaction. 5.3. INDIVIDUAL JOB SATISFACTION FACTORS

Of the three groups of factors affecting job satisfaction, the individual factors have the least to do with the actual job. The individual factors mainly concern a person and the person's family and network of friends. There are nine individual job satisfaction factors: Commitment Job involvement Effort/reward ratio Influence of coworkers Comparisons Opinions of others Personal outlook P a g e | 17

Although these factors can greatly affect how someone feels about his or her job, many of these consist of opinions. Opinions can be changed by facts and information. So although these factors can have a great influence on job satisfaction, the individual has more control over them and can effect change if it is needed. 5.3.1. Commitment

The more carefully someone has researched, selected, and prepared for a job, the more likely that person is to be satisfied with the job. If the actions of researching, selecting, and preparing for the job are highly visible to friends and family, then the person is more likely to be satisfied with the job and less likely to admit to any dissatisfaction. The greater the commitment the person has made to a job, the bigger the mistake would appear to be if the person said he or she was wrong in selecting it. For a few people, this means that they may stay in an unsatisfying job, unwilling to look foolish or unable to admit to a mistake... 5.3.2. Job Involvement

Job involvement refers to how important a person's job is in his or her life. The more involved a person is in his or her job, the more satisfaction he or she generally feels. It is possible, however, to become over involved in a job. Over involvement (becoming a workaholic) can be identified when work becomes as pervasive as to affect one's personal life negatively. At this point, one might need to determine whether work is part of the overall solution or part of the problem. 5.3.3. Effort/Reward Ratio

People compare the rewards they receive from work to the effort they put into work partially to determine job satisfaction. If the ratio between the two is heavy on the effort side, then people generally feel less satisfied because they feel they are putting more into their work than they are getting out of it. People will also compare their effort/reward ratio to the ratio of others. If they believe their ratio is less than their coworkers' ratios, then they will feel less satisfied because they will feel that they are getting less out of their jobs for the effort they put in than their coworkers. In all of this analysis, people look at total rewards from work, not just monetary compensation. Also, we are once again dealing with people's perceptions of effort and reward, which may be real or imaginary. P a g e | 18

5.3.4.

Influence of Coworkers

The importance coworkers place on certain issues affects the importance an individual places on those issues; this influence of coworkers in turn may affect job satisfaction. For instance, coworkers can influence our thinking if they constantly grumble about the state of the equipment. We may also feel that this is important and will tend to agree that the equipment is substandard. Or if coworkers constantly talk about what a great place we work in, then we will also tend to think that the place is good and our job satisfaction will increase. 5.3.5. Comparisons

People make comparisons between their jobs and how satisfied they are with them and the jobs of friends, relatives, and neighbors. A person who is a middle manager may feel quite satisfied if his or her family and neighbors are CEOs and doctors. Here, each job has relative worth, rather than absolute worth. 5.3.6. Opinions of Others

The opinions of others concerning our job also affect our job satisfaction. If other people, especially people whom we admire and respect, believe that we have a good job, then we will typically feel more satisfied than if the people around us think we have a lousy job. This also applies to the way society views entire professions. If society generally regards our profession as valuable and of higher status, then we will be more satisfied than if society feels our job is of low status and worth. 5.3.7. Personal Outlook

A person's general outlook on life is another factor that influences job satisfaction. A person with high self-esteem, with confidence in his or her abilities, and with a positive outlook on life is more likely to have high job satisfaction than someone with a negative attitude. 6. THE EFFECT OF JOB SATISFACTION ON EMPLOYEE

PERFORMANCE Managers' interest in job satisfaction tends to center on its effect on employee performance. Researchers have recognized this interest, so we find a large number of P a g e | 19

studies that have been designed to assess the impact of job satisfaction on employee productivity, absenteeism, and turnover. 6.1. Satisfaction and productivity

