The impact of medical staff motivation on the quality of practice in healthcare: a systematic review

INTRODUCTION

Motivation is "the extent to which an individual is willing to expend and maintain an effort towards an organization's goals" in the workplace. Human resource management (HRM) policies can benefit from insight into the elements that motivate workers. Health professionals' motivation and, by extension, their productivity could benefit from HRM policies and interventions designed specifically for their care or organization.¹ Because the performance of the health professionals who supply these services determines the quality of the health services and their efficacy, efficiency, accessibility, and viability, health policies must make the motivation and development of staff a fundamental issue.² The utilization of resources is contingent on the availability of human resources to that because they're the most crucial component of healthcare systems' resources. Human resource management systems, despite their importance, are plagued with difficulties in low-income countries. Health systems' potential for underachievement may be inherited from a history of inadequate investment in human resources. Therefore, keeping doctors and nurses in their jobs is essential for a successful healthcare system.³ Health worker motivation is cited as the primary factor in health worker retention and health sector effectiveness since a highly engaged staff is more likely to put their training and education into practice.⁴ Given the current difficulties, such as unsafe working conditions, worries about personal safety, and defective equipment, job motivation may be crucial to the effectiveness of human resources for health in developing nations. The fundamental problem is pinpointing the causes of low morale among workers.⁵

METHODS

Study design

We used a systematic review methodology to analyze the results of this investigation. The research conducted a comprehensive literature to uncover studies examining the connection between healthcare personnel's motivation levels and their quality of practice from January 2013 to December 2023. Specifically, this assessment included only those studies that have been done and published in publications that undergo a rigorous peer review process. After that, Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and the JBI assessment were used to determine how well each included study adhered to standards for reporting study quality. Lastly, the included studies' data were combined and evaluated to reveal patterns and trends in the evidence.

Several databases and search strategies were used to find papers relevant to this systematic review of the correlation/relationship between employee motivation, quality of practice, and performance on the job. Identifying appropriate studies by thoroughly searching electronic databases, including PubMed, Scopus, Google Scholar, and Medline. We manually checked the reference files of applicable assessment articles and primary studies to identify more research. This systematic review employed various search tactics, including keyword as mentioned earlier first page and subject heading searches and filters and restrictions, to narrow in on only the most relevant studies for analysis.

Data collection and analysis

We first located and picked the appropriate research studies using the inclusion and exclusion criteria to collect the necessary information for this systematic review. Then we needed to extract the relevant data from those studies. After the relevant studies and articles have been pulled from the peer-reviewed journals and studies, the following step was to analyze the data to look for recurring themes and trends in the evidence. This required using methods such as PRISMA guidelines and JBI assessment to combine the results of various studies or using qualitative analysis methods to interpret and synthesize the findings of individual studies for the systematic review.

Search strategy and eligibility criteria

Using a combination of MeSH terms and free-text words, including all possible synonyms, alternative terms, and spellings, we searched PubMed, Google Scholar, Base, Core, and Medline for all related publications from beginning of 2013 to the end of last quarter of 2023 to discover relevant studies (Figure 1). To further organize the search results, duplicates were initially deleted using Mendeley. The next step was importing the references into Microsoft Excel, performing a manual search, and selecting relevant articles. Additionally, the researchers considered the degree of job satisfaction, work stress, and turnover intention as possible reflections of motivation that may influence work performance. As a result, all the research investigated work motivation and job satisfaction. Additionally, the factors that influence these motivational expressions were also investigated. Researchers also looked for the relevant studies and discovered them in the references of the papers included as well as other sources. All the articles included were written in English and were published between 2013 and 2023. Studies not related to employee motivation and the effect that factor has on employee performance and the quality of practice, were not published in journals that experts review, were not conducted in a healthcare setting, or required more data about the research approaches and results were excluded. The (Table 1) summarizes the inclusion/exclusion criteria used in this systematic review.

RESULTS

This paper provides a summary of the results of the research as well as contributes to closing the knowledge gap. In addition, the outcomes of the investigations are evaluated in connection to the research questions. The findings of the conducted systematic review to assess the effect of medical staff motivation on the quality of practice in healthcare are shown in the Table 2. The PRISMA and JBI evaluations are used to screen around eight different studies. The extraction, evaluation, and outcomes of the investigations are outlined in greater depth below the table that has been given.

Characteristics of reviewed studies

Standardized reporting formats for systematic reviews and meta-analyses (PRISMA) were followed in our analysis (Figure 1).