Happy workers may not necessarily be productive workers. At the individual level, the evidence suggests the reverse to be more accurate that productivity is likely to lead to satisfaction. Interestingly, if we move from the individual level to that of the organization, there is renewed support for the original satisfaction performance relationship. When satisfaction and productivity data are gathered for the organization as a whole, rather than at the individual level, we find that the organizations with more satisfied employees tend to be more effective than organizations with fewer satisfied employees. It may well be that the reason we have not got strong support for the satisfaction causes productivity. Studies have focused on individuals rather than on the organization and at individual level measures of productivity do not take into consideration all the interactions and complexities in the work process. So although we might not be able to say that a happy worker is more productive, it might be true that happy organizations are more productive. 6.2. Satisfaction and Absenteeism

Results of a study showed that the rate of absenteeism increased down the ladder of hierarchy, with managers having the lowest absence rate, technical workers having the highest absence rate and supervisors occupying the intermediate position. Managers were the most satisfied employees with their jobs, followed by the supervisors, and technical staff. Absenteeism was positively correlated to job satisfaction and to the feeling of insecurity. Also, absenteeism was negatively correlated with achievement motivation. A satisfied worker has a positive attitude towards his work and will try to avoid being absent from work. This does not mean that workers who are highly satisfied with their jobs would almost never be absent. However, absenteeism would be less among those who are satisfied than those who are dissatisfied with their jobs. 6.3. Satisfaction and Turnover P a g e | 20

Satisfaction is also negatively related to turnover, but the correlation is stronger than what we found for absenteeism. Yet, again, other factors such as labormarket conditions, expectations about alternative job opportunities, and length of tenure with the organization are important constraints on the actual decision to leave one's current job. Evidence indicates that an important moderator of the satisfaction turnover relationship is the employee's level of performance. Specifically, level of satisfaction is less important in predicting turnover for superior performers. Why? The organization typically makes considerable efforts to keep these people. They get pay raises, praise, recognition, increased promotional opportunities, and so forth. Just the opposite tends to apply to poor performers. Few attempts are made by the organization to retain them. There may even be subtle pressures to encourage them to quit. We would expect, therefore, that job satisfaction is more important in influencing poor performers to stay than superior performers. Regardless of level of satisfaction, the latter are more likely to remain with the organization because the receipt of recognition, praise, and other rewards gives them more reasons for staying. 7. JOB SATISFACTION AND PERFORMANCE VIEWED FROM

A TWO DIMENSIONAL MODEL Traditional theory suggests that job performance is affected by job satisfaction; increase job satisfaction and we will increase job performance. However job performance is much more complex than the traditional theory. The prevailing theory was/is that increased job satisfaction results in increased performance. Intuitively this theory makes sense. While countless hours of research and money have been invested in this theory, there still seems to be a problem with encouraging high performance. The two attributes, job satisfaction and job performance, are too closely linked to one another, and that they affect each other. Here are cases in point: If a person is highly satisfied with his/her job, this would lead the person to want to do a good job and to perform well. On the other side is the person's ability level. If the person is struggling with performing the job, it may give the appearance that the person is a poor performer even though he/she may be exhausting a great deal of effort in trying to perform the job. This person's frustration then in turn leads to poor job satisfaction. P a g e | 21

Some researchers have expressed similar ideas, such as performance affects satisfaction, while one researcher went so far as to say that there is no relation. Intuitively we feel that there must be a relationship. After all, it makes sense in our minds, researchers continue their efforts to explore the concept, and many are hungry for the latest information on the subject. 7.1. New Measure of Performance

I started trying to find another way to look at job performance. To begin, I looked at job satisfaction as a combination of three elements: task satisfaction, employment satisfaction, and market satisfaction. Task satisfaction comes from performing the tasks required of the job. Increasing a person's salary may make an undesirable task more bearable, but it doesn't necessarily make it more enjoyable. Employment satisfaction consists of elements such as personnel policies, benefits, career opportunities, work environment, style of management, fit in the organization, etc. Many of these elements are within the company's control; others are not. For example, there may be very little that a company can do for an employee who does not get along with his/her peers. The employer can try to assure that all individuals are treated professionally, but the company cannot make the coworkers become close friends. Market satisfaction is comprised of forces external to the company that affect the individual's job. Political situations and public laws can easily affect job dissatisfaction. An individual may be unhappy with having to conform to such law but the company cannot waive the requirement to improve an individual's job satisfaction. In most cases, market satisfaction will be consistent across the job market; the same external forces will be present even if the employee changes employers. However there are differences in the external forces affecting jobs within the government and those within the private sector. The diagram in Figure 1 illustrates the assumed correlation between job satisfaction and job performance. The theory is that the employee's performance is in direct correlation to their satisfaction; improve their satisfaction and we will improve their performance. P a g e | 22

Figure 1: Traditional Satisfaction vs. Performance Model. 1 In looking for a new way to look at performance vs. satisfaction, I started with a very basic view: comparing the satisfaction and performance of a specific task. I will refer to these as task satisfaction and task performance. Task satisfaction is strongly influenced by a person's aptitude; it is the satisfaction received by the employee for performing that specific task. Task satisfaction excludes any outside influences on the individual's total job satisfaction. In developing this model, I considered the research of those who have performed a great deal of work in the field of management, including Peter Ducker, Herzberk, and Maslow. The test of this model was 1) it should not strongly contradict the work previously performed, and 2) it should help answer the challenges of the earlier work. In Figure 2, I have broken the relationship of performance and satisfaction into four quadrants to further explore and explain the complexity of the relationship. This figure helps to understand the complexity while trying to keep the concept manageable. There are varying degrees of satisfaction and performance so it is difficult to state exactly where one would draw the line between high performance and low performance and between high satisfaction and low satisfaction. Each person is somewhere along those two lines. We can only try to understand what will happen as the employees move along those lines.

David B. Putman; the Journal of Defense Software Engineering P a g e | 23

Figure 2: Two Dimensional View of Task Satisfaction vs. Task Performance 2 Figure 2 creates four quadrants. Two of the quadrants are the ones referenced by traditional theory:

High Task Satisfaction and High Task Performance. Low Task Satisfaction and Low Task Performance.

The other two quadrants are:

High Task Satisfaction and Low Task Performance. Low Task Satisfaction and High Task Performance.

My discussion using the two-dimensional model will look at the two axes from a positive viewpoint, i.e., the person wants to perform well. High Task Satisfaction and High Task Performance: This individual loves his/her job. He/she has the aptitude, the skill, and resources necessary to perform the assigned task, and he/she performs the task quite well. A person in this quadrant may become so caught up in his/her task that the person does not realize that he/she has worked past quitting time.
2

David B. Putma; The Journal of Defense Software Engineering P a g e | 24

Low Task Satisfaction and Low Task Performance: The manager should consider whether or not something is missing. Does the employee lack the aptitude, the skills, or the resources necessary to perform the task well? Being in this quadrant does not mean that the employee is not trying! From the employee's perception, the employee may be expending a great deal of effort in trying to complete the task. The employee may feel that he/she is doing everything humanly possible and he/she does not understand why management is unhappy with his/her performance. This person may experience very low task satisfaction because he/she finds it difficult or unfavorable to perform the task. This person may be a clock-watcher, never arriving early or staying late without being mandated and compensated. Low Task Satisfaction and High Task Performance: Is a person in this quadrant really that rare? This person is indicating that they would rather be doing another job, but at the same time their personal values are such that they are giving this task their best effort. I suggest that this is a person that we want to keep. It may well be worth our effort to look at developing a graceful transition plan that would allow this individual to move to another position while minimizing the impact to our present operations. High Task Satisfaction and Low Task Performance: From a positive viewpoint, a person in this quadrant loves his/her work but he/she is not performing as expected. The employee may find it hard to quit working on a task knowing that he/she can always make it better (i.e., a perfectionist that never finishes his task). Or, the person may enjoy what he/she is doing but lacks the aptitude, skill, or other resources necessary to do the task quickly. The discussion so far has been from a positive viewpoint. If the person's aptitude is such that they enjoy the tasks and they have the skills to perform the tasks, then they have the potential of being in the high satisfaction and high performance quadrant. If the basic needs are not met, then increasing the person's salary is not going to improve performance. If a person should be in the high task satisfaction and high task performance quadrant and they are not performing as expected then the question is one of choice, "Why the employee did conscientiously or unconscientiously chose to move towards the left (decreased performance) in Figure 2?" Factors influencing the person's conscious or unconscious movements along the performance line include those related to employment satisfaction and market satisfaction. P a g e | 25