To determine which research were relevant, we initially read over 282 titles and abstracts before retrieving 85 full papers to read through. Eight articles were included after the full-text screening to help us understand the current state of staff motivation, its impact on employee performance, and the quality of practice. Two additional articles were selected and added from the reference search after eligibility criteria were applied to acquire sufficient information linked to staff motivation and its impact on employee performance and the quality of practice. The initial database search identified 282 publications. 197 duplicate articles were found, leaving 85 abstracts for examination. While screening the abstract, 75 articles were excluded either because the articles is not written in English (N=1), or they are published before 2013 (N=39), or the full text is not conducted in the health care setting (N=29), as well as 6 systematic reviews were excluded. Those that passed the full text review (N=10) were included in the final analysis.

Research characteristics

The final analysis included ten studies during the period of January 2013 to December 2023 about the impact that the motivation of medical staff has on the quality of practice in the healthcare industry. Five research studies were carried out in Asia (China, India, Indonesia, Iraq, and Iran), three studies were carried out in Africa (2 in Ghana and 1 in Nigeria), one study was carried out in Europe (Poland), and one study was carried out in United Kingdom (London). These articles have been used from primary, secondary, and tertiary hospitals including all different healthcare staff such as managers, physicians, nurses, pharmacists, technologist etc.

DISCUSSION

Studies from different continents were selected; five studies (50%) were conducted in Asia (China, India, Indonesia, Iraq, and Iran), three studies (30%) were conducted in Africa (2 in Ghana and 1 in Nigeria), and 1 study (10 %) was conducted in Europe (Poland) and 1 in the UK (10 %). Studies from public and private healthcare facilities, including primary and tertiary hospitals were selected. Analyses included all healthcare staff, such as managers, physicians, nurses, pharmacists, technologists, etc. Six studies found that financial motivation is the key to quality improvement, productivity, and patient safety efforts.^6-9,14,15

These findings are consistent with the results of the other studies, which all suggest that motivating employees is essential for both healthcare organizations and their workforce. Several studies have shown that the best way to motivate employees is to use a combination of financial and non-financial methods based on the situation of the employees and the healthcare organization.^10,13 According to Lalani et al and Chmielewska et al multiple factors more than motivation is needed to produce good work from people. In addition, establishing policy and practice that recognizes the significance of communication, organizational growth, and the efficient management of human resources needs to go hand in hand with implementing these high management standards, which will ensure that the staff's efforts are put to the best possible use and will maximize productivity.^11,12 According to the findings of Lalani et al practitioners of quality improvement initiatives in healthcare face a significant obstacle in the form of mixed empirical data on the effectiveness of improvement collaboratives and a limited understanding of the factors that motivate practitioners to engage in quality improvement collaboratives.¹² It is necessary to inspire workers to boost their overall productivity, and a variety of financial and non-financial tactics may be utilized to accomplish this goal. Second, no single overarching principle can be applied to every scenario. When it comes to their demands, lower-level, middle-level, and higher-level employees are all distinct from one another. According to Asadi et al and Lalani et al specific individuals require both financial incentives and close supervision in order to reach their full potential.^9,12 When there is a sense of fairness, equity, love, and encouragement in the environment, others can work more effectively. This means that before they work, it may be necessary to coerce or even punish some people.¹⁴

CONCLUSION

Establishing a work environment that incentivizes and engages healthcare employees to ensure the industry's success is of utmost importance. To achieve this, it is vital to comprehend the factors that lead to employee satisfaction and engagement. Building a proficient and motivated workforce with specialized abilities to provide patients with quality care is a top priority for healthcare organizations. Employees who lack motivation are at risk of developing negative attitudes toward patients, absenteeism, or quitting, all of which can have a negative impact on the organization's performance. Therefore, it is necessary to identify the factors that can boost employee performance and efficacy in the healthcare sector. Healthcare employees have individual needs that differ from one another, and it is paramount to tailor incentives to meet those requirements precisely. By applying motivators, healthcare organizations can improve employee retention, motivation, and performance, leading to better patient outcomes. Based on the information presented in this review, the motivation of healthcare workers is not caused by a single overarching factor but rather is the result of a complex interaction of many different factors, all of which need to be considered within the framework of the cultural norms that govern the healthcare system in each country. We conclude that robust human resource management systems, including salary, promotion, recognition, a suitable working environment, equity and fairness, and other characteristics, are necessary to raise motivation, increase job satisfaction, and increase overall quality and productivity. The literature review shows that higher levels of employee motivation correlate with a more outstanding quality of performance on the part of the healthcare organization. Management can inspire staff in monetary and non-monetary ways. Employees' salaries are the critical incentive for their hard work, making pay a powerful motivator. There is no assurance of improved efficiency, though. Other elements must be present for optimal performance to be achieved. Employee motivation and satisfaction can also positively affect the corporate outcome if factors such as the organization's environment, job structure, workplace safety, employee performance appraisal, reward system, and leadership style are considered.

ACKNOWLEDGEMENTS

Authors would like to thank all the research contributors in the field of study.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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