Each person is consciously or unconsciously moving along the line from low performance to high performance based upon their own personal value system and their moral reasoning. This is why two individuals with similar skills, knowledge, and capabilities appear to be at different ends of the performance spectrum. Both employees may feel as though the company does not value them, but the first employee's value system is based upon the thinking, "Two wrongs don't make a right, and I'm still going to do my best." Whereas the other employee's value system may be based upon, "You get what you pay for. You pay me half of what I feel that I am worth, therefore I'll produce half of what I'm capable of producing." We will never be able to pinpoint an exact correlation between job satisfaction and performance that will work in every situation. Doing a job well may improve job satisfaction, being satisfied may encourage a person to try harder, and each person's personal value system will have an effect on how he/she reacts to motivators and impediments. The best we can do is try to understand that performance is a complex issue, and recognize where we have control to address issues affecting an individual's performance. 8. HOW TO FACE DISSATISFACTION OF EMPLOYEES?

Many people have found themselves unsatisfied and under performing in a job at some point in their career, despite a fair salary and benefits package. Others might love their team, but feel discouraged by leadership that seems out of touch and removed from the day-to-day work. A company whose employees lack passion and engagement is like an engine running on only a few cylinders. Its simple: Motivated employees are more productive. And a more productive team means a more profitable company. To achieve our companys strategic goals, especially in an unstable economy, it is critical to attract and retain high-performing talent by understanding and meeting their motivational needs.

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B.

Employee turnover:
1. Definition:

Employee turnover is the rotation of workers around the labour market; between firms, jobs and occupations; and between the states of employment and unemployment Abassi et al. (2000). The term turnover is defined by Price (1977) as: the ratio of the number of organizational members who have left during the period being considered divided by the average number of people in that organization during the period. Frequently, managers refer to turnover as the entire process associated with filling a vacancy: Each time a position is vacated, either voluntarily or involuntarily, a new employee must be hired and trained. This replacement cycle is known as turnover Woods, (1995). This term is also often utilized in efforts to measure relationships of employees in an organization as they leave, regardless of reason. 2. Turnover types:

Turnover is unavoidable issue to the organizations as there are a range of reasons for employee to come and leave the organization. Employee may involuntarily leave the organization, through layoff or discharge, or voluntarily leave the organization, through resignation or retirement. Voluntary Turnover: Gomez-Mejia, Balkin & Cardy .described that voluntary separations is the situation when an employee decides to end the relationship with the employer for personal or professional reasons. In most of the case, the decision to leave is associated with being unsatisfied with the features of current job and having attractive alternative from other organization. Voluntary turnover is the turnover that commenced by employees. This turnover type is often occurring with the capable employees or the employees that the company would prefer to keep. Involuntary Turnover: Involuntary Turnover is the turnover initiated by the organization (often among people who would prefer to stay.

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An involuntary separation occurs when manager decides to terminate its relationship with an employee due to (1) economic necessity or (2) a poor fit between the employee and the organization. Voluntary separations are the result of very serious and painful decision that can have a profound impact on the entire organization, especially on the employee those who loses his or her job. 3. Factors affecting staff turnover

General, the factors affecting employee turnover is particularly considered in terms of pulled, pushed and outside factors. Employees are pulled to resign by number of attractive alternatives outside the organization or whether they are pushed due to the level of job dissatisfaction in the organization or resign by outside factors which are not related to work or organization. Pull Factors: Pull factors are the series of reasons that attract the employees to a new workplace. In this category the employees satisfy with better paying job, a career advancement opportunity that they would not receive in the short term when they stayed with their present employer. Employee leaves their current job in order to improve their life standards and also concerning to the new benefits package which they expect to receive. In addition there are broader notions of career development, the wish to move into new areas of work for which there are better practical questions commuting time. Push Factors: Employees are 'pushed' due to dissatisfaction in their current jobs to seek alternative employment. Employees start thinking about other choices, talking to recruiters, looking at the job advertisement in the newspaper, on the internet or to others advertisement sources. In some case employees will even leave without having a new job prepared. A wide range of problems can be mentioned to explain such resignations. Insufficient development opportunities, boredom, ineffective supervision, low levels of employee involvement and straightforward personalitys conflicts are the most common accelerating factors for the employees to leave their job. Previous research suggests that push factors are more significant in most situations that managers and supervisors appreciate their employees. Front line manager behavior has been found to be particularly risky to the level of commitment, P a g e | 28

motivation and satisfaction reported by employees and a poor relationship with a manager is often a significant factor in employee turnover. Outside factors: Outside factors associate to the situation in which someone leaves the organization for reasons that are mainly not related to their work. In most common cases, people involve moving away or resign when a spouse or family is relocated. Others factor includes the wish to carry out a long-term ambition to travel, pressures associated with juggling the needs of work, family and illness. To an extent this type of turnover is unavoidable, although it is possible to reduce it through the provision of career breaks, forms of flexible working and/or childcare facilities. 4. Measuring employee turnover

According to Acas, the way of measuring employee turnover is to measure the number of leavers in a particular period as a percentage of the number of total employees during the same period. The organization will usually calculate employee turnover rate on a quarterly or annual basis. Turnover rate is sometimes called the separation rate, and it is revealed as below:

Number of leavers x 100 = Separation rate Average no. working

This formula will present a percentage rate of employee turnover for the organization, and can also be used for a comparative relation over the time. This method too can be used as the indicator to compare particular organization to the industrys average turnover rate. This is known as benchmarking. 5. Job satisfaction and employee turnover

High turnover and absenteeism are reported to be related to job dissatisfaction, while low absenteeism is associated with high job satisfaction. The Mobley model was a landmark conceptual piece that persuasively explained the process of how job dissatisfaction can lead to employee turnover. The model proposes that an employee normally experiences seven sequential and intermediate stages between job dissatisfaction and eventual turnover. Specifically, Mobley theorized that job dissatisfaction likely leads an employee (1) to think about quitting, which may help that employee to lead in. (2) to evaluate the expected usefulness of searching for P a g e | 29

another job and the costs associated with quitting the current job. From the evaluation, (3) an intention to search for alternative jobs may occur, which in turn likely leads the employee (4) to the intend searching for alternative jobs and (5) to the evaluation of the acceptability of any specific alternatives. From that second evaluation, the employee would likely (6) to compare the new alternatives to the current job, which in turn can lead to (7) an intention to quit, and eventual employee turnover. Recent studies completed, too shows a consistent relationship between leadership support and job satisfaction and which is also affecting employee turnover.

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CHAPTER III: METHODOLOGY, STRUCTURE AND DESIGN OF THE PROJECT

:Setting

of the study

-1

This study has taken place in Saida, in where the researcher made his survey and collect in which we investigate and make our survey and collect our information from different province that included necessary information from .different department Administration and Nursing at Hammoud Hospital
:The

Participants

-2

Interviews have been conducted with 32 employees from all departments such as Administration and Nursing at Hammoud Hospital. They were male and female individuals who have different experience in above mentioned professional fields. These individuals came from different education back ground such as middle school, high school and college. In addition to their .education they accrued certain amount of experience
:The

questionnaire Survey

-3

The questionnaire used for data collection consists of 12 questions, divided into general information part and job satisfaction and turnover part. The questionnaire distributed to 32 employee who works at Hammoud Hospital in .saida

4-

Data Collection:

The data consist of compiling a comprehensive questionnaire survey with coded questions. These coded questions follow the role of Lickert Scale of measurement. The writer distributed the surveys on an individual bases; afterwards the numerical information was collected and inserted into the most sophisticated computer program called SPSS (statistical package for social science).

5-

Limitations of the study:

:The research method used in which .i .Busy people may not want to take the time .a The respondent may try to help by giving pleasant answers .b The people unable to answer because they cannot remember or never .c .gave a thought to what they do and why .The respondent may answer in order to look smart or well informed .d Respondents reluctance to answer questions asked by unknown .e .interviewers about things they consider private .The sample taken for the study is small in size .ii P a g e | 31

The variables in the study which include job satisfaction and employee .iii .turnover cannot be evaluated easily

:Results
a. Descriptive Analysis:
Table 1: Descriptive Statistics N Age Experience Valid N (listwise) 32 32 32 Minimum 23.00 1.00 Maximum 48.00 26.00 Mean 30.0313 7.8750 Std. Deviation 6.75127 7.01036

-6

Table 1: The table shows that the mean age of respondents is 30.03 and the standard deviation of age is 6.75, while for experience the mean was 7.87 and the standard deviation was 7.01.
Table 2: Gender Cumulative Frequency Valid Male Female Total 16 16 32 Percent 50.0 50.0 100.0 Valid Percent 50.0 50.0 100.0 Percent 50.0 100.0

Table 2: The table shows that 50% of respondents were males and the rest were females as demonstrated in the pie chart.

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Table3: Educational Level Cumulative Frequency Valid BT TS BS Master Total 6 2 19 5 32 Percent 18.8 6.2 59.4 15.6 100.0 Valid Percent 18.8 6.2 59.4 15.6 100.0 Percent 18.8 25.0 84.4 100.0

Table 3: The table shows that 59.4% of the respondents BS degree, 18.8% have BT degree, 15.5% have Master Degree and the rest have TS degree as demonstrated in the pie chart.

Table 4: Marital Status Cumulative Frequency Valid Single Married Total 12 20 32 Percent 37.5 62.5 100.0 Valid Percent 37.5 62.5 100.0 Percent 37.5 100.0

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Table 4: the table shows that 62.5% of respondents were married and the rest were single as demonstrated in the pie chart.

Table 5: Absientism Cumulative Frequency Valid Never 32 Percent 100.0 Valid Percent 100.0 Percent 100.0

Table 5: The table shows that all respondents have never been absent as demonstrated in the pie chart.

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Table 6: Working Overtime Cumulative Frequency Valid Yes No Sometimes Total 9 7 16 32 Percent 28.1 21.9 50.0 100.0 Valid Percent 28.1 21.9 50.0 100.0 Percent 28.1 50.0 100.0

Table 6: The table shows that 50% of the respondents sometimes accept to work overtime, while 28.1% accept to work overtime and the rest refuse as demonstrated in the pie chart.

Table 7: Proud Of Organization Cumulative Frequency Valid Yes No Total 13 19 32 Percent 40.6 59.4 100.0 Valid Percent 40.6 59.4 100.0 Percent 40.6 100.0

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Table 7: The table shows that 59.4% of respondents are not proud by working to their organization and the rest are proud as demonstrated in the pie chart.
Table 8: Job Security Cumulative Frequency Valid Yes No Total 14 18 32 Percent 43.8 56.2 100.0 Valid Percent 43.8 56.2 100.0 Percent 43.8 100.0

Table 8: The table shows that 56.2%of respondents are not feeling security in the job while the rest are feeling security as demonstrated in the pie chart. P a g e | 36

Table 9: Job Satisfaction Cumulative Frequency Valid Satisfied Neutral Dissatisfied Total 8 13 11 32 Percent 25.0 40.6 34.4 100.0 Valid Percent 25.0 40.6 34.4 100.0 Percent 25.0 65.6 100.0

Table 9: The table shows that 40.6% of respondents are feeling neutral to their jobs, while 34.4% are feeling dissatisfied and the rest are satisfied as demonstrated in the pie chart.

Table 10: Change Current Job Cumulative Frequency Valid Yes No Total 20 12 32 Percent 62.5 37.5 100.0 Valid Percent 62.5 37.5 100.0 Percent 62.5 100.0

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Table 10: 62.5% of respondents prefer to change their jobs, while the rest prefer to stay in their jobs as demonstrated in the pie chart.
Table 11: Cause Of Changing Job Cumulative Frequency Valid Extra Benifits Environment Place of work Total 20 10 2 32 Percent 62.5 31.2 6.2 100.0 Valid Percent 62.5 31.2 6.2 100.0 Percent 62.5 93.8 100.0

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Table 11: The table shows that 62.5% of respondents can change their job for extra benefits, while 31.2% may change their job due to environment, and the rest may change the job due to place of work (distance from home) as demonstrated in the pie chart.

b. Correlations:
At this part we are going to try to answer the research questions: Question 1: What is the relationship between job satisfaction and Employee turnover?
Table 12: Correlations( changing job and job security) Change Current Job Change Current Job Pearson Correlation Sig. (2-tailed) N Job Security Pearson Correlation Sig. (2-tailed) N 32 -.098 .595 32 32 1 Job Security -.098 .595 32 1

Table 12: The table shows that there is a direct relation between feeling security in the job and the need to change the job, since the significance is 0.595 greater that the significance level 0.005.

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Table 13: Correlations (job satisfaction and change current job) Change Current Job Satisfaction Job Satisfaction Pearson Correlation Sig. (2-tailed) N Change Current Job Pearson Correlation Sig. (2-tailed) N *. Correlation is significant at the 0.05 level (2-tailed). 32 -.433* .013 32 32 1 Job -.433* .013 32 1

Table 13: The table below shows that there is no correlation between job satisfaction and changing current job since the significance is 0.013 and the significance level is 0.05, this may be related to the results seen above, 40.6% of respondents were neutral (not satisfied nor dissatisfied).
Table 14: Correlations( changing current job and working overtime) Change Current Job Change Current Job Pearson Correlation Sig. (1-tailed) N Working Overtime Pearson Correlation Sig. (1-tailed) N 32 -.047 .399 32 32 1 Working Overtime -.047 .399 32 1

Table 14: The table below shows that there is a correlation between need to changing the job and working overtime (an indicator for satisfaction).

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Table 15: Correlations (Changing current job and feeling proud of organization) Change Current Job Change Current Job Pearson Correlation Sig. (1-tailed) N Proud Of Organization Pearson Correlation Sig. (1-tailed) N **. Correlation is significant at the 0.01 level (1-tailed). 32 -.411** .010 32 32 1 Proud Of Organization -.411** .010 32 1

Table 15: The table below shows that there is correlation between need to changing current job and feeling proud of organization, since the significance is equal to the significance level which is 0.1.

Question2: What methods can a company follow in order to decrease turnover and increase satisfaction?
Table 16:Correlations (Changing current job and cause of changing the job) Change Current Job Change Current Job Pearson Correlation Sig. (2-tailed) N Cause Of Changing Job Pearson Correlation Sig. (2-tailed) N 32 -.344 .054 32 32 1 Cause Of Changing Job -.344 .054 32 1

Table 16: The table shows that there is a correlation between need to change current job and the causes of changing current job, since the significance is 0.054 greater than the significance level which is 0.05.

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Table 17: Correlations ( Causes of changing the job and job satisfaction) Cause Of Changing Job Cause Of Changing Job Pearson Correlation Sig. (2-tailed) N Job Satisfaction Pearson Correlation Sig. (2-tailed) N 32 -.088 .632 32 32 1 Job Satisfaction -.088 .632 32 1

Table 17: The table shows that there is a correlation between job satisfaction and causes of changing the job, since the significance is 0.632 greater than the significance level 0.05.

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CHAPTER IV: CONCLUSIONS AND RECOMMENDATIONS:

B. Conclusions:
From the above statistics and results we can conclude that the hypothesis which is employee satisfaction effect turnover rate is really true when the statistics done in Hammoud hospital From the above results we can conclude the following: 1. Absientism percentage was 0% this may be due to the field of work, in hospital absientism effect the patients directly so the employees even when they are not satisfied with their job will not be absent. 2. The respondents who answered that they accept or sometimes accept to work overtime are much higher than those who refuse to work overtime, this may be related to the economic situation, so working overtime here may not bee as an indicator for satisfaction. 3. Most of respondents are not satisfied in their jobs since the results shows that there are a high percentage of respondents are not proud by working to their organization and they can change their job if they found another opportunity. 4. 5. The results showed that the respondents who want to change Hammoud Hospital must work on job satisfaction and their job is very high this reflects the image of emolpyee turnover. decreasing turnover rate by regulating the benefits, and make improvements in the environment.

C. Recommendations:
Here are some suggestions that could help Hammoud hospital to improve employee satisfaction and try to decrease turnover rate:

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1.

Hammoud hospital must make satisfaction of their employees a

priority, in order to reduce turnover rate. 2. The hospital must work on increasing the benefits, since most of the

employees can change their jobs for another one with extra benefits. 3. The hospital must make changes in its environment, in order to try to

satisfy its employees and attract them to stay, this could be done by applying shared governance, and this will make the employee feel that he is a part of decisions take. 4. The hospital should do a career leader, this will help to reduce

turnover, since each employee will have a goal to reach and each time he reach his goal, he will find another goal to reach. 5. The hospital must do interviews with those who want to leave the

hospital, and try to find the reasons for leaving of employees.

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Annex: 1 Questionnaire:
General information: 1- How old are you?

2- Indicate your gender: 1. Male 2. Female 3- What is your educational level? 1. BT 2. TS 3. BS 4. Master 4- Indicate your marital status: 1. Single 2. Married 3. Divorced 4. Widowed
5- How many years of experience do you have?

Job satisfaction and turnover: 6- How many days are you absent per month? 1. More than a week 2. One week 3. Less than a week 4. Never

7- If your manager asks you to work overtime, do you accept? 1. Yes P a g e | 45

2. No 3. Sometimes 8- Do you feel proud by working to your organization? 1. Yes. 2. No. 9- Do you feel this job Provides security for you? 1. Yes 2. No 10- Are you satisfied with your job? 1. Satisfied 2. Neutral 3. Dissatisfied 11- If you found another job would you leave your current job? 1. Yes 2. No 12- What would attract you to change your job? 1. Extra benefits. 2. Environment. 3. Place of work (distance from home)

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REFERENCES:
Websites:

www.abika.com www.scribd.com www.wikipedia.org www.academicjournals.org/AJBM/pdf/pdf2007/jun/ongori.pdf www.etd.uum.edu.my/1826/1/Masdia_Masri.pdf

Books:

A Handbook of HUMAN RESOURCE MANAGEMENT PRACTICE 10th edition. (Michael Armstrong) Alderfer, C.P. (1969). An empirical test of a new theory of human needs. Organizational Behavior and Human Performance, 4, 142 175. Arnold, H.J. & Feldman, D.C. (1986). Organizational behavior. New York: McGraw-Hill.

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